Ghost cells transformation of oral epithelium in irritational fibroma and oral submucous fibrosis: A pathogenetic viewpoint

Abstract

ObjectiveIt was proposed that ghost cells (GCs) are formed as a result of metaplasia caused due to reduction in oxygen supply. Hence, identification of GC like features in irritational fibroma and oral submucous fibrosis (OSMF) is carried out where reduction in oxygen supply to the overlying epithelium is expected due to fibrosis and hyalinization in the stroma. Materials and methodWe retrospectively analyzed 113 cases of irritational fibroma and 55 cases of OSMF. The epithelium of each lesion was carefully searched for GC like features. ResultsFive cases (4.43%) of irritational fibroma and 2 OSMF cases (3.63%) showed GC transformation of spinous and basal cells of epithelium. The surface keratinized layers were absolutely normal. No differences were seen in the degree of fibrosis between GC cases and non-GC cases. The stroma showed patent vascular spaces just beneath the basement membrane in all the cases. ConclusionGC transformation of oral epithelium in irritational fibroma and OSMF is not reported in the literature till date. Patent vascular spaces are seen in the histopathological examination which goes against the hypothesis. Hence, alternate hypothesis of mucin induced GC transformation has been proposed for mucosal pathologies.