Diagnosis Of Oral Cavity Lesions Research Articles

Rhabdomyoma of the Oral Cavity Mimicking Reactive Lesions: A Case Report and Review of the Literature.

Extracardiac rhabdomyoma is a tumor that rarely occurs in head and neck region. Adult and fetal types of extracardiac rhabdomyoma are diagnosed only by histopathological examination. In the oral cavity, this lesion usually affects the mouth floor and tongue. Despite the low incidence, adult rhabdomyoma should be considered in the differential diagnosis of oral cavity lesions, and histopathological evaluation might be helpful for the final diagnosis. This study aims to report a rare case of rhabdomyoma mimicking reactive lesions and review the literature. A 34-year-old male was referred to the pathology department with a yellowish sessile lesion in the labial maxillary vestibule. During an excisional biopsy, a mass of unencapsulated soft tissue beneath the vestibular mucosa was observed. The yellowish color in clinical features has led to lipoma as the initial clinical diagnosis. The histological examination exhibited an encapsulated, well-circumscribed benign neoplasm composed of multiple lobules of large polygonal cells with prominent abundant granular eosinophilic cytoplasm. No cellular atypia was observed. Diagnosis of the adult type of rhabdomyoma was made by collective agreement. Rhabdomyoma can be mistaken for other reactive lesions and may resemble their appearance.

Utility of Indigenous Cytology Technique in the Diagnosis of Oral Cavity Lesions using Normal Saline as a Processing Fluid: A Comparative Study.

Oral cancer is a major health problem in developing countries. Cytology has been widely accepted as a tool in the early diagnosis of cancer. To evaluate the diagnostic utility of four different cytology techniques, that is, modified brush cytology (BR) technique, brush cytology cytocentrifugation (BRCC) technique, modified scrape cytology (SR) technique, and scrape cytology cytocentrifugation (SRCC) technique and correlate the cytopathological diagnosis with the available histopathological diagnosis. It was a prospective observational study of oral cavity lesions conducted from January 2018 to December 2018 at a rural tertiary care referral institute. Smears prepared by four different techniques, that is, BR technique, BRCC technique, SR technique and SRCC technique were evaluated using a scoring system. Normal saline was used as a processing fluid for cytocentrifugation techniques, and the cytological diagnosis was compared with an available histopathological diagnosis for concordance. Twenty-seven cases of oral cavity lesions were analyzed. Squamous cell carcinoma (55.56%) constituted the most common lesion diagnosed by cytology. Total concordance was 95.65%. Brush cytology techniques were better technique than scrape cytology techniques. Cytocentrifugation techniques were better than modified brush cytology technique and modified scrape cytology technique and the values were statistically highly significant (P<0.0001). The utility of only normal saline as a processing fluid for cytocentrifugation may be considered an unexplored and prudent endeavor. This indigenously designed technique may be employed to improve the quality of cytological preparation for the evaluation of oral cavity lesions.

EXFOLIATIVE CYTOPATHOLOGY IN THE DIAGNOSIS OF LESIONS OF THE ORAL CAVITY

<h3>Objectives</h3> Early diagnosis is a priority activity to perform less aggressive treatments and improve survival in oral cancer. An activity that can contribute to the early diagnosis of lesions is exfoliative cytology. The aim of this study was to evaluate the efficacy of the use of exfoliative cytology for the diagnosis of oral cavity lesions. <h3>Study Design</h3> This was a prospective, observational, cross-sectional, descriptive study of a series of cases, aiming to determine the contribution of exfoliative cytopathology in the preoperative diagnosis of lesions of the oral cavity. <h3>Results</h3> The study sample included 50 patients. In 70% of cases, the lesions were histologically interpreted as benign and 30% as malignant. When comparing the 2 methods of cytology, traditional and liquid-based, we obtained 100% sensitivity, 97% specificity, 97% accuracy, kappa = 0.91. Regarding the accuracy of the cytologic and histopathologic diagnosis, sensitivity was 86.6%, specificity 100%, positive predictive value 100%, negative predictive value 94.5%, kappa = 0.958, and accuracy 96%. <h3>Conclusions</h3> Traditional and liquid-based cytology methods were able to identify and classify cell changes with characteristics of malignancy. Cytology techniques have proven reproducible and, if well indicated, can be routinely used for the early detection of malignant lesions.

