TB can be easily differentiated from squamous cell carcinoma by:

There is general agreement that lesions of the oral mucosa are seldom primary, but rather secondary to pulmonary disease. Lesions of secondary tuberculosis may occur at any site on the oral mucous membrane, but the tongue is most commonly affected, followed by the palate, lips, buccal mucosa, gingiva and frenula. The diagnosis of active infection must be confirmed by the demonstration of the organisms by special microbial stains and culture of the infected tissue or sputum. The presence of acid-fast bacilli (AFB) in sputum. TB can be easily differentiated from squamous cell carcinoma by biopsy. Biopsy can confirm the diagnosis.