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Bağlan T, Sak SD, Ersöz CC, Ceyhan K. Contribution of small tissue biopsy and flow cytometry to preoperative cytological categorization of salivary gland fine needle aspirates according to the Milan System: Single center experience on 287 cases. Diagn Cytopathol 2021; 49:509-517. [PMID: 33444463 DOI: 10.1002/dc.24698] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/08/2020] [Revised: 12/30/2020] [Accepted: 01/04/2021] [Indexed: 11/06/2022]
Abstract
BACKGROUND Milan system for reporting salivary gland cytopathology (MSRSGC) was proposed to provide a standardized reporting system for salivary gland fine needle aspiration biopsies. Modified Menghini type semi-automatic aspiration biopsy needles provide small tissue fragments (STFs), as well as cellular smears, and immunohistochemical and molecular studies can be performed using the STFs. AIMS We aimed to evaluate the contribution of STFs and ancillary techniques to pre-operative diagnosis of salivary gland lesions. MATERIALS AND METHODS In this study, smears of 287 cases with histopathological correlation were re-reviewed and assigned to one of the MSRSGC categories. In the second step, histopathological and immunohistochemical findings in STFs were evaluated together with cytological findings. Final diagnoses were obtained with the inclusion of flow cytometry (FC) results when available. Risk of malignancy (ROM) was calculated for each diagnostic category. RESULTS In the evaluation based on smears, a specific diagnosis could be obtained in 64.8% of the cases. ROMs were 0% for nondiagnostic (ND), 5.6% for non-neoplastic (NN), 55% for atypia of undetermined significance (AUS), 0.6% for benign neoplasm (BN), 27.8% for salivary gland neoplasm of uncertain malignant potential (SUMP), and 100% for suspicious for malignancy (SFM) and malignant (M) categories. With the addition of histopathological and immunohistochemical findings and FC results, a specific diagnosis could be obtained in 75.2% of the cases. ROMs were 0% for ND, 4.5% for NN, 53.8% for AUS, 0.6% for BN, 0% for SUMP, and 100% for SFM/M categories. CONCLUSIONS STFs contribute correct categorization of salivary gland lesions. The major contribution of ancillary methods is in the SUMP category.
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Affiliation(s)
- Tolga Bağlan
- Department of Cytopathology, Faculty of Medicine, Ankara University, Ankara, Turkey
| | - Serpil Dizbay Sak
- Department of Pathology, Faculty of Medicine, Ankara University, Ankara, Turkey
| | | | - Koray Ceyhan
- Department of Cytopathology, Faculty of Medicine, Ankara University, Ankara, Turkey
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Cho J, Kim J, Lee JS, Chee CG, Kim Y, Choi SI. Comparison of core needle biopsy and fine‐needle aspiration in diagnosis of ma lignant salivary gland neoplasm: Systematic review and meta‐analysis. Head Neck 2020; 42:3041-3050. [DOI: 10.1002/hed.26377] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/05/2020] [Revised: 05/28/2020] [Accepted: 06/23/2020] [Indexed: 11/09/2022] Open
Affiliation(s)
- Jungheum Cho
- Department of Radiology Seoul National University Bundang Hospital Seongnam South Korea
| | - Junghoon Kim
- Department of Radiology Seoul National University Bundang Hospital Seongnam South Korea
| | - Ji Sung Lee
- Clinical Research Center, Asan Medical Center Seoul South Korea
| | | | - Youngjune Kim
- Aerospace Medical Group Air Force Education and Training Command Jinju Korea
| | - Sang Il Choi
- Department of Radiology Seoul National University Bundang Hospital Seongnam South Korea
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Benchetrit L, Torabi SJ, Morse E, Mehra S, Rahmati R, Osborn HA, Judson BL. Preoperative biopsy in parotid malignancies: Variation in use and impact on surgical margins. Laryngoscope 2019; 130:1450-1458. [PMID: 31411749 DOI: 10.1002/lary.28224] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/25/2019] [Revised: 06/17/2019] [Accepted: 07/19/2019] [Indexed: 12/26/2022]
