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Jin GQ, Su DK, Xie D, Zhao W, Liu LD, Zhu XN. Distinguishing benign from malignant parotid gland tumours: low-dose multi-phasic CT protocol with 5-minute delay. Eur Radiol 2011; 21:1692-8. [PMID: 21547526 PMCID: PMC3128264 DOI: 10.1007/s00330-011-2101-y] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/12/2010] [Revised: 02/12/2011] [Accepted: 02/18/2011] [Indexed: 12/13/2022]
Abstract
Objectives To explore the percentage enhancement wash-out ratio (PEW) and relative PEW (RPEW) of low-dose multi-phasic computed tomography (CT) in distinguishing benign from malignant parotid gland tumours. Methods This study was approved by the ethics committee, and informed patient consent was obtained. 51 patients with parotid tumours proven by histopathology received CT, including 18 with pleomorphic adenomas, 14 with Warthin’s tumours and 19 with malignant tumours. Size and attenuation of parotid tumours were measured. Compared with 5-min attenuation, the 30-s and 90-s PEW (PEW30, PEW90) and RPEW (RPEW30, RPEW90) were calculated. Results There was a significant difference in PEW30, RPEW30, PEW90 and RPEW90 in the parotid neoplasms groups (P < 0.01), and statistical significance existed simultaneously in pleomorphic adenomas vs malignant tumours and Warthin’s tumours vs malignant tumours according to SNK-q test. The optimal diagnosis results of malignancy with 100% specificity (32/32) was obtained by using a combination of the following criteria: −70% > PEW30 < 36%, −30% > PEW30 < 19%, PEW90 > 12%, and the sensitivity (74%) for diagnosis of malignancy was yield. Conclusions Wash-out ratio may assist in differentiating the benign from malignant parotid gland tumours. Combining the percentage of enhanced wash-out ratios of CT protocols can yield diagnostic results for malignancy.
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Affiliation(s)
- G Q Jin
- Department of Radiology, Oncology Hospital, Guangxi Medical University, Nanning, People's Republic of China.
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52
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Pleomorphic adenoma (benign mixed tumour) of the salivary glands: its diverse clinical, radiological, and histopathological presentation. Br J Oral Maxillofac Surg 2011; 49:14-20. [DOI: 10.1016/j.bjoms.2009.09.014] [Citation(s) in RCA: 46] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/13/2009] [Accepted: 09/29/2009] [Indexed: 11/19/2022]
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Tan TJ, Tan TY. CT features of parotid gland oncocytomas: a study of 10 cases and literature review. AJNR Am J Neuroradiol 2010; 31:1413-7. [PMID: 20395389 DOI: 10.3174/ajnr.a2090] [Citation(s) in RCA: 26] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
Oncocytomas of the salivary glands are rare benign epithelial tumors which occur most commonly in the parotid gland. The aim of our study was to characterize the clinical-radiologic-pathologic spectrum of parotid oncocytomas in a series of 10 cases seen in our institution between January 2003 and November 2008. The CT features of parotid oncocytomas in the largest imaging series of this rare but important benign lesion include a well-defined enhancing tumor with a "deformable" appearance when large, and a non-enhancing curvilinear cleft or cystic component. These CT findings are potentially helpful in distinguishing these benign lesions from other parotid tumors in clinical scenarios that preclude surgical resection or when biopsy results are non-diagnostic. Further studies are advocated to validate the specificity and positive predictive value of these imaging features.
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Affiliation(s)
- T J Tan
- Department of Diagnostic Radiology, Changi General Hospital, Singapore.
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Chu ZG, Yu JQ, Yang ZG, Zhu ZY, Yuan HM. Myopericytoma involving the parotid gland as depicted on multidetector CT. Korean J Radiol 2009; 10:398-401. [PMID: 19568469 PMCID: PMC2702050 DOI: 10.3348/kjr.2009.10.4.398] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/10/2008] [Accepted: 03/02/2009] [Indexed: 02/05/2023] Open
Abstract
Myopericytoma is a newly proposed subgroup of perivascular tumors in the World Health Organization classification of soft tissue tumors. In this study, we report a case of a benign myopericytoma with detailed multidetector CT (MDCT) findings in the parotid gland, a location that has not been described for this type of tumor previously. The clinical presentation, imaging features, histopathological and immunohistochemical findings, and the differential diagnosis with other tumors in the parotid gland are described and reviewed.
