Eritroplasia

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Eritroplasia

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Area aterciopelada o granulosa que no se asocia con irritación por trauma o por protesis. Es aún más sospechosa que la Leucoplasia. El 90% son carcinomas.

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Figure 1. A flat, red, triangular patch of mucosa located on the left posterior hard palate and tuberosityAn 82-year-old man visited the dental clinic for fabrication of a new maxillary denture. During his comprehensive head-and-neck examination, the clinician discovered an asymptomatic 1.5 x 1.5-centimeter red, macular lesion on the left posterior lateral hard palate and tuberosity region (Figure 1). The patient wasnot wearing a denture, and no other obvious source of irritation could be identified. He reported having smoked cigarettes when he was much younger, but he indicated that he had quit smoking more than 50 years ago. He stated that he did not drink alcohol.

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Digito- presión Si al hacerla cambia de color, durante la digito presión es blanca y posterior a esta es roja, descartar, podría ser una hemorragia. Si no hay cambio alguno, biopsia para verificar eritroplasia ….. Esta lesión no tiene predilección por localización. OBLIGATORIO realizar biopsia en todos los sitios representativos de la lesión

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Figure 2. A medium-power photomicrograph showing epithelial hyperplasia with a rough, pebbly surface. The epithelial cells appear crowded and disorganized (hematoxylin-eosin stain, original magnification x200).  At low and medium power, the epithelium demonstrated a slightly papillary surface with hyperplasia of the rete ridges (Figure2). At higher magnification, the cells exhibited a disorderly maturation pattern with hyperchromatism, pleomorphism and increased nuclear size (Figure 3). These changes focally involved the entire thickness of the epithelium.

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Figure 3. A high-power photomicrograph showing hyperchromatic and pleomorphic cells that extend to the epithelial surface (hematoxylin-eosin stain, original magnification x400)

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Signos importantes Granulación o engrosamiento de la mucosa. Dolor de garganta y afonía. Difícultad para mover la lengua o la mandíbula. parlalisis de lengua.

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El diagnostico es fundamental para la detección precoz, examen clínico exahustivo. Sólo la biopsia confirma el diagnostico

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Eritroplasia: “la contraparte roja de Leucoplasia”. Es un término que refiere un parche rojo en la mucosa oral que no puede ser definido clinica o patológicamente como resultado de otra condición. Aunque la eritroplasia no se encuentra frecuente cerca de leucoplasia, es una lesión más inquietante a lo que se refiere con displasia o cambios malignos Generalmente todas las eritroplasias exiben una considerable displasia epitelial, en un estudio realizado por Shafer y Waldron, mostró que el 51% de eritroplasias exibian un carcinoma invasivo, el 40% displasia severa o carcinoma in situ (CIS) y el 9% restante una leve-moderada displasia.

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In this case, the biopsy specimen revealed CIS. CIS represents a transitional stage between pre-malignant epithelial dysplasia and invasive squamous cell carcinoma. By definition, CIS is characterized by dysplastic changes that involve the entire thickness of the surface epithelium, but without invasion of tumor cells through the basement membrane into the underlying connective tissue.5 Although CIS is considered to be a cancer, theoretically it cannot metastasize at this stage, because the tumor cells have not yet gained access to the lymphovascular structures in the lamina propria. However, it is important to evaluate the entire lesion microscopically to ensure that early invasion has not occurred elsewhere in the specimen.

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Clinical erythroplakia often is associated with a history of tobacco or alcohol use, although some cases develop with no identifiable causative factors. Treatment usually involves totalsurgical removal of the lesion with clear margins. Also, because many patients with oral carcinoma or epithelial dysplasia exhibit multifocal involvement (so-called "field cancerization"), the clinician should perform a detailed oral and oropharyngeal examination to identify any other possible lesions.6 In addition, periodic follow-up of the area is advisable for the rest of the patient’s life.5

Summary: con propósitos de estudio, no cité el articulo, pero acá pueden encontrarlo http://jada.ada.org/cgi/content/full/137/11/1537

Tags: eritroplasia lesion precancerosa

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