Abstract
OBJECTIVES Determine rate of preoperative biopsy in parotid malignancies, identify factors associated with its use, and its association with surgical margins. STUDY DESIGN Retrospective cohort. SETTING Commission on Cancer-Accredited Institutions. SUBJECTS AND METHODS We included 5533 patients treated surgically for a parotid malignancy 2004-2014 in the National Cancer Database. Chi-squared tests, univariable, and multivariable logistic regressions were used to evaluate predictors of preoperative biopsy (defined as needle, aspiration, or incisional), and associate biopsy with surgical margins. RESULTS Preoperative biopsy was utilized in 26.0% of patients. Biopsy was more likely in patients >60 years (odds ratio [OR]: 1.19, P = .035), advanced clinical T stage (vs. T1,T2 OR: 1.23, P = .009; T3 OR: 1.26, P = .026; T4A OR: 2.05, P < .001), advanced clinical N stage (vs. N0, N1: OR: 1.39, P = .013; N2/3: OR: 1.63, P < .001), in academic centers (OR: 1.18, P < .024), and in higher volume centers (vs. low, medium OR: 1.28, P = .002; high OR: 2.16, P < .001). Biopsy use increased over time (vs. 2004-2006, 2007-2010 OR: 1.20, P = .047; 2011-2014 OR: 1.39, P < .001). Biopsy was associated with a reduced risk of positive margins in patients with clinical T1 stage (OR: 0.70, P = .012), and younger than 61 (OR: 0.79, P = .036). CONCLUSION The national rate of preoperative biopsy in parotid malignancy is low at 26.0%, but has increased over time. Preoperative biopsy is associated with a reduced risk of positive margins in younger patients and those with early clinical stage, suggesting its increased use may improve surgical outcomes and decrease reoperation or adjuvant therapy in these subgroups of patients. LEVEL OF EVIDENCE 3 Laryngoscope, 130:1450-1458, 2020.
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Affiliation(s)
- Liliya Benchetrit
- Department of Surgery, Yale University School of Medicine, New Haven, Connecticut, U.S.A
| | - Sina J Torabi
- Department of Surgery, Yale University School of Medicine, New Haven, Connecticut, U.S.A
| | - Elliot Morse
- Department of Surgery, Yale University School of Medicine, New Haven, Connecticut, U.S.A
| | - Saral Mehra
- Department of Surgery, Yale University School of Medicine, New Haven, Connecticut, U.S.A.,Yale Cancer Center, New Haven, Connecticut, U.S.A
| | - Rahmatullah Rahmati
- Department of Surgery, Yale University School of Medicine, New Haven, Connecticut, U.S.A.,Yale Cancer Center, New Haven, Connecticut, U.S.A
| | - Heather A Osborn
- Department of Surgery, Yale University School of Medicine, New Haven, Connecticut, U.S.A.,Yale Cancer Center, New Haven, Connecticut, U.S.A
| | - Benjamin L Judson
- Department of Surgery, Yale University School of Medicine, New Haven, Connecticut, U.S.A.,Yale Cancer Center, New Haven, Connecticut, U.S.A
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Gupta N, Gupta P, Rajwanshi A. Trucut/Core Biopsy versus FNAC: Who Wins the Match? Thyroid Lesions and Salivary Gland Lesions: An Overview. J Cytol 2018; 35:173-175. [PMID: 30089948 PMCID: PMC6060581 DOI: 10.4103/joc.joc_18_18] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
Abstract
Thyroid and salivary gland are amongst the most common sites subjected to fine needle aspiration cytology (FNAC) due to easy accessibility of these sites along with high diagnostic accuracy of FNAC. The performance of FNAC can be increased with the use of ultrasonographic guidance and rapid on-site evaluation. Cell block along with immunochemistry and other ancillary techniques further helps in clinching the correct diagnosis in certain diagnostically challenging cases. Core needle biopsy (CNB) is proposed to have a better diagnostic accuracy in certain situations. However, CNB has no definite role as an upfront first-line diagnostic technique for thyroid or salivary gland lesions. We describe role of FNAC and CNB in thyroid and salivary gland lesions with detailed discussion of advantages and disadvantages of both these techniques.
