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Oral verruciform xanthoma: a clinicopathologic and immunohistochemical study of 20 cases

Verruciform xanthoma of the oral cavity is an uncommon benign lesion that usually affects the palate and gingiva mainly as a well‐circumscribed solitary yellowish to whitish plaque or nodule, which is promptly recognized microscopically by identification of sub‐epithelial foamy macrophages. The aim of this study was to evaluate the clinicopathologic and immunohistochemical features of 20 cases of oral verruciform xanthoma. All cases were evaluated by conventional hematoxylin/eosin staining and six of those were submitted to immunohistochemical reactions for CD68, CD63, CD163, syndecan‐1 (CD138), S‐100 protein and cytokeratins (CK) 8, 14 and 19. Oral verruciform xanthoma presented as yellowish papillary nodules affecting mainly the palate (30%), buccal mucosa (30%) and gingiva (25%) of middle‐aged male patients. Most cases presented papillary epithelial hyperplasia and sub‐epithelial foamy cells, which were immunopositive for CD68, CD63 and CD163 in all cases. The orange parakeratin superficial layer was negative for CK14 and presented a distinct granular membrane pattern of positivity for CD138. S‐100 protein, CK8, and CK19 were negative.