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Figure 1 | Head & Neck Oncology

Figure 1

From: Histological changes in intra-oral skin flaps

Figure 1

(a) Scanning view of a skin flap (asterisk) which has been transferred adjacent to lingual foliate papillae (FP). The panniculus adiposus (subcutaneous fat, PA), submucosal skeletal muscle (M) and the mammillated surface of the papillae are easily seen. The linear segment indicates the junction between the flap and native mucosa. The areas in rectangles labelled as b-i are magnified in Figs 1b-i respectively, so that particular features are appreciated. (b) The linear segment indicates the junction between epidermis (left part of the photomicrograph) and oral epithelium (right part of the photomicrograph). The stratum granulosum (arrowheads) of the epidermis is discernible. The lower border of both epidermis and oral epithelium is irregular. This indicates hyperplasia of rete in response to the presence of non-specific chronic inflammation (asterisk) in underlying stroma. (c) Cross-sectioned profile of a crypt (C) of the lingual tonsil, which is surrounded by hyperplastic lymphoid tissue with germinal centres (arrows). Emigrant lymphoid cells and debris are present in the crypt lumen. (d) Cross-sectioned profile of a metaplastic collecting duct of the posterior superficial lingual salivary gland (Weber's). Lymphoid tissue with three germinal centres is present at the left of the photomicrograph. It is difficult to distinguish the surface oral epithelium at this magnification. (e) Two lobules of the posterior superficial lingual salivary gland, which are variably affected by parenchymal atrophy and non-specific chronic inflammation. Inflammation (asterisk) is prominent in the upper lobule, whereas mucous acini and tubules are preserved in the lower. The arrows indicate ectatic atrophic duct-like structures. (f) Randomly mixed fat (F), skeletal muscle (M), nerve fascicles (N) and vessels (V) characterise the submucosal soft tissues and contrast with the uniform and orderly arrangements of panniculus adiposus. (g) Two eccrine sweat-gland lobules. Paler secretory segments (S) and darker ducts (D) are distinguished. Adipocytes are mixed with the secretory segments. (h) Retiform downward growth of epidermis. The changes resemble senile (solar) lentigo or inchoate seborrhoeic keratosis. The structure indicated by the arrowhead is probably a cross-sectioned plugged infundibulum. Elsewhere, the epidermis of the flap shown in Fig. 1a is attenuated or ulcerated. (i) Area of ulceration covered by fibrinous membrane (F). There is underlying non-specific chronic inflammation (asterisk). E, preserved epidermis. Other small ulcerated areas are discernible in Fig. 1a, but these are not shown. Note: Unless otherwise specified, the photomicrographs in this article are from sections of routinely processed tissue, which were stained with haematoxylin and eosin (HE); it was not deemed necessary to give objective magnifications.

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