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Affiliation(s)
- Zhi-Gang Chu
- Department of Radiology, West China Hospital, Sichuan University, Sichuan, China
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55
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Kei PL, Tan TY. CT "invisible" lesion of the major salivary glands a diagnostic pitfall of contrast-enhanced CT. Clin Radiol 2009; 64:744-6. [PMID: 19520223 DOI: 10.1016/j.crad.2009.02.015] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2009] [Revised: 02/18/2009] [Accepted: 02/23/2009] [Indexed: 10/20/2022]
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56
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Giant epithelial-myoepithelial carcinoma of the parotid gland. Clin Imaging 2009; 33:237-9. [PMID: 19411033 DOI: 10.1016/j.clinimag.2008.11.013] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/08/2008] [Accepted: 11/20/2008] [Indexed: 11/20/2022]
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Brunese L, Ciccarelli R, Fucili S, Romeo A, Napolitano G, D'Auria V, Collina A, Califano L, Cappabianca S, Sodano A. Pleomorphic adenoma of parotid gland: delayed enhancement on computed tomography. Dentomaxillofac Radiol 2009; 37:464-9. [PMID: 19033432 DOI: 10.1259/dmfr/79964183] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022] Open
Abstract
OBJECTIVES To assess the efficacy of multiphasic CT with 8 min delayed acquisition in the differential diagnosis between pleomorphic adenomas and other parotid neoplasias. METHODS Between January 2004 and April 2007, 62 patients with parotid enlargement were enrolled in this prospective study. The CT protocol applied included the following four acquisitions: without contrast medium and 30 s, 120 s and 8 min after intravenous injection of contrast medium. We considered the degree of the enhancement of the lesions (rated as "low", "moderate" and "strong") and the degree of enhancement homogeneity (rated as "not homogeneous", "mildly homogeneous" and "uniform"). These parameters were compared with Hounsfield values of the lesions computed in each phase. The diagnosis was confirmed in all patients after surgery. RESULTS On histological examination, 36 tumours were classified as pleomorphic adenomas and 26 as non-pleomorphic adenomas. On the basis of a statistical comparison, the third phase proved to be the most effective in the differential diagnosis between pleomorphic adenoma and non-pleomorphic adenomas, both for the assessment of the degree of the enhancement (in this phase, strong enhancement showed a sensitivity of 61.11%, specificity of 100%, positive predictive value (PPV) of 100% and negative predictive value (NPV) of 53.33%) and, above all, for the homogeneity of the enhancement (in this phase, indeed, uniform enhancement showed sensitivity, specificity, PPV and NPV of 100%). CONCLUSIONS Our results seem to indicate that multiphasic CT with 8 min delayed acquisition allows the differential diagnosis between pleomorphic adenomas and other parotid neoplasias.
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Affiliation(s)
- L Brunese
- Department of Health Sciences, Università del Molise, Contrada Tappino, Campobasso, Molise 86100, Italy.
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Wang S, Shi H, Wang L, Yu Q. Myoepithelioma of the parotid gland: CT imaging findings. AJNR Am J Neuroradiol 2008; 29:1372-5. [PMID: 18467518 DOI: 10.3174/ajnr.a1109] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
BACKGROUND AND PURPOSE Myoepitheliomas (MEs) are rare tumors of the parotid gland. Only a few case reports describing CT imaging features of ME have been published. The aim of this study was to describe and characterize the CT findings of MEs of the parotid gland. MATERIALS AND METHODS We retrospectively reviewed CT images of ME with pathologic correlation in 10 cases (4 men and 6 women; age range, 30-70 years) collected between August 2003 and October 2007 from our pathologic database. All of the CT images were retrospectively evaluated with respect to the location, size, marginal morphology, enhancement, and enhancement pattern by 2 experienced radiologists. RESULTS Nine tumors were located in the superficial lobe of the parotid gland, and 1 was located in the tail of parotid gland. All of the tumors abut on the capsule of the gland. Nine tumors had well-defined margins with lobulations in 5 patients. Two cases showed homogenous enhancement. In the other 8 cases, the enhancement was inhomogeneous because of enhancing nodules and nonenhancing areas of linear bands, slitlike-shaped or of cystic configuration. CONCLUSION CT imaging findings of MEs were well circumscribed, enhancing the mass lesion with smooth or lobulated margins, located chiefly in the superficial lobe and abutted on the capsule of the gland. They may contain enhancing nodules and nonenhancing areas of linear bands, slitlike-shaped or of cystic configuration. Although MEs are a rarity, they should be suspected when a tumor shows all of the characteristics noted here.
