Sinuses:

• mycetoma: sinus debris is mycetoma until proven otherwise; d-Pas stain may not stain dead organisms...advised to do silver stains (far less false positive).

• watch out for asymetry, surface papillary lesions, or erosions

• Greenspan Score (minor salivary gland is biopsied in effort to diagnose Sjogren's syndrome): beware of over-diagnosing secondary inflammation (duct dilation, extravasated saliva, and extravascular polys indicate secondary)
  • two goals:
  • gland variability
  • scoring method & rules:
  • other pointers:
• metaplasias:
  • fatty

• lichen planus: a lot of nonspecific chronic stomatitis looks "lichenoid". The oral lesions should look clinically like LP, lichenoid inflammation should be discerned on biopsy, and the direct fluorescent staining of the biopsy should match the diagnosis.