Role of exfoliative cytology in oral lesions: with special reference to rule out malignancy

Abstract

Oral malignancy is quite common in country like India because of tobacco chewing and smoking. Cytology is cheaper and easy procedure that can be carried out at outdoor patient department to diagnose malignancy at early stage. The present study carried out to detect cancer pre-invasive stage by use of exfoliative cytology and to explore the possibility of using this technique in diagnosis of other oral lesions considered as premalignant Two smears by scrap method, from each patient were prepared and after air dried stained with RAPID PAP stain. The smear were evaluated along with clinical, epidemiological data and classified in group I to IV according to the Papanicolaou classification.In our result 25 cases were normal. 47 were Leukoplakia with mean age 47.5 years, 85% male. Smear show anucleated squames predominantly 53%. Six cases were submucous fibrosis 66.7% female with mean age 38.3 years and, smear revealed rarification of nuclei in 66% cases. Two cases of mucosal hyperemia (Erythema), one-one case of traumatic ulcer and granular buccal mucosa included. Out of Twenty cases of malignancy, male were 75% with mean age of 46 year. Cheek and tongue were the common site with incidence of 60%. The smear revealed inflammatory cells in 100%, malignant cells in 75% cases either in groups or in singles. The third type of cells 60%, the undifferentiated cells 37%, and Tadpole cells in 5% cases. In study 75% cases were positive for cancer, 10% were suspicious for cancer and remaining 15% were given as negative for cancer.Cytology is reliable diagnostic tool in diagnosis of presence or absence of malignancy in a lesion with high accuracy rate. The oral cytologic technique is easy to do and can provide the help of surgeon/physician, where he/she might hesitate to perform an invasive procedure, like a biopsy, or desire more information regarding a lesion before referring the patient.

Keratinized Tadpole Cells in Human Oral Neoplasm: A Cytodiagnostic Approach

“…in 5 per cent cases. In his study, 75 per cent cases were positive for cancer, 10 per cent were suspicious for cancer and remaining 15 per cent were given as negative for cancer [15]. In a study of pleomorphic adenoma, cytological smears revealed moderately atypical squamous cells, clumps of keratin material, necrosis, inflammatory cells and macrophages along with bland epithelial and myo-epithelial cell in fibromyxoid stroma.…”

Screening of Oral Potentially Malignant Disorders Using Exfoliative Cytology: A Diagnostic Modality

“…In a study from Sudan, cytological analysis of buccal scrapings has been proposed as a useful early diagnostic method for epithelial atypia and malignant oral lesions where nearly 5% of clinically benign appearing mucosal lesions were sampled by this technique and later confirmed by typical scalpel biopsy to represent dysplastic epithelial changes or invasive cancer [ 9 ]. Singh (2010) elucidated the role of exfoliative cytology in determining the cellular atypical features of oral leukoplakia and oral submucous fibrosis [ 4 ]. Kumar et al (2011) observed 69% sensitivity in leukoplakia cases using OEC [ 2 ].…”

“…The smears were then prepared on the slides which were subjected to Papanicolaou stain (Rapid PAP kit) and analyzed microscopically for the evaluation of the cytomorphological features. They were classified according to Papanicolaou's classification (1960) as follows: Class I (normal): only normal cells observed; Class II (atypical): presence of minor atypia but no evidence of malignancy; Class III (intermediate): an in-between cytology (the cells display wide atypia that may be suggestive of malignancy but are not clear cut cancer and represent precancerous lesions or in situ carcinoma); Class IV (suggestive of cancer): a few epithelial cells with malignant characteristics or cells with borderline characteristics; Class V: positive cancer cells that are obviously malignant [ 4 ].…”

Changes in Exfoliative Cell of Oral Mucosa in Kidney Transplant Patients

“…Before and after 12 months transplantation, smears were taken from areas of oral mucosa in patients using a cytobrush and transferred onto clean, dry glass slides. These slides were then immediately rinsed in fixative containing 95% ethyl alcohol for 10 minutes and then stained using the Papanicolaou technique [9].…”