Hairy leukoplakia--a histological study.
Hairy leukoplakia is a recently described oral mucosal condition seen in immunosuppressed individuals, usually in association with HIV infection, when it is thought to be a sign of decreasing immunocompetence. It probably results from reactivation of infection by Epstein-Barr virus (EBV) and usually presents as bilateral white patches on the lateral borders of the tongue. From a histological study of 20 cases we have found that the typical appearance of hairy leukoplakia is of acanthotic, hyperparakeratinized epithelium with Candida hyphae sometimes present in the parakeratin. A band of EBV infected, koilocyte-like cells is present in the upper part of the prickle cell layers, these cells being swollen and pale staining, with prominent cell borders and perinuclear vacuoles. There is a paucity of inflammation in both the epithelium and lamina propria. An atypical appearance shows the koilocyte-like cells lying isolated or in small groups, irregularly arranged in the prickle cell layer and without a hyperparakeratinized surface. Diagnosis of hairy leukoplakia should normally be confirmed by demonstrating EBV in the koilocyte-like cells by immunocytochemistry or DNA in situ hybridization.
Southam
J C
JC
Department of Oral Medicine & Oral Pathology, University of Edinburgh, Scotland, UK.
Felix
D H
DH
Wray
D
D
Cubie
H A
HA
D002175:Candida / Q000302:isolation & purification; D004273:DNA, Neoplasm / Q000235:genetics; D004848:Epithelium / Q000382:microbiology / Q000473:pathology; D015658:HIV Infections / Q000150:complications; D004854:Herpesvirus 4, Human / Q000302:isolation & purification; D006801:Humans; D007150:Immunohistochemistry; D007972:Leukoplakia, Oral / Q000150:complications / Q000175:diagnosis / Q000473:pathology*; D009693:Nucleic Acid Hybridization; D012334:RNA, Neoplasm / Q000235:genetics; D014059:Tongue / Q000382:microbiology / Q000473:pathology; D014062:Tongue Neoplasms / Q000150:complications / Q000175:diagnosis / Q000473:pathology*
D004273:DNA, Neoplasm; D012334:RNA, Neoplasm