Application of stereologic methodology to inflammatory infiltrates residing in oral mucous membrane lesions. Structural and morphometric comparison of benign mucous membrane pemphigoid and reticular lichen planus

Histoquantitative study of inflamed tongue mucosa

A quantitative, semiautomatic analysis of histologic features of the specific inflammatory changes occurring on the dorsum of human tongue was made for 37 tongues. Well-documented histologic differences between clinically normal appearing tongue (control), atrophic, geographic and fissured tongue were shown quantitatively. The epithelium of atrophic tongue was thinner compared to the controls. Reduction of the thickness was due to the shortened or totally missing rete pegs. Epithelium of geographic and fissured tongue showed irregular rete pegs. In fissured tongue heavy inflammation seemed to shorten the rete pegs. In atrophic tongue the connective tissue was thicker compared to the controls. This could be due to mild, chronic inflammation causing loose connective tissue described in atrophic tongue. Muscle cells of geographic tongue appeared to be as in the controls, whereas in atrophic and fissured tongue the uppermost muscle cells were small and separated compared to the controls.

Stereologic analysis of leukocyte infiltration in oral ulcers of developing Mikulicz aphthae

Biopsy specimens of 1- to 7-day-old oral ulcers from patients with minor (Mikulicz), herpetiform, and Behcet's aphthae and of nonulcerated oral mucosa of aphthous patients were subjected to a quantitative, stereologic, electron microscopic analysis of the connective tissue infiltrate residing both at the center of and lateral to the ulcers. The data representing volume fractions and the numerical density of cellular and other infiltrate components demonstrated that (1) the infiltrate under the epithelium lateral to the ulcer is different from that at the ulcer's center, (2) at both sites, composition of the gross infiltrate does not change with age of the ulcer, (3) a large population of leukocytes (about 18% in the lateral and 23% in the central region) belong to the monocyte/macrophage series, (4) blast-forming T-lymphocytes are consistently present, blast-forming B-lymphocytes and plasma cells are very rare, and (5) mast cells are several times more numerous than in normal mucosa. In a comparison of the infiltrates of Mikulicz aphthae with those of herpetiform and Behcet's ulcers, it appears that the pathogenesis of the various oral ulcerations may well be diverse.

Stereology of inflammatory connective tissue infiltrates in oral mucosa

In the present summary, different approaches to analyse inflammatory connective tissue infiltrates are reviewed. The most appropriate model for this purpose was found to be the stereological analysis at the electron microscopic level. This method furnishes data comparable with results obtained by other quantifying methods, such as biochemical analysis. The presently used methodology for the analysis of diseased portions of oral mucous membranes, as well as selected results thereof are described. The usefulness and reliability of the method are discussed and future developments are suggested.

Epithelial differentiation patterns in buccal mucosa affected by lichen planus

The epithelium derived from buccal mucosa affected by lichen planus reticularis was subjected to histometric and stereologic analysis. Point counting procedures were employed to analyse a total of 2,220 electron micrographs sampled from 5 epithelial strata in 9 biopsies, 7 with distinct and 2 with faint Wickham's striae. Histologically the reticular elements presented an atrophy of the entire epithelium which had altered its differentiation pattern from that of normal buccal epithelium. The epithelium of faintly striated lichen planus differed from that of distinctly striated lichens in regard to a series of cytoplasmic organelles representing key features of stratified epithelia, i.e. the volume densities of glycogen, membrane coating granules, keratohyalin granules, cytoplasmic filaments and the cytoplasmic ground substance. The data emphasize that the clinically discernable features of reticular lichen planus of the buccal mucosa are produced by at least two different stages in the deviation of the epithelial differentiation pattern from normality, one stage (distinct striae) being more drastically altered than the other (faint straie).