Pathomorphological study and its role in differential diagnostics of oral diseases

A full examination of a dental patient is necessary for accurate diagnosis and the right tactics for treating the disease, but it has certain difficulties. Diseases of oral tissues are diverse in etiology, range, nature of the problems that arise. Some oral diseases have identical preliminary symptoms. These causes create diagnostic problems. Diagnosis of oral tissue diseases is based mainly on the patient’s medical history (disease course, type of symptoms, modulating factors, and accompanying symptoms) and a systematic clinical examination. The problem of a complete and comprehensive diagnosis of patients with pathological conditions of the oral cavity is still very relevant. It is necessary to create clear algorithms for examining patients with pathological changes in the tissues of the oral cavity to find a clear approach to diagnosis and treatment. Often, non-compliance with the protocols for examining a dental patient causes difficulties for practitioners in differentiating certain conditions of the oral cavity that have similar symptoms and clinical manifestations. Early detection of altered epithelium of the mucous membranes of the oral cavity can help in the timely diagnosis of malignancy processes and the necessary medical intervention. Changes in the structure, composition, and shape of oral tissue cells are one of the signs of cancer development, which can be detected at the intracellular level using pathomorphological examination with high-resolution electron microscopy. When determining the severity of pathological changes in the tissues of the studied biopsy specimens, hematoxylin-eosin staining procedures were carried out to more accurately analyze the structure of the cell elements of lymphocytes, cell mitosis; and the state and reaction of the connective tissue vessels were also assessed. On the example of biopsy specimens with severe hyperkeratosis and acanthosis, with the formation of large layers of keratin, the destruction of desmosomal connections of spinous layer cells with visible intracellular vacuolar dystrophy, as well as eosinophilic paranuclear and perinuclear densities was observed, which helped to differentiate pemphigus vulgaris. Cytological changes, including dyskeratosis, parakeratosis, hyperkeratosis, increased granulocyte count, karyorrhexis, pycnosis, together with an increase in the total number of lymphatic cells, were detected using immunocytochemical analysis of the biopsy specimens, which helped to differentiate the development of dense lesion of plasmacytoma in bone tissue.

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