Pathology anatomy diagnostic for oral hairy leukoplakia: A review article
Nanda Rachmad Putra Gofur, Aisyah Rachmadani Putri Gofur, Soesilaningtyas, Rizki Nur Rachman Putra Gofur, Mega Kahdina, Hernalia Martadila Putri
Introduction: Oral Hairy Leukoplakia (OHL) is a disorder of mucocutaneous epithelial cell hyperplasia caused by the Epstein-Barr virus (EBV), and is the first managed pathological manifestation of EBV infection. OHL occurs almost exclusively in persons with immunosuppressive conditions and is usually seen in patients with human immunodeficiency virus (HIV), although there have also been reports of the incidence of OHL in patients with other non-HIV immunosuppressive conditions. The diagnosis of OHL can be made based on the presumptive diagnosis, namely the discovery of bilateral lesions on the lateral part of the white / gray tongue that cannot be removed by rubbing and can show vertical verugation. However, exact diagnosis requires information further pathology anatomy examination. Aim of this study to review pathology anatomy examination for OHL. Discussion: The histopathological features found in OHL are not pathognomonic. In OHL can be found epithelial hyperplasia, hyper and parakeratosis and ballooning, vacuoalization, koilocytic epithelial cells with no or minimal inflammation, 28 as well as nuclei with ground-glass image and nuclear beading. Candida sp. is also common on the histopathological features of OHL. Sampling for histopathological examination can be done with a punch biopsy or brush biopsy. Exfoliative cytology as a method of diagnosis of OHL is a relatively new, innovative study. The feature found on exfoliating cells is Cowdry type A inclusions which are characteristic of EBV virus infection. In situ hybridization (ISH) is a reliable technique, specific nucleic acids (eg DNA, RNA) at the single cell stage in distribution and quantitative. ISH is the most accurate and sensitive technique, and is the gold standard for the diagnosis of OHL. Immunohistochemical examination of OHL showed the presence of EBV particles. Immunohistochemical analysis using antibodies to EBV antigen from the viral lysis cycle such as viral capsid antigen (VCA), and early antigen (EA-D). Conclusion: OHL immunohistochemical examination has low sensitivity and high specificity. Polymerase Chain Reaction (PCR) can regulate the viral load in the subclinical state but cannot determine the location of EBV infection. PCR has a high sensitivity but low specificity.