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Contrast-Enhanced Ultrasound in the Differentiation between the Most Common Benign Parotid Gland Tumors: A Systematic Review and Meta-Analysis. J Clin Med 2022; 11:jcm11247360. [PMID: 36555976 PMCID: PMC9787854 DOI: 10.3390/jcm11247360] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2022] [Revised: 12/03/2022] [Accepted: 12/09/2022] [Indexed: 12/14/2022] Open
Abstract
Recently, contrast-enhanced ultrasound (CEUS) has become a promising tool in distinguishing benign from malignant parotid gland tumors. However, its usefulness in differentiating various benign parotid tumors has not been determined so far. This study aimed to systematically review the literature to determine the utility of CEUS in the preoperative differentiation between pleomorphic adenomas (PAs) and Warthin's tumors (WTs) of the parotid gland. PubMed, Embase, and Cochrane were searched for English-language articles published until 21 July 2022. Fifteen studies were included. On CEUS examination, a significantly greater percentage of PAs displayed heterogeneous enhancement texture compared to WTs. Contrarily, the enhanced lesion size, the enhancement margin, and the presence of the enhancement rim did not differ significantly between the entities. Significantly longer normalized mean transit time (nMTT) and time to peak (TTP) were observed in PAs. Contrarily, the mean values of area under the curve (AUC) and time from peak to one half (TPH) were significantly higher for WTs. Due to the considerable overlap among the qualitative CEUS characteristics of PAs and WTs, the reproducible, investigator-independent quantitative CEUS measurements have a greater potential to distinguish PAs from WTs, which might influence the selection of an appropriate management strategy.
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Jering M, Mayer M, Thölken R, Schiele S, Maccagno A, Zenk J. Diagnostic Accuracy and Post-Procedural Complications Associated with Ultrasound-Guided Core Needle Biopsy in the Preoperative Evaluation of Parotid Tumors. Head Neck Pathol 2021; 16:651-656. [PMID: 34919166 PMCID: PMC9424419 DOI: 10.1007/s12105-021-01401-w] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/05/2021] [Accepted: 12/01/2021] [Indexed: 11/08/2022]
Abstract
Correct diagnosis of a parotid neoplasm based on histology preoperatively is of utmost importance in order to guide patient management. The aim of this study was to evaluate the diagnostic accuracy of an ultrasound-guided core needle biopsy of a parotid lesion and to describe associated post-procedural complications. A retrospective study was conducted between January 2015 and March 2021 of all patients who were referred to a tertiary care center for evaluation of a parotid lesion and who underwent core needle biopsy due to high-risk features or when malignancy was suspected on clinical examination or ultrasonography. Patient characteristics, histological findings, and post-procedural complications were recorded and evaluated. Among 890 patients referred for evaluation of a parotid lesion, in 138 patients a core needle biopsy was undertaken. On the basis of core needle biopsy findings, 11 lymphomas and 82 non-lymphoma malignancies were diagnosed in the parotid gland. The sensitivity of the core needle biopsy predicting the accurate tumor type was 97.56% (95% CI 91.47-99.70%) and the specificity 94.64% (95% CI 85.13-98.88%). The accuracy for the correct histopathological diagnosis was 93.48% (95% CI 87.98-96.97%). Post-procedural minor complications occurred in 19 patients (13.8%). In conclusion, a core needle biopsy can identify malignancy in the parotid gland with high sensitivity and specificity in a safe manner and therefore guide surgical treatment.
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Affiliation(s)
- Monika Jering
- grid.7307.30000 0001 2108 9006Department of Otolaryngology, Head and Neck Surgery, Medical Faculty, University Hospital Augsburg, University of Augsburg, Sauerbruchstaße 6, 86156 Augsburg, Germany
| | - Marcel Mayer
- grid.6190.e0000 0000 8580 3777Department of Otolaryngology, Head and Neck Surgery, Medical Faculty, University of Cologne, Kerpener Straße 62, 50931 Cologne, Germany
| | - Rubens Thölken
- grid.7307.30000 0001 2108 9006Department of Otolaryngology, Head and Neck Surgery, Medical Faculty, University Hospital Augsburg, University of Augsburg, Sauerbruchstaße 6, 86156 Augsburg, Germany
| | - Stefan Schiele
- grid.7307.30000 0001 2108 9006Institute of Mathematics, University of Augsburg, Universitätsstraße 2, 86159 Augsburg, Germany
| | - Andrea Maccagno
- grid.7307.30000 0001 2108 9006Institute of General Pathology and Molecular Diagnostics, Medical Faculty, University of Augsburg, Stenglinstraße 2, 86156 Augsburg, Germany
| | - Johannes Zenk
- grid.7307.30000 0001 2108 9006Department of Otolaryngology, Head and Neck Surgery, Medical Faculty, University Hospital Augsburg, University of Augsburg, Sauerbruchstaße 6, 86156 Augsburg, Germany
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Bewley AF, Azhdam AM, Borrelli M. Intraparotid Facial Nerve Schwannoma Mimicking Primary Parotid Neoplasm. EAR, NOSE & THROAT JOURNAL 2021; 100:881S-883S. [PMID: 34402315 DOI: 10.1177/01455613211040372] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
The following report is of a 36-year-old male who presented with a growing mass in the region of the parotid gland. Initial fine needle aspiration biopsy suggested a primary neoplasm of the parotid gland, but subsequent frozen section analysis intraoperatively demonstrated a schwannoma of the facial nerve. An intracapsular enucleation of the schwannoma was performed in order to preserve the fibers of the motor nerve.
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Affiliation(s)
- Arnaud F Bewley
- Department of Otolaryngology/Head and Neck Surgery, University of California, Davis, CA, USA
| | - Ariel M Azhdam
- Rosalind Franklin University of Medicine and Science, Chicago Medical School, Chicago, IL, USA
| | - Michela Borrelli
- Cedars Sinai Sinus Center of Excellence, Los Angeles, CA, USA.,Cedars-Sinai Division of Otolaryngology, Los Angeles, CA, USA
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Ultrasound core biopsies of neck lumps: an experience from a tertiary head and neck cancer unit. The Journal of Laryngology & Otology 2021; 135:799-803. [PMID: 34266504 DOI: 10.1017/s0022215121001833] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
BACKGROUND Traditionally, fine needle aspiration cytology was the primary diagnostic investigation for head and neck lumps; however, ultrasound-guided core biopsy offers the advantage of preserving tissue architecture with increased tissue yield. This study reviews the diagnostic utility of ultrasound-guided core biopsy for investigating head and neck lumps. METHODS Overall, 287 ultrasound-guided core biopsies were reviewed between May 2017 and April 2019 at a single tertiary site for head and neck cancer. RESULTS On initial ultrasound-guided core biopsy, a diagnostic sample was obtained in 94.4 per cent of patients and in 83.7 per cent of patients with lymphoma. Where the initial ultrasound-guided core biopsy was non-diagnostic, 50 per cent of samples were diagnostic on repeat ultrasound-guided core biopsy. Overall, five complications were seen related to ultrasound-guided core biopsy, and all were managed conservatively. No cases of disease recurrence were identified at the biopsy site. CONCLUSION Ultrasound-guided core biopsy is a safe procedure with a high diagnostic yield when investigating head and neck lumps. Patients whose ultrasound-guided core biopsies were non-diagnostic should be considered for excisional biopsy over repeat ultrasound-guided core biopsy.
