Your diagnosis

Squamous papilloma of the esophagus

This article will help you read and understand your pathology report for squamous papilloma of the esophagus.

by Jason Wasserman MD PhD FRCPC, reviewed by our Patient Partners on November 13, 2020

Quick facts:

  • A squamous papilloma is a non-cancerous growth that develops on the inside of the esophagus.
  • It is made up of specialized squamous cells that connect together to form long finger like projections of tissue called papilla.
  • Causes of squamous papilloma in the esophagus include excessive alcohol consumption, acid reflux disease, trauma, and infection by human papillomavirus (HPV).

The anatomy of the esophagus

The esophagus is a long hollow tube that starts at the back of your throat and ends at the top of your stomach. Swallowed food travels down the esophagus into the stomach.

normal esophagus histology

The esophagus is made up of six layers of tissue:

  • Epithelium – The epithelium is on the inside surface of the esophagus. The epithelium is made up of specialized squamous cells. The squamous cells connect together to form a barrier that protects the inside of the esophagus from injury.
  • Lamina propria – The lamina propria is a thin layer of connective tissue directly below the epithelium. The lamina propria supports the squamous cells.
  • Muscularis mucosa – The muscularis mucosa is a thin layer of muscle cells below the lamina propria.
  • Submucosa – The submucosa sits directly below the muscularis mucosa. It contains large blood vessels, lymphatic channels, and glands.
  • Muscularis propria – The muscularis propria is a thick bundle of muscle in the middle of the wall of the esophagus. The muscularis propria allows the esophagus to move food towards the stomach.
  • Adventitia – The tissue on the outer surface of the esophagus is called the adventitia. It surrounds the esophagus and separates is from nearby tissues and organs such as the airway and the aorta.

What is a squamous papilloma?

A squamous papilloma is a common type of non-cancerous growth. It starts from the epithelium lining the inside of the esophagus and is made up of squamous cells that connect together to form long finger like projections of tissue. Pathologists call these finger like projections papilla.

squamous papilloma esophagus

What causes a squamous papilloma?

Common causes of squamous papillomas in the upper or middle esophagus include excessive alcohol consumption and mechanical irritation of the esophagus by impacted food or medical devices (for example stents). Squamous papillomas in the lower esophagus are often caused by acid reflux disease (GERD). A small number of squamous papillomas in the esophagus are caused by infection with human papilloma virus (HPV). There are many types of human papilloma virus and the types that cause squamous papilloma are called low risk because they are not associated with an increased risk of developing cancer.

How do pathologists make this diagnosis?

The diagnosis is made after the growth is removed and sent to a pathologist for examination under a microscope. Sometimes only a small sample of the papilloma will be removed in a procedure called a biopsy. In these situations, your doctor may suggest a second procedure to remove the remainder of the growth.

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