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.

Morphological spectrum of gastrointestinal tuberculosis.

Introduction: Gastrointestinal tuberculosis (GITB) is a great mimicker and it is often difficult to distinguish GITB from other inflammatory lesions of the intestine. Aim: This study was carried out with the objective of analysing the entire morphological spectrum of GITB. Methods: A total of 110 diagnosed cases of GITB were included in the study. The diagnosis was based on the presence of acid-fast bacilli (AFB) on histology, caseating or non-caseating epithelioid cell granulomas (ECGs), evidence of tuberculosis at other extraintestinal sites, and all of these along with a complete response to anti-tuberculous treatment (ATT). Results: The mean age was 30.9 years with M:F ratio of 1:1. On gross examination, apart from typical tuberculous lesions in the form of transverse ulcers, strictures, hyperplastic lesions and serosal tubercles, intestinal perforation (32.6%) was seen with higher frequency and ischemic bowel was also identified (7.3%). Varied morphological patterns of ECGs in the form of caseating, non-caseating, confluent, discrete and even suppurative granulomas were identified on histopathology. An important finding was the co-existence of different types of granulomas within the same case. In a significant number of cases (44.5%) granulomas were seen in a submucosal location. The predominant type of inflammation seen in the lamina propria was lymphoplasmacytic in 85.5% cases. Conclusion: Pathologists should be aware of the entire spectrum of gross and histopathological features of GITB, so as to avoid misdiagnosis.