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Affiliation(s)
- S Wang
- Department of Radiology, Ninth People's Hospital, Medical School, Shanghai Jiao Tong University, Shanghai, People's Republic of China
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Kim HJ, Kim HJ, Kim YD, Yim YJ, Kim ST, Jeon P, Kim KH, Byun HS, Song HJ. Solitary fibrous tumor of the orbit: CT and MR imaging findings. AJNR Am J Neuroradiol 2008; 29:857-62. [PMID: 18272558 PMCID: PMC8128581 DOI: 10.3174/ajnr.a0961] [Citation(s) in RCA: 57] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/09/2007] [Accepted: 11/11/2007] [Indexed: 12/12/2022]
Abstract
BACKGROUND AND PURPOSE Solitary fibrous tumor (SFT) is a rare spindle-cell neoplasm originating from mesenchymal fibroblast-like cells. The purpose of this study was to describe the CT and MR imaging features of SFTs in the orbit. MATERIALS AND METHODS We retrospectively reviewed CT and MR images in 6 patients (2 men and 4 women), aged 18 to 51 years, with SFT proved on histologic examination located in and around the orbit. All patients underwent CT (including dual-phase CT in 3), and MR imaging was obtained in 3. We evaluated the imaging findings with emphasis on the location, size, margin, internal architecture, and pattern of enhancement of the lesion. RESULTS All 6 lesions were found as a solitary, well-defined mass, ranging in size from 18 to 30 mm (mean, 24 mm). Three were located in the postseptal orbit, 2 in the lacrimal sac, and 1 on the lower eyelid. Compared with the cerebral cortex, all 3 lesions examined by MR imaging showed homogeneous isointense signal intensity on T1-weighted images and heterogeneous mixed isointense and hyperintense signal intensity on T2-weighted images. On visual inspection, all 6 lesions showed marked homogeneous (n = 4) or heterogeneous (n = 2) enhancement on postcontrast CT and MR images. In 3 patients examined with dual-phase CT, all lesions demonstrated rapid enhancement with early washout of contrast material. CONCLUSION SFT might be included in the differential diagnosis of soft tissue masses in the orbit, if one sees a markedly enhancing mass showing the similar characteristics to those of the internal carotid artery on postcontrast CT or MR images.
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Affiliation(s)
- H J Kim
- Department of Radiology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea.
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60
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Kim HS, Lee WM, Choi SM. Myoepitheliomas of the soft palate: helical CT findings in two patients. Korean J Radiol 2008; 8:552-5. [PMID: 18071288 PMCID: PMC2627460 DOI: 10.3348/kjr.2007.8.6.552] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
Abstract
We describe the enhancement patterns of myoepithelioma in two patients with a soft palate mass. In the first case, helical CT revealed a faintly enhancing mass. Histologically, the tumor was composed of plasmacytoid cells in a background of rich myxoid stroma. Immunostaining for CD34 showed scanty blood vessels. In the second case, helical CT revealed an intensely enhancing mass. Histologically, the mass was a cellular tumor with fibrous stroma. Immunostaining for CD34 also showed frequent blood vessels.
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Affiliation(s)
- Hyun-Sook Kim
- Department of Radiology, Eulji Medical Center, Eulji University School of Medicine, Seoul, Korea.
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62
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Yerli H, Agildere AM. Parotid Gland Tumors. Cancer Imaging 2008. [DOI: 10.1016/b978-012374212-4.50135-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022] Open
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63
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Piscioli I, Morelli L, Falzone A, Del Nonno F, Neri M, Di Rocco ZC, Catalucci A, Donato S, Licci S. Epithelial-myoepithelial carcinoma of the parotid gland, unusual malignancy radiologically simulating a benign lesion: case report. INTERNATIONAL SEMINARS IN SURGICAL ONCOLOGY 2007; 4:25. [PMID: 17939852 PMCID: PMC2092427 DOI: 10.1186/1477-7800-4-25] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/04/2007] [Accepted: 10/16/2007] [Indexed: 11/16/2022]
Abstract
Background Ultrasound (US), Computed Tomography (CT) and Magnetic Resonance Imaging (MRI) are widely used in the clinical diagnosis of parotid gland tumors and their efficacy in identifying benign lesions is well documented. However, problems arise when facing some malignant lesions. Only few cases of salivary gland low grade malignant tumors have been previously reported in the literature complete with the radiological features. Case presentation We here describe a case of epithelial-myoepithelial carcinoma (EMC) of the parotid gland, a low grade malignant tumor, with spread to an intraparotid lymph node and with CT and MRI findings mimicking a benign lesion. Conclusion All the images revealed sharply outlined profiles and a homogeneous enhancement of the nodule, suggesting a benign tumor and demonstrating that a radiological evaluation of the lesion alone may be unsatisfactory and misleading in the diagnosis of salivary gland tumours, especially in the case of low grade malignant tumors, such as EMC.
