CORRELATIONS BETWEEN CLINICAL AND

MICROSCOPIC FEATURES OF PREMALIGNANT

LESIONS

Done by : Ahmed Ali Al-Asmari

Idiopathic Leukoplakia :

Clinical features :

Asymptomatic white patch; cannot be wiped off; males affected more than females

- Age

Usually over 40 years

- High-Risk Sites for Malignant Transformation

Floor > tongue > lip > palate > buccal > vestibule > retromolar

Microscopic Diagnoses At First Diagnosis

Hyperkeratosis—80%

Dysplasia—12%

In situ carcinoma—3%

Squamous cell carcinoma—5%

Erythroplakia :

Clinical features :

Asymptomatic red velvety patch; red lesions may have foci or white hyperkeratosis (speckled erythroplakia)

- Age

typically between 50 and 70 years

- High-risk sites

floor of mouth, tongue, retromolar mucosa, soft palate

Histopathology

Squamous cell carcinoma (50%)

Severe dysplasia or in situ carcinoma (40%)

Mild-to-moderate dysplasia (10%)

Lichen planus :

Clinical features :

asymptomatic except when erosions are present; occasionally present and are purple pruriticpapules; forearm and lower leg most common skin areas

- Age

seen in middle age

- High-risk sites

buccal mucosa most commonly affected, with lesions occasionally on tongue, gingiva, and palate; skin lesions

Possible Risk of Carcinoma Transformation

May be slightly increased with erosive form (0.4%–2.5% of cases)

Reference :

Oral Pathology : Clinical Pathologic Correlations by Joseph A. Regezi , James J. Sciubba , and Richard C.K. Jordan , 5th ed2007 , Saunders Company , Chapter 4 , Page 100-130