Oral Submucous Fibrosis and Its Relation with Stromal Vascularity: A Systematic Review

Abstract

Oral submucous fibrosis (OSMF) is a chronic progressive, scarring disease affecting oral, oropharyngeal, and sometimes the esophageal mucosa. It is characterized by the progressive fibrosis of the submucosal tissue. The pathogenesis of OSMF has been directly related to the habit of chewing areca nut and its commercial preparation, which is widespread in Indian subcontinent and Southeast Asia. Malignant transformation has been reported in 7%–12% cases of OSMF. Histopathological spectrum of OSMF includes the apparent alterations observed in the epithelium and connective tissue. Vascularity in OSMF has always been a matter of debate. The prevailing concept is that epithelial atrophy occurs due to lack of perfusion. The present systemic review was done to evaluate oral submucous fibrosis and its relation with stromal vascularity.

Evaluation of muscle involvement & degeneration in advanced oral submucous fibrosis using three different stains – a retrospective cross-sectional study

“…Based on the degree of subepithelial hyalinization and fibrosis, OSMF is classified either as very early, early, moderately advanced and advanced OSMF [16]. The classification of OSMF is characterized by the fibro-elastic changes associated with the underlying inflammatory reaction [5,17,18]. These changes are visible as eosinophilic bands (Edema and hyalinization) in routine H&E sections [5,17,18].…”

“…The classification of OSMF is characterized by the fibro-elastic changes associated with the underlying inflammatory reaction [5,17,18]. These changes are visible as eosinophilic bands (Edema and hyalinization) in routine H&E sections [5,17,18]. The very early and early stages of OSMF have a greater number of fibroblasts and fewer collagen fibres [5,17,18].…”

“…These changes are visible as eosinophilic bands (Edema and hyalinization) in routine H&E sections [5,17,18]. The very early and early stages of OSMF have a greater number of fibroblasts and fewer collagen fibres [5,17,18]. As the disease progresses, the cellular content decreases and fibrous content increases.…”

“…As the disease progresses, the cellular content decreases and fibrous content increases. In advanced stages of the disease, there is evidence of extensive hyalinized smooth sheets of collagen fibres with extensive fibrosis and evidence of extensive degeneration of muscle fibres [5,17,18]. In routine H&E staining, hyalinization and fibrosis appear as homogenous glassy eosinophilic bands extending or involving the adjacent skeletal muscle and muscle degeneration appears as loss of striations or irregular striations seen over the skeletal muscle [17,18].…”

“…In advanced stages of the disease, there is evidence of extensive hyalinized smooth sheets of collagen fibres with extensive fibrosis and evidence of extensive degeneration of muscle fibres [5,17,18]. In routine H&E staining, hyalinization and fibrosis appear as homogenous glassy eosinophilic bands extending or involving the adjacent skeletal muscle and muscle degeneration appears as loss of striations or irregular striations seen over the skeletal muscle [17,18]. Although H&E can be used to grade OSMF, use of connective tissue special stains such as Van Gieson and Masson's Trichrome aid in better distinguishing these changes at the earlier stage which in turn helps in accurate grading and management of the advanced OSMF.…”