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Nobre DAB, Moura MDG, de Arruda JAA, Felix FA, Diniz PB, Duarte ECB, Abreu LG, Gomez RS, Mesquita RA. Identification of Epstein-Barr virus after topical treatment for oral hairy leukoplakia: A preliminary study. Int J STD AIDS 2024; 35:627-634. [PMID: 38606785 DOI: 10.1177/09564624241246298] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/13/2024]
Abstract
BACKGROUND This study evaluated the presence of Epstein-Barr virus type 1 (EBV-1) DNA in patients living with HIV, before and after three different topical therapy protocols for oral hairy leukoplakia (OHL). METHODS The sample consisted of five patients treated with topical solution of 25% podophyllin resin; six with 25% podophyllin resin plus 5% acyclovir cream; and four with 25% podophyllin resin plus 1% penciclovir cream. DNA was extracted from OHL scrapings and amplified by the PCR using specific primers for EBV-1 (EBNA-1). RESULTS Clinical healing of OHL lesions was observed across all treatment groups over time. At baseline, EBNA-1 was detected in all OHL lesions. After treatment, OHL samples from three patients treated with 25% podophyllin resin plus 5% acyclovir cream and from one patient treated with 25% podophyllin resin plus 1% penciclovir cream exhibited negative EBNA-1 viral gene encoding. Despite the clinical resolution of OHL, 11 patients (73.3%) showed EBNA-1 positivity immediately after the lesion disappeared. Three patients (20%) treated with podophyllin resin displayed both EBNA-1 positivity and a recurrence of OHL, in contrast to no recurrence in the other two groups. CONCLUSIONS These findings suggest potential associations between treatment formulations, EBNA-1 persistence, and the recurrence of OHL lesions.
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Affiliation(s)
- Daniel Augusto Barnabé Nobre
- Department of Oral Surgery, Pathology and Clinical Dentistry, School of Dentistry, Universidade Federal de Minas Gerais, Belo Horizonte, Brazil
| | | | - José Alcides Almeida de Arruda
- Department of Oral Surgery, Pathology and Clinical Dentistry, School of Dentistry, Universidade Federal de Minas Gerais, Belo Horizonte, Brazil
| | - Fernanda Aragão Felix
- Department of Oral Surgery, Pathology and Clinical Dentistry, School of Dentistry, Universidade Federal de Minas Gerais, Belo Horizonte, Brazil
| | - Priscilla Barbosa Diniz
- Department of Oral Surgery, Pathology and Clinical Dentistry, School of Dentistry, Universidade Federal de Minas Gerais, Belo Horizonte, Brazil
| | | | - Lucas Guimarães Abreu
- Department of Child and Adolescent Oral Health, School of Dentistry, Universidade Federal de Minas Gerais, Belo Horizonte, Brazil
| | - Ricardo Santiago Gomez
- Department of Oral Surgery, Pathology and Clinical Dentistry, School of Dentistry, Universidade Federal de Minas Gerais, Belo Horizonte, Brazil
| | - Ricardo Alves Mesquita
- Department of Oral Surgery, Pathology and Clinical Dentistry, School of Dentistry, Universidade Federal de Minas Gerais, Belo Horizonte, Brazil
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Diagnosis of Oral Hairy Leukoplakia: The Importance of EBV In Situ Hybridization. Int J Dent 2017; 2017:3457479. [PMID: 28798771 PMCID: PMC5536144 DOI: 10.1155/2017/3457479] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2016] [Revised: 05/29/2017] [Accepted: 06/19/2017] [Indexed: 11/18/2022] Open
Abstract
Oral hairy leukoplakia (OHL) is caused by the Epstein-Barr virus (EBV), which has been related to HIV infection. In situ hybridization (ISH) is the gold-standard diagnosis of OHL, but some authors believe in the possibility of performing the diagnosis based on clinical basis. The aim of this study is diagnose incipient lesions of OHL by EBV ISH of HIV-infected patients and the possible correlations with clinical characteristics of the patients. Ninety-four patients were examined and those presenting with clinical lesions compatible to OHL were submitted to biopsy prior to EBV ISH. Twenty-eight patients had lesions clinically compatible to the diagnosis of OHL, but only 20 lesions were confirmed by EBV ISH. The patients with OHL had a mean age of 41.9 years and were HIV-infected for 11.2 years, on average, including CD4 count of 504.7 cells/mm3 and log10 viral load = 1.1. Among the quantitative variables, there was a statistically significant correlation with age only (P = 0.030). In conclusion, the presence of OHL in patients with HIV/AIDS results in changes in the epidemiological characteristics of the disease, and this fact allied with subtle clinical-morphological features makes clinical diagnosis very difficult. Therefore, EBV ISH is important for a definitive diagnosis of OHL.
