Focal epithelial hyperplasia feh which is also known as hecks disease or multifocal papilloma 1, 2, is a rare benign lesion of the oral mucosa produced by the subtypes or 32 of human papillomavirus hpv 24. The purpose of the paper is to add additional information concerning the geographic distribution of the. Micronodular thymic carcinoma with lymphoid hyperplasia. Intravascular papillary endothelial hyperplasia ipeh is a benign overgrowth of endothelial cells the cells lining blood vessels. Hyperplastic cells may be normal in appearance or pleomorphic, or rarely may have atypia. Five cases of an unusual variant of thymic carcinoma are described, which represent the counterpart of the socalled micronodular thymoma with lymphoid hyperplasia. Focal epithelial hyperplasia in a human immunodeficiency. Usually hpv involves either cutaneous or mucosal surfaces. Jul 01, 20 focal epithelial hyperplasia feh is an asymptomatic benign mucosal disease, which is mostly observed in specific groups in certain geographical regions. Focal nodular hyperplasia definition of focal nodular. Clinically, feh is typically characterized by multiple, painless.
Focal epithelial hyperplasia feh is a benign proliferation of the oral mucosa with well defined clinical and histological characteristics. Focal epithelial hyperplasia hecks disease, associated almost exclusively with hpv types and 32, is a condition characterized by multiple nodular lesions in the mouth and is particularly prevalent in the inuit people indigenous peoples inhabiting the northern circumpolar region and in indigenous south and central american people. Microscopic analysis showed parakeratosis, acanthosis, epithelial hyperplasia, and koilocytic cells. Oct 31, 2011 the pubmed database was used to search the international literature up to april 2011, for the following key words. This uncommon, benign disease of the oral mucosa is induced by an infection with hpv type or hpv type 32.
Focal epithelial hyperplasia feh is an asymptomatic benign mucosal disease, which is mostly observed in specific groups in certain geographical regions. Focal epithelial hyperplasia or hecks disease is a rare contagious disease caused by human papillomavirus types or 32, initially described among native american populations. New who classification of endometrial hyperplasias. Sep 23, 2019 focal epithelial hyperplasia feh or hecks disease is a rare contagious disease caused by human papillomavirus that was first described in 1965 from the observation of isolated or multiple soft papular and nodular eruptions on the oral mucosa of navajo xavante indian and alaska eskimo children. Focal epithelial hyperplasia feh or hecks disease is a rare, benign and asymptomatic mucosal proliferation associated with human papillomavirus hpv infection, mainly with genotypes and 32. The present report is the first description of this disease in a neotropical primate, a howler monkey alouatta fusca. This condition is characterized by the occurrence of multiple small papules or nod ules in oral cavity, especially on labial and buccal mucosa and tongue.
The mucosa may be eight to 10 times thicker than normal. In general, focal epithelial hyperplasia is asymptomatic. Beaudenon s, praetorius f, kremsdorf d, lutzner m, worsaae n, pehauarnaudet g, orth g 1987 a new type of human papillomavirus associated with oral focal epithelial hyperplasia. No other areas of epithelial hyperplasia were noted in the thymus from this rat nor were any evident in any of the other controls in this study. The search was not limited by publication year due to the scant information on the disease. The most frequent sites for ipeh are the deep vascular inner layers of skin dermis and subcutis of the head and neck regions and in the lip, tongue and buccal mucosa. Focal fibrous hyperplasia article about focal fibrous. Focal epithelial hyperplasia actas dermosifiliograficas. Focal nodular hyperplasia spontaneous nodular regenerative hyperplasia portal. Focal fibrous hyperplasia definition of focal fibrous. Focal epithelial hyperplasia is a rare disease of the oral mucosa caused by the human papilloma virus hpv. Focal epithelial hyperplasia definition of focal epithelial.
We show three cases of focal epithelial hyperplasia in afghan patients. The clinical diagnosis was focal epithelial hyperplasia feh, a rare benign condition caused by human papillomavirus subtype or 32. Structural units of the normal gastric mucosa antraltype figure by mit ocw. Multifocal epithelial hyperplasia of oral cavity expressing.
