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. Author manuscript; available in PMC: 2015 May 1.
Published in final edited form as: Oral Maxillofac Surg Clin North Am. 2014 May;26(2):123–141. doi: 10.1016/j.coms.2014.01.001

Table 5.

Histopathologic grading of oral epithelial dysplasia

Grade Cytologic aberrations Architectural aberrations Level of involvement
Hyperkeratosis &
hyperplasia 		None Hyper-, para-, or
orthokeratosis
Epithelial hyperplasia		 Not applicable
Mild dysplasia Increased
nuclear/cytoplasmic ratio,
nuclear hyperchromatism &
increased number of
mitotic figures		 Basal cell hyperplasia &
sharply demarcated
hyperkeratosis		 Lower 1/3 of the
epithelium
Moderate
dysplasia 		All of the above + variations
in nuclear & cell size and
shape, nuclear
hyperchromatism,
increased & abnormal
mitotic figures		 All of the above + loss of
polarity & stratification,
increased cell density with
dyscohesion, bulbous or
drop-shaped rete-pegs		 Lower 1/2 of the
epithelium
Severe dysplasia All of the above + mitotic
figures within the
superficial epithelial layers,
increased number and size
of nucleoli & apoptotic
bodies		 All of the above +
dyskeratosis or keratin
pearl formation		 Lower 2/3 of the
epithelium
Carcinoma in situ All of the above All of the above Full thickness
epithelium