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Braz-Silva PH, Santos RTM, Schussel JL, Gallottini M. Oral hairy leukoplakia diagnosis by Epstein-Barr virusin situhybridization in liquid-based cytology. Cytopathology 2013; 25:21-6. [DOI: 10.1111/cyt.12053] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/17/2013] [Indexed: 11/28/2022]
Affiliation(s)
- P. H. Braz-Silva
- Laboratory of Virology; Institute of Tropical Medicine; University of São Paulo; São Paulo Brazil
- Department of Oral Pathology; School of Dentistry; University of São Paulo; São Paulo Brazil
| | - R. T. M. Santos
- Division of Pathology; Adolfo Lutz Institute; São Paulo Brazil
| | - J. L. Schussel
- Department of Oral and Maxillofacial Surgery; Erasto Gaertner Hospital; Curitiba Brazil
| | - M. Gallottini
- Department of Oral Pathology; School of Dentistry; University of São Paulo; São Paulo Brazil
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Braz-Silva PH, Magalhães MHCG, Hofman V, Ortega KL, Ilie MI, Odin G, Vielh P, Hofman P. Usefulness of oral cytopathology in the diagnosis of infectious diseases. Cytopathology 2010; 21:285-99. [PMID: 20629682 DOI: 10.1111/j.1365-2303.2010.00779.x] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/28/2023]
Abstract
In recent years, the incidence of oral opportunistic infections has increased, partly due to the widespread implementation of organ and bone marrow transplantation and the increase in the prevalence of human immunodeficiency virus (HIV) infection. Cytology can be used as a rapid, inexpensive and simple routine procedure in diagnosing infectious diseases of the mouth. Moreover, ancillary methods can be applied to cytological samples, increasing the specificity and sensitivity for the diagnosis of infectious diseases. This review describes the cytopathological features of the main viral, fungal, bacterial and parasitic infections of the mouth. Cytological techniques of specimen collection, identification of infectious agents by cytomorphological approaches and ancillary methods, and diagnostic pitfalls will be discussed.
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Affiliation(s)
- P H Braz-Silva
- Laboratory of Clinical and Experimental Pathology, Pasteur Hospital, University of Nice Sophia Antipolis, Nice, France
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Abstract
Oral hairy leukoplakia (OHL) is a white, hyperplastic, vertically corrugated lesion that occurs on the lateral border of the tongue, usually unilateral. Caused by the Epstein–Barr Virus (EBV), the lesion is said to be an early indicator of an immune deficiency status, thereby unmasking subclinical systemic conditions. OHL mimics many other white lesions of the oral cavity; therefore, it becomes imperative to identify the lesion. This study used exfoliative cytology, a noninvasive procedure, which helped in identifying the cellular changes brought about by the virus in the oral epithelium. The study revealed a subclinical phase of OHL, where the cellular changes were seen even before the appearance of the clinical lesion.
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Affiliation(s)
- Ajay Reginald
- Department of Oral & Maxilofacial Pathology, Narayana Dental College and Hospital, Chinthareddypalem, Nellore, Andhra Pradesh, India
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Mendoza N, Diamantis M, Arora A, Bartlett B, Gewirtzman A, Tremaine AM, Tyring S. Mucocutaneous manifestations of Epstein-Barr virus infection. Am J Clin Dermatol 2009; 9:295-305. [PMID: 18717604 DOI: 10.2165/00128071-200809050-00003] [Citation(s) in RCA: 28] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/02/2022]
Abstract
This review focuses on Epstein-Barr virus (EBV) infection, diagnosis, and current treatment, with emphasis on EBV-associated mucocutaneous manifestations in primary infections, acute EBV-associated syndromes, chronic infections, lymphoproliferative disorders, and lymphomas. In primary infection, EBV infects B cells and can cause mucocutaneous manifestations in infectious mononucleosis or acute EBV-associated syndromes such as Gianotti-Crosti syndrome and hemophagocytic syndrome. EBV then persists in the majority of humans generally without causing disease. In some cases, however, latent EBV infection may result in diseases such as hydroa vacciniforme, hypersensitivity to mosquito bites, and lymphoproliferative disorders such as plasmablastic lymphoma, oral hairy leukoplakia, and post-transplant lymphoproliferative disorders, particularly in immunocompromised patients. Latent EBV infection has also been implicated in a variety of malignant conditions such as Burkitt lymphoma, Hodgkin lymphoma, nasopharyngeal carcinoma, and Kikuchi histocytic necrotizing lymphadenitis. Since the immune system is critical in preventing the progression of EBV disease, the immunologic status of the patient plays a crucial role in the subsequent development of pathologies.
