Grades of dysplasia Mild dysplasia In general, architectural disturbance limited to the lower third of the epithelium, accompanied by minimal

cytological atypia defines the minimum criteria of dysplasia. Moderate dysplasia Architectural disturbance extending into the middle third of the epithelium is the initial criterion for recognizing this category. Consideration is then given to the degree of cytological atypia. The presence of marked atypia may indicate that a lesion should be categorized as severe dysplasia despite not extending into the upper third of the epithelium. Alternatively, lesions with mildly atypical features extending into the middle third of the epithelium may merit being graded as mild dysplasia. Severe dysplasia Recognition of severe dysplasia starts with greater than two-thirds of the epithelium showing architectural disturbance with associated cytological atypia. However, as noted in the previous paragraph, architectural disturbance extending into the middle third of the epithelium with sufficient cytological atypia is upgraded from moderate to severe dysplasia. Figures 111 illustrate the dysplasia gradings assigned to tissue samples by using the above system of grading as often practiced by oral pathologists