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Al-Haj Husain A, Stadlinger B, Winklhofer S, Müller M, Piccirelli M, Valdec S. Mandibular Third Molar Surgery: Intraosseous Localization of the Inferior Alveolar Nerve Using 3D Double-Echo Steady-State MRI (3D-DESS). Diagnostics (Basel) 2021; 11:diagnostics11071245. [PMID: 34359328 PMCID: PMC8303593 DOI: 10.3390/diagnostics11071245] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/17/2021] [Revised: 07/02/2021] [Accepted: 07/07/2021] [Indexed: 11/16/2022] Open
Abstract
The aim of this study was to evaluate the inferior alveolar nerve's (IAN) intraosseous position within the inferior alveolar canal (IAC) using a 3D double-echo steady-state MRI sequence (3D-DESS). The IAN position was prospectively evaluated in 19 patients undergoing mandibular third molar (MTM) surgery. In the coronal reference layer, the IAC was divided into six segments. These segments were checked for the presence of hyperintense tubular MRI signals representing the IAN's nervous tissue and assessed as visible/non-visible. Furthermore, the IAN in MRI and the IAC in MRI and CBCT were segmented at the third and second molar, determining the maximum diameter in all planes and a conversion factor between the imaging modalities. Regardless of the positional relationship at the third and second molar, the IAN showed the highest localization probability in the central segments (segment 2: 97.4% vs. 94.4%, segment 5: 100% vs. 91.6%). The conversion factors from IAC in CBCT and MRI to IAN in MRI, respectively, were the following: axial (2.04 ± 1.95, 2.37 ± 2.41), sagittal (1.86 ± 0.96, 1.76 ± 0.74), and coronal (1.26 ± 0.39, 1.37 ± 0.25). This radiation-free imaging modality, demonstrating good feasibility of accurate visualization of nervous tissue within the nerve canal's osseous boundaries, may benefit preoperative assessment before complex surgical procedures are performed near the IAC.
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Affiliation(s)
- Adib Al-Haj Husain
- Center of Dental Medicine, Clinic of Cranio-Maxillofacial and Oral Surgery, University of Zurich, 8032 Zurich, Switzerland; (A.A.-H.H.); (B.S.)
| | - Bernd Stadlinger
- Center of Dental Medicine, Clinic of Cranio-Maxillofacial and Oral Surgery, University of Zurich, 8032 Zurich, Switzerland; (A.A.-H.H.); (B.S.)
| | - Sebastian Winklhofer
- Clinical Neuroscience Center, Department of Neuroradiology, University Hospital of Zurich, University of Zurich, 8091 Zurich, Switzerland; (S.W.); (M.P.)
| | - Marcel Müller
- Statistical Services, Center of Dental Medicine, University of Zurich, 8032 Zurich, Switzerland;
| | - Marco Piccirelli
- Clinical Neuroscience Center, Department of Neuroradiology, University Hospital of Zurich, University of Zurich, 8091 Zurich, Switzerland; (S.W.); (M.P.)
| | - Silvio Valdec
- Center of Dental Medicine, Clinic of Cranio-Maxillofacial and Oral Surgery, University of Zurich, 8032 Zurich, Switzerland; (A.A.-H.H.); (B.S.)
- Department of Stomatology, Division of Periodontology, Dental School, University of São Paulo, Butantã 2227, SP, Brazil
- Correspondence: ; Tel.: +41-44-634-32-90
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Yan M, Xu D, Chen L, Zhou L. Comparative Study of Qualitative and Quantitative Analyses of Contrast-Enhanced Ultrasound and the Diagnostic Value of B-Mode and Color Doppler for Common Benign Tumors in the Parotid Gland. Front Oncol 2021; 11:669542. [PMID: 34307139 PMCID: PMC8292955 DOI: 10.3389/fonc.2021.669542] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/19/2021] [Accepted: 06/17/2021] [Indexed: 12/02/2022] Open
Abstract
Purpose To preliminarily identify three common benign parotid gland tumors: pleomorphic adenomas (PA), Warthin tumors (WT), and basal cell adenomas (BCA) by qualitative and quantitative analyses using contrast-enhanced ultrasound (CEUS). Methods Preoperative images of parotid gland masses were analyzed, including 129 cases of ultrasonography (US) and color Doppler sonography (CDS) and 110 cases of qualitative and quantitative CEUS. The diagnosis was confirmed by postsurgical pathology outcomes. Results PA presented low and heterogeneous enhancement and echo-free area, whereas most WT and BCA presented with high and relatively homogeneous enhancement. Compared with WT and BCA groups, a “slow in” pattern was more common in the PA group and a “slow out” pattern was more frequently noted in the WT group than in the PA and BCA groups. The unique features of qualitative CEUS in the PA group enable distinguishing PA from the 2 other groups. The further distinction among the groups was made based on quantitative parameters of time-intensity curves (TICs), which revealed that the mean peak intensity (PI), mean transit time (MTT), the area under the curve (AUC), and time from peak to one half (HT) exhibited significant differences. ROC analysis was next applied to determine the optimal cutoff points to predict the diagnostic tendency among the groups. When the rising slope (RS) was >2.145, the possibility of BCA was greater than WT. Conclusions CEUS ultrasound is of significant value in the differential diagnosis of the 3 common benign parotid gland masses.
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Affiliation(s)
- Meiying Yan
- Department of Radiology (Ultrasound), Cancer Hospital of the University of Chinese Academy of Sciences (Zhejiang Cancer Hospital), Institute of Cancer and Basic Medicine (IBMC), Chinese Academy of Sciences, Hangzhou, China
| | - Dong Xu
- Department of Radiology (Ultrasound), Cancer Hospital of the University of Chinese Academy of Sciences (Zhejiang Cancer Hospital), Institute of Cancer and Basic Medicine (IBMC), Chinese Academy of Sciences, Hangzhou, China
| | - Liyu Chen
- Department of Radiology (Ultrasound), Cancer Hospital of the University of Chinese Academy of Sciences (Zhejiang Cancer Hospital), Institute of Cancer and Basic Medicine (IBMC), Chinese Academy of Sciences, Hangzhou, China
| | - Lingyan Zhou
- Department of Radiology (Ultrasound), Cancer Hospital of the University of Chinese Academy of Sciences (Zhejiang Cancer Hospital), Institute of Cancer and Basic Medicine (IBMC), Chinese Academy of Sciences, Hangzhou, China.,Key Laboratory of Head & Neck Cancer Translational Research of Zhejiang Province, Hangzhou, China
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Microbial Screening Reveals Oral Site-Specific Locations of the Periodontal Pathogen Selenomonas noxia. Curr Issues Mol Biol 2021; 43:353-364. [PMID: 34204609 PMCID: PMC8929098 DOI: 10.3390/cimb43010029] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/06/2021] [Revised: 06/05/2021] [Accepted: 06/10/2021] [Indexed: 12/29/2022] Open
Abstract
INTRODUCTION Selenomonas noxia (SN) is an important periodontal pathogen, associated with gingivitis and periodontitis. Many studies have found associations between SN and indicators of poor health outcomes, such as smoking, low socioeconomic status and obesity. However, less is known about the prevalence of this organism and more specifically about other oral site-specific locations that may harbor this organism. METHODS Using an existing patient repository (n = 47) of DNA isolated from saliva and other oral sites (n = 235), including the dorsum of the tongue, lower lingual incisor, upper buccal molar and gingival crevicular fluid (GCF), molecular screening for SN was performed. Screening results were analyzed for associations between demographic variables (age, sex, race/ethnicity) and clinical information (body mass index or BMI, presence of orthodontic brackets, primary/mixed/permanent dentition). RESULTS qPCR screening revealed a total of n = 62/235 sites or 26.3% harboring SN with saliva and GCF (either alone or in combination with one or more sites) most often observed (Saliva, n = 23/27 or 85.18%, GCF, n = 14/27 or 51%). Analysis of site-specific data revealed most positive results were found among saliva and GCF alone or in combination, with fewer positive results observed among the tongue (33.3%), lower lingual incisor (29.6%), and upper buccal molar (25.9%). No significant associations were found between demographic or clinical variables and presence of SN at any site. CONCLUSIONS These results may be among the first to describe site-specific locations of S. noxia among various additional oral biofilm sites. These data may represent a significant advancement in our understanding of the sites and locations that harbor this organism, which may be important for our understanding of the prevalence and distribution of these organisms among patients of different ages undergoing different types of oral treatments, such as orthodontic treatment or therapy.
