Jaypee Brothers
In Current Chapter
In All Chapters
X
Clear
X
GO
Normal
Sepia
Dark
Default Style
Font Style 1
Font Style 2
Font Style 3
Less
Normal
More
Color Atlas of Oral Cancer
KMK Masthan, N Aravindha Babu, Vidyarani Shyamsundar
CHAPTER 1:
Introduction
CHAPTER 2:
Epidemiology
CHAPTER 3:
Causes of Oral Potentially Malignant Disorder and Cancer
Different Forms of Tobacco Smoking
Chewable Forms of Tobacco
Other Forms of Tobacco
CHAPTER 4:
Clinical Features of Oral Potentially Malignant Disorders
CLINICAL VARIANTS OF LEUKOPLAKIA
Homogenous Leukoplakia
Homogenous thin leukoplakia.
Thick leukoplakia on the buccal mucosa.
Homogenous leukoplakia of the right buccal vestibule.
Large homogenous leukoplakia at the site of tobacco pouching.
Leukoplakia of the tongue. Patient had complain of severe dryness of the mouth.
Erythroleukoplakia—Lesion with mixed white and red areas.
Erythroleukoplakia of the palate in an edentulous patient.
Nonhomogenous leukoplakia involving angle of the mouth.
Large leukoplakia on the buccal mucosa colored red with betel quid chewing.
Leukoplakia of the lower lip in a bidi smoker.
Nodular Leukoplakia
Nodular leukoplakia at the anterior buccal mucosa in a patient with the habit of tobacco chewing.
Nodular leukoplakia with the nonhealing ulcer. Biopsy showed severe dysplasia and early SCC at the region of the ulcer.
Leukoplakia of the Palate
Smokers palate with erosive areas in the soft palate. No candida hyphae were seen in a smear. Biopsy from the palate showed severe dysplasia.
Smokers palate with erosive areas in the soft palate. No candida hyphae were seen in a smear. Biopsy from the palate showed severe dysplasia.
Pseudomembranous candidiasis of the palate. It is very important to differentiate the pseudomembranous candidiasis from the leukoplakia. Pseudomembranous candidiasis can be treated by antifungals, and not a premalignant lesion
Smokers Palate
Smokers palate showing severe hyperkeratinization of the palate.
Smokers palate with erythematous areas. Biopsy from the erythematous area showed moderate dysplasia.
Proliferative verrucous leukoplakia.
Verrucous leukoplakia
Tobacco pouch keratosis
Tobacco pouch keratosis
Tobacco pouch keratosis of the maxillary labial vestibule.
Tobacco pouch keratosis associated with the non-healing ulcer in the gingiva (within the circle). Biopsy from the nonhealing ulcer showed moderately differentiated squamous cell carcinoma.
Erythroplakia
Erythroplakia associated with SCC. First biopsy (from black circle) showed only moderated dysplasia. Repeat biopsy (White circle) showed moderately differentiated SCC. This explains the importance of taking biopsy from the representative site.
Chronic nonhealing ulcer in buccal mucosa of a tobacco quid chewer. Biopsy showed severe dysplasia.
Erythematous proliferative lesion on the hard palate of a bidi smoker. Biopsy showed severe dysplasia.
ORAL SUBMUCOUS FIBROSIS (OSF)
Severe Fibrosis of the Soft Palate
Severe fibrosis of the buccal mucosa (black arrow) and the pterygomandibular raphae (white arrow).
Moderate OSF—very prominent, fibrosed pterygomandibular raphae.
Severe oral submucous fibrosis involving the hard and soft palate.
Severe fibrosis of the soft palate.
Mild OSF. Small homogenous leukoplakia seen on the buccal mucosa.
Inability to fill air in the cheek due to OSF.
Moderate OSF with the blanching of the ventral surface of the tongue and floor of the mouth. Tiny bleeding spots are seen on the ventral surface of the tongue.
Moderate OSF. Erythroplakia (within circle) seen on the posterior buccal mucosa.
OSF with moderately restricted mouth opening.
Same as above patient-OSF with malignant ulcer in the buccal mucosa.
Extreme blanching of buccal mucosa and bald tongue.
Blanching of gingiva and labial mucosa.
Blanching of gingiva and labial mucosa.
Blanching of lower lip.
Blanching seen in the ventral surface of the tongue.
Mouth Opening
Mild reduction of mouth opening in early OSF.
