PMC9341348_01
Gross view of the ulcer on the posterolateral border of the tongue.
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On inspection of the lesion, a single crater-like ulcer was present on the left posterolateral border of the tongue, measuring approximately 1.5 cm x 2.0 cm in size, oval in shape, with a velvety red base (Figure 1).
Photomicrographs of the biopsy. A - dysplastic surface epithelial cells with large, pleomorphic, and hyperchromatic nuclei infiltrating the connective tissue stroma (H&E,4X); B - connective tissue stroma infiltrated with tumor cells (Arrow) (H&E, 10X); C - connective tissue stroma containing dysplastic clear cells along with epithelial cells (20X); D - clear cells with cellular and nuclear pleomorphism (40X).
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Islands of round to polygonal-shaped cells with clear cytoplasm occupied almost 50% of the stromal tissue (Figure 2).
Photomicrograph of the biopsy. Positive PAS diastase staining in clear cells (arrow) (40X).
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The tumor cells rich in glycogen showed strong positivity for PAS diastase (Figure 3).
Photomicrograph of the biopsy -A and B - Immunohistochemical staining for cytokeratin (AE1/AE3) showing strong immunoreactivity in the epithelium and epithelial cells present in the connective tissue; A - (4X) and B - (40X).
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AE1/AE3 was strongly positive in the epithelium and the dysplastic epithelial island, keratin pearls, and clear cells in connective tissue stroma suggesting malignancy of epithelial origin (Figure 4).