Oral leukoplakia - Is biopsy at the initial appointment a must?

Sunil Mutalik, Vimi S. Mutalik, Keerthilatha M. Pai, Venkatesh G. Naikmasur, Khoo Suan Phaik

Research output: Contribution to journalArticle

1 Citation (Scopus)

Abstract

Background: Oral leukoplakia is a potentially malignant disorder of the oral cavity. Leukoplakias with chances of undergoing malignant transformation owing to the presence of dysplastic changes may not be clinically distinguishable from leukoplakias without dysplasia. The study was carried out to evaluate the usefulness of biopsy in assessing the clinico-pathologic correlations of oral leukoplakia at the patient's initial visit. Materials and Methods: Hospital records with clinical diagnosis of oral leukoplakia were retrospectively analysed. All these patients had undergone biopsy in their initial visit. Histopathological slides were reviewed and reported by a single pathologist. Diagnosis agreement was considered to be present if the clinical diagnosis matched the histopathological diagnosis. Misdiagnosis was considered if the clinical diagnosis did not match the histopathological diagnosis and underdiagnosis when malignancy was detected on histopathological examination. Results: A total of 115 patients were clinically diagnosed with oral leukoplakia. According to clinical appearance of the leukoplakia patch was categorized in to three types viz homogeneous leukoplakia (n= 24 i.e. 20.87%), speckled leukoplakia (n=76 i.e. 66.08%) and verrucous leukoplakia (n=15 i.e. 13.04%). Histopathological examination confirmed clinical diagnosis in 88 cases (a diagnosis agreement of 76.52%). Histopathological examination of 19 cases revealed a different diagnosis, thus categorized as misdiagnosis (16.52%) and 8 cases had unexpected malignancy which accounted for underdiagnosis in 6.96% cases. There was dysplasia in 45 (51.13%) of the histopathologically confirmed cases of leukoplakia. Conclusion: The clinical appearance of suspicious white lesions does not provide a true nature of its disease status and malignant changes may be missed.

Original languageEnglish
JournalJournal of Clinical and Diagnostic Research
Volume8
Issue number8
DOIs
Publication statusPublished - 01-01-2014

Fingerprint

Oral Leukoplakia
Biopsy
Leukoplakia
Appointments and Schedules
Diagnostic Errors
Hospital Records
Mouth
Neoplasms

All Science Journal Classification (ASJC) codes

  • Clinical Biochemistry

Cite this

Mutalik, Sunil ; Mutalik, Vimi S. ; Pai, Keerthilatha M. ; Naikmasur, Venkatesh G. ; Phaik, Khoo Suan. / Oral leukoplakia - Is biopsy at the initial appointment a must?. In: Journal of Clinical and Diagnostic Research. 2014 ; Vol. 8, No. 8.
@article{ce269a4776474d11adf683c447ca6a9d,
title = "Oral leukoplakia - Is biopsy at the initial appointment a must?",
abstract = "Background: Oral leukoplakia is a potentially malignant disorder of the oral cavity. Leukoplakias with chances of undergoing malignant transformation owing to the presence of dysplastic changes may not be clinically distinguishable from leukoplakias without dysplasia. The study was carried out to evaluate the usefulness of biopsy in assessing the clinico-pathologic correlations of oral leukoplakia at the patient's initial visit. Materials and Methods: Hospital records with clinical diagnosis of oral leukoplakia were retrospectively analysed. All these patients had undergone biopsy in their initial visit. Histopathological slides were reviewed and reported by a single pathologist. Diagnosis agreement was considered to be present if the clinical diagnosis matched the histopathological diagnosis. Misdiagnosis was considered if the clinical diagnosis did not match the histopathological diagnosis and underdiagnosis when malignancy was detected on histopathological examination. Results: A total of 115 patients were clinically diagnosed with oral leukoplakia. According to clinical appearance of the leukoplakia patch was categorized in to three types viz homogeneous leukoplakia (n= 24 i.e. 20.87{\%}), speckled leukoplakia (n=76 i.e. 66.08{\%}) and verrucous leukoplakia (n=15 i.e. 13.04{\%}). Histopathological examination confirmed clinical diagnosis in 88 cases (a diagnosis agreement of 76.52{\%}). Histopathological examination of 19 cases revealed a different diagnosis, thus categorized as misdiagnosis (16.52{\%}) and 8 cases had unexpected malignancy which accounted for underdiagnosis in 6.96{\%} cases. There was dysplasia in 45 (51.13{\%}) of the histopathologically confirmed cases of leukoplakia. Conclusion: The clinical appearance of suspicious white lesions does not provide a true nature of its disease status and malignant changes may be missed.",
author = "Sunil Mutalik and Mutalik, {Vimi S.} and Pai, {Keerthilatha M.} and Naikmasur, {Venkatesh G.} and Phaik, {Khoo Suan}",
year = "2014",
month = "1",
day = "1",
doi = "10.7860/JCDR/2014/8717.4659",
language = "English",
volume = "8",
journal = "Journal of Clinical and Diagnostic Research",
issn = "2249-782X",
publisher = "Journal of Clinical and Diagnostic Research",
number = "8",

}

Oral leukoplakia - Is biopsy at the initial appointment a must? / Mutalik, Sunil; Mutalik, Vimi S.; Pai, Keerthilatha M.; Naikmasur, Venkatesh G.; Phaik, Khoo Suan.

