Detection of the Epstein–Barr Virus (EBV) by In situ Hybridization as Definitive Diagnosis of Hairy Leukoplakia

Abstract

Histopathological findings in cases of hairy leukoplakia (HL) are not exclusive to this lesion. A total of 36 tissue samples from patients previously diagnosed with HL based solely on morphological aspects were used in this study. Our purpose was to confirm the presence of EpsteinBarr virus (EBV) in these tissue samples by in situ hybridization (ISH), and to compare the detection of EBV with specific histopathological findings observed in each case. Among the 36 specimens, 80.55% were EBV positive, confirming the previous clinical and histhophatological diagnosis. None of the histopathological findings analyzed correlated with the presence or absence of EBV. This shows that a definitive diagnosis of HL cannot be established based on histopathological findings alone. Because there are many important implications on the establishment of definitive diagnosis of HL, the detection of EBV by ISH is obligatory.

Physiological Changes in Salivary Gland and Kidney that help the Diagnosis caused of Epstein-Barr virus: A Brief Review

“…A comparative study between sialometry techniques and minor salivary gland biopsy in patients with Sjogren's syndrome showed no difference in sensitivity between both procedures and the authors concluded that the positivity of both tests increases the specificity for Sjögren's syndrome (95%) than when they are considered in isolation. In recent years research has focused on less invasive diagnostic methods in order to cause a minor annoyance in patients [19][20][21].…”

“…To validate the cytology as a complementary exam, for diagnosis of Hairy leukoplakia using in situ techniques (hybridization) for the detection in oral mucosa. Thus, diagnostic studies involving hairy leukoplakia orally in situ hybridization for EBV detection based cytology via ThinPrep test Pap shown that cytology EBV-associated hybridization is simple, efficient and non-invasive tool as efficient as biopsies [19].…”

Twenty-first-century oral hairy leukoplakia—a non–HIV-associated entity

“…5,6 As these histologic features are not exclusive to OHL, a definitive diagnosis relies on the detection of EBV in the lesional tissue. 6 …”

“…5,6 However, ISH is the most widely used method and is considered the "gold standard" for the detection of the DNA or RNA of EBV in tissue sections. 7,8 Pathogenesis…”

“…12 Previously, in HIV-positive patients not receiving highly active antiretroviral therapy, the detection of OHL may have determined the start of treatment. 5 However, in 2013, the World Health Organization (WHO) issued new guidelines recommending the initiation of highly active antiretroviral therapy when the CD4 count falls below 0.5 Â 10 9 /L. 13 Therefore, it is unlikely that physicians would now wait for the development of OHL before commencing treatment in these patients.…”