OSF with moderate reduction in mouth opening.
Severe OSF with restricted mouth opening.
Patchy depapillation of the tongue.
Partial depapillation of the tongue in OSF.
Bald tongue due to depapillation.
Bald tongue due to depapillation and tiny vesiculations.
Bald tongue with vesicle (black arrow) and nonhealing ulcer (white arrows) in an edentulous patient.
Blanching of the ventral surface of the tongue in OSF patients.
Restricted movement of the tongue, demonstrated by inability of the tip of the tongue to touch the anterior hard palate.
Actinic chelitis.
LICHEN PLANUS
CHAPTER 5:
Clinical Presentation of Oral Squamous Cell Carcinoma (SCC)
CHAPTER 6:
Histopathology of Oral Precancers
CHAPTER 7:
Histopathology of Squamous Cell Carcinoma
OTHER RARE VARIANTS OF SCC
Spindle Cell Carcinoma
Nests of frank squamous carcinoma intimately admixed with spindle cell elements.
Spindle cells showing fasciculated arrangement of tumor cells.
Adenosquamous Cell Carcinoma
Blend of adenocarcinoma and squamous cell carcinoma within a single tumor mass, adenomatous nature demonstrated by a mucicarmine stain.
Basaloid Squamous Cell Carcinoma
The basaloid component in close association with or involving the surface mucosa frequently demonstrates marked mitotic activity and comedonecrosis in the center of the neoplastic islands.
The basaloid component seen as small, closely arranged, pleomorphic cells with hyperchromatic nuclei and scant cytoplasm in a lobular configuration.
CHAPTER 8:
Metastasis
CHAPTER 9:
Screening for Oral Cancers and Potentially Malignant Disorders
CHAPTER 10:
Diagnosis
Visual examination with vital tissue staining
LUGOL'S IODINE
Visualization Adjuncts
Identafi 3000
Spectroscopy
Elastic scattering spectroscopy
Differential path length spectroscopy
Multimodal snapshot imaging spectrometer
Spectral imaging from invasive carcinoma patient. The lesion in white light. Loss of autofluorescence in the lesion but boundaries are not clear. Spectral analysis done to determine the tissue region (white line) with areas of reduced autofluorescence highlighted (red line).
Fluorescence endoscopy using 5-ALA (5-Aminolevulinic acid)
Images of white light (left) and ALA induced PPIX fluorescence (right) of an oral lesion obtained using a fluorescence endoscopy system.
Hypericin fluorescence endoscope
Representative images of white light (left) and hypericin image (right) of an oral lesion acquired using a fluorescence endoscopy system.
Optical Coherence Tomography (OCT)
Laser confocal endomicroscope
Other advanced diagnostic aids. Laser capture microdissection
In vivo confocal microscope
Confocal Reflectance Microscopy (CRM)
DIAGNOSTIC TESTS
Exfoliative Cytology
Technique of exfoliative cytology using of the oral mucosa using icecream stick.
Picture demonstrating spreading of sample on a slide.
Picture demonstrating smearing of sample on a slide.
Brush Biopsy
The head of the brush is rotated clockwise with firm pressure till the bleeding points appear.
BIOPSY
Punch Biopsy
Scalpel Biopsy
Laser Beam Biopsy
IMAGING
Orthopantomograph (OPG)
Computed Tomography
Bone Scintigraphy with Single Photon Emission CT (SPECT)
Dynamic Contrast Enhanced MRI
CHAPTER 11:
Prevention
CHAPTER 12:
Treatment
ORAL LEUKOPLAKIA
ORAL SUBMUCOUS FIBROSIS
Treatment Details
ORAL LICHEN PLANUS
Asymptomatic Nonulcerative Lichen Planus
Symptomatic Nonulcerative Lichen Planus-Compensatory
Atrophic/Ulcerative Oral Lichen Planus
Severe, Symptomatic Atrophic/Ulcerative Oral Lichen Planus, Unresponsive to Topical
Recalcitrant Oral Lichen Planus
Desquamative Gingivitis
NONPHARMACOLOGICAL MODALITIES
PUVA Therapy
Photodynamic Therapy (PDT)
Laser Therapy
Treatment for Oral Cancer
Stage 0 (Carcinoma in Situ)
Stages I and II
Stages III and IV
Recurrent Oral Cancer
Bibliography
INDEX
TOC
Index
×
Chapter Notes
Save
Clear