Artificial Intelligence in Diagnosis of Oral Potentially Malignant Lesions- Need of the Hour

Artificial intelligence (AI) is a technological breakthrough that is rapidly progressing and has captivated the minds of researchers all over the world. AI can be used to make a diagnosis of oral cavity lesions, detect and identify suspicious changed oral mucosa undergoing premalignant and malignant transformations. The purpose of this review is to give a comprehensive summary of developing optical imaging technologies, innovative artificial intelligence-based techniques. The concepts of image-based techniques for identifying oral cancer are defined in terms of clinical requirements and features. Although artificial intelligence (AI) is beginning to have a significant impact on increasing diagnosis accuracy in a variety of fields of medicine, there has been limited research on oral cancer to date. These results suggest that combining artificial intelligence with imaging can improve oral cancer outcomes, applications ranging from very low-cost oral cancer screening with Smartphone-based probes to algorithm-guided identification premalignant lesion heterogeneity and margins using optical coherence tomography. Oral cancer outcomes can be improved by combining imaging and artificial intelligence technologies for better detection and diagnosis.

Optical diagnosis of oral cavity lesions by label-free Raman spectroscopy.

Oral squamous cell carcinoma (OSCC) is one of the most prevalent cancers and frequently preceded by non-malignant lesions. Using Shifted-Excitation Raman Difference Spectroscopy (SERDS), principal component and linear discriminant analysis in native tissue specimens, 9500 raw Raman spectra of OSCC, 4300 of non-malignant lesions and 4200 of physiological mucosa were evaluated. Non-malignant lesions were distinguished from physiological mucosa with a classification accuracy of 95.3% (95.4% sensitivity, 95.2% specificity, area under the curve (AUC) 0.99). Discriminating OSCC from non-malignant lesions showed an accuracy of 88.4% (93.7% sensitivity, 76.7% specificity, AUC 0.93). OSCC was identified against physiological mucosa with an accuracy of 89.8% (93.7% sensitivity, 81.0% specificity, AUC 0.90). These findings underline the potential of SERDS for the diagnosis of oral cavity lesions.

ORAL IATROGENIC KAPOSI'S SARCOMA: CASE REPORT

This study presents a case of a 29-years old male patient with immunosuppression-associated Kaposi´s Sarcoma (KS) caused by the medicines for the leprosy treatment. The patient was presented to the stomatology service of the Hospital Metrolpolitano Odilon Behrens, Brazil, with a tumoral growth in the rights side of the lip commissure, with no history of local trauma. He was previously diagnosticated with borderline leprosy, cataract and glaucoma and was under regular use of 100mg prednisone for 1 year and 6 months for treatment of leprosy complication. At the clinical examination it was possible to observe an erythematous tumoral growth in the lip commissure, right side, with necrosis on the surface measuring approximately 12mm. In view of the diagnostic hypothesis of non-neoplastic proliferative lesion and neoplasia of mesenchymal origin, an incisional biopsy of the lesion was performed. Microscopic findings and immunohistochemical examination of the lesion led to a final diagnosis of KS. The patient was submitted to the rapid serology test for human immunodeficiency virus (HIV), which proved to be negative, a result confirmed by the fourth-generation test. The patient was referred for surgical evaluation of the lesions and for reevaluation of the systemic steroid dosage. Faced with the infeasibility of reducing corticoid dosage, the patient underwent surgical excision of the lesions and was free of recurrence of the disease for 2 years. So, this case shows the importance of including KS in the differential diagnosis of oral cavity lesions in patients who use chronic immunosuppressant drugs.

