51. Histopathogenesis of non-HPV-related differentiated oral squamous intraepithelial neoplasia
- Author
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Kien T. Mai, Chi K. Lai, Bernhard Olberg, Muhannad Hassan, and Bibianna Purgina
- Subjects
Male ,Intraepithelial neoplasia ,Pathology ,medicine.medical_specialty ,Histology ,business.industry ,medicine.disease ,Pathology and Forensic Medicine ,Medical Laboratory Technology ,Ki-67 Antigen ,Carcinoma ,medicine ,Carcinoma, Squamous Cell ,Humans ,Female ,Mouth Neoplasms ,sense organs ,Tumor Suppressor Protein p53 ,skin and connective tissue diseases ,business ,Grading (tumors) - Abstract
A study of immunohistopathologic and cytohistopathologic changes of the parabasal/basal layers in the differentiated squamous intraepithelial neoplasia (DSIN) may elucidate the histopathogenesis and reveal changes aiding early diagnosis and grading of the lesion.A total of 55 consecutive resection specimens of nonbasaloid squamous cell carcinoma of the anterior oral cavity and 8 biopsies before resections displaying DSIN in the overlying squamous epithelium were examined.Squamous epithelium that is continuous/immediately adjacent to invasive squamous cell carcinoma (type 1) and the more peripheral (type 2) epithelium of resection specimens displayed consistent changes in the parabasal/basal layers: (A) cytologic atypia with proliferation of parabasal cells with downward expansion causing reactive proliferation of the basal cell layer in the early stage, invading the basal layer in the late stage; (B) disordered nuclear/cytoplasmic arrangement; (C) "Cobblestone" appearance. Immunoreactivity for TP53 and Ki67 was helpful in the diagnosis. The epithelial spectrum of changes decreased as one moved from type 1 to type 2 lesions. Five out of 8 biopsies showed type 1 lesions (followed by resection in a period of 11±6 mo) and 3 showed type 2 lesions (followed by resection in a period of 55±20 mo). In addition, resections were margin positive for type 2 lesions in 5 cases associated with recurrence at the site of resection during a period of 69±9 months.DSIN is characterized by a proliferation of neoplastic parabasal cells with dyskeratosis, downward expansion/pushing of the basal layer with elongation of rete ridges. We proposed grading of DSIN based on the changes of the parabasal/basal layers.
- Published
- 2014