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Determination of Diagnostic Dilemma at Preoperative Biopsy Diagnosis of Oral Cavity Lesions with Recommendations | Chapter 19 | New Frontiers in Medicine and Medical Research Vol. 14

Background: Oral cavity lesions come in a variety of shapes and sizes, ranging from a plaque to a proliferative growth. Biopsy is an important preoperative diagnostic tool for determining the therapy and degree of surgery for lesions ranging from small tumours to malignancies. It can be difficult for a pathologist to determine the exact nature of a tumour during a biopsy. The purpose of this study was to investigate the role of biopsy in determining the genuine nature of oral cavity lesions, as well as its issues and hazards. The authors discuss their reporting experiences and dilemmas, as well as solutions.

Over a two-year period, all punch biopsies and subsequent surgical resections of the oral cavity received in the department of pathology were evaluated. They underwent routine tissue processing in an automatic tissue processor, section cutting at 4-5 microns, and routine H& E staining. The histopathology was assessed. The WHO classification of Head and Neck Tumors was used to classify all of the tumours. The features provided by many writers in the literature were used to evaluate tumour-like lesions. The oral cavity biopsy's specificity, sensitivity, accuracy, percentage of false negative and positive results, and positive and negative predictive value were all assessed.

The majority of oral cavity lesions, regardless of their origin, appeared as exophytic proliferative growth (83.9 percent ). Biopsy has a diagnosis accuracy of 95.1 percent for evaluating oral cavity lesions. False negative reports accounted for 6.9% of the total. The method's sensitivity and positive predictive value for detecting malignant and premalignant lesions, respectively, were 93.1 percent and 100 percent, while specificity and negative predictive value were 100 percent and 85 percent. The challenge of histopathological assessment was faced in 19 cases.

Conclusion: In order to avoid problems and pitfalls in determining the nature of an oral cavity lesion prior to surgery, the reporting pathologist should exercise extreme caution in properly orienting and processing the tiny oral cavity biopsies, be knowledgeable about accurate definitions, characteristic features, and criteria of malignancy, and work closely with the treating surgeon.


Author (S) Details

Madhu I. Chaturvedi
Pathology department, LTM Medical College and General Hospital Sion, Mumbai, India.

Arshad K. Pathan
Pathology department, LTM Medical College and General Hospital Sion, Mumbai, India.


View Book :- https://stm.bookpi.org/NFMMR-V14/article/view/3401

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