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Affiliation(s)
- Irene Piscioli
- Department of Pathology, National Institute for Infectious Diseases "L, Spallanzani" IRCCS, Rome, Italy.
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Yerli H, Aydin E, Coskun M, Geyik E, Ozluoglu LN, Haberal N, Kaskati T. Dynamic multislice computed tomography findings for parotid gland tumors. J Comput Assist Tomogr 2007; 31:309-16. [PMID: 17414771 DOI: 10.1097/01.rct.0000236418.82395.b3] [Citation(s) in RCA: 34] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
OBJECTIVE Our aim was to research the enhancement features of parotid gland masses in detail and characterize if the masses were Warthin tumors, adenomas, or malignant tumors. METHODS The prospective study included 25 parotid tumors in 21 patients. Neck computed tomography (CT) was performed using a multislice CT unit. A full-neck CT examination was done at 30 seconds after completion of contrast injection, and then tumor-level images were obtained at 90 seconds and at 5 and 25 minutes. Computed tomography number (lesion density in Hounsfield units) was determined at each phase, and differences within and among tumor groups were statistically analyzed. Diagnoses were confirmed by histopathology. RESULTS There were 11 Warthin tumors, 8 pleomorphic adenomas, 5 malignant tumors, and 1 basal cell adenoma. Ten Warthin tumors showed rapid contrast enhancement at 30 seconds and rapid reduction of enhancement from the first to the fourth phase. The basal cell adenoma showed also a peak enhancement at 30 seconds. Seven pleomorphic adenomas showed increased enhancement through the first 3 phases. Four malignant tumors showed peak enhancement at 90 seconds. Statistically significant differences within and among tumor groups were determined. CONCLUSIONS The data suggest that peak tumor enhancement at 30 and 90 seconds, respectively, might identify Warthin and malignant tumors. Increased enhancement through all phases might be an indicator for diagnosing pleomorphic adenomas.
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Affiliation(s)
- Hasan Yerli
- Department of Radiology, Baskent University Medical School, Ankara, Turkey.
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65
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Chawla AJ, Tan TY, Tan GJS. Basal cell adenomas of the parotid gland: CT scan features. Eur J Radiol 2006; 58:260-5. [PMID: 16414228 DOI: 10.1016/j.ejrad.2005.12.001] [Citation(s) in RCA: 15] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/18/2005] [Revised: 11/30/2005] [Accepted: 12/02/2005] [Indexed: 12/13/2022]
Abstract
Basal cell adenoma (BCA) is a rare tumor of the parotid gland, and except for a few case reports, the imaging features of this pathological entity are not well described. We describe the computed tomography (CT) features of 14 cases of histologically proven BCA, the largest series to date. In all cases, the tumor appeared as a round or oval, sharply marginated mass. Three cases showed homogenous enhancement. In the other 11 cases, the enhancement was inhomogeneous, due to either cystic areas, linear bands or stellate-shaped areas of non-enhancement. The latter two patterns have not been previously described in BCA or other parotid tumors, and may therefore aid in distinguishing BCA from other benign parotid neoplasms on CT.
