Читать книгу Oral Pathology in Clinical Dental Practice - Robert E. Marx - Страница 23

The three entities that cause a clinical leukoplakia will appear different:

1. Fibrin: Thin strands of light eosinophilic staining over a wound base with inflammation.

2. Candida: Vertically positioned hyphae with prominent periodic acid-Schiff (PAS) or silver staining on an epithelial surface.

3. Acanthosis/hyperkeratosis:

a. Acanthosis/benign hyperkeratosis: A thickened keratinocyte layer without cellular atypia but with surface keratin.

b. Premalignant dysplasia: Various degrees of epithelial atypia above an intact basement membrane.

c. Carcinoma in situ: Severe epithelial dysplasia with nuclear pleomorphism and abnormal mitotic figures from the basal cell layer to the surface.

d. Verrucous carcinoma: A significant exophytic proliferation as well as a blunted endophytic proliferation of epithelial cells but with an intact basement membrane beneath which most often resides a dense inflammatory response.

e. Invasive carcinoma: Atypical epithelial cells forming bundles and cords through the basement membrane into the underlying tissues.