Clinicopathologic Study of Tongue Lesions at a Tertiary Care Hospital

Tongue lesions constitute a considerable proportion of oral mucosal lesions. Varying pathologic conditions may affect the tongue of which chronic lesions often necessitate biopsy and histological diagnosis.Most of the studies are based on clinical presentation of tongue lesions or histopathological study of oral cavity lesions as a whole. There are limited studies on clinico-pathologic review of histologically diagnosed tongue lesions which are mostly case specific. Lesions of tongue encompass a diverse spectrum of non-neoplastic and neoplastic entities. Varying pathologic conditions may affect the tongue of which chronic lesions often necessitate biopsy. Clinico-pathological correlation with microscopic examination helps in accurate diagnosis and management of patients.METHODSThis retrospective study included 192 tongue biopsies, and was conducted over a period of one year from January 2018 to December 2018 at a tertiary ENT hospital. Data on age, gender, tobacco usage, site distribution, type of lesion and histological diagnosis was analysed. RESULTSTongue lesions were seen in 133 males and 59 females. The predominant age group affected was the 5th decade of life accounting for 40 cases (20.8%). Biopsies of ulceroproliferative type of lesions were most commonly submitted. Neoplastic lesions constituted 137 cases (71.3 %) of total cases of which well differentiated squamous cell carcinoma was the most common malignant lesion accounting for 85 cases (44.2%). Using the WHO ICD-O code for topography of lesions, the tongue lateral border (ICD-O-2.1) was the most commonly affected site in the present study.CONCLUSIONSTongue lesions are relatively common in our environment with male predilection, above 40 years age group, strong association with tobacco usage, a predominance of neoplastic lesions, predilection for the lateral border of the tongue and squamous cell carcinoma as the most common histological diagnosis. The high frequency of tongue involvement emphasizes the importance of early adequate biopsy of elementary lesion. Histological characterization can help the clinician in planning early successful management of cases.

Lesions of Tongue : A Five Year Experience.

Context: Tongue lesions are quite common and affect both genders and all age groups. However, very few studies concentrate on the histopathological spectrum of tongue lesions, usually including them as a part of oral cavity lesions. No such study has been published from the newly formed state of Uttarakhand. Aim: A retrospective review of histopathology of various types of tongue lesions in different age groups of both genders, amongst cases reported in the department of pathology. Methods and Materials: Study included a total of 121 cases of tongue lesions reported in the histopathology section over a duration of five years, from July 2004 to June 2009. Result: In this study, the most common lesions were malignant (58.7%), followed by benign lesions (33%) and pre-malignant lesions (8.3%). The most common site for tongue lesions was base of tongue (52.8%). Common age groups affected were 41- 50 years (27.2%) and 51-60 years (28.0%). The most common clinical presentation was growth and induration. Overall males were affected more than females; with Male:Female ratio of 3.3:1. Conclusions: The commonest tongue lesion in this study was moderately differentiated squamous cell carcinoma among the malignant lesions whereas chronic inflammation was the commonest out of non-malignant lesions. Tongue may show some less common tumours like schwannoma and hemangioma etc.

Common Superficial Tongue Lesions.

The tongue is an important structure in the oral cavity and the strongest muscular organ in the body involved in critical functions of taste, speaking, chewing and swallowing. The basic anatomy of tongue is such that unless scrupulous dental hygiene is followed it may lead to pathological lesions. Since the earliest days of medicine, the tongue has been considered a good reflection of systemic diseases. Assessment of the tongue has historically been an important part of a clinical medical examination as many pathological lesions are seen exclusively on the tongue. Lesions occurring on the tongue are vast and range from developmental disorders to infections to idiopathic lesions to malignancies; some lesions may be clues to the underlying systemic illness. General practitioners/physicians and dentists regularly come across such lesions on tongue in their day-to-day practice. A basic and through knowledge of the commonly occurring lesions on the tongue may enlighten the general practitioner in regards to the diagnosis and thereby help in the most effective management of the patients. Uniform diagnostic criteria may heighten the level of clinical diagnosis. Most lesions occurring on tongue heal fast owing to the rich blood supply and if a lesion fails to heal within 10-14 days it must be biopsied and/or further evaluation is necessary for an appropriate diagnosis.