The LCP classification and staging system can be used to characterize lesions of oral leukoplakia. A provisional diagnosis can be made when the external appearance cannot distinguish between the different causes of a white mucosal lesion. A definitive diagnosis can be made when an etiologic cause is identified, which usually requires histologic examination of a biopsy.
Parameters:
(1) size in diameter (L)
(2) clinical features (C)
(3) pathologic features on biopsy (P)
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Parameter
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Finding
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Code
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lesional size (L)
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<= 2 cm
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L1
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> 2 to <= 4 cm
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L2
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> 4 cm
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L3
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not specified
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Lx
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clinical aspect (C)
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homogeneous
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C1
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|
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non-homogeneous
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C2
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not specified
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Cx
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pathologic features (P)
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no dysplasia
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P1
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mild dysplasia
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P2
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moderate dysplasia
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P3
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|
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severe dysplasia
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P4
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not specified
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Px
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where:
• homogeneous lesion = predominantly white lesion of uniform flat, thin appearance that may exhibit shallow cracks and has a smooth, wrinkled or corrugated surface with consistent texture throughout.
• non-homogeneous lesion = predominantly white or mixed white-red lesion that may be irregularly flat, nodular or exophytic. The nodular lesions have a slightly raised, rounded, red and/or white excrescences . The exophytic lesions have irregular blunt or sharp projections.
• erythroplakia are reddish lesions of the oral mucosa for which the etiology cannot be identified based on external examination. Mixed red and white lesions are termed erythroleukoplakia.
Use:
(1) A provisional diagnosis of oral leukoplakia can be made based on size (L) and clinical (C) features.
(2) A definitive diagnosis of oral leukoplakia usually requires histologic examination of a biopsy (P) from the lesion.
(3) If there is doubt as to which code should be assigned for a given finding, the lower category should be used.
(4) Staging is done only for lesions which have been examined histologically.
(5) If more than one lesion is present, the L code is based on the largest lesion present and the code is designated "(m)". For example, multiple lesions with the largest one measuring 3 cm would be termed L2(m).
(6) If multiple lesions are present, the C code reported is the maximum for all the lesions present.
(7) If multiple biopsies from (a) multiple lesions or (b) a single lesions were done, then the highest pathologic code should be reported.
(8) The oral subsite for the lesions should be given, according to the ICD-DA
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Findings
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Stage
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no lesion
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0
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any L, C1, P1 or P2
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1
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any L, C2, P1 or P2
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2
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any L, any C, P3 or P4
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3
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