Eldhose KG1, Stephen Paul1, Sunil Shivani 2, Kuttappan Smitha 2

1-Department of Oral and Maxillofacial Surgery, Annoor Dental College and Hospital, Muvattupuzha

2-Department of Oral and Maxillofacial Pathology, Annoor Dental College and Hospital, Muvattupuzha

Running title – Epithelial Dysplasia

Received: 02-11-2023

Revised: 07-11-2023

Accepted: 18-11-2023

Address for correspondence: Dr. Smitha Kuttapan, Post graduate, Department of Oral and Maxillofacial Pathology, Annoor Dental College and Hospital, Muvattupuzha, 686673

Email ID: drsmithakop@gmail.com

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How to cite this article: Eldhose K G, Stephen P, Sunil S, Kuttappan S. Moderate Epithelial Dysplasia- A Case Report. J Oral Biomed Sci 2023; 2(3):139-140

Abstract

Lesions presenting as speckled leukoplakia exhibit both red and white areas. Speckled leukoplakia, though rare, carries the highest risk of malignancy among leukoplakia types

 Key words: Ventral aspect of tongue, speckled, white lesion

 Case report: A 54-year-old male patient reported with a white and red patch on the ventral aspect of the tongue in relation to 34 and 35 with thick white area. History of trauma from adjacent teeth.

 On Examination: White and red patches seen on the ventral aspect of the tongue in relation to 34,35.

FIGURE 1: Clinical picture (white and red patch on ventral surface of tongue in relation to 34,35 of size 1.5-2cm)

 Diagnosis:

Incisional biopsy Diagnosis- Severe epithelial dysplasia

Excisional biopsy Diagnosis- Moderate epithelial dysplasia with suture granuloma

FIGURE 2: Histopathological diagnosis (incisional biopsy) was severe epithelial dysplasia (10x)

FIGURE 3: Histopathological diagnosis (Excision biopsy) was moderate epithelial dysplasia (10x)

 

FIGURE 4: On excisional biopsy suture granuloma (red arrows) in the connective tissue (10x)


FIGURE 5: Foci of foreign material bordered by chronic granulation tissue(10X)

 

FIGURE 6: Foreign body giant cells (red arrow) engulfing foreign material (yellow arrow) seen along with epithelioid macrophages and lymphocytes (40x)

Discussion:

Our case presented with a suture granuloma during the excision biopsy along with dysplastic changes Suture granulomas are localised inflammatory reactions that develop at the site of retained suture material, triggered by suture antigenicity or bacterial infection. While braided silk and Dacron are highly reactive, any suture material can induce a reaction. These granulomas may be superficial, presenting early, or deep, manifesting later. They can emerge months or years post-intervention and can occur anywhere in the body. While often asymptomatic, they may become palpable and tender, resembling a tumor, abscess, or perforation.

Conflict of interest: None

Source of support: Nil

References:

  1. Eladawi S, Ragab A, Kayed M, Elsabaa B, Khaled M. Suture granuloma extending intra-abdominally, detected five months postappendectomy. BJR| case reports. 2021 Sep 1;7(5):20200191.
  2. Singh SK, Kannan N, Talwar R, Tyagi AK, Madan R, Jaiswal P, et al.. Suture granuloma: a rare differential diagnosis of residual/recurrent gastrointestinal stromal tumor of stomach. Int Cancer Conf J 2016; 5

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