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Saito D, Shiga K, Katagiri K, Oikawa S, Ikeda A, Tsuchida K, Miyaguchi J, Kusaka T, Kuroda H, Takahashi F. Contrast-enhanced ultrasonography for the differential diagnosis of pleomorphic adenomas and Warthin tumors in salivary glands. Laryngoscope Investig Otolaryngol 2021; 6:425-431. [PMID: 34195363 PMCID: PMC8223473 DOI: 10.1002/lio2.565] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/17/2020] [Revised: 03/09/2021] [Accepted: 04/11/2021] [Indexed: 01/10/2023] Open
Abstract
OBJECTIVE Pleomorphic adenomas have risks of malignant transformation and post operate recurrence. Therefor it is important that diagnosing pleomorphic adenomas or Warthin tumors before an operation. We evaluated the usefulness of contrast-enhanced ultrasonography (CEUS) with Sonazoid for making differential diagnoses between pleomorphic adenomas and Warthin tumors. METHODS CEUS was performed the day before surgery in 39 patients. We compared the time-intensity curve and capillary density rate of 14 pleomorphic adenomas and 13 Warthin tumors. RESULTS Pleomorphic adenomas demonstrated a significantly longer time to peak intensity and lower maximum curve gradient of wash-in than Warthin tumors. The capillary density rate of Warthin tumors tended to be greater than that of pleomorphic adenomas. CONCLUSIONS CEUS and capillary density rate analysis using Sonazoid is helpful for the differential diagnosis of pleomorphic adenomas and Warthin tumors. LEVEL OF EVIDENCE 3b.
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Affiliation(s)
- Daisuke Saito
- Department of Head and Neck SurgeryIwate Medical University HospitalYahaba‐choJapan
| | - Kiyoto Shiga
- Department of Head and Neck SurgeryIwate Medical University HospitalYahaba‐choJapan
| | - Katsunori Katagiri
- Department of Head and Neck SurgeryIwate Medical University HospitalYahaba‐choJapan
| | - Shin‐ichi Oikawa
- Department of Head and Neck SurgeryIwate Medical University HospitalYahaba‐choJapan
| | - Aya Ikeda
- Department of Head and Neck SurgeryIwate Medical University HospitalYahaba‐choJapan
| | - Kodai Tsuchida
- Department of Head and Neck SurgeryIwate Medical University HospitalYahaba‐choJapan
| | - Jun Miyaguchi
- Department of Head and Neck SurgeryIwate Medical University HospitalYahaba‐choJapan
| | - Takahiro Kusaka
- Department of Head and Neck SurgeryIwate Medical University HospitalYahaba‐choJapan
| | - Hidekatsu Kuroda
- Department of Internal MedicineIwate Medical University HospitalYahaba‐choJapan
| | - Fumiaki Takahashi
- Division of Medical Engineering, Department of Information ScienceIwate Medical UniversityYahaba‐choJapan
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Canullo L, Rossi-Fedele G, Camodeca F, Menini M, Pesce P. A Pilot Retrospective Study on the Effect of Bone Grafting after Wisdom Teeth Extraction. MATERIALS 2021; 14:ma14112844. [PMID: 34073339 PMCID: PMC8198454 DOI: 10.3390/ma14112844] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/17/2021] [Revised: 05/20/2021] [Accepted: 05/24/2021] [Indexed: 12/04/2022]
Abstract
This study aimed to retrospectively investigate the effect of bone graft after extraction of wisdom teeth impacting with the distal aspect of the second molar, on soft tissue wound healing, bone loss, and periodontal parameters. Sixteen patients treated an for impacted mandibular wisdom tooth at least one year ago were re-called (18 teeth). Dental panoramic tomography and periodontal parameters were assessed. A graft material was used to fill the post-extractive sockets in the test group (GUIDOR easy-graft CRYSTAL), whereas in the control group, the socket was filled using a collagen sponge and blood clot (Hemocollagene, Septodont, Matarò, Spain). The radiographic bone loss was measured at the distal aspect of the second molar. The Wilcoxon singed-rank test for paired data was performed to evaluate statistical differences. In the test group, only two cases out of nine showed bone loss, with an average of 0.55 ± 1.30 mm. Conversely, in the control group, five teeth out of nine showed bone resorption with an average of 1.22 ± 1.30 mm. However, the differences were not statistically significant. Periodontal parameters at the second molar demonstrated similar behavior between the test and control groups. Soft tissue healing complications were lower in the grafted compared to the comparator sites without reaching statistical significance. Within the limitations of the present study, no difference was found between the two groups.
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Affiliation(s)
- Luigi Canullo
- Department of Periodontology, University of Bern, 3000 Bern, Switzerland;
| | | | | | - Maria Menini
- Department of Surgical Sciences and Integrated Diagnostics, University of Genoa, 16100 Genoa, Italy;
| | - Paolo Pesce
- Department of Surgical Sciences and Integrated Diagnostics, University of Genoa, 16100 Genoa, Italy;
- Correspondence:
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Pilmane M, Jain N, Vitenberga-Verza Z. Expression Analysis of FGF/FGFR and FOX Family Proteins in Mucosal Tissue Obtained from Orofacial Cleft-Affected Children. BIOLOGY 2021; 10:423. [PMID: 34068496 PMCID: PMC8151933 DOI: 10.3390/biology10050423] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/13/2021] [Revised: 05/04/2021] [Accepted: 05/06/2021] [Indexed: 01/02/2023]
Abstract
Orofacial clefts affect hundreds of thousands of children worldwide annually and are usually corrected by a series of surgeries extending to childhood. The underlying mechanisms that lead to clefts are still unknown, mainly because of the multifactorial etiology and the myriad of interactions between genes and environmental factors. In the present study, we investigated the role and expression of candidate genes belonging to the FGF/FGFR signaling pathway and FOX family in tissue material obtained from 12 pediatric patients undergoing cleft correction surgery. The expression was investigated using immunohistochemistry (IHC) and chromogenic in-situ hybridization (CISH) in three cell/tissue types-epithelial cells, connective tissue, and endothelial cells. We found elevated expression of FGFR1 in epithelial cells while no expression was observed in endothelial cells. Further, our results elucidate the potential pathogenetic role of FGFR1 in cellular proliferation, local site inflammation, and fibrosis in cleft patients. Along with bFGF (also called FGF2), FGFR1 could play a pro-inflammatory role in clefts. Over-amplification of FGFR2 in some patients, along with bFGF, could potentially suggest roles for these genes in angiogenesis. Additionally, increased expression of FOXE1 (also called TTF2) contributes to local site inflammation. Finally, zero to low amplification of FOXO1 could suggest its potential role in inducing oxidative stress in the endothelium along with reduced epithelial apoptosis.
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Affiliation(s)
| | - Nityanand Jain
- Department of Morphology, Institute of Anatomy and Anthropology, Riga Stradinš University, LV-1007 Riga, Latvia; (M.P.); (Z.V.-V.)
