A 30-year Evaluation of the Agreement between Clinical and Histopathological Diagnoses of Peripheral Epithelial and Mesenchymal Lesions In Mashhad Dental School: 1976-2006

Statement of Problems: Sufficient knowledge, experience and careful examination usually lead to appropriate clinical diagnosis. However, lesions with similar clinical features present a diagnostic challenge. Therefore, a confirmatory histopathological examination can be helpful to reach the final diagnosis.

The present study was conducted to evaluate the agreement between clinical and histopathological diagnoses of oral epithelial and mesenchymal lesions in a period of 30-years (1976-2006) at Mashhad Dental School.

The percentage of concurrence and discrepancy between clinical and histopathological diagnoses of 625 epithelial and 2480 mesenchymal lesions was compared. Clinical data including the patient’s gender and age and the lesion’s location were also evaluated in cases with discrepancy. Data were analyzed using Mann-Whitney, T-Test, Chi-Square, Likehood Ratio, Fisher’s Exact and Kappa tests.

An overall agreement between clinical and histopathological diagnoses was seen in 71/4% of epithelial lesion cases, with maximum parity in squamous cell carcinoma and papilloma. In 57/1% of the mesenchymal cases, the diagnosis was in total agreement. Denture hyperplasia, epulis fissuratum, and pregnancy tumor showed the highest concurrence, respectively.

Although histopathological examination leads to final diagnosis, in some cases proper strategies and more attention to clinical features of the lesion are necessary to minimize the discrepancy, especially for those with non-specific clinical presentation.