Focal epithelial hyperplasia feh or hecks disease is a rare viral infection of the oral mucosa caused by human papilloma virus especially subtypes or 32. Multifocal epithelial hyperplasia hecks disease is a rare, contagious, asymptomatic, and benign disease affecting the oral mucosa. In 1994, the who classified endometrial hyperplasias into 4 categories. Here we report the clinicopathological features of twelve cases of meh referred to oral medicine department of. In general, hyperplasia can either be simple, nodular, or papillary figure 1, figure 2, figure 3, and figure 4, which may not be important to diagnose for occasional and spontaneous cases. It appears as a benign epithelial growth, usually in the mucosa of the lower lip. Anterior highresolution optical coherence tomography hroct is a novel noninvasive in vivo imaging modality that can assist in the diagnosis and management of various ophthalmic pathologies. Oral focal epithelial hyperplasia is a rare and seldom reported disease in animals and humans induced by a papillomavirus. Jan 15, 2014 in general, hyperplasia can either be simple, nodular, or papillary figure 1, figure 2, figure 3, and figure 4, which may not be important to diagnose for occasional and spontaneous cases. Usually hpv involves either cutaneous or mucosal surfaces, whereas concomitant mucocutaneous involvement is extremely rare. Management of flat epithelial atypia on breast core biopsy. Focal epithelial hyperplasia, chimpanzees springerlink.
Histopathologically, the lesions consist of acanthosis, epithelial hyperplasia, and wild chronic inflammation. Hecks disease or focal epithelial hyperplasia is a benign contagious disease caused by human papillomavirus types or 32. Observational studies have suggested that at least some of these lesions may represent either. The frequency of this disease varies widely from one geographic region to another, and can vary, from 0. Stomach, forestomach, epithelium hyperplasia in a male f344n rat from a chronic study. Papules and plaques are usually the color of normal mucosa, but may be pale or, rarely, white. Focal epithelial hyperplasia, multifocal epithelial hyperplasia, hecks disease, papillomavirus infections, hpv and hpv32. The first biopsy a shows evidence of tubular injury loss of proximal tubular brush border and cytoplasm, and hypocellularity. Focal epithelial hyperplasia an update request pdf.
Focal epithelial hyperplasia feh, or hecks disease, is an uncommon asymptomatic proliferation of the oral mucosa that was first introduced into dermatology literature in 1965 by archard et al. In this context, papilla refers to the projection created by the tumor, not a tumor on an already existing papilla such as the nipple. Hecks disease or focal epithelial hyperplasia is a rare, benign and asymptomatic lesion of oral mucosa that is characterized by the presence of soft, sessile. Multifocal epithelial hyperplasia heck disease in a 7. Heck disease focal epithelial hyperplasia is an unusual oral condition caused by specific hpv types and 32, mainly in ethnic groups such as inuits and american indians. The diagnosis was based on gross and microscopic findings. Focal epithelial hyperplasia may be suspected clinically, particularly in high risk populations. Focal epithelium hyperplasia an overview sciencedirect topics. A case report of focal epithelial hyperplasia hecks disease. It is caused by the human papilloma virus types and 32. A case of oral focal epithelial hyperplasia feh treated with co2 laser surgery is presented.
Stomach, forestomach, epithelium hyperplasia in a male b6c3f1 mouse from a chronic study. Focal epithelial hyperplasia is somewhat different from other hpv infections in that it is able to produce extreme acanthosis or hyperplasia of the prickle cell layer of the epithelium with minimal production of surface projections or induction of connective tissue proliferation. A case report of focal epithelial hyperplasia hecks disease with. A case of focal epithelial hyperplasia involving the oral epithelium is being presented in a patient of mexican indian ancestry. Photomicrograph demonstrates acanthosis, parakeratosis and epithelial hyperplasia. Epithelial tumors can be named for cell of origin, microscopic architecture, or macroscopic appearance.