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Metallothionein 3 Promotes Osteoblast Differentiation in C2C12 Cells via Reduction of Oxidative Stress. Int J Mol Sci 2021; 22:ijms22094312. [PMID: 33919218 PMCID: PMC8122383 DOI: 10.3390/ijms22094312] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/24/2021] [Revised: 04/17/2021] [Accepted: 04/19/2021] [Indexed: 02/06/2023] Open
Abstract
Metallothioneins (MTs) are intracellular cysteine-rich proteins, and their expressions are enhanced under stress conditions. MTs are recognized as having the ability to regulate redox balance in living organisms; however, their role in regulating osteoblast differentiation is still unclear. In this research, we found that the expression of MT3, one member of the MT protein family, was specifically upregulated in the differentiation process of C2C12 myoblasts treated with bone morphogenetic protein 4 (BMP4). Transfection with MT3-overexpressing plasmids in C2C12 cells enhanced their differentiation to osteoblasts, together with upregulating the protein expression of bone specific transcription factors runt-related gene 2 (Runx2), Osterix, and distal-less homeobox 5 (Dlx5). Additionally, MT3 knockdown performed the opposite. Further studies revealed that overexpression of MT3 decreased reactive oxygen species (ROS) production in C2C12 cells treated with BMP4, and MT3 silencing enhanced ROS production. Treating C2C12 cells with antioxidant N-acetylcysteine also promoted osteoblast differentiation, and upregulated Runx2/Osterix/Dlx5, while ROS generator antimycin A treatment performed the opposite. Finally, antimycin A treatment inhibited osteoblast differentiation and Runx2/Osterix/Dlx5 expression in MT3-overexpressing C2C12 cells. These findings identify the role of MT3 in osteoblast differentiation and indicate that MT3 may have interesting potential in the field of osteogenesis research.
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Morales Morales CA, Ramos Mayo AE, Gonzalez-Urquijo M, Barbosa Quintana Á, Guzmán Huerta EA. Non-sebaceous Lymphadenoma of the Parotid Gland Mimicking a Pleomorphic Adenoma. CLINICAL PATHOLOGY (THOUSAND OAKS, VENTURA COUNTY, CALIF.) 2021; 14:2632010X21996338. [PMID: 33709077 PMCID: PMC7907658 DOI: 10.1177/2632010x21996338] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/13/2020] [Accepted: 01/31/2021] [Indexed: 11/15/2022]
Abstract
Non-sebaceous lymphadenoma of the salivary glands is a rare benign lesion, first described in 1991. We present the case of a 54-year-old woman, with a right parotid mass. She underwent right superficial parotidectomy, and histopathology reported a non-sebaceous lymphadenoma due to an encapsulated lesion and multiple non-atypical epithelial inclusions without sebaceous differentiation. The etiology of non-sebaceous lymphadenoma is not yet understood, but it can arise predominantly from the parotid gland. Surgical excision is the treatment of choice.
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Kilavuz AE, Songu M, İmre A, Arslanoğlu S, Özkul Y, Pinar E, Ateş D. Application of Sal classification to parotid gland fine-needle aspiration cytology: 10-year retrospective analysis of 312 patients. Head Neck 2018; 40:937-942. [PMID: 29385293 DOI: 10.1002/hed.25056] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/19/2016] [Revised: 09/10/2017] [Accepted: 11/22/2017] [Indexed: 11/07/2022] Open
Abstract
BACKGROUND The accuracy of fine-needle aspiration biopsy (FNAB) is controversial in parotid tumors. We aimed to compare FNAB results with the final histopathological diagnosis and to apply the "Sal classification" to our data and discuss its results and its place in parotid gland cytology. METHODS The FNAB cytological findings and final histological diagnosis were assessed retrospectively in 2 different scenarios based on the distribution of nondefinitive cytology, and we applied the Sal classification and determined malignancy rate, sensitivity, and specificity for each category. RESULTS In 2 different scenarios FNAB sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV) were found to be 81%, 87%, 54.7%, and 96.1%; and 65.3%, 100%, 100%, and 96.1%, respectively. The malignancy rates and sensitivity and specificity were also calculated and discussed for each Sal category. CONCLUSION We believe that the Sal classification has a great potential to be a useful tool in classification of parotid gland cytology.
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Affiliation(s)
- Ahmet Erdem Kilavuz
- Department of Otorhinolaryngology, Acibadem Healthcare Group Taksim Hospital, Istanbul, Turkey
| | - Murat Songu
- Department of Otorhinolaryngology, Izmir Katip Celebi University, Ataturk Training and Research Hospital, Izmir, Turkey
| | - Abdulkadir İmre
- Department of Otorhinolaryngology, Izmir Katip Celebi University, Ataturk Training and Research Hospital, Izmir, Turkey
| | - Secil Arslanoğlu
- Department of Otorhinolaryngology, Izmir Katip Celebi University, Ataturk Training and Research Hospital, Izmir, Turkey
| | - Yilmaz Özkul
- Department of Otorhinolaryngology, Izmir Katip Celebi University, Ataturk Training and Research Hospital, Izmir, Turkey
| | - Ercan Pinar
- Department of Otorhinolaryngology, Izmir Katip Celebi University, Ataturk Training and Research Hospital, Izmir, Turkey
| | - Düzgün Ateş
- Department of Otorhinolaryngology, Izmir Katip Celebi University, Ataturk Training and Research Hospital, Izmir, Turkey
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Gavín-Clavero MA, Usón-Bouthelier T, Jariod-Ferrer ÚM, Fernández-Larrañaga A, Pantilie B, Lobera-Molina F, Simón-Sanz MV, Cristóbal BN. Accuracy of FNAC and CT in the Differentiation of Benign and Malignant Parotid Tumours in a Case Series. ACTA OTORRINOLARINGOLOGICA ESPANOLA 2018. [DOI: 10.1016/j.otoeng.2017.12.009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
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Shkedy Y, Alkan U, Mizrachi A, Shochat T, Dimitstein O, Morgenstern S, Shpitzer T, Bachar G. Fine-needle aspiration cytology for parotid lesions, can we avoid surgery? Clin Otolaryngol 2017; 43:632-637. [DOI: 10.1111/coa.13038] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/21/2017] [Indexed: 11/29/2022]
Affiliation(s)
- Y. Shkedy
- Departments of Otorhinolaryngology-Head and Neck Surgery; Rabin Medical Center; Petach Tikva Israel
| | - U. Alkan
- Departments of Otorhinolaryngology-Head and Neck Surgery; Rabin Medical Center; Petach Tikva Israel
| | - A. Mizrachi
- Departments of Otorhinolaryngology-Head and Neck Surgery; Rabin Medical Center; Petach Tikva Israel
| | - T. Shochat
- Departments of Medical Statistics; Rabin Medical Center; Petach Tikva Israel
| | - O. Dimitstein
- Sackler Faculty of Medicine; Tel Aviv University; Tel Aviv Israel
| | - S. Morgenstern
- Departments of Pathology & Cytology; Rabin Medical Center; Petach Tikva Israel
| | - T. Shpitzer
- Departments of Otorhinolaryngology-Head and Neck Surgery; Rabin Medical Center; Petach Tikva Israel
| | - G. Bachar
- Departments of Otorhinolaryngology-Head and Neck Surgery; Rabin Medical Center; Petach Tikva Israel
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Accuracy of FNAC and CT in the differentiation of benign and malignant parotid tumours in a case series. ACTA OTORRINOLARINGOLOGICA ESPANOLA 2017; 69:25-29. [PMID: 28844507 DOI: 10.1016/j.otorri.2017.05.003] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2016] [Revised: 04/13/2017] [Accepted: 05/10/2017] [Indexed: 11/21/2022]
Abstract
INTRODUCTION Parotid tumours, in addition to the wide variety of types, are histologically complex. Differentiating between benign and malignant tumours in preoperative diagnosis is important in deciding the type of surgery required. Fine needle aspiration cytology (FNAC) is a simple, quick, low-cost, low-invasive and well-tolerated tool used in the preoperative diagnosis of these tumours. MATERIAL AND METHODS we calculated the sensitivity, specificity, predictive positive value (PPV) and negative predictive value (NPV) of FNAC and computed tomography (CT) in the differentiation of benign and malignant parotid tumours operated between 2010 to 2014 in the oral and maxillofacial surgery department of the University Hospital Miguel Servet. RESULTS The sensitivity of FNAC is 50%, while the specificity is high, at 98.7%. FNAC offers high reliability in the diagnosis of malignant tumours, despite its low sensitivity. However, when the diagnosis is indeterminate or benign, other than pleomorphic adenoma or Whartin tumour, the reliability to exclude malignancy decreases. CONCLUSION The low sensitivity of FNAC to differentiate malignant from benign parotid tumours, means that we cannot rule out other diagnostic tests, clinical symptoms and especially the intraoperative vision of each surgeon. Especially when the diagnosis is indeterminate. Nevertheless, it is a technique used in a systematised way and helps in pre-surgical decision-making.