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Robaina TF, Valladares CP, Tavares DS, Napolitano WC, Silva LE, Dias EP, Leite JPG. Polymerase chain reaction genotyping of Epstein-Barr virus in scraping samples of the tongue lateral border in HIV-1 seropositive patients. Mem Inst Oswaldo Cruz 2008; 103:326-31. [PMID: 18660984 DOI: 10.1590/s0074-02762008000400002] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/11/2007] [Accepted: 06/10/2008] [Indexed: 11/22/2022] Open
Abstract
The Epstein-Barr virus (EBV) is the etiological agent of oral hairy leukoplakia (OHL), an oral lesion with important diagnostic and prognostic value in acquired immunodeficiency disease syndrome. The two EBV genotypes, EBV-1 and EBV-2, can be distinguished by divergent gene sequences encoding the EBNA-2, 3A, 3B, and 3C proteins. The purpose of this study was to identify the EBV genotype prevalent in 53 samples of scrapings from the lateral border of the tongue of HIV-1 seropositive patients, with and without OHL, and to correlate the genotypes with presence of clinical or subclinical OHL with the clinic data collected. EBV-1 and EBV-2 were identified through PCR and Nested-PCR based on sequence differences of the EBNA-2 gene. EBV-1 was identified in the 31 samples (15 without OHL, 7 with clinical OHL and 9 with subclinical OHL), EBV-2 in 12 samples (10 without OHL, 1 with clinical and 1 subclinical OHL), and a mixed infection in 10 samples (2 without OHL, 3 with clinical and 5 with subclinical OHL). The presence of EBV-1 was higher in women, but a significant statistical result relating one the EBV genotypes to the development of OHL was not found. We conclude that the oral epithelium in HIV-1 seropositive patients can be infected by EBV-1, EBV-2 or by a mixed viral population.
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Affiliation(s)
- T F Robaina
- Instituto de Matemática, Universidade Federal Fluminense, Niterói, RJ, Brasil
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Braz-Silva PH, de Rezende NPM, Ortega KL, de Macedo Santos RT, de Magalhães MHCG. Detection of the Epstein-Barr virus (EBV) by in situ hybridization as definitive diagnosis of hairy leukoplakia. Head Neck Pathol 2008; 2:19-24. [PMID: 20614337 PMCID: PMC2807608 DOI: 10.1007/s12105-007-0039-9] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/14/2007] [Accepted: 12/14/2007] [Indexed: 11/29/2022]
Abstract
Histopathological findings in cases of hairy leukoplakia (HL) are not exclusive to this lesion. A total of 36 tissue samples from patients previously diagnosed with HL based solely on morphological aspects were used in this study. Our purpose was to confirm the presence of Epstein-Barr virus (EBV) in these tissue samples by in situ hybridization (ISH), and to compare the detection of EBV with specific histopathological findings observed in each case. Among the 36 specimens, 80.55% were EBV positive, confirming the previous clinical and histhophatological diagnosis. None of the histopathological findings analyzed correlated with the presence or absence of EBV. This shows that a definitive diagnosis of HL cannot be established based on histopathological findings alone. Because there are many important implications on the establishment of definitive diagnosis of HL, the detection of EBV by ISH is obligatory.
