Comparison of Clinical and Histopathological Diagnosis in Oral Surgery

Klinička dijagnoza, tj. klinički izgled patološke promjene, često ne otkriva pravu narav bolesti i tek patohistološka analiza potvrdi ili odbaci kliničku dijagnozu. Zajednički rad oralnog kirurga i patologa osigurava postavljanje točne dijagnoze. Retrospektivno smo usporedili kliničku i patohistološku dijagnozu ambulantno operiranih bolesnika tijekom 1990. godine. Apikotomija, alveotomija i cistektomija najčešće su izvedeni operacijski zahvati. Na patohistološki pregled upućeno je 278 uzoraka tkiva. Najčešće dijagnoze pod kojima smo slali materijal na patohistološku pretragu jesu cista (45%), fibroma (12,6%) i epulis (9,7%). Prosječna podudarnost kliničke i patohistološke dijagnoze iznosi 70%, a analizirana je za svaku kliničku dijagnozu posebno. U jednog bolesnika je za klinički benignu promjenu — hiperkeratozu, patohistološka dijagnoza glasila carcinoma planocellulare. Autori raspravljaju o potrebi patohistološke potvrde kliničke dijagnoze i ističu važnost i opravdanost patohistološkog pregleda svakog odstranjenog tkiva.Only a successful cooperation of an oral surgeon and the pathologist can ensure a reliable diagnosis. The authors have analyzed operations performed during 1990 at outpatient clinic of the Department o f Oral and Maxillofacial Surgery, University of Zagreb, School of Dentistry. Clinical appearance of the disease and clinical diagnosis sometimes enable us to recognize the real nature of the disease. The clinical diagnosis in correlation with the histological diagnosis can be either denied or improved. The aim o f this investigation was to correlate the clinical and the histological diagnosis and to find out the number of improvement. Material most often sent for histological examination was an operated cyst. Although the removed tissues were analyzed under different clinical diagnoses, approximately 70% o f the clinical diagnoses corresponded to the histopathological findings. In one case the clinical diagnosis of benign lesion — hyperkeratosis — was after histopathological examination find as carcinoma planocellulare. The authors recommend every part of the excised tissue to be sent for a histopathological examination