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Kilic K, Sakat M, Gozeler M, Demirci E. Parotid gland involvement as an initial presentation of papillary thyroid carcinoma. Int J Oral Maxillofac Surg 2017; 46:965-967. [DOI: 10.1016/j.ijom.2017.04.002] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/04/2016] [Revised: 02/28/2017] [Accepted: 04/06/2017] [Indexed: 10/19/2022]
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Routine non-thyroid head and neck cytology in a large UK centre: clinical utility and pitfalls. The Journal of Laryngology & Otology 2015; 129:682-7. [DOI: 10.1017/s0022215115000092] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
AbstractObjective:This study aimed to examine the performance of head and neck cytology at Nottingham University Hospitals between 2009 and 2010.Methods:Cases were extracted from the Winpath pathology reporting system and correlations were investigated between results and the histological and clinical outcomes. Specimen adequacy and the sensitivity, specificity, positive and negative predictive values, and diagnostic accuracy of the cytology tests were calculated.Results:In all, 19.7 per cent of aspirates were judged to be inadequate. The absolute and relative sensitivities of head and neck cytology were 87.0 per cent and 89.0 per cent, respectively, and the absolute and relative specificities were 99.0 per cent and 97.0 per cent, respectively. The positive predictive values were 99.0 per cent and 96.0 per cent and the negative predictive values were 92.0 per cent and 92.0 per cent for a diagnostic accuracy of 94.5 per cent and 93.0 per cent. The performance was consistent with previous reports and superior to that of a recent UK series. The high rate of inadequate samples is, however, a concern.Conclusion:Head and neck cytology is a robust technique at our institution, although there are certain problem areas. There is room for improvement in the technical quality of fine needle aspiration.
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Altinay S, Taskın U, Sar M, Aydın S, Oktay MF. Histopathological diversity in parotidectomy materials in Turkish population: clinicopathologic analysis and demographic features of 136 cases in a tertiary care hospital. Asian Pac J Cancer Prev 2015; 15:5701-7. [PMID: 25081689 DOI: 10.7314/apjcp.2014.15.14.5701] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Salivary gland tumours, which account for approximately 3% of head-neck cancers, are a heterogeneous group and thus it is difficult to identify their epidemiological characteristics. The aim of this study is to determine demographic features and histopathologic distribution of parotid neoplasms in a large sample from Turkey. MATERIALS AND METHODS This study was conducted retrospectively on 136 parotidectomy materials from operations between May 2009-May 2013. Age, gender, tumor diameter, histopathological diagnosis and surgical margin status were recorded. RESULTS The benign cases were 112 (82.4%), while the malignancies were 24 (17.6%). The accuracy rate of FNAC was 91%. There were 46 (33.8%) male and 90 (66.2%) female patients. Female/ male ratio (M/F=0.5) was two, the Warthin (WT) tumor being more apparent in males (p<0.05). Pleomorphic adenoma (PA) was detected most frequently among benign pathologies at 61.6% (69/112), while the Warthin Tumor (WT) was detected as the second most frequent tumor at 20.5% (23/112). Mucoepidermoid carcinoma (MEC) and carcinoma ex pleomorphic adenoma (Ca ex PA) were detected at equal frequency at 20.8% (5/24) among malign tumors. These were followed by acinic cell carcinoma at 16.7% (4/24). While the surgical margin was positive in ten patients with malignant tumors (41.7%), all of the benign tumors were negative (p<0.01). No significant difference was detected in the age-gender of patients, tumor size and distribution of sites among benign and malignant groups (p>0.05). CONCLUSIONS Pleomorphic adenoma is the most frequently reported benign tumor almost in all global literature. Yet, the distribution of malignant tumors displays geographical differences. Based on these data, we believe that our findings will provide a significant contribution to future epidemiological studies. We think that it will be beneficial to generate awareness on parotid tumors and ensure a fight against smoking as with all head-neck cancers.
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Affiliation(s)
- Serdar Altinay
- Department of Pathology, Bagcilar Training and Research Hospital, Istanbul, Turkey E-mail :
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Consamus EN, Smith D, Pina Oviedo S, Mody DR, Takei H. Diagnostic accuracy of fine-needle aspiration cytology of salivary gland lesions: A 6-year retrospective review. J Am Soc Cytopathol 2015; 4:63-73. [PMID: 31051711 DOI: 10.1016/j.jasc.2014.11.003] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2014] [Revised: 11/06/2014] [Accepted: 11/06/2014] [Indexed: 06/09/2023]
Abstract
INTRODUCTION The aim of this study was to evaluate the diagnostic accuracy of salivary gland fine-needle aspiration (FNA) in comparison to histologic examination and to recognize possible pitfalls in diagnosis. MATERIALS AND METHODS The diagnoses and demographics of all cases of salivary gland FNAs with concurrent or subsequent histologic correlation at our institution over a 6-year period (2006-2011) were retrospectively reviewed and compared for discrepancies. Discrepancies were categorized as either major or minor and due to sampling or interpretive variance. RESULTS Overall, the following values were calculated: sensitivity 80.6%, specificity 97.5%, positive predictive value 92.6%, negative predictive value 92.8%, accuracy 92.7%, and concordance rate 90.9%. In addition, concordance rates were calculated for the 2 most common diagnoses: pleomorphic adenoma (97.1%, n = 35) and Warthin tumor (88.9%, n = 9). Five major and 5 minor discrepancies were found. Most of the major discrepancies and all of the minor discrepancies were due to sampling and interpretive variances, respectively. Sampling issues occurred in FNAs with and without ultrasound guidance. The interpretive variance included interpretative discrepancies in monomorphic cellular lesions, abundant inflammation and reactive atypia, cystic changes, abundant matrix deposition or fibrosis, and difficulty in diagnosing mucoepidermoid carcinoma or lymphoma on cytology. CONCLUSIONS FNA of salivary gland lesions is a procedure with high specificity, positive predictive value, negative predictive value, accuracy, and concordance with histologic examination; however, discrepancies do exist. Recognizing potential pitfalls is key to avoiding discrepancies.
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Affiliation(s)
- Erin N Consamus
- Department of Pathology and Genomic Medicine, Houston Methodist Hospital, 6565 Fannin Street, Houston, Texas
| | - Deborah Smith
- Department of Pathology and Genomic Medicine, Houston Methodist Hospital, 6565 Fannin Street, Houston, Texas
| | - Sergio Pina Oviedo
- Department of Pathology and Genomic Medicine, Houston Methodist Hospital, 6565 Fannin Street, Houston, Texas
| | - Dina R Mody
- Department of Pathology and Genomic Medicine, Houston Methodist Hospital, 6565 Fannin Street, Houston, Texas
| | - Hidehiro Takei
- Department of Pathology and Genomic Medicine, Houston Methodist Hospital, 6565 Fannin Street, Houston, Texas.
