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Demystifying oral epithelial dysplasia: a histological guide
Paul Hankinson1, Hanya Mahmood2, Hannah Walsh1
1Unit of Oral and Maxillofacial Pathology, School of Clinical Dentistry, University of Sheffield, England, UK.
Pathology
|November 29, 2023
Summary
Diagnosing oral epithelial dysplasia, a premalignant condition, is challenging due to poorly defined features and inconsistent grading. This review clarifies diagnostic criteria and mimics to improve accuracy in identifying oral dysplasia.
Area of Science:
- Oral Pathology
- Histopathology
- Oncology
Background:
- Oral epithelial dysplasia is a potentially premalignant condition of the oral mucosa.
- It carries a risk of malignant transformation into squamous cell carcinoma.
- Current diagnosis and grading are challenging, leading to poor inter- and intra-examiner agreement.
Purpose of the Study:
- To discuss the 28 features of oral epithelial dysplasia as listed in the WHO classification.
- To provide suggested definitions for these features and highlight common mimics.
- To offer insights for refining diagnostic criteria and simplifying the grading of oral epithelial dysplasia.
Main Methods:
- Review of the 28 histological features of oral epithelial dysplasia.
- Discussion of subjective interpretations and lack of evidence-based definitions.
- Inclusion of examples and common mimics of oral epithelial dysplasia.
Main Results:
- The 28 features of oral epithelial dysplasia are poorly defined and subjective.
- There is a paucity of evidence defining these features and their contribution to grading.
- Normal histological features and other conditions can mimic oral epithelial dysplasia.
Conclusions:
- Clearer definitions and refined diagnostic criteria are needed for oral epithelial dysplasia.
- Simplifying the identification of key features will improve diagnostic accuracy.
- This review aims to aid pathologists in the diagnosis and grading of oral epithelial dysplasia.
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