Focal breakdown common due to unopposed estrogen irregularly developed secretory type glands coexist with proliferative glands. It may present because of the appearance, a feeling of roughness or accidental biting of a lesion. This condition is characterized by the occurrence of multiple, small papules or nodules in the oral cavity, especially on the labial and buccal mucosa and tongue. In this paper, we describe three examples of endometrial stromal hyperplasia which have a remarkable. The occurrence of focal epithelial hyperplasia hecks disease in a 12. Laser excision of focal epithelial hyperplasia hecks disease. Focal epithelial hyperplasia feh, or hecks disease, is a rare disease of the oral mucosa. In caucasians there have been only a few cases reported. F ocal epithelial hyperplasia is an uncommon benign oral condition that occurs mainly in young individuals of certain racial groups. Focal epithelial hyperplasia feh, also termed heck disease, multifocal epithelial hyperplasia, or multifocal papilloma, is a relatively rare, benign, human papillomavirus hpvinduced alteration of the oral mucosa, caused by lowrisk human papillomavirus hpv, namely the subtypes or 32. Focal epithelial hyperplasia is an hpv induced epithelial proliferation.
Microscopic analysis showed parakeratosis, acanthosis, epithelial hyperplasia, and koilocytic cells, which confirmed feh. We report such a unique case of multifocal epithelial hyperplasia involving multiple sites of oral cavity along with skin lesions in a 65year. The genealogical evidence indicates a genetic predisposition to the disease. Multifocal epithelial hyperplasia, a rare oral infection.
Focal epithelial hyperplasia feh, or hecks disease, is a rare disease of the oral mucosa, characterized by asymptomatic papules in the oral cavity. Focal epithelial hyperplasia, or hecks disease, is a rare, viralinduced proliferation of oral squamous epithelium. This is a report of an unusual case of focal epithelial hyperplasia in a young black adult presenting with. Pdf focal epithelial hyperplasia or hecks disease is a rare contagious disease caused by human papillomavirus. Hecks disease focal epithelial hyperplasia feh is clinically characterized by multiple circumscribed, soft elevated nodules of the oral mucosa. It has been associated with infection of the oral mucosa by types and 32 of the human papillomavirus. Histopathologically, feh is characterized by parakeratosis, epithelial hyperplasia, and acanthosis. Focal nodular hyperplasia synonyms, focal nodular hyperplasia pronunciation, focal nodular hyperplasia translation, english dictionary definition of focal nodular hyperplasia. Focal epithelial hyperplasia feh or heck disease, is a rare viral infection of the oral mucosa caused by hpv or hpv 32. Figure 12 focal epithelial hyperplasia is present at the septum separating thymic lobules in this control female f344 rat in a 3month toxicity study figure 12a and 12b. Oral focal epithelial hyperplasia in a howler monkey.
The implementation of diagnosing ocular surface lesions has been explored in previous studies, successfully revealing specific signs in some ocular lesions. Stomach, forestomach, epithelium hyperplasia, focal. Focal epithelial hyperplasia hecks disease hallmon. Feh is usually a disease of childhood and adolescence and is generally associated with people who live in poverty and of low socioeconomic status.
Disease may persist for years, producing a significant reduction in quality of life. Focal epithelial hyperplasia in a mexican indian jama. Focal epithelium hyperplasia an overview sciencedirect. Clinically, feh is typically characterized by multiple, painless, soft, sessile papules. Find out information about focal fibrous hyperplasia. Two exophytic, papillary foci of hyperplasia are present. Weise, alendronateassociated focal segmental glomerulosclerosis, ndt plus. Multiple labial and buccal papular lesions were noted in two israeli young adults.
Urinary bladder, urothelium hyperplasia nonneoplastic. Alendronateassociated focal segmental glomerulosclerosis. Focal epithelial hyperplasia feh or hecks disease is a rare contagious disease caused by human papillomavirus that was first described in 1965 from the observation of isolated or multiple soft papular and nodular eruptions on the oral mucosa of navajo xavante indian and alaska eskimo children. Hyperplasia of the endometrial stroma is a poorly recognized lesion, lacking widespread recognition with most, if not all, such cases sequestrated in the literature as endometrial stromal nodules or lowgrade endometrial stromal sarcomas. Focal epithelial hyperplasia by human papillomavirus hpv. Neoplasia new growth abnormal mass of tissue with growth that. Read focal epithelial hyperplasia of the oral mucosa, british journal of dermatology on deepdyve, the largest online rental service for scholarly research with thousands of academic publications available at your fingertips. The clinical and histopathologic appearance of the lesions led to a diagnosis of focal epithelial hyperplasia. Focal epithelial hyperplasia of the oral mucosa, british. Focal epithelial hyperplasia an update, journal of oral.
