Isfahan University of Medical SciencesDental Research Journal1735-33279120120218A clinical and fine needle aspiration cytology study of gingiva in acute leukemia900900ENA. Sri Kennath J.ArulDepartments of Oral and Maxillofacial Pathology, Best Dental Science College, Madurai, Tamil Nadu, India. kenkajal@gmail.comSonikaVermaShaheenAhmedA. Sri Sennath J.Arul20120218Background: Oral manifestations are frequently the initial signs of acute leukemia, promptingthe patient to consult the dentist first. The gingival tissue is one site commonly involved eitherby leukemic infiltration or by inflammatory reactive hyperplasia, causing gingival enlargement. Thegingival infiltration may also be present without gingival enlargement. Early recognition of clinicalfindings in the oral cavity leads to its timely diagnosis and management. Since biopsy is highlycontraindicated, gingival fine needle aspiration cytology was performed to assess its diagnosticvalue in detecting gingival infiltration in acute leukemia patients.Materials and Methods: Fifty patients of acute leukemia received clinical and gingival cytologicalexamination. The cases were diagnosed based on bone marrow aspiration findings and classifiedaccording to the French–American–British criteria. The absence or presence of intraoral findingswas recorded. Site for gingival fine needle aspiration cytology was selected.Results: Leukemic gingival infiltration was found to be more common in acute lymphoblasticleukemia, while the characteristic oral findings were seen more commonly in acute myeloblasticleukemia. All the eight cases of acute lymphoblastic leukemia that were positive for leukemicgingival infiltration showed no clinical evidence of gingival enlargement. In terms of leukemic gingivalinfiltration, L2 subtype was the only subtype involved, while M5 was more commonly involved thanM4 subtype. Two cases of L2 subtype showed gingival enlargement due to local factors like plaque/calculus rather than due to leukemic infiltration.Conclusion: The technique was found to be safe and of definitive diagnostic value in detectinggingival infiltration in acute leukemia patients.Key Words: Acute leukemia, fine needle aspiration cytology, gingiva