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Affiliation(s)
- Ashish J Chawla
- Department of Radiology, Changi General Hospital, 2 Simei Street 3, Singapore 529889, Singapore
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66
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Abstract
OBJECTIVE The goal of this study was to report the radiologic characteristics of basal cell adenoma of the parotid gland, which is a relatively rare neoplasm. METHODS A radiology and otolaryngology specialist reviewed the 2-phase helical computed tomography (CT) (n = 6) and/or magnetic resonance (MR) imaging (n = 2) scans of 7 patients with basal cell adenoma. The authors evaluated the imaging characteristics, including tumor size, location, contour and margin, internal density or signal intensity, contrast enhancement pattern, and presence of calcification. The imaging features were then analyzed and correlated with the pathologic findings. RESULTS All the tumors presented as small (less than 3 cm), well-encapsulated, round or oval masses on CT or MR imaging. On the 2-phase CT scan, the mostly solid-looking tumors (n = 4) showed marked contrast enhancement on the early phase, and there was a subsequent decrease in attenuation on the delayed phase. These tumors were classified as the solid subtype on histologic examination. Meanwhile, the tumors with large cystic areas (n = 2) showed gradual and additional enhancement on the delayed phase and were classified as the tubular or trabecular subtype on pathologic evaluation. There were small spots of low attenuation in the tumors of the solid subtype, which were proved to be intratumoral microcysts in the pathologic correlation. Calcification was found in a tumor. CONCLUSIONS Basal cell adenomas of the parotid gland present as small well-marginated tumors and appear as masses with central large cysts or solid masses with microcysts on CT and MR imaging scans. Basal cell adenomas of the parotid gland had at least 2 different enhancement patterns on the 2-phase helical CT scans, and the enhancement patterns and imaging architecture were related to the histologic subtype of the tumors.
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Affiliation(s)
- Dong Kyung Lee
- Department of Otorhinolaryngology--Head and Neck Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
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67
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Yerli H, Teksam M, Aydin E, Coskun M, Ozdemir H, Agildere AM. Basal cell adenoma of the parotid gland: dynamic CT and MRI findings. Br J Radiol 2005; 78:642-5. [PMID: 15961849 DOI: 10.1259/bjr/32453517] [Citation(s) in RCA: 24] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022] Open
Abstract
Imaging findings in basal cell adenoma (BCA) of the parotid gland have been rarely reported. We report dynamic CT and MRI findings of BCA in the parotid gland in a 78-year-old woman. Dynamic CT study demonstrated strong multinodular contrast enhancement in the early phase which decreased gradually in the later phases. The mass was isointense on T(1) weighted and hyperintense on T(2) weighted MR images with a central haemorrhagic-necrotic component. The microscopic findings were consistent with membranous type BCA.
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Affiliation(s)
- H Yerli
- Department of Radiology, Baskent University Medical School, Ankara 06490, Turkey
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Chikui T, Shimizu M, Goto TK, Nakayama E, Yoshiura K, Kanda S, Oobu K, Nakamura S. Interpretation of the origin of a submandibular mass by CT and MRI imaging. ACTA ACUST UNITED AC 2005; 98:721-9. [PMID: 15583547 DOI: 10.1016/j.tripleo.2004.02.054] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
Abstract
OBJECTIVE To clarify the useful findings for determining whether the submandibular mass is intraglandular or extraglandular. STUDY DESIGN Forty-eight patients with swelling of the submandibular region were reviewed. The relationship between the lesion and the submandibular gland and the displacement of the anterior facial vein were analyzed. RESULTS The accuracy of the predictions based on the relationship between the lesion and the submandibular gland (SMG) was 87% on contrast-enhanced CT (CECT), 85% on CT sialography (CTS), and 91% on MRI. Although the displacement of the facial vein outside the lesion suggested an intraglandular lesion, and inside the lesion suggested an extraglandular lesion, these were not sufficient to differentiate the lesions in 7 out of 23 CECT cases and 4 out of 11 MRI cases. CONCLUSION The finding of a relationship between the lesion and the SMG is the most important finding of this study.
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Affiliation(s)
- Toru Chikui
- Department of Oral and Maxillofacial Radiology, Kyushu University Hospital, Japan.
