Pathology · single question

A patient with geographic tongue asks whether they need a biopsy. What is the MOST appropriate response?

Biopsy is needed only if the lesion does not resolve in 2 weeks
Annual biopsy is required to monitor for dysplasia
A biopsy should always be done to confirm the diagnosis
No biopsy is needed — geographic tongue is diagnosed clinically and has no malignant potential

Show answer and explanation

Correct answer: D. No biopsy is needed — geographic tongue is diagnosed clinically and has no malignant potential

A. Geographic tongue can persist for years or be recurrent — waiting 2 weeks is not a criterion for biopsy decision-making for this known benign condition.
B. Geographic tongue has no dysplastic or malignant potential — annual monitoring biopsy is not indicated.
C. Routine biopsy of geographic tongue is not indicated — the clinical appearance is diagnostic. Biopsy would only be performed if the presentation was atypical or suspicious.
D. CORRECT. Geographic tongue (erythema migrans) is diagnosed CLINICALLY based on the characteristic migratory map-like pattern. It has NO malignant potential and does NOT require biopsy. The diagnosis is confirmed by the clinical presentation (migratory erythematous patches with white serpentine borders on the dorsum). Biopsy is unnecessary and not indicated.

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