Oral leukoplakias: clinical-histopathologic relation

Abstract

The relation between the clinical aspects and histologic characteristics of oral leukoplakias was evaluated on 28 adult patients presenting with oral leukoplakia. The lesions were clinically classified as homogeneous and nonhomogeneous, and divided regarding their histopathologic characteristics in six groups: hyperkeratosis without epithelial dysplasia; mild epithelial dysplasia; moderate epithelial dysplasia; severe epithelial dysplasia, squamous cell carcinoma in situ and invasive carcinoma. Homogeneous leukoplakia comprised 78.6% of the cases and nonhomogeneous, 21.4%. Microscopically, 32.2% of the lesions disclosed hyperkeratosis without evidences of epithelial dysplasia, 53.5% epithelial dysplasia (39.3% mild, 7.1% moderate, and 7.1% severe) and 14.3% invasive carcinoma. Homogeneous leukoplakia showed discreet histologic changes, while nonhomogeneous lesions evidenced histologic characteristics of severe epithelial dysplasia and even of invasive carcinoma. The results suggest great precaution in the diagnosis and follow-up of leukoplakia, considering the possibility of malignant transformation.