Pathology/Geographic tongue

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Question
For over a year that we have noticed my husband has spots only on the left side of his tongue, tip and somewhat on the dorsal that are red with white raised borders. The spots start out small grow large and then disappear only to reappear the very next day in the same spot. We have been to three dentist and an ent. The dentist both seem to agree that's its geographic tongue. One checks his mouth regularly with the velescope because my husband uses smokeless tobacco and refuses to stop no matter what I say. The third dentist did a brush biopsy in January of this year. I have the brush biopsy report. Mild atypical, atypical epithelial cells found. Abnormal keratinization, clusters and tissue fragments of hyperplastic basal cells with an increase in nuclear staining, an increasen in the nuclear toncytoplasmic ratio and nuclear crowding. Changes are possibly reactive occurring in a background of acute and chronic inflammation and blood.

Following the brush biopsy he went to an ent. The ent did a scaple biopsy in the same location but not the exact same spot because that lesion where the brush biopsy was taken already disappeared. The scaple biopsy showed chronic glossitis consistent with geographic tongue.

My main worry even with the reassurance of the dentist and doctors is is the pathology from the brush biopsy consisten with the findings from the scaple biopsy showing inflammation which is consistent with geographical tongue? I do tend to over worry about this so a little reassurance is mainly what I am seeking. He still has spots, they act the same and hid dentist still agrees its nothing more than geographic tongue.

Here are a few photos of the spots to help assist you

http://i1209.photobucket.com/albums/cc393/kkingery83/05FFA111-4E04-43E3-BE59-7CA

http://i1209.photobucket.com/albums/cc393/kkingery83/A876BA04-00B5-428B-9ADC-92D

http://i1209.photobucket.com/albums/cc393/kkingery83/CFEF18F3-5520-4F12-BF33-BDD

Answer
Hello Kim:

The biopsy report is definitely not pointing to anything serious. Chronic inflammatory changes are present so there are some atypical cells. Geographic tongue is benign and the lesions are migratory...they disappear and reappear in different parts of the tongue.

If the lesions ulcers, starts bleeding or is painful then further action is needed.mother wise topical steroids are advised by the dentists/ENT specialists

Pathology

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Neha Dahiya MD

Expertise

Help patients understand the medical terminology of their lab results and / or tissue biopsy reports.

Experience

I am a pathologist and director of clinical laboratory services. I have been a practicing pathologist for last 9 years in a 350 bed multi specialty hospital laboratory in India.

Organizations
Indian association of pathologists and microbiologists.
International Academy of Cytology
International association of Pathologists - Indian division
Indian association of Cytology

Education/Credentials
MD (pathology) MBA

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