Incisional and excisional biopsy

The histology of both biopsies was similar in morphology and the photographs demonstrated represent the second biopsy.  The histology is typical of this disease; the surface is covered by a thick layer of orthokeratin and parakeratin with small chevrons (Figures 3 & 4).  The spinous layer shows evidence of focal thickening but maintains the usual pattern of cell maturation except in the basal and parabasal cell layers, where mild and focal hyperchromatism and nuclear crowding is noted.  The underlying connective tissue shows evidence of focal fibrosis.

Figure 3. H & E stained section at 20X magnification (low scanning) demonstrating a mass of lamellar bone covered by a thin mucosa.  The surface epithelium is stretched and lacks filliform papillae.

 

Figure 4. Low power (x100) histology shows a piece of oral mucosa with a thick keratin layer and focal areas of acanthosis and connective tissue fibrosis