Clinical and histological diagnosis of oral pathologic lesions, any concordance?

Abstract Introduction: Histopathology examination is employed to confirm or rule out presumptive clinical diagnosis and there are different types and techniques of obtaining the specimen used for the examination. Histopathologic examination though regarded as the gold standard for diagnosis of oral pathologic lesions has also been reported to have varying rates of misdiagnosis depending on the technique or type.  Objective: This study aims to examine the concordance between clinical and histopathological diagnosis as well as partial biopsy technique and surgical specimen of oral lesions. Methods: This was a cross-sectional retrospective study that utilized the data obtained from the case notes and histology record of 433 patients that had biopsy done between 2006 and 2016. Information on patients’ age, gender, type of biopsy, presumptive clinical diagnosis and histopathologic diagnosis were obtained. Concordance between presumptive clinical and histopathologic diagnosis (incisional and final surgical specimen as the case may apply) and rate of misdiagnosis were assessed.   Results: Excisional biopsies were more often used for benign lesions while incisional biopsy with or without surgical specimen were more often used for malignant lesions. Benign lesions were more frequently diagnosed than malignant lesions. The presumptive clinical diagnosis was erroneous for 40.3% and 22.1% of lesions following incisional histopathology and surgical specimen histopathology report respectively. Lesions that were subjected to both incisional and surgical specimen biopsies had a misdiagnosis rate of 11.2%. Conclusion: Incisional biopsy and post-surgical specimen histopathology investigation are important tools in the effective management of oral pathologic lesions.