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Davachi B, Imanimoghaddam M, Majidi MR, Sahebalam A, Johari M, Javadian Langaroodi A, Shakeri MT. The efficacy of magnetic resonance imaging and color Doppler ultrasonography in diagnosis of salivary gland tumors. J Dent Res Dent Clin Dent Prospects 2014; 8:246-51. [PMID: 25587388 PMCID: PMC4288916 DOI: 10.5681/joddd.2014.044] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/20/2013] [Accepted: 01/09/2014] [Indexed: 12/11/2022] Open
Abstract
Background and aims. Although salivary gland tumors are not very common, early diagnosis and treatment is crucial because of their proximity to vital organs, and therefore, determining the efficacy of new imaging procedures becomes important. This study aimed to evaluate the efficacy of magnetic resonance imaging (MRI) and color doppler ultrasonography parameters in the diagnosis and differentiation of benign and malignant salivary gland tumors. Materials and methods. In this cross-sectional study, color doppler ultrasonography and MRI were performed for 22 patients with salivary gland tumor. Demographic data as well as MRI, color doppler ultrasonography, and surgical parameters including tumor site, signal in MRI images, ultrasound echo, tumor border, lymphadenopathy, invasion, perfusion, vascular resistance index (RI), vascular pulse index (PI) were analyzed using Chi-square test, Fisher's exact test, and independent t-test. Results. The mean age of patients was 46.59±13.97 years (8 males and 14females). Patients with malignant tumors were older (P < 0.01). The most common tumors were pleomorphic adenoma (36.4%), metastasis (36.4%), and mucoepidermoid carcinoma (9%). Nine tumors (40.9%) were benign and 13 (59.1%) were malignant. The overall accuracy of MRI and color doppler ultrasonography in determining tumor site was 100% and 95%, respectively. No significant difference observed between RI and PI and the diagnosis of tumor. Conclusion. Both MRI and ultrasonography have high accuracy in the localization of tumors. Well-identified border was a sign of benign tumors. Also, invasion to adjacent structures was a predictive factor for malignancy.
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Affiliation(s)
- Behrooz Davachi
- Assistant Professor, Department of Radiology, Ghaem Hospital, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Mahrokh Imanimoghaddam
- Professor, Oral and Maxillofacial Diseases Research Center, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Mohamad Reza Majidi
- Assistant Professor, Department of Otorhinolaryngology, Ghaem Hospital, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Ahmad Sahebalam
- Associate Professor, Department of Radiology, Ghaem Hospital, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Masoomeh Johari
- Assistant Professor, Department of Oral and Maxillofacial Radiology, Faculty of Dentistry, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Adineh Javadian Langaroodi
- Assistant Professor, Department of Oral and Maxillofacial Radiology, Faculty of Dentistry, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Mohamad Taghi Shakeri
- Professor, Department of Biostatistics, Mashhad University of Medical Sciences, Mashhad, Iran
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Haldar S, Mandalia U, Skelton E, Chow V, Turner SS, Ramesar K, Tighe D, Williams M, Howlett D. Diagnostic investigation of parotid neoplasms: a 16-year experience of freehand fine needle aspiration cytology and ultrasound-guided core needle biopsy. Int J Oral Maxillofac Surg 2014; 44:151-7. [PMID: 25457828 DOI: 10.1016/j.ijom.2014.09.025] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/17/2014] [Revised: 07/25/2014] [Accepted: 09/30/2014] [Indexed: 01/12/2023]
Abstract
This study aimed to examine the diagnostic yield of fine needle aspiration cytology (FNAC) and ultrasound-guided core needle biopsy (USCB) in the diagnosis of parotid neoplasia. A 16-year retrospective analysis was performed of patients entered into our pathology database with a final diagnosis of parotid neoplasia. FNAC and USCB data were compared to surgical excision where available. One hundred and twenty FNAC, 313 USCB, and 259 surgical specimens were analyzed from 397 patients. Fifty-six percent of FNAC and 4% of USCB were non-diagnostic. One hundred and thirty-two (33%) patients had a final diagnosis made by USCB and did not undergo surgery. Surgery was performed in 257 (65%) patients, 226 (88%) of whom had a preoperative biopsy. Most lesions were benign, but there were 62 parotid and 13 haematological malignancies diagnosed; false-negative results were obtained in three FNAC and two USCB samples. The sensitivity and specificity of FNAC were 70% and 89%, respectively, and for USCB were 93% and 100%, respectively. This study represents the largest series of patients with a parotid neoplasm undergoing USCB for diagnosis. USCB is highly accurate with a low non-diagnostic rate and should be considered an integral part of parotid assessment.
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Affiliation(s)
- S Haldar
- Department of Radiology, Eastbourne District General Hospital, Eastbourne, East Sussex, UK.
| | - U Mandalia
- Department of Radiology, Eastbourne District General Hospital, Eastbourne, East Sussex, UK
| | - E Skelton
- Department of Radiology, Eastbourne District General Hospital, Eastbourne, East Sussex, UK
| | - V Chow
- Department of Radiology, Eastbourne District General Hospital, Eastbourne, East Sussex, UK
| | - S S Turner
- Department of Radiology, Eastbourne District General Hospital, Eastbourne, East Sussex, UK
| | - K Ramesar
- Department of Radiology, Eastbourne District General Hospital, Eastbourne, East Sussex, UK
| | - D Tighe
- Department of Radiology, Eastbourne District General Hospital, Eastbourne, East Sussex, UK
| | - M Williams
- Department of Radiology, Eastbourne District General Hospital, Eastbourne, East Sussex, UK
| | - D Howlett
- Department of Radiology, Eastbourne District General Hospital, Eastbourne, East Sussex, UK
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Yang TL, Chen CN. Optimizing Clinical Utility of the Ultrasound-guided Core Biopsy for Head and Neck Tumor. J Med Ultrasound 2014. [DOI: 10.1016/j.jmu.2014.06.001] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
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Segal N, Gluck O, Bavnik Y, Plakht Y, Yakirevitch A. The usefulness of preoperative biopsy in unilateral nasal masses. ALLERGY & RHINOLOGY 2014; 5:53-5. [PMID: 24684868 PMCID: PMC4124578 DOI: 10.2500/ar.2014.5.0082] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 12/03/2022]
Abstract
Unilateral nasal masses are considered suspicious for proliferative diseases. Several tools are routinely used to investigate unilateral lesions such as imaging and nasal biopsy. This study investigated the usefulness of nasal biopsy in predicting the actual nature of unilateral lesions. Preoperative nasal biopsy pathological results were compared with the final pathology obtained during an operation. Forty-six patients with unilateral nasal masses were included in the study group. In 40 patients the final pathology was similar to the preoperative nasal biopsy. In three patients the biopsy specimen was a benign polyp and the final pathology was of an inverted papilloma in two patients and hemangiopericytoma in one patient. In two patients the biopsy specimen was suspicious for an inverted papilloma and the final pathology was a benign polyp. In one patient the biopsy specimen was chordoma and the final pathology was osteosarcoma. The total agreement was 86.9%. The kappa value was 81.2%. Preoperative nasal biopsy is important and useful in evaluating unilateral nasal masses.
