Background: Cancer cells tend to shed from the original tumor site and spread to another part of the body, group together and form a small collection of secondary tumors known as micro-metastatic tumor cells, frequently to lymph nodes in a predictable pattern often unobserved with advanced imaging techniques, that it can only be visible under microscope. Head and neck oral squamous cell carcinoma (HNSCC) has a significant potential for creating such micro-metastasis with higher incidence compared to clinically detected macro-metastasis. Aim: The aim of the study is to detect micro-metastatic lymph node by tumor cells and evaluate an effective method by using routine hematoxylin and eosin stain, Modified Papanicolaou stain and Toluidine blue by serial sectioning. Materials and method: A total of 60 lymph nodes retrospectively obtained from 10 patients diagnosed with oral squamous cell carcinoma who had undergone radical neck dissection, (i.e., three lymph nodes from both of Level I, II for each case), which initially identified as nonmetastatic by routine Hematoxylin and Eosin stain, were subjected to serial sectioning and re-evaluated for detection of micrometastasis. Results: Out of all the sections analyzed only 3 sections in level I and 2 sections in level II stained by Modified Papanicolaou stain showed positivity. Only 4 sections in level I lymph node and 3 sections in level II stained by toluidine blue showed positivity in detecting micro-metastasis. Conclusion: The present study concluded that special stains both toluidine blue and modified Papanicolaou stain are definitely valuable and sensitive in detecting micro-metastasis over Hematoxylin and Eosin stain.

Background Oral squamous cell carcinoma (OSCC) is the sixth most common cancer worldwide accounting for 90% of all malignant oral lesions with high mortality and a five-year survival rate of about 50%. Various studies have shown mast cells regulate carcinogenesis by immunosuppression, angiogenesis enhancement, and promotion of tumor cell mitosis. Aim Hence, the present study was aimed to compare mast cell counts in normal oral mucosa with histological grades of oral squamous cell carcinoma by using toluidine blue stain. Methodology Sixty formalin-fixed, paraffin-embedded tissue samples included 15 well-differentiated, 15 moderately differentiated, and 15 poorly differentiated OSCC, as well as 15 cases of the normal oral mucosa (control), were sectioned and stained with 1% toluidine blue. Results We observed that the mean mast cell (MMC) count was comparatively more in normal mucosa than in various grades of OSCC. It was higher in low-grade OSCC. However, the differences between grades were not statistically significant. Conclusion In the present study, according to the results obtained, the MMC count was significantly decreased in OSCC in comparison with normal oral mucosa. Therefore, it can be assumed that mast cells could serve as an indicator of tumor progression.

Objectives: Squamous cell carcinoma of the oral cavity is the most common aggressive epithelial malignant neoplasm. Its biological behavior is influenced by the host immune cells, such as multifaceted eosinophils, associated with wound healing and tissue damage processes. Their presence within a variety of human cancers raises queries about their role. The infiltrations of tumor stroma by eosinophils are believed to play a significant role in progression of the carcinoma and could be either a potential diagnostic tool for stromal invasion or as a prognostic indicator. Its role in cancer still remains unclear since in the literature, there are very few studies showing improved prognosis and few contradictory studies showing poor prognosis. This study was conducted with an aim to compare the tumor-associated tissue eosinophilia in oral squamous cell carcinoma (OSCC) and normal tissue and to correlate the expression in different grades of carcinoma using a special stain that targets eosinophils exclusively and vividly. Materials and Methods: The study includes 30 samples, six normal, and 24 histopathologically diagnosed with OSCC. 5 μ thick sections were made and stained using special stain and examined under high power (×40), ten consecutive microscopic fields were studied. The average numbers of eosinophils were statistically analyzed. Results: Eosinophil count for carcinoma was higher compared to normal mucosa, but the comparison in different grades of cancer did not show much difference. Conclusion: Since eosinophil count was higher in carcinoma, eosinophil infiltration in dysplastic cases should prompt thorough evaluation for invasiveness.

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