Histopathology Session III DENT4217 **Epithelial disorders** **A/Prof Omar Kujan** **Case 1** * Slide ID 1064 * Image ID 714 Histological image of skin tissue with epidermis and dermis layers stained (H&E stain).  Histological image of stratified squamous epithelium with rete ridges.  200um  **Microscopic description** * Prominent hyperparakeratosis and marked acanthosis * Clearing of the cytoplasm of the cells in the spinous layer * In some instances an eosinophilic condensation is noted in the perinuclear # **Diagnosis** * **White Sponge Nevus** **Background** * White sponge nevus (WSN) is a relatively rare cutaneous and mucosal lesion. * First reported in 1909 * Etiology: rare developmental anomaly inherited as an autosomal dominant trait with variable expressivity and a high degree of penetrance. This condition is attributed to a defect in the normal keratinization (keratin 4 and keratin) * Lesions appear at birth or in early childhood * The lesions consist of symmetric, thickened, white, corrugated or velvety, diffuse plaques. * Buccal mucosa is the most frequently affected, followed by the labial and gingival mucosa, and the floor of the mouth. * Extra-oral mucosal sites, such as the nasal, esophageal, laryngeal, and anogenital mucosa, appear to be less commonly affected. * Patients are usually asymptomatic. The white color does not diminish when the tissue is stretched in any mucosal site. Clinical images showing white patches or lesions on the inside of the cheeks and on the tongue.    **Differential diagnosis** * Leukoedema * hereditary benign intraepithelial dyskeratosis. Case 2 * Slide ID 1063 * Image ID 713 No text detected in the image.  The text from the image is a scale bar at the bottom left corner: **400μm**  **200µm**  200um  **Microscopic description** * long, thin and finger-like projections extending above the mucosal surface. * Each finger-like projection is lined by stratified squamous epithelium and connective tissue centrally. * The spinous cells proliferate in a papillary pattern. * Koilocytes-HPV altered cells may be observed. The upper epithelial layer shows pyknotic nuclei, often surrounded by edematous or optically clear zone, the so-called "koilocytic" cell. # **Diagnosis** * Oral squamous papilloma **Background** * Oral squamous papilloma is a benign tumor and its pathogenesis has been associated with human papillomavirus (HPV) infection (type 6, or 11). * The HPV infection is one of the risk factors associated with the development of cervical, anogenital, pharynx, larynx and oral cavity carcinomas. * Transmission of the virus can occur by direct contact with lesions, sexual intercourse or from mother to child during delivery. * The classic clinical presentation of oral squamous papilloma is an exophytic growth, with a rough surface that appears a cauliflower- like and, depending on the degree of keratinization, the lesion may be white, pink and/or red. * The lesion can affect any oral region, being more common on the tongue, lip, uvula and soft palate. * The treatment of choice for oral squamous papilloma is the surgical removal. No text found in the image or PDF.   **Differential diagnosis** * Verruca vulgaris * Focal epithelial hyperplasia * Condyloma acuminatum **Case 3** * Slide ID 1062 * Image ID 712 600um  I'm sorry, but there is no textual content to extract from the provided images or PDF text. The images show what appears to be a histological slide with biological tissue, and the PDF text is instructional and does not contain subject matter text from the main image. Therefore, I cannot perform the requested text extraction.  **<font color="#0000FF">Diagnosis</font>** * Mild epithelial dysplasia Clinical photographs showing leukoplakia lesions in the oral cavity.    **Case 4** * Slide ID 1065 * Image ID 715 **700um**  200um  Histological image with "200 μm" scale bar.  **Diagnosis** * Severe epithelial dysplasia Text: Image OCR: Extract text using both sources. Prioritize image text but use PDF text for context.Extract all of the text from this image, use the pdf text for context to enhance the ocr **, try to match the text formatting as much as possible, if the text is in a different colour then it should be bold. Note that erros may occur with the pdf text, if it is obviously corrupted or error ridden text then ignore it ! DO NOT SAY ANYTHING ELSE.Here is the original image:**   **Case 5** * Slide ID 1061 * Image ID 711 500um  200um  200um  **Diagnosis** * Actinic Cheilitis **Microscopic description** * epithelial changes of hyperkeratosis, acanthosis, dyskeratosis and moderate dysplasia, with a dense chronic inflammatory infiltrate and basophilic degeneration of the lamina propria **Background** * Actinic cheilitis is a lip inflammation caused by long-term sunlight exposure. * It most frequently affects the vermilion border of the lower lip * It usually appears as very chapped lips, then may turn white or scaly. * Actinic cheilitis may be painless, but it can lead to **squamous cell carcinoma** if left untreated. It seems you have provided images and asked for text extraction. However, there is no text present in the provided images. Therefore, there is no text to extract.