Histopathology and TCR Clonality in 5 Cases of Eosinophilic Ulceration of the Oral Mucosa.
Alberto Gonzalez-Menchen, Julio A Diaz-Perez, Santiago Montes-Moreno, Raquel Pajares, Maria Rodriguez-Pinilla, Miguel A Piris. Spanish National Cancer Research Institute (CNIO), Madrid, Spain
Background: The Eosinophilic Ulcers of the Oral Mucosa (EUOM) are benign lesions that affect the oral cavity, predominantly the tongue. However, histopathological and phenotypical features are worrisome and may lead to a misdiagnosis of malignancy. The aim of our study was to characterize the clinical, pathological and clonality features of five new cases of EUOM.
Design: 5 cases that fulfilled the criteria for the diagnosis of EUOM were retrieved from CNIO consultation files. A detailed immunohistochemical study together with clonality testing for TCR rearrangements with Biomed2 primers was done.
Results: A summary of the results is shown in Tables 1&2. All patients were male with age between 23 to 74 years-old. The location of the lesions was the lateral margin of the tongue. Pathological evaluation showed in all cases a prominent inflammatory polymorphic cell population with invasive features and predominantly composed of lymphocytes, hystiocites and eosinophis. Mild necrosis was seen and the mitotic rate was generally low. By immunochemistry it is shown a predominance of T-cells (CD3+, CD4+, CD30+, TCR betaF1+), with scattered B cells (CD20+). The PCR analysis for TCR rearrangements was polyclonal for all loci tested in all but one case that showed a single monoclonal peak in TCR G1.
|Case Number||Age y/o||Sex||Location||Deep involment||Cellular atypia||Atypical Mitosis|
|1||46||Male||Tongue lateral margin||Soft tissue / Muscle||YES||8/10 HPF|
|2||23||Male||Tongue||Soft tissue / Muscle||NO||1/10 HPF|
|3||31||Male||Tongue lateral margin||Soft tissue / Muscle||NO||3/10 HPF|
|4||50||Male||Tongue lateral margin||Soft tissue / Muscle||NO||1/10 HPF|
|5||74||Male||Tongue lateral margin||Soft tissue / Muscle||NO||1/10 HPF|
|Case Number||CD3||CD30||TCR betaF1||CD4||CD8||Clonality|
|1||+++||++||+++||+++||++||TCR G1 clonal. G2 Polyclonal|
|3||+++||++||+++||++||+||TCR non clonal (G1, G2, B1, B2)|
|4||+||+||+++||+++||-||TCR Polyclonal (G1, B1, B2)|
|5||+||+||+++||+++||-||TCR Polyclonal(G2, B2)|