Characterization of Clinical and Histopathological Profiles of Oral Potentially Malignant Disorders With Oral Epithelial Dysplasia: Focus on Subepithelial Lymphoplasmacytic Infiltrate and Its Grading

Abstract

ABSTRACT Objectives This study was conducted to describe the clinical and histopathological features of OPMDs characterized by OED with a special focus on the subepithelial LPI and its grades. Material and Methods This cross‐sectional study was conducted on hematoxylin and eosin‐stained slides of 82 diagnosed cases of OPMDs with OED. Histologic review was performed based on the WHO and binary grading system for OED. Subepithelial LPI and its grades were also noted and reported. χ 2 test and Fisher's exact test were used to compare different categorical variables related to OPMDs. Results The mean age of OPMD cases with OED was 58.51 ± 12.38, with a male‐to‐female ratio of 2.28:1. OED lesions were mostly (N = 41; 50%) seen on the buccal mucosa, retromolar area, and vestibule of the oral cavity. Oral leukoplakia was the most (N = 52; 63.4%) commonly diagnosed clinical variant of OPMDs. Drop‐shaped rete ridges (N = 78; 95.12%) and hyperchromasia (N = 76; 92.68%) were the most commonly occurring architectural and cellular alterations of OED, respectively. The overall interobserver agreement for various histopathologic variables ranged from moderate to perfect. Histologically, moderate dysplasia was the most frequently occurring grade (N = 37; 45.12%). Most (N = 45; 54.9%) of the OPMDs were marked as high‐risk dysplasia. Subepithelial LPI was significantly (p < 0.01) related to the histologic grades of OED lesions. The grades of LPI were significantly (p = 0.018) related to the binary grading system only. Conclusion The subgrades of LPI were significantly associated with the binary grading system of OED, suggesting that subepithelial LPI may reflect underlying microenvironmental changes related to dysplasia severity.