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Affiliation(s)
- Nili Segal
- Faculty of Health Sciences Ben-Gurion University, Soroka University Medical Center, Beer Sheva, Israel
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25
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Ko E, Katabi N, Estilo C, Huryn J. Left parotid mass in a 71-year-old woman. Oral Surg Oral Med Oral Pathol Oral Radiol 2014; 118:152-6. [PMID: 24581749 DOI: 10.1016/j.oooo.2014.01.024] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/19/2013] [Revised: 01/06/2014] [Accepted: 01/15/2014] [Indexed: 10/25/2022]
Affiliation(s)
- Eugene Ko
- Dental Service, Memorial Sloan Kettering Cancer Center, New York, NY, USA.
| | - Nora Katabi
- Pathology, Memorial Sloan Kettering Cancer Center, New York, NY, USA
| | - Cherry Estilo
- Dental Service, Memorial Sloan Kettering Cancer Center, New York, NY, USA
| | - Joseph Huryn
- Dental Service, Memorial Sloan Kettering Cancer Center, New York, NY, USA
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Quantitative diagnosis of salivary gland tumors with contrast-enhanced ultrasound--a preliminary study. Oral Surg Oral Med Oral Pathol Oral Radiol 2013; 116:784-90. [PMID: 24209995 DOI: 10.1016/j.oooo.2013.09.013] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2013] [Revised: 09/05/2013] [Accepted: 09/17/2013] [Indexed: 01/19/2023]
Abstract
OBJECTIVE To quantitatively analyze the value of qualitative diagnosis of salivary gland masses with contrast-enhanced ultrasound (CEUS). STUDY DESIGN The enhanced sonographic features of 68 salivary gland masses were analyzed to differentiate them. The final diagnoses were confirmed by biopsy pathology. RESULTS We observed from the perfusion kinetics of CEUS that most pleomorphic adenomas manifested lower enhancement and well-defined margins; most Warthin tumors presented with higher enhancement and well-defined margins; and most malignant tumors had higher enhancement and poorly defined margins. Their time-intensity curves showed pleomorphic adenomas were hypovascularized with a poor perfusion, whereas Warthin tumors and malignant tumors were hypervascularized with a rich perfusion. Additionally, malignant tumors showed significantly shortened time to peak and richer maximum signal intensity compared with Warthin tumors. CONCLUSIONS The features of salivary gland masses identified with CEUS were helpful in the differential diagnosis of salivary gland masses.
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Hajiioannou JK, Florou V, Kousoulis P, Kretzas D, Moshovakis E. Reversible facial nerve palsy due to parotid abscess. Int J Surg Case Rep 2013; 4:1021-4. [PMID: 24096025 PMCID: PMC3825968 DOI: 10.1016/j.ijscr.2013.08.016] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/23/2012] [Accepted: 08/26/2013] [Indexed: 11/26/2022] Open
Abstract
INTRODUCTION A facial nerve palsy combined with parotid enlargement usually suggests malignancy. It is highly unusual for facial nerve palsy to result from a benign situation such as inflammation or infection of the gland. PRESENTATION OF CASE We present a rare case of facial nerve palsy due to parotid abscess. DISCUSSION A literature search retrieved thirty-two cases of facial nerve palsy due to benign parotid lesions since 1969. Only nine reported the presence of a parotid abscess. The etiology of paralysis remains unknown although certain factors such as the virulence of the offending organisms or perineuritis, have been suggested. Best diagnostic evaluation and management are discussed. CONCLUSION In clinical practice, exclusion of malignancy is mandatory, as it represents the most common cause of facial palsy in the presence of a parotid lump.
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Affiliation(s)
| | - Vasiliki Florou
- Corresponding author at: 25 Kathigitou Rossidou St., Thessaloniki, pc 54655, Greece. Fax: +30 2310812341.
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Mallon DH, Kostalas M, MacPherson FJ, Parmar A, Drysdale A, Chisholm E, Sadek S. The diagnostic value of fine needle aspiration in parotid lumps. Ann R Coll Surg Engl 2013; 95:258-62. [PMID: 23676809 PMCID: PMC4132499 DOI: 10.1308/003588413x13511609958370] [Citation(s) in RCA: 38] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/20/2013] [Indexed: 11/22/2022] Open
Abstract
INTRODUCTION Fine needle aspiration (FNA) is a safe and quick method of diagnosing superficial lumps, which aids preoperative planning. However, FNA of the parotid gland has not gained the widespread acceptance noted in other head and neck lumps. The aim of this study was to determine the ability of FNA of the parotid gland to differentiate benign and malignant disease, and to determine the impact on surgical outcome. METHODS A retrospective analysis of 201 consecutive parotid operations with preoperative FNA in a large district hospital in the UK was performed. The diagnostic characteristics were calculated for benign and malignant disease, and the impact on surgical procedure was determined. RESULTS In identifying benign disease, FNA has a sensitivity of 85% and a specificity of 76%. In detecting malignant disease, FNA has a sensitivity and specificity of 52% and 92% respectively. A false positive on FNA was associated with a higher incidence of neck dissection. CONCLUSIONS FNA is a useful diagnostic test. However, owing to low sensitivity, it is necessary to interpret it in the context of all other clinical information.
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Affiliation(s)
- D H Mallon
- Cambridge University Hospitals NHS Foundation Trust, UK.
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Jeong WJ, Park SJ, Cha W, Sung MW, Kim KH, Ahn SH. Fine needle aspiration of parotid tumors: diagnostic utility from a clinical perspective. J Oral Maxillofac Surg 2013; 71:1278-82. [PMID: 23540432 DOI: 10.1016/j.joms.2013.01.017] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/21/2012] [Revised: 01/12/2013] [Accepted: 01/17/2013] [Indexed: 11/29/2022]
Abstract
PURPOSE The utility of fine needle aspiration (FNA) for parotid tumors is limited owing to its low diagnostic accuracy. In this study, the authors sought to analyze and interpret FNA results for parotid tumors from a clinical perspective. MATERIALS AND METHODS Parotid tumors subjected to preoperative FNA and subsequent complete excision were the subject of this study. Patient demographics, medical records, FNA findings, and final pathology of 158 consecutive cases were analyzed. RESULTS The accuracy of FNA was 77.8%. The positive predictive value and likelihood ratio for malignancy were 90.0% and 52.8% (95% confidence interval, 7.02-397), respectively. The positive predictive value and likelihood ratio for benign pathology of Warthin tumor plus pleomorphic adenoma were 97.8% and 7.67% (2.03-29.0), respectively. CONCLUSIONS The FNA diagnosis of Warthin tumor or pleomorphic adenoma is reliable and can be safely regarded as a benign tumor. Based on the high positive predictive value and likelihood ratio, FNA of the parotid gland can offer valuable information in surgical planning and patient counseling in many centers.
