Non-HPV Papillary Lesions of the Oral Mucosa: Clinical and Histopathologic Features of Reactive and Neoplastic Conditions

  • Gisele N. MainvilleEmail author
Special Issue: Colors and Textures, a Review of Oral Mucosal Entities


Excluding human papillomavirus (HPV)-driven conditions, oral papillary lesions consist of a variety of reactive and neoplastic conditions and, on occasion, can herald internal malignancy or be part of a syndrome. The objectives of this paper are to review the clinical and histopathological features of the most commonly encountered non-HPV papillary conditions of the oral mucosa. These include normal anatomic structures (retrocuspid papillae, lingual tonsils), reactive lesions (hairy tongue, inflammatory papillary hyperplasia), neoplastic lesions (giant cell fibroma), lesions of unknown pathogenesis (verruciform xanthoma, spongiotic gingival hyperplasia) and others associated with syndromes (for instance Cowden syndrome) or representing paraneoplastic conditions (malignant acanthosis nigricans). Common questions regarding differential diagnosis, management, and diagnostic pitfalls are addressed, stressing the importance of clinico-pathologic correlation and collaboration.


Oral mucosa Hairy tongue Giant cell fibroma Verruciform xanthoma Malignant acanthosis nigricans Cowden syndrome 


Compliance with Ethical Standards

Conflict of interest

Gisele N. Mainville declares that she has no conflict of interest.

Informed Consent

Informed consent was obtained from all individuals.

Research Involving Human and Animal Participants

This article does not contain any studies with human participants or animals performed by any of the authors.


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© Springer Science+Business Media, LLC, part of Springer Nature 2019

Authors and Affiliations

  1. 1.Department of Stomatology, Faculty of Dental MedicineUniversité de Montréal MontrealMontrealCanada

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