Diagnostic efficacy of deeper sections in routine oral histopathology practice: a retrospective study

Statement of the Problem: Histopathology is a gold standard diagnostic tool for oral lesions. Nonspecific and overlapping microscopic features often pose diagnostic challenges in routine practice. In such conditions, deeper sections have utility to enhance the sensitivity and accuracy of the diagnosis

Purpose: To analyze the percentage of deeper sections requested and to evaluate the diagnostic efficacy of these deeper sections in routine oral histopathology practice. Additionally, the utility of deeper sections in specific oral lesions have also been evaluated

Materials and Method: A total of 850 cases from the archives of Department of Oral Pathology and Microbiology, were analyzed, and 106 cases with deeper sections were selected. Out of 106, 82 cases were accepted for our analysis and 24 were rejected as deeper sections were done due to staining errors or folding of tissue. The present retrospective study involves comparison of initial histological findings with those seen in deeper sections of same specimen

Results: Deeper sections improved the diagnosis of 48 cases [58.54%]. Remaining 31 cases [38%] showed the same histological features, whereas in 3 cases [3.66%], initial sections were good as compared to deeper sections. Out of 22 cases of provisional hyperkeratotic/ dysplastic lesion, 16 [72.72%] showed change in diagnosis, i.e. from mild to severe dysplasia or from dysplasia to carcinoma. A total 12 out of 17 [70.59%] cases of odontogenic lesions were non- diagnostic or showed minimal characteristic features on initial sections, but their deeper sections revealed clearly identifiable features and some of them also showed cystic lesion turning into tumor pathology

Conclusion: This study highlights the diagnostic efficacy of deeper sections and their contribution towards providing accurate and more descriptive features

Basal cell adenoma of palate, a rare occurrence with review of literature

Basal cell adenoma is an uncommon benign epithelial neoplasm of salivary gland which derives its name from the basaloid appearance of tumor cells and accounting for 1-2% of all salivary gland epithelial tumors. This tumor usually arises in the major salivary glands, with the parotid being the most frequent site of occurrence, followed by the upper lip; while it is very rare in the minor salivary glands. Microscopically, it is composed of isomorphic cells similar to basal cells with nuclear palisading. We report a case of BCA presenting as an asymptomatic swelling over the right side of palate of 55-year-old female patient. A follow-up of 1 year revealed no recurrence. This report emphasizes the rare site of occurrence of this tumor and briefly reviews the literature