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Affiliation(s)
- Paulo Henrique Braz-Silva
- Department of Oral Pathology, School of Dentistry, University of São Paulo, Av. Prof. Lineu Prestes, 2227, Cidade Universitária, Sao Paulo, 05508-000 Brazil
| | - Nathalie Pepe Medeiros de Rezende
- Department of Oral Pathology, School of Dentistry, University of São Paulo, Av. Prof. Lineu Prestes, 2227, Cidade Universitária, Sao Paulo, 05508-000 Brazil
| | - Karem Lopez Ortega
- Department of Oral Pathology, School of Dentistry, University of São Paulo, Av. Prof. Lineu Prestes, 2227, Cidade Universitária, Sao Paulo, 05508-000 Brazil
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Moura MDG, Grossmann SDMC, Fonseca LMDS, Senna MIB, Mesquita RA. Risk factors for oral hairy leukoplakia in HIV-infected adults of Brazil. J Oral Pathol Med 2006; 35:321-6. [PMID: 16762011 DOI: 10.1111/j.1600-0714.2006.00428.x] [Citation(s) in RCA: 14] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
BACKGROUND Oral hairy leukoplakia (OHL) may be an indicator of the progression of Human Immunodeficiency Virus (HIV)-induced immuno-depression, and the evaluation of risk factors leading to OHL is important in the management of these HIV-infected patients. However, there are few studies that analyze risk factors leading to OHL in the Brazilian population. The aim of this case-control study is to present data about prevalence rates and risk factors leading to OHL in a sample of HIV-infected adults in Brazil. METHODS This case-control study included 111 HIV-infected patients treated at a clinic for sexually transmitted diseases and HIV. In the initial examinations with dentists, variables were collected from all patients. Diagnosis of OHL was performed in accordance with the International Classification System and cytological features. The Fisher and the chi-squared tests were used for statistical analysis. The proportional prevalence and odds ratio were estimated. RESULTS Outcome presented a positive, statistically significant association among the presence of OHL and viral load of 3000 copies/mul or greater (P = 0.0001; odds ratio (OR) = 5.8), presence of oral candidiasis (P = 0.0000; OR = 11.1), previous use of fluconazole (P = 0.0000; OR = 24.6), and use of systemic acyclovir (P = 0.032; OR = 4.3). Antiretroviral medication presented a negative, statistically significant association with the presence of OHL (P = 0.002; OR = 8.4). CONCLUSIONS Prevalence of OHL was 28.8%. Viral load, oral candidiasis, previous use of fluconazole, and systemic acyclovir were determined to be risk factors for OHL. Antiretroviral medication proved to be protective against the development of OHL.
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Affiliation(s)
- Mariela Dutra Gontijo Moura
- Oral Pathology, Medicine and Surgery Department, Dentistry School, Federal University of Minas Gerais, Av. Antônio Carlos 6627, Pampulha, 31270-901 Belo Horizonte, MG, Brazil
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10
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Moura MDG, Guimarães TRM, Fonseca LMS, de Almeida Pordeus I, Mesquita RA. A random clinical trial study to assess the efficiency of topical applications of podophyllin resin (25%) versus podophyllin resin (25%) together with acyclovir cream (5%) in the treatment of oral hairy leukoplakia. ACTA ACUST UNITED AC 2006; 103:64-71. [PMID: 17178496 DOI: 10.1016/j.tripleo.2006.02.016] [Citation(s) in RCA: 15] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/22/2005] [Revised: 02/05/2006] [Accepted: 02/13/2006] [Indexed: 12/13/2022]
Abstract
OBJECTIVE The objective of this study was to assess the efficiency of topical applications of podophyllin resin (25%) (P) versus podophyllin resin (25%) together with acyclovir cream (5%) (PA) in the treatment of oral hairy leukoplakia (OHL) in accordance with the following criteria: (1) number of applications necessary for the total clinical resolution of OHL; (2) correlation between the decrease of lesion size and the number of applications; (3) total clinical resolution of OHL; and (4) clinical reevaluation 12 months after the end of treatment. STUDY DESIGN Forty-six OHLs were treated with P (P group) or with PA (PA group). Applications were performed weekly. Student t, Fisher exact, and Pearson correlation tests were used for statistical analysis. RESULTS All 24 lesions from the PA group presented total clinical resolution while 4 lesions from the P group did not. The P group required up to 25 applications performed weekly while the PA group required up to 18. Observed was a negative significant association between the size of the lesions and the number of applications performed weekly in the PA group. CONCLUSIONS The present study demonstrated the following: (1) P and PA topical treatments presented a similar average number of applications performed weekly; (2) both groups showed the same clinical response at 12 months post-therapy; and (3) PA presented a 100% clinical resolution and a continuous decrease in OHL size over the course of weekly applications.