In: Journal of Clinical and Diagnostic Research, Vol. 8, No. 8, 01.01.2014.

Research output: Contribution to journalArticle

TY - JOUR

T1 - Oral leukoplakia - Is biopsy at the initial appointment a must?

AU - Mutalik, Sunil

AU - Mutalik, Vimi S.

AU - Pai, Keerthilatha M.

AU - Naikmasur, Venkatesh G.

AU - Phaik, Khoo Suan

PY - 2014/1/1

Y1 - 2014/1/1

N2 - Background: Oral leukoplakia is a potentially malignant disorder of the oral cavity. Leukoplakias with chances of undergoing malignant transformation owing to the presence of dysplastic changes may not be clinically distinguishable from leukoplakias without dysplasia. The study was carried out to evaluate the usefulness of biopsy in assessing the clinico-pathologic correlations of oral leukoplakia at the patient's initial visit. Materials and Methods: Hospital records with clinical diagnosis of oral leukoplakia were retrospectively analysed. All these patients had undergone biopsy in their initial visit. Histopathological slides were reviewed and reported by a single pathologist. Diagnosis agreement was considered to be present if the clinical diagnosis matched the histopathological diagnosis. Misdiagnosis was considered if the clinical diagnosis did not match the histopathological diagnosis and underdiagnosis when malignancy was detected on histopathological examination. Results: A total of 115 patients were clinically diagnosed with oral leukoplakia. According to clinical appearance of the leukoplakia patch was categorized in to three types viz homogeneous leukoplakia (n= 24 i.e. 20.87%), speckled leukoplakia (n=76 i.e. 66.08%) and verrucous leukoplakia (n=15 i.e. 13.04%). Histopathological examination confirmed clinical diagnosis in 88 cases (a diagnosis agreement of 76.52%). Histopathological examination of 19 cases revealed a different diagnosis, thus categorized as misdiagnosis (16.52%) and 8 cases had unexpected malignancy which accounted for underdiagnosis in 6.96% cases. There was dysplasia in 45 (51.13%) of the histopathologically confirmed cases of leukoplakia. Conclusion: The clinical appearance of suspicious white lesions does not provide a true nature of its disease status and malignant changes may be missed.

AB - Background: Oral leukoplakia is a potentially malignant disorder of the oral cavity. Leukoplakias with chances of undergoing malignant transformation owing to the presence of dysplastic changes may not be clinically distinguishable from leukoplakias without dysplasia. The study was carried out to evaluate the usefulness of biopsy in assessing the clinico-pathologic correlations of oral leukoplakia at the patient's initial visit. Materials and Methods: Hospital records with clinical diagnosis of oral leukoplakia were retrospectively analysed. All these patients had undergone biopsy in their initial visit. Histopathological slides were reviewed and reported by a single pathologist. Diagnosis agreement was considered to be present if the clinical diagnosis matched the histopathological diagnosis. Misdiagnosis was considered if the clinical diagnosis did not match the histopathological diagnosis and underdiagnosis when malignancy was detected on histopathological examination. Results: A total of 115 patients were clinically diagnosed with oral leukoplakia. According to clinical appearance of the leukoplakia patch was categorized in to three types viz homogeneous leukoplakia (n= 24 i.e. 20.87%), speckled leukoplakia (n=76 i.e. 66.08%) and verrucous leukoplakia (n=15 i.e. 13.04%). Histopathological examination confirmed clinical diagnosis in 88 cases (a diagnosis agreement of 76.52%). Histopathological examination of 19 cases revealed a different diagnosis, thus categorized as misdiagnosis (16.52%) and 8 cases had unexpected malignancy which accounted for underdiagnosis in 6.96% cases. There was dysplasia in 45 (51.13%) of the histopathologically confirmed cases of leukoplakia. Conclusion: The clinical appearance of suspicious white lesions does not provide a true nature of its disease status and malignant changes may be missed.

UR - http://www.scopus.com/inward/record.url?scp=84907321485&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=84907321485&partnerID=8YFLogxK

U2 - 10.7860/JCDR/2014/8717.4659

DO - 10.7860/JCDR/2014/8717.4659

M3 - Article

AN - SCOPUS:84907321485

VL - 8

JO - Journal of Clinical and Diagnostic Research

JF - Journal of Clinical and Diagnostic Research

SN - 2249-782X

IS - 8

ER -