Speckled Leukoplakia Research Articles

A critical evaluation of epithelial dysplasia in oral mucosal lesions using the Smith-Pindborg method of standardization.

Standardization is one of the greatest problems in assessing epithelial dysplasia, as is establishing the relative importance of different clinical and dysplastic features. In this study, 214 cases characterized histologically by varying degrees of epithelial dysplasia, were analyzed for various clinical features: and representative sections were assessed histologically and graded according to the Smith-Pindborg standardized scoring system. Data were analyzed by computer. Seven cases with scores of less than 10 were excluded as not dysplastic. There were 85 cases (41%) with scores of 11-25 which were regarded as mild dysplasia; 60 (29%) with scores of 26-45 were regarded as moderate dysplasia; and 62 (30%) with scores of more than 45 which were reported as severe dysplasia. Peak frequency was in the 6th decade and the severe dysplasias were most frequent in the 8th decade. The M:F was 2:1. Tongue (58 cases), lower lip (36), floor of mouth (32) and cheeks (26) were sites most commonly involved. Of 107 cases, 93 were described as homogeneous leukoplakia, 11 as speckled leukoplakia and 3 as erythroplakia. The distribution of mild, moderate and severe dysplasias did not differ significantly by age, sex or race. Half of all cases involving floor of mouth and oropharynx were severely dysplastic, whereas most lesions occurring in cheek and alveolar mucosa/gingiva were mildly dysplastic; but differences were not significantly different. Severe grades of each dysplastic feature, as might be expected, occurred in lesions classified finally as 'severe dysplasia'.(ABSTRACT TRUNCATED AT 250 WORDS)

Speckled Leukoplakia of the Floor of the Mouth

Speckled Leukoplakia of the Floor of the Mouth

Chewing and smoking habits in relation to precancer and oral cancer.

In a prospective epidemiologic house-to-house survey of a random sample in the district of Ernakulam in Kerala State, the annual incidence rate of leukoplakia per 1,000 adults was found to be 2.1 for males and 1.5 for females. The rate was highest in the mixed tobacco habits group and lowest (0) in the no habits group. During the same period, oral cancer developed only among the individuals, who had a history of a previously diagnosed oral lesion. Malignant transformation was significantly higher among the speckled leukoplakia cases. The rate of malignant transformation was also highest among leukoplakias associated with tobacco chewing habits. These results suggest that leukoplakias associated with different tobacco habits may have a different natural history.

Morphological classification of oral leukoplakia (author's transl)

656 cases of oral leukoplakia were analysed according to macroscopic aspects, microscopic growth patterns and histologicalcytological differentiation, and the relationship to cancer of the oral cavity was studied. Homogeneous and speckled leukoplakia can be distinguished macroscopically, while flat (70%), papillary-endophytic (22%) and papillomatous-exophytic (8%) types can be distinguished by their growth pattern. Histological-cytological characteristics consist of epithelial hyperplasia (hyperkeratosis with ortho- or parakeratosis; akanthosis) and epithelial dysplasia (dyskeratosis, basal-cell hyperplasia, loss of polar arrangement of the basal cells, cell polymorphism, increased mitosis rate). No or little dysplasia was demonstrated in 74% of leukoplakias, moderate in 17% and marked in 6%. Carcinoma-in-situ, defined as high-grade dysplasia with additional loss of epithelial layering, was found in 3%. Precancerous leukoplakia (in almost 10% of cases, counting high-grade dysplasias and carcinoma-in-situ) must be delineated as a special group. Numerous correlations were found between dysplastic leukoplakias and oral cavity cancer as regards localisation, age and sex distribution. In the various leukoplakia forms there was an increased incidence of marked stroma reactions and of Candida colonisation with increased degrees of dysplasia.