Objective: The objective of the present study is to investigate the cytopathology of human lip neoplasms, pattern of cervical lymph node (CLN) metastasis and to analyse the probable etiological risk factors associated with it.
Methodology: In this hospital based case-control study, 22 subjects (11 cases of lip neoplasm and 11 healthy individuals as Control group) were included in this study. Scraped exfoliated cytosmears were collected from the affected site of the lip and smearing was done in the precleaned- coded glass-slides. Two such slides were prepared from each subject. The cytosmears were immediately fixed in aceto-alcohol (1part of glacial acetic acid:3 part of absolute ethyl alcohol) fixative. One set of the slide was stained with Papanicolaou’s stain and the other set wascounter-stained with Giemsa’s Solution for cytopathological analysis.The TNM (Tumor- Node-Metastasis) System for staging of lip cancer formulated by American Joint Committee for Cancer (AJCC) Staging and End Results Reporting-2010 was followed.
Results: Lower lip is found to be the most common site in the genesis of lip neoplasm. Pleomorphic cytological atypias such as Micronucleated cell (MNC), Plump keratinized squamous cell (PKSC), Keratinized spindle cell (KSC), Keratinized spindle cell (KSC), Keratinized tadpole cell (KTC), Keratinized strap (Anitschkow) cell (KSC-A), Keratinized fiber cell (KFC), Keratinized round cell (KRC) and Non-keratinized malignant squamous cell (NMSC) with drastic modification were frequently observed in lip neoplasm. Unpredictable metastasis is a common feature in lip neoplasm cases.
Conclusion: Excluding PKSC and MNC, presence of any other atypias in the cytosmearoflip neoplasm indicates the state of malignancy. Thus, exfoliative cytopathology has a potentiality in early detection of lip carcinoma in particular and oral cancer in general.