Verrucous carcinoma of the buccal mucosa: histopathological, cytological and DNA-cytometric features.

We describe a patient with an exophytic oral lesion diagnosed as verrucous carcinoma. The lesion existed without metastases, at least 5 years. Local excisions led to recurrences and continuous expansion. Scalpel biopsies for histopathological and polymerase chain reaction examination were obtained from characteristic regions of the lesion. Brush biopsies for exfoliative cytology (EC) were taken, in order to screen the mucosal area covered by the lesion. After Feulgen restaining of the smears, nuclear DNA contents were measured using a TV image analysis system. An exophytic lesion of the buccal mucosa was diagnosed as low-grade malignant through histopathology and EC combined with DNA-image cytometry (peritetraploid DNA-aneuploidy). Due to almost normal microscopic appearance of the epithelium of verrucous carcinoma, thorough cytological/DNA-cytometric and histological examinations are needed. Brush biopsies of such neoplastic oral lesions showing DNA-aneuploidy with peritetraploid stemlines should be used for diagnosis and follow-up examination of these patients.

Cytologic and DNA-cytometric examination of oral lesions in lichen planus.

BACKGROUND: The aim of the present study was to evaluate the diagnostic value of exfoliative cytology (EC) and DNA image cytometry applied to oral lesions of lichen planus (LP; n = 56), in order to detect or exclude malignant transformation. METHODS: Brush and excisional biopsies were obtained from 56 patients. In cases of oral LP in which brush biopsies were suspicious for tumor cells, nuclear DNA contents were measured, using a TV Image Analysis System. RESULTS: In 50 patients EC yielded tumor cell-negative, doubtful in four cases and suspicious results obtained in two cases. DNA image cytometry revealed DNA-aneuploidy only in the two suspicious cases. The comparison between cytologic/DNA-cytometric diagnosis and biopsy histology resulted in a total agreement (LP without dysplasia: 54 and squamous cell carcinoma in LP: two cases). CONCLUSIONS: In conclusion, cytology with DNA-cytometry is a highly sensitive, specific, and non-invasive method, which can be used for periodical follow up of oral LP lesions in order to early detect or exclude malignancy.

Cytologic and DNA-cytometric follow-up of oral leukoplakia after CO2- and Er:YAG-laser assisted ablation: a pilot study.

BACKGROUND AND OBJECTIVES: The aim of the present pilot study was to determine therapeutic responses to Er:YAG- and CO(2)-laser ablation in patients with oral leukoplakia as evaluated by means of exfoliative cytology (EC) and DNA-image-cytometry (DNA-I). STUDY DESIGN/MATERIALS AND METHODS: Ten patients exhibiting a total of 16 lesions affecting a variety of intraoral sites were randomly treated with either (1) an Er:YAG laser (300 mJ/pulse, 10 Hz, defocused mode) (ERL), or (2) an CO(2) laser (4-6 W, 20-50 Hz, focused mode) (CO). Brush (B) and incisional (I) biopsies were obtained from the respective lesions immediately before treatment (B, I) as well as 24-96 weeks postoperatively (B). In cases, in which EC revealed suspicious cells, nuclear DNA-contents were measured using a TV image analysis system. RESULTS: Both treatment approaches resulted in a complete (C) or partial (P) remission of all investigated lesions. In particular, ERL exhibited C(3), P(5), and CO C(5), P(3). However, in the CO group, two of eight lesions showed a recurrence 32-48 weeks following treatment. Among all investigated lesions, both histological and EC/DNA-I diagnosis revealed no sign of malignancy or dysplasia before or following laser assisted ablation. CONCLUSIONS: Within the limits of the present study, it may be concluded that both treatment approaches seem to have limitations to achieve predictable eradication of oral leukoplakia.