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Affiliation(s)
- Mariela Dutra Gontijo Moura
- Oral Surgery, Medicine and Pathology Department, School of Dentistry, Federal University of Minas Gerais and Orestes Diniz's Treatment Center of Parasitic and Infectious Diseases, Minas Gerais, Brazil
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11
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Dias EP, Israel MS, Silva Junior A, Maciel VA, Gagliardi JP, Oliveira RH. Prevalence of oral hairy leukoplakia in 120 pediatric patients infected with HIV-1. Braz Oral Res 2006; 20:103-7. [PMID: 16878201 DOI: 10.1590/s1806-83242006000200003] [Citation(s) in RCA: 14] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/17/2005] [Accepted: 04/13/2006] [Indexed: 11/21/2022] Open
Abstract
Oral hairy leukoplakia (OHL) is an EBV (Epstein-Barr virus) opportunistic infection found in HIV-infected patients. It is an asymptomatic lesion that has an important prognostic value in AIDS. Differently from what takes place with HIV adult patients, OHL has been described in the literature as having a very small prevalence in pediatric patients. Therefore, the aim of this study was to investigate the prevalence of OHL in HIV pediatric patients using cytopathology. The sample consisted of 120 patients who were submitted to oral examination and had material scraped from both sides of their tongues. The diagnostic criterion was based on the identification of nuclear alterations. Clinical OHL was identified in two (1.67%) patients. The cytopathology revealed twenty (16.7%) cases of subclinical OHL. Our results show that in pediatric patients the prevalence of OHL may be larger than that described in the literature.
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Affiliation(s)
- Eliane Pedra Dias
- Department of Pathology, School of Medicine, Fluminense Federal University
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12
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Braz-Silva PH, Ortega KL, Rezende NP, Nunes FD, Magalhães MHCG. Detection of Epstein-Barr virus (EBV) in the oral mucosa of renal transplant patients. Diagn Cytopathol 2005; 34:24-8. [PMID: 16355381 DOI: 10.1002/dc.20380] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Abstract
The purpose of this study was to determine the prevalence of Epstein-Barr virus (EBV)-DNA in the oral mucosa of renal transplant patients and observe the efficacy of mouth rinses with phosphate-buffered saline (PBS) to eliminate EBV present in the saliva. Lingual, gingival, and buccal cytobrushings were obtained from normal oral mucosa of 10 renal transplant patients and 10 normal subjects, and were examined through polymerase chain reaction (PCR), before and after rinses with PBS. EBV-DNA was detected in 86.6% of renal transplant recipients and in 46.6% of healthy subjects. No significant difference was observed between oral scrapes obtained before and after rinses with PBS with regard to detection of EBV-DNA. Our results suggest that the use of PCR to detect the presence of EBV-DNA in oral mucosa in the absence of specific lesions gives rise to the problem of identifying the viral replication sites. In addition, PBS was not effective at minimizing contamination by saliva.
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Affiliation(s)
- Paulo H Braz-Silva
- Department of Oral Pathology, School of Dentistry, University of São Paulo, São Paulo, Brazil
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Walling DM, Flaitz CM, Adler-Storthz K, Nichols CM. A non-invasive technique for studying oral epithelial Epstein-Barr virus infection and disease. Oral Oncol 2003; 39:436-44. [PMID: 12747967 DOI: 10.1016/s1368-8375(03)00002-2] [Citation(s) in RCA: 17] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
Oral Epstein-Barr virus (EBV) infection is associated with hairy leukoplakia and possibly other oral diseases. Many studies of oral EBV infection utilize surgical specimens. This study tested a non-invasive brush biopsy technique as an alternative to surgical biopsy to study oral EBV infection and disease. Paired, same-site, samples of tongue epithelium were obtained from research subjects, first by brush and then by surgical biopsy. Brush cells and surgical specimens were fixed and prepared for histologic sectioning and/or processed for nucleic acid extraction. Brush cell pellet sections proved equivalent to surgical specimen tissue sections for hairy leukoplakia diagnosis by routine histologic staining and EBV immunohistochemistry or in situ hybridization. Amplification of EBV sequences demonstrated superiority of the brush cells over surgical specimens for both sensitivity (90% vs. 73%) and negative predictive value (93% vs. 82%). This non-invasive brush biopsy technique should facilitate larger, prospective studies of oral EBV infection and pathogenesis.
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Affiliation(s)
- Dennis M Walling
- Division of Infectious Diseases, Department of Internal Medicine, University of Texas Medical Branch at Galveston, 301 University Boulevard, Galveston, TX 77555-0435, USA.
