by Jason Wasserman MD PhD FRCPC
July 16, 2024
Moderate keratinizing squamous dysplasia is a precancerous condition characterized by abnormal growth and organization of squamous cells in the epithelium of the oral cavity. In this condition, the squamous cells exhibit atypia (abnormalities in size, shape, and organization) and increased keratin production, but the changes are less extensive than in severe dysplasia. The dysplasia is classified as moderate when these cellular abnormalities involve most but not all of the epithelial thickness.
Moderate keratinizing squamous dysplasia can occur in various parts of the oral cavity, including:
The symptoms of moderate keratinizing squamous dysplasia can be subtle and may include:
Several factors can contribute to the development of moderate keratinizing squamous dysplasia, including:
Yes, moderate keratinizing squamous dysplasia is associated with an increased risk of developing squamous cell carcinoma, a type of oral cavity cancer. The risk is lower than that associated with severe dysplasia but higher than with mild dysplasia. Therefore, early detection and appropriate management of dysplastic lesions are important in preventing the progression to oral cancer.
Microscopically, moderate keratinizing squamous dysplasia shows a disorganized epithelial structure with loss of normal stratification and architecture, but these changes are typically confined to the lower two-thirds of the epithelium. The cells display abnormalities in size, shape, and nuclear features, including hyperchromasia (darkly staining nuclei), pleomorphism (variation in cell and nuclear size and shape), and an increased nuclear-to-cytoplasmic ratio. There is an increased number of mitotic figures, but they are usually confined to the lower layers of the epithelium. The surface is typically thickened and keratotic. Additionally, there may be chronic inflammation in the underlying connective tissue, which can accompany the dysplastic changes.
A margin is any tissue that the surgeon cuts to remove the abnormal tissue area from your body. The types of margins described in your report will depend on the area of the oral cavity involved and the type of surgery performed. Margins are usually only described in your report after the entire abnormal tissue area has been removed.
A negative margin means that dysplasia was not seen at any of the cut edges of the tissue. A margin is called positive when dysplasia is seen at the very edge of the cut tissue. A positive margin is associated with a higher risk that dysplasia will come back at the same site after treatment.
Doctors wrote this article to help you read and understand your pathology report. If you have any questions, please contact us.