Oral potentially malignant lesions: first-level micro-histological diagnosis from tissue fragments sampled in liquid-based diagnostic cytology

Introduction: Incidence of oral epithelial dysplasia and oral squamous cell carcinoma (SCC) is very high in south Asian countries as compared to western population owing to a greater use of tobacco in these regions. While visual examination and exfoliative cytology are the most common screening and diagnostic modalities at present, it is a subjective analysis. Quantitative analyses such as nuclear size, cell size, and nuclear-to-cytoplasmic ratio may provide an accurate diagnosis and improve reproducibility. The aim of the study was to evaluate the role of morphometry as a diagnostic adjunct to exfoliative cytology and to derive a significant cutoff to identify the population at risk for development of SCC among chronic tobacco users. Material and Methods: This was an outpatient-based prospective study done in a tertiary hospital over a period of 2 years. Hundred and fifty cases with a history of chronic tobacco use for a minimum period of 5 years were evaluated. Visual inspection using acetic acid was done. Oral scrapes were taken for cytological and morphometric analysis followed by incision biopsy for histopathological evaluation, wherever possible. Results: On morphometrical analysis, mean nuclear area and nuclear:cytoplasmic (N:C) ratio increased, while the cytoplasmic area decreased from smears with normal cytology to oral dysplasia to SCC. Analysis of variance and post hoc Tukey’s honest significant difference test showed a statistically significant difference among the 3 groups (p value <0.05). A cutoff value for a significant N:C ratio was calculated as ≥0.08 using Youden’s index with a sensitivity and a specificity of 88% and 94%, respectively. Conclusion: In high-risk cases, morphometry can be a useful adjunct to exfoliative cytology and visual examination for an early and accurate diagnosis and timely intervention in oral potentially malignant and malignant lesions, thereby improving the prognosis.

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Benign and Potentially Malignant Lesions of the Squamous Epithelium and Squamous Cell Carcinoma

Pathology of the Head and Neck ◽

10.1007/3-540-30629-3_1 ◽

2006 ◽

pp. 1-38 ◽

Cited By ~ 5

Author(s):

N. Gale ◽

N. Zidar

Keyword(s):

Squamous Cell Carcinoma ◽

Cell Carcinoma ◽

Squamous Cell ◽

Squamous Epithelium ◽

Potentially Malignant ◽

Malignant Lesions

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Prevalence of fungal hyphae in potentially malignant lesions and conditions-does its occurrence play a role in epithelial dysplasia?

Journal of Oral and Maxillofacial Pathology ◽

10.4103/0973-029x.157193 ◽

2015 ◽

Vol 19 (1) ◽

pp. 10 ◽

Cited By ~ 8

Author(s):

BhagyalaxmiPraveen Hongal ◽

VenkateshV Kulkarni ◽

PriyaShirish Joshi ◽

PrasadPrakash Karande ◽

AdilS Shroff ◽

...

Keyword(s):

Epithelial Dysplasia ◽

Fungal Hyphae ◽

Potentially Malignant ◽

Malignant Lesions

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The mouth and salivary glands

Oxford Textbook of Medicine ◽

10.1093/med/9780198746690.003.0293 ◽

2020 ◽

pp. 2797-2827

Author(s):

John Gibson ◽

Douglas Robertson

Keyword(s):

Bacterial Infections ◽

Oral Manifestations ◽

Systemic Diseases ◽

Pain Syndromes ◽

Chronic Periodontal Disease ◽

Bacterial Action ◽

Potentially Malignant ◽

Oral Symptoms ◽

Complete Physical Examination ◽

Malignant Lesions

Many systemic diseases are associated with oral symptoms or signs, hence thorough examination of the lips, gums, teeth, tongue, and oropharynx should be part of any complete physical examination of a patient. Dental caries, caused by bacterial action, is one of the commonest human diseases and a cause of considerable misery. Chronic periodontal disease is the most important cause of dental loss in adults. In addition to describing these conditions, this chapter also covers potentially malignant lesions of the oral mucosa and oral cancer; viral, fungal, and bacterial infections; oral ulceration; oral manifestations of dermatological, gastroenterological, haematological, and multisystem disorders; orofacial pain syndromes; and salivary gland disorders.

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Accuracy of smartphone based photography in screening for potentially malignant lesions among a rural population in Tamil Nadu: A cross-sectional study

Digital Medicine ◽

10.4103/digm.digm_29_18 ◽

2019 ◽

Vol 5 (2) ◽

pp. 56

Author(s):

Ravi Karthikayan ◽

Aparna Sukumaran ◽

MadankumarParangimalai Diwakar ◽

VBijivin Raj

Keyword(s):

Rural Population ◽

Tamil Nadu ◽

Cross Sectional Study ◽

Sectional Study ◽

Cross Sectional ◽

Potentially Malignant ◽

Malignant Lesions

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Breast MR for the Evaluation of Occult Nipple Discharge

The American Surgeon ◽

10.1177/000313480807400813 ◽

2008 ◽

Vol 74 (8) ◽

pp. 739-742 ◽

Cited By ~ 1

Author(s):

Vincent E. Mortellaro ◽

Julia Marshall ◽

Steven E. Harms ◽

Steven N. Hochwald ◽

Edward M. Copeland ◽

...

Keyword(s):

Nipple Discharge ◽

Breast Mr ◽

Potentially Malignant ◽

Pathologic Nipple Discharge ◽

Malignant Lesions

Pathologic nipple discharge often presents a diagnostic and therapeutic dilemma for clinicians. We present two patients with pathologic nipple discharge in whom breast MR facilitated preoperative identification of and management of otherwise occult index lesions. Breast MR should be considered in the toolbox for evaluation of occult nipple discharge when other available strategies have failed to demonstrate an underlying etiology for the pathologic discharge. The use of breast MR in this setting may permit directed evaluation and management of potentially malignant lesions.

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