Direct immunofluorescence testing results in cases of premalignant and malignant oral lesions

Objectives Oral premalignant and malignant lesions may mimic oral lichen planus (OLP) clinically and microscopically. OLP often shows basement membrane fibrinogen positivity on direct immunofluorescence testing (DIF). This study examined fibrinogen positivity in oral premalignant lesions and squamou...

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Published in:Oral surgery, oral medicine, oral pathology and oral radiology oral medicine, oral pathology and oral radiology, 2015-06, Vol.119 (6), p.675-683
Main Authors: Montague, L.J., DMD, Bhattacharyya, I., DDS, MSD, Islam, M.N., DDS, BDS, Cohen, D.M., DMD, MS, MBA, Fitzpatrick, S.G., DDS
Format: Article
Language:English
Subjects:
Aged
Biopsy
Carcinoma, Squamous Cell - pathology
Cell Transformation, Neoplastic - pathology
Dentistry
Female
Fibrinogen - analysis
Fluorescent Antibody Technique, Direct
Humans
Lichen Planus, Oral - pathology
Male
Middle Aged
Mouth Neoplasms - pathology
Precancerous Conditions - pathology
Surgery
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Summary:Objectives Oral premalignant and malignant lesions may mimic oral lichen planus (OLP) clinically and microscopically. OLP often shows basement membrane fibrinogen positivity on direct immunofluorescence testing (DIF). This study examined fibrinogen positivity in oral premalignant lesions and squamous cell carcinoma. Study Design The University of Florida Oral Pathology Biopsy Service records were searched for the years 2003 to 2013 for oral premalignant lesions and squamous cell carcinoma with concurrent DIF testing. Demographic, clinical, and DIF or histologic information was collected and analyzed. Results Sixty-eight fibrinogen positive lesions were identified within a total of 164 cases. Low-grade dysplasia and premalignant verrucous lesions made up the majority of the fibrinogen positive lesions (combined n = 43; 63.2%), and the most common locations in positive cases were the buccal mucosa, tongue, and gingiva. A lichenoid distribution of the inflammatory infiltrate significantly predicted fibrinogen positivity ( P < .0005). Conclusions Fibrinogen positivity may be seen in premalignant and malignant oral lesions increasing the risk of misdiagnosis.
ISSN:2212-4403
2212-4411
DOI:10.1016/j.oooo.2015.02.478