Pathology of Idiopathic Leukoplakia
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Questions and Answers

What is the term used to describe a red patch on the oral mucosa that cannot be attributed to any other diagnosable condition?

  • Erythroplakia (correct)
  • Actinic Keratosis
  • Lichen Planus
  • Candidal leukoplakia

    • What percentage of erythroplakia cases show severe dysplastic changes or carcinoma in situ?

  • 20%
  • 60%
  • 80%
  • 40% (correct)

    • What is the term used to describe a white plaque superimposed by candidal infection?

  • Erythroplakia
  • Candidal leukoplakia (correct)
  • Lichen Planus
  • Actinic Keratosis

    • What is the term used to describe a condition caused by chronic sun exposure?

    <p>Actinic Keratosis</p> Signup and view all the answers

    What is the term used to describe a condition that appears as bright red patches with velvety texture and irregular outline?

    <p>Erythroplakia</p> Signup and view all the answers

    What percentage of erythroplakia cases are squamous cell carcinoma?

    <p>50%</p> Signup and view all the answers

    What is the term used to describe a condition that appears as white plaques superimposed by candidal infection?

    <p>Candidal leukoplakia</p> Signup and view all the answers

    What is the term used to describe a condition that appears as a patch on the oral mucosa?

    <p>Erythroplakia</p> Signup and view all the answers

    What is the term used to describe a condition caused by chronic candidal infection?

    <p>Candidal leukoplakia</p> Signup and view all the answers

    What is the term used to describe a condition that appears as focal white areas representing keratosis intermingling with red patches?

    <p>Erythroplakia</p> Signup and view all the answers

    Study Notes

    Idiopathic Leukoplakia

    • 15% of cases may undergo malignant transformation to verrucous carcinoma or squamous carcinoma
    • Characterized by a verrucous and hyperorthokeratinized surface with so-called epithelial crypts
    • epithelial cells extend below the level of the adjacent normal basement membrane, suggesting early development of verrucous carcinoma

    Histologic Changes in Idiopathic Leukoplakia

    • Vary from hyperkeratosis to dysplasia
    • May exhibit abnormal epithelial growth and hyperorthokeratosis or hyperparakeratosis
    • Graded as mild, moderate, or severe
    • Mild dysplasia: alteration limited to the basal and parabasal layers
    • Moderate dysplasia: involvement from the basal layer to the mid-portion of the prickle cell layer
    • Severe dysplasia: involvement from the basal layer to a level above the midpoint of the epithelium

    Invasive Carcinoma

    • Begins when a focus of epithelial cells invades the lamina propria
    • Spreads in a lateral direction, 1-2 mm beyond the basal lamina
    • Characterized by loss of polarity, loss of epithelial cell cohesiveness, and abnormal mitotic figures

    Cytological Changes in Idiopathic Leukoplakia

    • At low power:
      • Loss of polarity
      • Loss of epithelial cell cohesiveness
      • Bulbous or teardrop-shaped rete ridges and basal cell hyperplasia
      • Keratin or epithelial pearls
      • Loss of stratification
    • At high power:
      • Enlarged nuclei and cells
      • Pleomorphic nuclei and cells
      • Hyperchromatic nuclei
      • Abnormal nuclear-cytoplasmic ratio
      • Dyskeratosis
      • Large and prominent nucleoli
      • Increased mitotic activity
      • Abnormal mitotic figures

    Other Types of Leukoplakia

    • Candidal leukoplakia: a white plaque superimposed by candidal infection
    • Lichen planus: ???????????
    • Actinic keratosis (solar keratosis): ???????????
    • Actinic cheilosis (actinic chelitis, solar chelosis): ???????????
    • Erythroplakia: a red patch on the oral mucosa that cannot be attributed to any other diagnosable condition

    Erythroplakia

    • Etiology: same as oral cancer
    • Clinical features: bright red, velvety texture, homogeneous, irregular outline
    • Histopathologic features: 40% of cases show severe dysplastic changes or carcinoma in situ, 50% of cases are squamous cell carcinoma

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    Description

    Learn about the characteristics and transformations of idiopathic leukoplakia, a precancerous lesion. Discover the surface features and epithelial changes associated with this condition.

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