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Oral malignancies associated with negative transepithelial brush biopsy
Tyler J Potter1, Don-John Summerlin, John H Campbell
1Indiana University, Indianapolis, IN 46202, USA.
Summary
Oral brush biopsies can yield false negative results for squamous cell carcinoma, with 3.5% of malignancies initially testing negative. Persistent oral lesions warrant definitive tissue biopsy for accurate diagnosis.
Area of Science:
- Oral pathology
- Oncology
- Diagnostic cytology
Background:
- Oral squamous cell carcinoma (OSCC) is a significant malignancy.
- Brush biopsy is a minimally invasive technique for preliminary oral lesion assessment.
- Accurate diagnosis is crucial for timely OSCC treatment.
Observation:
- A review of OSCC cases from a university oral pathology service was conducted.
- Cases with prior "negative for epithelial abnormality" brush biopsy results were identified.
- The time interval between brush biopsy and definitive diagnosis was analyzed.
Findings:
- 3.5% of OSCC cases (4 out of 115) had initial negative brush biopsy results.
- The average delay between a negative brush biopsy and a definitive OSCC diagnosis was 117.25 days.
- A wide range in the delay period was observed (5 to 292 days).
Implications:
- The oral brush biopsy technique can produce false negative results for OSCC.
- Persistent or suspicious oral lesions require follow-up with tissue biopsy.
- Clinicians should maintain a high index of suspicion for OSCC despite initial negative brush biopsy findings.