case_images: PMC4274645_01
case_images: Clinical consistency of OVX with granular, yellow-whitish surface in the lateral border of the tongue (a); photomicrograph of OVX (H and E; 100x) showing the connective tissue exhibiting the accumulation of foam cell between the epithelial rete pegs (b); low magnification 10x of the lesion exhibiting the uniform rete pegs with parakeratotic invaginating crypts and connective tissue filled with xanthoma cells (c); negative image of fat and PAS-positive granules inside the cytoplasm (high magnification 400x) (d); and strong positive immunoreactivity to antibody CD-68 (high magnification 200x) (e).
case_images: CRIPA2014-641015.001.jpg
case_images: PMC4274645_01_CRIPA2014-641015.001.jpg
case_images: fig1
case_images: Physical examination of oral mucosa revealed a well-circumscribed, sessile nodule with slight pedunculation at the periphery and fibrous consistency and yellow-whitish verrucous surface fixed to the lateral edge of the tongue (Figure 1(a)). Excisional biopsy of the soft mass was performed and histopathological examination revealed a parakeratotic epithelium with mild acanthosis, uniform elongated epithelial ridges, with parakeratotic plugs, and exocytosis in superficial layer (Figure 1(c)). The connective tissue was composed by uniform papillae filled with large vacuolated foam cells (xanthoma cells) with eccentrically placed nuclei (Figure 1(b)). The Periodic Acid-Shiff (PAS) reaction exhibited positivity on granules inside the foam cells and immunohistochemical reaction to CD-68 antibody revealed a strong and uniform staining of all the subepithelial foamy macrophages (Figures 1(d) and 1(e)).