case_images: PMC4555910_01
case_images: Leukoplakia over the ventral aspect of the tongue
case_images: IJSTD-36-89-g001.jpg
case_images: PMC4555910_01_IJSTD-36-89-g001.jpg
case_images: F1
case_images: On examination, there was a white patch of 1 cm x 1 cm over the ventral aspect of the tongue [Figure 1].
case_images: Perforation of the hard palate with induration and necrotic tissue at the margins
case_images: IJSTD-36-89-g002.jpg
case_images: PMC4555910_01_IJSTD-36-89-g002.jpg
case_images: F2
case_images: There was also a perforation of 1.5 cm x 1 cm over the hard palate with induration and sloughing at the margins [Figure 2].
case_images: (a) Squamous cells with nuclear hyperchromasia and mitotic figures in a biopsy from palatal lesion on (H and E, x400), (b) malignant pearl with concentric rings of keratin within an epithelial island on (H and E, x400), (c) areas of necrosis with a background of lymphocytic infiltrate on (H and E, x100)
case_images: IJSTD-36-89-g003.jpg
case_images: PMC4555910_01_IJSTD-36-89-g003.jpg
case_images: F3
case_images: Biopsy from palatal lesion showed squamous cells with nuclear hyperchromasia and high mitotic index extending beyond the basement membrane [Figure 3a]. Epithelial pearl/keratin whorl/malignant pearl was seen as concentric squames of keratin within an epithelial island [Figure 3b]. There was also areas of necrosis with surrounding lymphocytic infiltrate [Figure 3c].
case_images: (a) Epithelial dysplasia with basement membrane intact from a biopsy taken from leukoplakia on (H and E, x100), (b) epithelial dysplasia on (H and E, x400)
case_images: IJSTD-36-89-g004.jpg
case_images: PMC4555910_01_IJSTD-36-89-g004.jpg
case_images: F4
case_images: There was cellular atypia with hyperchromatic nuclei [Figure 4].