Oral Epithelial Dysplasia, Atypical Verrucous Lesions and Oral Potentially Malignant Disorders: Focus on Histopathology

Publication date: Available online 1 March 2018
Source:Oral Surgery, Oral Medicine, Oral Pathology and Oral Radiology
Author(s): Susan Müller
Oral potentially malignant disorders (OPMD) describe a recognizable group of mucosal diseases that have a risk of squamous cell cancer development. Oral leukoplakia, the most common OPMD, has a 1% prevalence and reported malignant transformation rates of 2-5%. Other OPMD include erythroplakia, erythroleukoplakia, submucous fibrosis, lesions of reverse smokers, as well as inherited genetic disorders such as Fanconi anemia. The histopathologic assessment of OPMD is an area of subjectivity and oral epithelial dysplasia is fraught with both inter-rater and intra-rater variability. Both architectural and cytologic changes are utilized when developing criteria for grading oral epithelial dysplasia. However, the concept of atypical verrucous lesions, particularly as it pertains to proliferative verrucous leukoplakia suffers from a lack of histopathologic diagnostic criteria. Histopathologic mimics of OPMD including reactive/regenerative epithelium, frictional keratosis, and infection can result in patient mismanagement. This review will focus specifically on the histologic features of oral epithelial dysplasia, including human papillomavirus associated dysplasia, as well as the histologic features of atypical verrucous keratoses/hyperplasia, particularly those that arise in the setting of proliferative verrucous leukoplakia along with OPMD mimics.



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