Oral lichen planus versus epithelial dysplasia: difficulties in diagnosis

Abstract

Hi stopathological diagnosis of oral lichen planus is not easy since some cases of epithelial dysplasia may present traits which are very similar to those from lichen planus. Aim: to compare cell alterations which suggest malignancy present in oral lichen planus with those from epithelial dysplasia. Material and methods: histological cross-sections of oral lichen planus and dysplasia, dyed by hematoxylin-eosin, were analyzed by means of light microscopy. Results: variance analysis (alpha=5%) revealed a statistically significant difference between the average number of cell alterations in the lichen planus (5.83±1.61) and epithelial dysplasia (4.46±1.26). The chi-squared test did not show statistically significant differences between oral lichen planus and epithelial dysplasia in relation to the following cell alterations: increase in nucleus/cytoplasm ratio, nuclear hyperchromatism, irregular chromatin distribution and enlarged nuclei (p>0.05). Conclusion: Some cell alterations which suggest malignancy present in the oral lichen planus may also be found in epithelial dysplasia, impairing its diagnosis and, consequently, stressing the importance of following these patients in the long run.

Suitability/Unsuitability of Cell Proliferation as an Indicator of Malignant Potential in Oral Lichen Planus: an Immunohistochemical Study

“…From statistical point of view and regarding to the similar Ki67 expression rate in OLP and mild dysplastic lesions , it might be possible to consider OLP as a premalignant lesion in the current study but review of literature shows it is not possible to express a definitive idea in this regard as: i) Some inflammatory features in OLP, appeared due to many growth factors released to epithelial cells, might be similar to what is seen in premalignant and malignant lesions especially those features indicating an increase in proliferation (Sousa et al, 2009c); Hence, it seems activating factors for some of cellular mechanisms might be different from each other (such as inflammation vs genetic instability) among the studied groups. Nevertheless, activity outcome for those mechanisms which are evaluated by IHC markers might demonstrate similarly, like nuclear staining.…”

FoxP3+ T regulatory cells in oral lichen planus and its correlation with the distinct clinical appearance of the lesions

“…According to Sousa et al . (), the main histological characteristics of OLP include liquefaction degeneration of the basal layer of the lining epithelium, intense lymphocyte infiltration in the subepithelial region and a normal keratinization pattern of epithelial cells.…”

Comparison among oral lichen planus, lichenoid lesions and proliferative verrucous leukoplakia: a clinicopathological, transversal study

“…This induction of epithelial alterations would not be such as to mimic more severe dysplastic degrees. When moderate or severe dysplasia were present, the cases were classi ed as oral lichenoid lesions [12,15,[18][19][20][21].…”