T-Cell Lymphoma Of Palate – A Rare Case Report

The head and neck is the second most common anatomical site of extranodal lymphomas. Among them extranodal NK/T-cell lymphoma, nasal type (ENKTCL) is a relatively newly recognised distinct clinico-pathological entity in the WHO classification. This case report describes a patient with such a tumor. The case was a 45 year old male presenting with a painless ulcer on palate mucosa. He had suffered from nasal obstruction. Pathology revealed the presence of a T-cell lymphoma tumor in the palate. Though rare, the signs and symptoms of the case suggest that T-cell lymphoma should be considered in the differential diagnosis of oral cavity lesions and needs to special tests for correct diagnosis.

Amelanotic melanoma of the tongue

Malignant melanoma of the oral cavity is a rare lesion, with an incidence of about 0.2% to 0.8% of all melanomas. Melanoma of tongue is still rarer and represents less than 2% of oro-nasal melanoma cases. We report a rare case of amelanotic melanoma of the tongue in a young man. The importance of consideration of melanoma in the differential diagnosis of oral cavity lesions is discussed since mucosal melanoma carries a bad prognosis and early diagnosis is vital.

Extranodal Natural-Killer/T-Cell Lymphoma, Nasal Type – Presenting as Non-Healing Palatal Ulcer

Oral cavity T-cell lymphoma occurs rarely. This case report describes a patient with such a tumor. The case was a 48 year old male presenting with a painless ulcer on palate mucosa. He had suffered from nasal obstruction. Pathology revealed the presence of a T-cell lymphoma tumor in the palate. Though rare, the signs and symptoms of the case suggest that T-cell lymphoma should be considered in the differential diagnosis of oral cavity lesions.

DEVELOPMENT OF A LASER CONFOCAL ENDOMICROSCOPE FOR IN VIVO FLUORESCENCE IMAGING

Malignancies of the oral cavity are conventionally diagnosed by white light endoscopy, biopsy and histopathology. However, it is often difficult to distinguish between benign lesions and premalignant or early lesions. There is a need for a more definitive, non-invasive technique for diagnosis of oral cavity lesions. A laser confocal endomicroscope offers non-invasive surface and subsurface imaging of tissue. We investigated its potential for fluorescence imaging of the oral cavity using hypericin, fluorescein and aminolevulinic acid. Fluorescence imaging was carried out both in vivo and on resected tissue samples of the oral cavity in both humans and animal models. Good structural images of the oral cavity were obtained. Morphological differences between normal and lesion tissue can be distinguished. The use of Pharmasolve® enhanced the subsurface depth from which images can be obtained. Our results show that laser confocal fluorescence endomicroscopy has great potential for the diagnosis of oral cavity malignancies.

Detection of squamous cell carcinomas and pre-cancerous lesions in the oral cavity by quantification of 5-aminolevulinic acid induced fluorescence endoscopic images.

Studies of 5-aminolevulinic acid-induced protoporphyrin IX fluorescence have shown a sensitivity of 95-100% for oral cancer diagnosis, but the specificity is only about 50-60%. Here, we explore the applicability of quantifying PPIX fluorescence images to improve the diagnostic specificity and detect early oral lesions. PPIX Fluorescence endoscopy and imaging were performed on 28 patients with a known or suspected premalignant or malignant oral cavity lesion. A total of 70 biopsies were taken from the tissue sites imaged for histological analysis. The red-to-blue and red-to-green intensity ratios were calculated from the fluorescence images to correlate with histology. Suspicious lesions display bright reddish fluorescence, while normal mucosas exhibit blue color background in the fluorescence images. The red-to-blue and red-to-green intensity ratios of malignant tissues are larger than those of benign tissues. Combining the two ratio diagnostic algorithms yields a sensitivity and specificity of 95% and 97%, respectively, exceeding each diagnostic algorithm alone for discriminating malignant tissue from benign tissue. Quantifying PPIX fluorescence endoscopic images combined with the ratio diagnostic algorithms developed in this study has the potential to significantly improve the noninvasive diagnosis of oral cavity lesions in vivo.