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Table 1 Histopathological classification of OSF

From: Correlation of histopathological diagnosis with habits and clinical findings in oral submucous fibrosis

Very early stage (Grade I): Early stage (Grade II): Moderately advanced stage (Grade III): Advanced stage (Grade IV):
❖ A finely fibrillar collagen, dispersed with marked edema.
❖ The fibroblastic response is strong.
❖ The blood vessels are sometimes normal, but more often they are dilated and congested.
❖ Inflammatory cells, mainly polymorphonuclear leukocytes with an occasional eosinophil are present.
❖ The juxta-epithelial area shows early hyalinization.
❖ Plump young fibroblasts are present in moderate numbers.
❖ The blood vessels are dilated and congested.
❖ The inflammatory cells are mostly mononuclear lymphocytes, eosinophils and an occasional plasma cell.
❖ The collagen is moderately hyalinized.
❖ The fibroblastic response is less marked, the cells present being mostly adult fibrocytes.
❖ Blood vessels are normal or constricted.
❖ The inflammatory exudates consist of lymphocytes and plasma cells, although an occasional eosinophil is seen.
❖ The collagen is completely hyalinized.
❖ The hyalinized areas are devoid of fibroblasts.
❖ Blood vessels are completely obliterated or narrowed.
❖ The inflammatory cells are lymphocytes and plasma cells.