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69
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Kim J, Kim EK, Park CS, Choi YS, Kim YH, Choi EC. Characteristic sonographic findings of Warthin's tumor in the parotid gland. JOURNAL OF CLINICAL ULTRASOUND : JCU 2004; 32:78-81. [PMID: 14750138 DOI: 10.1002/jcu.10230] [Citation(s) in RCA: 25] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/24/2023]
Abstract
PURPOSE The aim of this study was to define the characteristic sonographic features of Warthin's tumors in the parotid gland, thus enhancing the ability to make a preoperative diagnosis of this disease process. METHODS We retrospectively evaluated the sonograms of Warthin's tumors of the parotid gland that had been confirmed by histopathologic examination of surgically excised specimens from patients treated at our institution over a 2-year period. We recorded the echogenicity, shape, margin, and internal structure of the tumors and categorized them into 2 groups on the basis of size (< 5 cm versus > or =5 cm in the largest diameter). RESULTS Eighteen patients (16 men and 2 women) with a mean age of 57 years (range, 29-82 years) were included in the analysis. One patient had 2 tumors (1 in each parotid gland); the other 17 patients each had only 1 tumor. Our review of the sonographic findings revealed that all 19 tumors were hypoechoic compared with the normal parenchyma of the affected parotid glands. Most of the tumors were ovoid, had well-defined margins, and contained multiple irregular, small, sponge-like anechoic areas. Tumors that were 5 cm or greater in diameter had a higher proportion of cystic content than smaller lesions had and in some cases were composed almost entirely of cystic material. CONCLUSIONS Our evidence suggests that the sonographic appearance of a Warthin's tumor in the parotid gland is distinctive: a well-defined round or ovoid hypoechoic mass containing microcystic anechoic areas. These sonographic features constitute useful criteria in the preoperative diagnosis of Warthin's tumor in the parotid gland, although sonographically guided fine-needle aspiration biopsy may be needed to confirm the diagnosis.
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Affiliation(s)
- Jinna Kim
- Department of Diagnostic Radiology, Yonsei University College of Medicine, 134 Shinchon-dong, Seodaemun-gu, Seoul 120-752, Korea
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Moon WJ, Na DG, Ryoo JW, Kim MJ, Kim YD, Lim DH, Byun HS. Orbital lymphoma and subacute or chronic inflammatory pseudotumor: differentiation with two-phase helical computed tomography. J Comput Assist Tomogr 2003; 27:510-6. [PMID: 12886134 DOI: 10.1097/00004728-200307000-00010] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
OBJECTIVE The differentiation between orbital lymphoma and subacute or chronic inflammatory pseudotumor (SCIPT) may be difficult clinically and radiologically. The aim of this study was to evaluate the enhancement characteristics of orbital lymphoma and SCIPT with two-phase helical computed tomography (CT) and delayed coronal CT and to determine whether attenuation measurements on CT can be used to differentiate between the 2 diseases. METHODS Nineteen histopathologically proven orbital lymphomas and 9 SCIPTs were examined with two-phase helical CT. After injecting 90 mL contrast material at a rate of 3 mL/s, early- and late-phase axial CT scans were obtained with scanning delays of 30 and 90 seconds, respectively. Delayed coronal scans were obtained with delays of 4-9 minutes. Attenuation of the lesions at each phase was measured quantitatively. Relative percentages of contrast enhancement (CE) were calculated to determine the cutoff value for differentiating SCIPT from lymphoma. RESULTS The CT attenuation change over time was significantly different between orbital lymphoma and SCIPT (P < 0.05). Increased CT attenuation between early- and late-phase axial scans was seen in 42% (n = 8) of lymphoma cases, and decreased CT attenuation was seen in 58% (n = 11). In 17 lymphomas (90%), the CT attenuation decreased between late-phase axial and delayed coronal scans. Conversely, in 7 SCIPTs (78%), the CT attenuation increased gradually over time from early-phase axial to delayed coronal scans. The relative percentage of CE at the delayed coronal scan had a cutoff value of -6.97%, a sensitivity of 84%, and a specificity of 100%. CONCLUSION Different characteristics of attenuation change on two-phase helical CT and delayed coronal CT can be helpful in differentiating between orbital lymphoma and SCIPT.
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Affiliation(s)
- Won-Jin Moon
- Department of Radiology, Kangbuk Samsung Hospital, Samsung Medical Center, 50 Ilwon-Dong, Kangnam-Ku, Seoul 135-230, Korea
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Groell R, Wiltgen M, Wolf G, Habermann W. Digital image fusion of early and delayed CT scans: how to achieve optimal opacification of vessels and squamous cell carcinomas of the head and neck. AJR Am J Roentgenol 2002; 178:211-3. [PMID: 11756122 DOI: 10.2214/ajr.178.1.1780211] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Affiliation(s)
- Reinhard Groell
- Department of Radiology, University Hospital Graz, Auenbruggerplatz 9, A-8036 Graz, Austria
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