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Affiliation(s)
- Woo-Jin Jeong
- Seoul National University Bundang Hospital, Department of Otorhinolaryngology-Head and Neck Surgery, Seoul National University College of Medicine, Seoul, Korea
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Kim BY, Hyeon J, Ryu G, Choi N, Baek CH, Ko YH, Jeong HS. Diagnostic accuracy of fine needle aspiration cytology for high-grade salivary gland tumors. Ann Surg Oncol 2013; 20:2380-7. [PMID: 23440550 DOI: 10.1245/s10434-013-2903-z] [Citation(s) in RCA: 41] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/12/2012] [Indexed: 11/18/2022]
Abstract
BACKGROUND Preoperative differentiation between high-grade malignancy and others (benign or low-grade tumors) is more important than differentiation between malignant and benign tumors for surgical planning, treatment outcome, and prognosis in salivary gland tumors. Fine needle aspiration cytology (FNAC) has a relatively low sensitivity for differentiating malignant from benign salivary tumors. However, the diagnostic performance of FNAC has not been studied in predicting high-grade salivary malignancy, which can significantly affect patient care. METHODS Experienced cytopathologists reevaluated the adequate FNAC on 521 salivary gland tumors. The diagnostic performances of FNAC for total malignancy and high-grade malignancy were calculated, and the results were validated in independent 105 cases. In cases of high-grade cancer on FNAC, we recorded the additional diagnostic procedures and the change of surgical extent to decide how FNAC impacts clinical practice. RESULTS The sensitivity, specificity, and diagnostic accuracy of FNAC in differentiating malignant from benign tumors were 64.2 % (95 % confidence interval 52.3-75.0), 98.4 % (96.5-99.3), and 92.1 % (89.1-94.6). Meanwhile, FNAC predicted high-grade malignancy accurately (94.6 % [80.0-99.5], 99.2 % [97.8-99.7], 98.9 % [97.3-99.6], respectively), a finding reproduced with similar results in the validation set. FNAC indicative of high-grade malignancy added additional imaging assessments in 94.9 %, frozen biopsy samples during surgery (tumor and lymph nodes) in 71.2 %, and changed the extent of surgery in 59.0 %. CONCLUSIONS FNAC has an excellent diagnostic performance in discriminating high-grade salivary cancer, which guides clinical decision and surgical planning in salivary gland tumors.
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Affiliation(s)
- Bo Young Kim
- Department of Otorhinolaryngology-Head and Neck Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
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Zbären P, Vander Poorten V, Witt RL, Woolgar JA, Shaha AR, Triantafyllou A, Takes RP, Rinaldo A, Ferlito A. Pleomorphic adenoma of the parotid: formal parotidectomy or limited surgery? Am J Surg 2012; 205:109-18. [PMID: 23062782 DOI: 10.1016/j.amjsurg.2012.05.026] [Citation(s) in RCA: 58] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/21/2011] [Revised: 04/16/2012] [Accepted: 05/10/2012] [Indexed: 11/30/2022]
Abstract
BACKGROUND Optimal surgery for pleomorphic adenoma of the parotid is controversial. In the present review, we discuss the advantages and disadvantages of the various approaches after addressing the surgical pathology of the parotid pleomorphic adenoma capsule and its influence on surgery. DATA SOURCES PubMed literature searches were performed to identify original studies. CONCLUSIONS Almost all pleomorphic adenomas can be effectively treated by formal parotidectomy, but the procedure is not mandatory. Extracapsular dissection is a minimal margin surgery; therefore, in the hands of a novice or occasional parotid surgeon, it may result in higher rates of recurrence. Partial superficial parotidectomy may be a good compromise. The tumor is removed with a greater cuff of healthy parotid tissue than in extracapsular dissection. This may minimize the recurrence rate. On the other hand, the removal of healthy parotid tissue compared with formal parotidectomy is limited, thus minimizing complications such as facial nerve dysfunction and Frey syndrome.
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Affiliation(s)
- Peter Zbären
- Department of Otorhinolaryngology, Head and Neck Surgery, University Hospital, Freiburgstrasse, 3010 Bern, Switzerland.
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Ettl T, Schwarz-Furlan S, Gosau M, Reichert TE. Salivary gland carcinomas. Oral Maxillofac Surg 2012; 16:267-283. [PMID: 22842859 DOI: 10.1007/s10006-012-0350-9] [Citation(s) in RCA: 65] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/17/2012] [Accepted: 07/18/2012] [Indexed: 06/01/2023]
Abstract
INTRODUCTION Salivary gland carcinomas are rare tumours of heterogeneous morphology that require distinctive surgical and adjuvant therapy. METHODS Relevant studies were electronically searched in PubMed and reviewed for innovative and important information. RESULTS Recent insights in genetic alterations like chromosomal aberrations, expression of receptor tyrosine kinases, malfunction of tumour suppressor genes or DNA promoter methylations increased the knowledge about aetiology and pathogenesis. New histological subtypes are recognised, and a three-tiered grading system seems reasonable. Ultrasound remains the basic diagnostic imaging procedure. New developments comprise the diffusion-weighed magnetic resonance imaging, while fluorodeoxyglucose positron emission tomography/computed tomography shows good diagnostic accuracy in detecting distant metastases and local recurrence. Fine-needle aspiration cytology helps in differentiating a neoplasia from a non-neoplastic lesion while being unreliable in recognising malignancy. In contrast, additional core needle biopsy and/or intraoperative frozen section diagnosis increase the accuracy in diagnosing a malignant lesion. Conservative parotid surgery with nerve monitoring remains state-of-the-art. Free flaps or musculoaponeurotic flaps are proposed for prevention of Frey's syndrome. As parotid cancer often shows skip metastases, complete ipsilateral neck dissection (level I-V) is indicated particularly in high-grade lesions. Adjuvant radio(chemo)therapy increases local tumour control, whereas overall survival is not necessarily improved. Current results of systemic chemotherapy or targeted therapy in advanced tumour stages are disappointing. CONCLUSION Despite several developments, salivary gland carcinomas remain a heterogeneous group of tumours challenging both pathologists and clinicians.
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Affiliation(s)
- Tobias Ettl
- Department of Oral and Maxillofacial Surgery, Regensburg University, Franz-Josef-Strauß-Allee 11, 93053, Regensburg, Germany.
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Diagnostic value of ultrasound-guided core needle biopsy in patients with salivary gland masses. Int J Oral Maxillofac Surg 2011; 41:437-43. [PMID: 22204925 DOI: 10.1016/j.ijom.2011.12.005] [Citation(s) in RCA: 46] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/29/2010] [Revised: 08/25/2011] [Accepted: 12/01/2011] [Indexed: 12/23/2022]
Abstract
The salivary glands are unique in the diversity and complexity of their pathologies. Because fine needle aspiration cytology and frozen section are associated with major diagnostic difficulties, the authors analyzed the use of core needle biopsy (CNB) for the histologic assessment of salivary gland lesions. A systematic observational clinicopathologic quality assessment study was performed over 81 months including 161 CNB procedures in 76 patients with salivary gland pathologies. Adequate samples containing the target tissue were obtained in 73 patients. These samples revealed malignant disease in 45 (62%) patients, benign disease in 26 (36%) patients, and were inconclusive in 2 (3%) patients. Follow-up uncovered no false-positive or false-negative results. On the basis of secondary histologic and clinical follow-up, the statistical parameters were calculated as follows: sensitivity 94%; specificity 100%; accuracy 96%; positive predictive value 100%; negative predictive value 90%. The advantages and potential limitations of CNB in patients with salivary gland masses are discussed. CNB is a reliable biopsy technique for the assessment of salivary gland pathologies, although limitations remain for the subclassification of some neoplastic lesions. The authors recommend CNB as the biopsy technique of choice for a selection of indications.
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Giusti L, Iacconi P, Lucacchini A. Fine-needle aspiration for proteomic study of tumour tissues. Proteomics Clin Appl 2011; 5:24-9. [PMID: 21246744 DOI: 10.1002/prca.201000091] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/26/2010] [Revised: 10/08/2010] [Accepted: 11/08/2010] [Indexed: 12/18/2022]
Abstract
Fine-needle aspiration (FNA) is a technique largely applied in the diagnosis of tumours. FNA is a safe diagnostic procedure that is widely employed in the examination of masses at relatively low cost and minimal risk to the patient. In this review, we report on the state-of-the-art and the potential role of FNA to search for protein biomarkers by the proteomic approach.
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Affiliation(s)
- Laura Giusti
- Department of Psychiatry, Neurobiology, Pharmacology and Biotechnology, University of Pisa, Pisa, Italy
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