Most common microscopic features seen in nonneoplastic lesions were basal cell hyperplasia
, squamous metaplasia, glandular and stromal hyperplasia, clear cell change, cystically dilated glands, Corpora amylacea and ischaemic changes.
However, the diagnostic criteria for low-grade dysplasia do not clearly distinguish it from basal cell hyperplasia
. The WHO 2017 classification for oral epithelial dysplasia remains unclear and complicated, and the variable grading systems still make head and neck intraepithelial lesions difficult to interpret.
Odze classified the histological findings of EoE as major: increased eosinophils (greater than 15), eosinophilic microabscesses, superficial layering of the eosinophils, surface sloughing of squamous cells, and degranulation of eosinophils, and minor: "marked" basal cell hyperplasia
, lengthening of the lamina propria papillae, increased intraepithelial lymphocytes and mast cells, increased intracellular edema, and increased lamina propria fibrosis .
Histological examination showed mild dysplasia in the lower half of the squamous epithelium, similar to basal cell hyperplasia
, and irregular extension into the lamina propria [Figure 2]b and [Figure 2]c.
Distinctive focal areas of palisaded hyperchromatic basal cells as well as areas of basal cell hyperplasia
Other changes, including basal cell hyperplasia
(n=11) and squamous metaplasia (n=8), were frequently observed (Fig.
With passage of time, a significant increase (P=0.000) in frequency of basal cell hyperplasia
(90% in group 1 to 100% in group 4) and basal layer atypia (70% in group 1 to 90% in group 4) was observed.
The percentage of Hyal-1 was significantly higher in basal cell hyperplasia
compared with moderate dysplasia (P=0.02), adenomatous hyperplasia (P=0.0001), severe dysplasia (P=0.05), squamous cell carcinoma (P=0.0001), and adenocarcinoma (P=0.0001; Figure 3A).
Post-operative histopathological examination revealed features of Verrucous carcinoma depicting broad bulbous reteridges extending into deeper tissues with basal cell hyperplasia
and mild dysplasia(fig 9).
HGPIN has to be differentiated from prostatic carcinoma, clear cell cribriform hyperplasia (CCCH) and basal cell hyperplasia
. They are typically located in the transition zone and typically although not always sampled on TURP, whereas HGPIN predominates in the peripheral zone.
Basal Cell Hyperplasia
.--Basal cell hyperplasia is also a benign proliferative process that is typically seen in the transition zone; it may be mistaken for HGPIN owing to its basophilic appearance, prominent nucleoli, and mitotic activity that may be seen.
Basal cell hyperplasia
and large vacuolated epithelial cells with a clear cytoplasm are typical.