[1182] 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.

TABLE 1

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

Clinical and pathological features

TABLE 2

Case Number	CD3	CD30	TCR betaF1	CD4	CD8	Clonality
1	+++	++	+++	+++	++	TCR G1 clonal. G2 Polyclonal
2	++	-	+++	++	++	NV
3	+++	++	+++	++	+	TCR non clonal (G1, G2, B1, B2)
4	+	+	+++	+++	-	TCR Polyclonal (G1, B1, B2)
5	+	+	+++	+++	-	TCR Polyclonal(G2, B2)

Immunohistochemical and clonality features


Conclusions: The EUOM may resemble morphologically a malignant lesion, particularly T-cell lymphoma. A detailed phenotypic and clonality study helps to confirm the reactive nature of the infiltrate in most instances. However few cases may show monoclonal T cell populations that do not necessarily indicate malignancy in this particular context.
Category: Head & Neck

Wednesday, March 2, 2011 9:30 AM

Poster Session V # 140, Wednesday Morning