September 1997, Volume 3, Issue 3, Pages 148 – 152

Paper

Potentially malignant epithelial oral lesions: discrepancies between clinical and histological diagnosis MA Onofre, MR Sposto, CM Navarro, MESFM Motta, E Turatti & RT Almeida Oral Medicine Service, Department of Diagnosis and Surgery, School of Dentistry of Araraquara, UNESP, 14801-903 Araraquara, SP, Brazil

Keywords

leukoplakia;   lichen planus;   diagnostic errors;   discrepancy index;   oral diagnosis

Abstract

OBJECTIVE: To evaluate the discrepancy index between the clinical and histological diagnosis and the prevalence of epithelial dysplasia and carcinoma in 45 patients with potentially malignant epithelial oral lesions (PMEL). PATIENTS AND METHODS: We submitted 45 patients with PMEL to clinical examination and obtained a biopsy from each. The results of histological diagnosis were compared to the clinical diagnosis. RESULTS: Clinical diagnosis showed that the most common PMEL was leukoplakia followed by lichen planus and by actinic cheilitis associated with leukoplakia. The most common site was the buccal mucosa. Histological diagnosis revealed that 46.7% of the PMEL were lichen planus. The discrepancy index between clinical and histological diagnosis was 24.4%. The higher discrepancy index occurred among leukoplakias. The prevalence of epithelial dysplasia and carcinoma was 17.8%. CONCLUSIONS: We conclude that all PMEL should be submitted to a microscopic analysis because the discrepancy between clinical and histological diagnosis was present in a quarter of these lesions. Otherwise, the epithelial dysplasia and carcinoma were more frequent in the leukoplakias.

Received 17 December 1996; Accepted 23 March 1997

^© Macmillan Publishers Ltd 1997