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Changes and diseases of oral mucosa: Histological terms

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Orthokeratosis

superficial corneous cell layers of the epithelium without nuclei and eosinophilic cytoplasm
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Parakeratosis

superficial corneous cell layers of the epithelium with pyknotic nuclei and eosinophilic cytoplasm

Hyperkeratosis

thickening of the keratin layer

Dyskeratosis

keratinisation of single cells under the stratum corneum

Acanthosis

a type of epithelial hyparplasia with broadening of the stratum spinosum, in particular

Dysplasia

Proliferation of atypical cells showing cytological signs of malignancy (disorders in differentiation, increased mitotic rate, etc.), which lie within the epithelium or replace it (intraepithelial neoplasia; carcinoma in situ). The epithelial stratification is partially or completely disturbed. The demarcation from stroma is ensured by an intact basement membrane. Depending on the degree of atypia, three dysplasia grades are distinguished by histology:

§ Grade 1 (mild)
  • basal cell hyperplasia
  • derangement in basal cell polarity
§ Grade 2 (moderate)
  • basal cell hyperplasia
  • loss of basal cell polarity
  • moderate cellular polymorphism
  • slightly increased mitotic rate
  • scattered dyskeratotic cells
§ Grade 3 (high-grade)
  • basal cell hyperplasia
  • loss of basal cell polarity
  • expressed cellular polymorphism
  • increased mitotic rate
  • numerous dyskeratotic cells
  • derangement in epithelial stratification
  • smooth transition into carcinoma in situ
§ Carcinoma in situ
  • intensified features of high-grade dysplasia
  • loss of epithelial stratification
  • lack of stroma invasion