Gingival fine needle aspiration cytology in acute leukemia.
BACKGROUND
Oral findings in acute leukemia (AL) are common and could be the presenting feature of the disease, namely, gingival enlargement, ulceration, bleeding, and infection. Gingival enlargement in AL is either due to leukemic infiltration, or due to reactive hyperplasia. To differentiate between them a biopsy is required, but being highly contraindicated, biopsy has been substituted in this study by fine needle aspiration cytology (FNAC).


METHODS
Gingival FNAC was performed on different sites in the upper and lower gingiva. Each site represents an interdental papilla, which was selected according to the clinical presentation, i.e., being enlarged or not. Seventy-two adult AL patients received a cytological and clinical examination in this study, and the cases were classified and categorized according to the French-American-British (FAB) criteria.


RESULTS
Twenty-one cases were diagnosed as being infiltrated, 16 with gingival enlargement, 4 with no evidence of enlargement. In one case the infiltration affected the alveolar mucosa of an edentulous patient. In six cases the ginigva was enlarged without being infiltrated (reactive hyperplasia). Leukemic gingival enlargement was seen mostly in patients with acute myeloid leukemia, particularly M4 and M5 subtypes; however, two patients with acute mixed lineage leukemia (AMLL) were both affected with leukemic infiltration.


CONCLUSIONS
FNAC was shown to be a simple, non-traumatic and useful diagnostic procedure for screening leukemic infiltration in gingival tissues in AL patients.
Abdullah
Bashar H
BH
Department of Oral Diagnosis, College of Dentistry, University of Baghdad, Iraq.
Yahya
Hassan I
HI
Kummoona
Raja K
RK
Hilmi
Ferial A
FA
Mirza
Khalid B
KB
D000208:Acute Disease; D000293:Adolescent; D000328:Adult; D000368:Aged; D001707:Biopsy, Needle / Q000379:methods*; D005260:Female; D005881:Gingiva / Q000473:pathology*; D005884:Gingival Hemorrhage / Q000473:pathology; D005885:Gingival Hyperplasia / Q000473:pathology; D006801:Humans; D007938:Leukemia / Q000473:pathology*; D015456:Leukemia, Biphenotypic, Acute / Q000473:pathology; D007948:Leukemia, Monocytic, Acute / Q000473:pathology; D007951:Leukemia, Myeloid / Q000473:pathology; D015479:Leukemia, Myelomonocytic, Acute / Q000473:pathology; D017254:Leukemic Infiltration / Q000473:pathology; D008297:Male; D008875:Middle Aged; D009061:Mouth Mucosa / Q000473:pathology; D009066:Mouth, Edentulous / Q000473:pathology; D019226:Oral Ulcer / Q000473:pathology