The most common manifestations of oral hpv infection are the various types of benign warts, which include the squamous papilloma sp, verruca vulgaris vv, condyloma acuminatum ca and a distinct entity known as focal epithelial hyperplasia feh. We report such a unique case of multifocal epithelial hyperplasia involving multiple sites of oral cavity along with skin lesions in a 65yearold female. It is mainly associated with hpv serotypes and 32 and there is a clear racial predilection for the disease in native. Abrupt epithelial thickening with marked acanthosis, absence of. Human papillomaviruses have been associated with feh and have been detected in the majority of lesions. Intravascular papillary endothelial hyperplasia genetic. A biopsy from a lesion in the mouth will show diagnostic pathology the epithelium is very thickened and raised above the surrounding mucosa with typical mitosoid cells. Lesions were also seen on the patients lip mucosa and tongue. Pdf focal epithelial hyperplasia feh or hecks disease is an uncommon asymptomatic proliferation of oral. Focal epithelial hyperplasia also known as hecks disease is a benign pathology characterized by the presence of multiple papules in the mucosa of the oral cavity. Focal epithelial hyperplasia feh or hecks disease is a rare disease of the oral mucosa. Multifocal epithelial hyperplasia meh is a benign, rare, familial. Focal epithelial hyperplasia or hecks disease, is a rare viral infection of the oral mucosa caused by human papillomavirus. A study on the presence of human papillomavirus hpv dna sequences and focal epithelial hyperplasia feh in a family of venezuelan ancestry has revealed that feh is an hpvinduced disease presenting familial aggregation.
The lesions most commonly affect the mucosal surfaces of the lips and they have been observed frequently to regress within a few months. Multifocal epithelial hyperplasia occurs in certain geographical regions e. Focal epithelial hyperplasia feh or hecks disease is a rare contagious disease caused by human papillomavirus that was first described in 1965 from the observation of isolated or multiple soft papular and nodular eruptions on the oral mucosa of navajo xavante indian and alaska eskimo children 1. Proximal tubular epithelial hyperplasia in patients with. An abnormal increase in the number of cells in a tissue or organ, with consequent enlargement of the part or organ. Focal epithelial hyperplasia is a relatively unusual and benign disorder characterized generally by multiple asymptomatic nodules, occurring most commonly in younger segments of indigenous populations and ethnic groups. This is a report of an unusual case of focal epithelial hyperplasia in a young black adult presenting with generalized involvement.
Multifocal epithelial hyperplasia of oral cavity expressing hpv 16. It is mainly associated with hpv serotypes and 32 and there is a clear racial predilection for the disease in native americans and eskimos. Multifocal epithelial hyperplasia meh is benign, asymptomatic oral disease with viral etiology. Progression of hyperplasia endometrium hyperplasia simple hyperplasia atypical hyperplasia adenocarcinoma constant estrogen other factors. Focal epithelial hyperplasia is a rare contagious disease caused by human papilloma virus. Multifocal epithelial hyperplasia meh is an uncommon disease. Flat epithelial atypia is a descriptive term that encompasses lesions of the breast terminal duct lobular units in which variably dilated acini are lined by one to several layers of epithelial cells, which are usually columnar in shape and which display lowgrade cytologic atypia. Pdf hecks disease focal epithelial hyperplasia feh is clinically. By contrast, the second biopsy bd shows multiple tubules with epithelial hyperplasia, focal crowding, and piling up of cells. Hecks disease, also known as focal epithelial hyperplasia, is an asymptomatic, benign neoplastic condition characterized by multiple white to pinkish papules that occur diffusely in the oral cavity 411 can present with slightly pale, smooth or roughened surface morphology. Pdf focal epithelial hyperplasia hecks disease treated with. Focal epithelial hyperplasia how is focal epithelial. The diagnosis and management of preinvasive breast. Hyperplasia in a female f344n rat from a chronic study.