skip to main content

Pseudoepitheliomatous Hyperplasia — ORE Part 1 MCQ

Instant feedback + full explanation. One question, done properly.

HardOral PathologyPseudoepitheliomatous HyperplasiaORE Part 1

A patient taking phenytoin has an oral ulcer that has not healed after 4 weeks. Incisional biopsy reports pseudoepitheliomatous hyperplasia. What is the most important significance of this finding?

Educational content. Not a substitute for clinical judgement or local policy.

Reveal the answer and explanation

Correct answer: A — It may mimic squamous cell carcinoma and requires careful clinicopathological exclusion of invasion

Explanation lettering: E = shown as B · B = shown as C · C = shown as E

The correct answer is A. PEH is a reactive histological pattern that may simulate well-differentiated squamous cell carcinoma, so it should prompt careful review of the specimen and correlation with the persistent ulcer clinically. It does not itself prove invasion or cancer, making B incorrect. Conversely, PEH is not sufficient to certify that a non-healing ulcer is benign, so C is unsafe. PEH can occur with varied inflammatory, infective, traumatic and neoplastic processes; it is not diagnostic of viral infection (D) or lichen planus (E). Phenytoin use should not distract from the key concern: exclusion of oral squamous cell carcinoma in a persistent ulcer.

Reference: Sarangarajan R, Vedam VKV, Sivadas G, et al. Pseudoepitheliomatous Hyperplasia: Relevance in Oral Pathology. J Int Oral Health. 2015;7(7):132-136. https://pubmed.ncbi.nlm.nih.gov/26229388/