Comparative analysis of oral epithelial malignancies using routine stain and modified Cajal’s trichrome stain: An histopathological study

Abstract

Diagnosis of initial epithelial pathology maybe difficult in Oral Squamous Cell Carcinoma (OSCC), early invasive squamous cell carcinoma and other atypical epithelial malignancies, under routine Haematoxylin and Eosin (H and E) stain. In this context, an appropriate differential stain capable of distinguishing epithelial cells in the connective tissue may well prove to be a valuable aid. In the present study, we endeavor to use Modified Cajal's trichrome stain for making diagnosis easier without resorting to expensive diagnostic aids. Aim of present study is to assess both the epithelial and connective tissue elements in early invasive carcinoma, verrucous carcinoma and oral squamous cell carcinoma in tissue sections stained with modified Cajal's trichrome stain (MCTS) and to compare it with H and E-stained sections. Formalin-fixed, paraffin-embedded tissue blocks of early invasive SCC (n = 10) Verrucous carcinoma (n = 10) OSCC (n = 10) were stained with MCTS and H&E. The sections were compared based on set histopathological criteria. In SCC cases stained with MCTS, invasion into connective tissue and keratin pearls were strikingly evident. Depth of invasion could be more accurately determined. Thus, CTS is a good differential stain, clearly delineating the epithelial elements from the connective tissue elements visually.