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14
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Dias EP, Spyrides KS, Silva Júnior AS, Rocha ML, da Fonseca EC. [Oral hairy leukoplakia: histopathologic features of subclinical stage]. PESQUISA ODONTOLOGICA BRASILEIRA = BRAZILIAN ORAL RESEARCH 2001; 15:104-11. [PMID: 11705191 DOI: 10.1590/s1517-74912001000200005] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
Oral hairy leukoplakia (OHL) is one of the most common oral manifestations of AIDS, with diagnostic and prognostic value. OHL is associated to the Epstein-Barr virus and presents clinical and histological defined characteristics. There have already been reports about a subclinical stage of OHL, although they lacked histopathologic characterization. The present study had the aim to describe the histopathological characteristics of subclinical hairy leukoplakia, as well as to carry out a comparative analysis between clinical and subclinical OHL. For that, 11 cases were analyzed--5 biopsies from patients who presented with the lesion and 6 samples from the borders of tongues obtained in necropsies. The histopathological findings in subclinical OHL were: absence of parakeratosis and papillomatosis, mild acanthosis, ballooning cells and nuclear alterations. In situ hybridization and immunostaining were positive for EBV in the nuclear alterations identified in the histopathological analysis. Based on the identification of EBV in the nuclear alterations, it was possible to conclude that subclinical OHL, similarly to the clinical lesion, presents histopathological features that are specific and sufficient to establish the definitive diagnosis, regardless of the identification of the virus.
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Affiliation(s)
- E P Dias
- Departamento de Patologia da Universidade Federal Fluminense
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15
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Guccion JG, Redman RS. Oral hairy leukoplakia: an ultrastructural study and review of the literature. Ultrastruct Pathol 1999; 23:181-7. [PMID: 10445285 DOI: 10.1080/019131299281680] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/17/2022]
Abstract
A 39-year-old, homosexual, Caucasian man with a 9-month history of acquired immunodeficiency syndrome by reduced CD4 lymphocyte count alone was found to have extensive, asymptomatic, nonremovable, corrugated, white patches on the lateral borders and ventral aspects of the tongue typical of oral hairy leukoplakia (OHL). Histologically, irregular hyperparakeratosis, acanthosis, and clusters of ballooned keratinocytes in the stratum spinosum were present in the biopsied lateral tongue. Some of the superficial ballooned keratinocytes had peripherally beaded nuclei, whereas others had ground glass intranuclear inclusions. Ultrastructurally, the ballooned keratinocytes had three important findings of diagnostic significance. First, frequent herpesvirus nucleocapsids were largely confined to superficial ballooned keratinocytes having marginated and condensed chromatin. In searching for herpesvirus nucleocapsids, the marginated and condensed chromatin was an invaluable marker for cells harboring the virions. Second, the marginated and condensed chromatin frequently had a distinctive punched-out or cribriform appearance. Third, the ground glass intranuclear inclusion bodies consisted of central, medium electron-dense, finely granular material containing frequent herpesvirus nucleocapsids and partially surrounded or capped by prominent, clumped chromatin. The patient died with progressive multifocal leukoencephalopathy 24 months after OHL was diagnosed.
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Affiliation(s)
- J G Guccion
- Department of Veterans Affairs Medical Center, Washington, DC, USA
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16
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Scully C. New aspects of oral viral diseases. CURRENT TOPICS IN PATHOLOGY. ERGEBNISSE DER PATHOLOGIE 1996; 90:29-96. [PMID: 8791748 DOI: 10.1007/978-3-642-80169-3_2] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/08/2023]
Affiliation(s)
- C Scully
- Eastman Dental Institute for Oral HealthCare Sciences, University of London, England
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17
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Epstein JB, Fatahzadeh M, Matisic J, Anderson G. Exfoliative cytology and electron microscopy in the diagnosis of hairy leukoplakia. ORAL SURGERY, ORAL MEDICINE, ORAL PATHOLOGY, ORAL RADIOLOGY, AND ENDODONTICS 1995; 79:564-9. [PMID: 7600218 DOI: 10.1016/s1079-2104(05)80096-4] [Citation(s) in RCA: 16] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/26/2023]
Abstract
The diagnosis of lesions clinically suggestive of hairy leukoplakia was assessed by light and electron microscopic examination of cytologic smears. We found exfoliative cytology to be a simple and noninvasive technique that can confirm the clinical diagnosis of hairy leukoplakia. Our results suggest that electron microscopy may be more sensitive and reliable than light microscopy in confirming the clinical diagnosis of hairy leukoplakia.
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Affiliation(s)
- J B Epstein
- BC Cancer Agency, St. Paul's Hospital, Vancouver, Canada
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