{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,25]],"date-time":"2026-09-25T18:30:45Z","timestamp":1790361045374,"version":"4.1.0"},"reference-count":49,"publisher":"Wiley","issue":"1","license":[{"start":{"date-parts":[[2024,3,18]],"date-time":"2024-03-18T00:00:00Z","timestamp":1710720000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Histopathology"],"published-print":{"date-parts":[[2024,7]]},"abstract":"<jats:sec><jats:title>Aims<\/jats:title><jats:p>Oral epithelial dysplasia (OED) often exhibits a lymphocytic\/lichenoid immune response (LIR), imparting histological resemblance to lichenoid mucositis and rendering diagnosis challenging. The clinical appearances of OED and lichenoid inflammatory processes are generally divergent, presenting as well\u2010demarcated hyperkeratotic plaques and diffuse white and\/or red mucosal change with variably prominent Wickham striae, respectively. To date, clinicopathological characterisation of OED with LIR, including clinical\/gross appearance, has not been depicted.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods and results<\/jats:title><jats:p>Cases of solitary OED with LIR for which a clinical photograph was available were identified in the authors\u2019 institutional files. Clinical and histological features were documented. In 44 identified cases, dysplasia was mild (19 of 44, 43.2%), moderate (19 of 44, 43.2%) and severe (six of 44, 13.6%). Clinically\/grossly, all 44 cases (100.0%), presented as well\u2010demarcated hyperkeratotic plaques lacking diffuse white\u2010and\u2010red mucosal change or Wickham striae. Histologically, OED with LIR exhibited numerous \u2018lichenoid\u2019 features beyond the lymphocytic band in the superficial lamina propria, including: leucocyte transmigration (38 of 44, 86.4%), spongiosis (37 of 44, 84.1%), Civatte\/colloid bodies (36 of 44, 81.8%), basal cell degeneration (29 of 45, 65.9%), sawtooth rete ridges (11 of 44, 25.0%) and subepithelial clefting (7 of 44, 15.9%).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Virtually any lichenoid histological feature may be seen in OED with LIR, representing a significant diagnostic pitfall. The typical clinical appearance of OED with LIR is of a well\u2010demarcated hyperkeratotic plaque, characteristic of keratinising dysplasia and devoid of lichenoid features. This suggests that pathologist access to clinical photographs during diagnostic interpretation of biopsied white lesions, which represents opportunity to perform gross examination of the disease process, may reduce interobserver variability and improve diagnostic accuracy in this challenging differential diagnosis.<\/jats:p><\/jats:sec>","DOI":"10.1111\/his.15171","type":"journal-article","created":{"date-parts":[[2024,3,18]],"date-time":"2024-03-18T10:04:59Z","timestamp":1710756299000},"page":"40-50","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":10,"title":["Oral epithelial dysplasia with lymphocytic immune response: clinicopathological characterisation of 44 cases"],"prefix":"10.1111","volume":"85","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-5903-350X","authenticated-orcid":false,"given":"Ivan J","family":"Stojanov","sequence":"first","affiliation":[{"name":"Department of Pathology University Hospitals Cleveland Medical Center  Cleveland OH USA"},{"name":"Department of Pathology Robert J. Tomsich Pathology and Laboratory Medicine Institute, Cleveland Clinic  Cleveland OH USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Joud","family":"Omari","sequence":"additional","affiliation":[{"name":"Harvard School of Dental Medicine  Boston MA USA"},{"name":"Department of Oral and Maxillofacial Surgery, Oral Medicine and Periodontology, School of Dentistry The University of Jordan  Amman Jordan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ibrahim","family":"Akeel","sequence":"additional","affiliation":[{"name":"Oral Diagnostic Sciences Department King Abdulaziz University Faculty of Dentistry  Jeddah Saudi Arabia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5286-4562","authenticated-orcid":false,"given":"Ahmed S","family":"Sultan","sequence":"additional","affiliation":[{"name":"Department of Oncology and Diagnostic Sciences, School of Dentistry University of Maryland  Baltimore MD USA"},{"name":"University of Maryland Marlene and Stewart Greenebaum Comprehensive Cancer Center  Baltimore MD USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sook\u2010Bin","family":"Woo","sequence":"additional","affiliation":[{"name":"Harvard School of Dental Medicine  Boston MA USA"},{"name":"Center for Oral Pathology StrataDx  Lexington MA USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2024,3,18]]},"reference":[{"key":"e_1_2_10_2_1","doi-asserted-by":"publisher","DOI":"10.1002\/hed.21131"},{"key":"e_1_2_10_3_1","doi-asserted-by":"publisher","DOI":"10.1007\/s12105-021-01363-z"},{"key":"e_1_2_10_4_1","first-page":"127","volume-title":"Surgical pathology of the head and neck","author":"Barnes EL","year":"2001"},{"key":"e_1_2_10_5_1","doi-asserted-by":"publisher","DOI":"10.1038\/modpathol.2016.207"},{"key":"e_1_2_10_6_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.oraloncology.2013.04.008"},{"key":"e_1_2_10_7_1","doi-asserted-by":"publisher","DOI":"10.1016\/S1079-2104(05)80201-X"},{"key":"e_1_2_10_8_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1600-0714.2007.00584.x"},{"key":"e_1_2_10_9_1","doi-asserted-by":"publisher","DOI":"10.1111\/jop.13056"},{"key":"e_1_2_10_10_1","doi-asserted-by":"publisher","DOI":"10.1177\/10668969211070171"},{"key":"e_1_2_10_11_1","doi-asserted-by":"publisher","DOI":"10.1111\/odi.13993"},{"key":"e_1_2_10_12_1","volume-title":"WHO classification of tumours series. 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