Abstract
Objective: To determine compatibility between clinical diagnosis and the pathological reports of biopsies from oral lesions. Material and Methods: In this descriptive study, 1146 clinical files of patients referring to Tabriz Faculty of Dentistry from 2004 to 2016 were retrieved and evaluated. The kappa coefficient was calculated for each file for compatibility of clinical and pathological diagnosis. Results: In relation to clinical (40.2%) and pathological (39.2%) diagnosis, irritational lesions of soft tissues exhibited the highest frequency. In 72.3% of cases, the clinical and pathological diagnosis were compatible and in 27.7% of cases these diagnosis were not compatible. The highest compatibility rates were detected for irritational lesions of soft tissues (81.5%) and mucocutaneous lesions (76.9%). There was no compatibility for osseous malignant tumors, inflammatory tissues, granulation tissues, metastatic lesions and hematologic disorders. Conclusion: Approximately one-third of clinical and histopathological diagnosis were not compatible. Therefore, to reach a correct diagnosis, the clinical, radiographic and histopathological views should be evaluated simultaneously.
Highlights
Clinicians commonly encounter oral mucosal lesions in their clinical practice
The majority of the lesions (71.9%) were soft tissue and soft tissue irritational lesions (39.2%)
The highest rate of compatibility was related to irritational soft tissue lesions (81.5%), followed by mucocutaneous lesions (76.9%)
Summary
Clinicians commonly encounter oral mucosal lesions in their clinical practice. A study in the United States showed that they occurred in almost 27.9% of patients aged ≥17 and in 10.3% of children and adolescents 2-17 years of age [1,2]. Each oral lesion has characteristics and clinical features that help clinicians diagnose them; similarities in clinical manifestations, lack of accurate definition of these characteristics, incompatibility of the signs and symptoms in different patients and the presence of different manifestations for a lesion leads to errors in clinical diagnosis [3,4]. Microscopic evaluation of biopsies taken from the lesions is the most accurate technique compared to other paraclinical diagnostic techniques; in some cases pathologists face ambiguities during histopathological evaluation of lesions because some lesions have similar microscopic views. In such cases, clinical diagnosis will be very helpful. For example mistaking an inflammatory lesion such as a radicular cyst for a tumor or an aggressive odontogenic tumor, with subsequent inappropriate treatments, will lead to irreparable damage to patients [4,5,6]
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