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Affiliation(s)
- Nalini Gupta
- Department of Cytology and Gynaecological Pathology, Postgraduate Institute of Medical Education and Research, Chandigarh, India
| | - Parikshaa Gupta
- Department of Cytology and Gynaecological Pathology, Postgraduate Institute of Medical Education and Research, Chandigarh, India
| | - Arvind Rajwanshi
- Department of Cytology and Gynaecological Pathology, Postgraduate Institute of Medical Education and Research, Chandigarh, India
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Kim HJ, Kim JS. Ultrasound-guided core needle biopsy in salivary glands: A meta-analysis. Laryngoscope 2017; 128:118-125. [DOI: 10.1002/lary.26764] [Citation(s) in RCA: 56] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/20/2017] [Revised: 05/23/2017] [Accepted: 06/01/2017] [Indexed: 01/22/2023]
Affiliation(s)
- Hee Joon Kim
- Department of Radiology; Presbyterian Medical Center; Jeonju Republic of Korea
| | - Jong Seung Kim
- Department of Otorhinolaryngology-Head and Neck Surgery; College of Medicine, Chonbuk National University; Jeonju Republic of Korea
- Research Institute of Clinical Medicine of Chonbuk National University; Biomedical Research Institute of Chonbuk National University Hospital; Jeonju Republic of Korea
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Ahn D, Roh JH, Kim JK. Ultrasound-Guided Core Needle Biopsy for Head and Neck Mass Lesions in Patients Undergoing Antiplatelet or Anticoagulation Therapy: A Preliminary Report. JOURNAL OF ULTRASOUND IN MEDICINE : OFFICIAL JOURNAL OF THE AMERICAN INSTITUTE OF ULTRASOUND IN MEDICINE 2017; 36:1339-1346. [PMID: 28370160 DOI: 10.7863/ultra.16.05045] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/19/2016] [Accepted: 09/23/2016] [Indexed: 06/07/2023]
Abstract
OBJECTIVES We compared the complications and diagnostic adequacy of ultrasound (US)-guided core needle biopsy (CNB) for head and neck mass lesions between patients who did and did not receive antiplatelet/anticoagulation therapy. METHODS This study was designed as a prospective case study including 146 consecutive patients who underwent US-guided CNB for head and neck mass lesions. Of these, 32 patients were undergoing antiplatelet/anticoagulation therapy involving aspirin, clopidogrel, cilostazol, and warfarin. RESULTS None of the patients had clinical bleeding/hematoma in either group. Subclinical bleeding/hematoma recognized only by a US examination was not significantly different between the groups (P = .229). No other complications were noticed. The rate of unsatisfactory sampling was also not different between the groups (P > .999). Furthermore, when patients receiving aspirin (n = 18) were reclassified into the no-antiplatelet/anticoagulation therapy group, there was still no significant difference in the incidences of complications compared with the patients receiving clopidogrel, cilostazol, or warfarin (n = 14). CONCLUSIONS Our study suggests that US-guided CNB is safe and provides good diagnostic results without necessitating the discontinuation of antiplatelet/anticoagulation therapy in patients with head and neck mass lesions. However, as this was a preliminary study, the cohort was relatively small. Larger studies are needed to confirm our findings.
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Affiliation(s)
- Dongbin Ahn
- Departments of Otolaryngology-Head and Neck Surgery, School of Medicine, Kyungpook National University, Daegu, Korea
| | - Jae-Hyung Roh
- Department of Cardiology, School of Medicine, Kyungpook National University, Daegu, Korea
| | - Jeong Kyu Kim
- Department of Otolaryngology-Head and Neck Surgery, School of Medicine, Catholic University of Daegu, Daegu, Korea
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Negahban S, Shirian S, Khademi B, Oryan A, Sadoughifar R, Mohammad MP, Aledavood A, Daneshbod K, Daneshbod Y. The Value of Ultrasound-Guided Fine-Needle Aspiration Cytology by Cytopathologists in the Diagnosis of Major Salivary Gland Tumors. JOURNAL OF DIAGNOSTIC MEDICAL SONOGRAPHY 2016. [DOI: 10.1177/8756479316634320] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Because of the typical sonographic appearances of many salivary gland masses, as well as the normal appearance and anatomy of the glands, differentiation of salivary glands tumors based only on clinical and imaging criteria is difficult. We compared the utility, safety, specificity, and accuracy of ultrasound-guided fine needle aspiration cytology (UG-FNAC) in the detection of nonpalpable tumors in the major salivary glands. A retrospective review was done of a 5-year experience of 102 consecutive patients undergoing UG-FNAC. Clinical opinion, FNA results, and final pathologic findings were examined. Histological evaluation showed 29 malignant tumors and 54 benign lesions (neoplasms and nonneoplastic lesions). The cytologic findings were nondiagnostic in 19 cases (18.6%), true negative in 50 (49%), true positive in 20 (19.6%), false negative in 9 (8.8%), and false-positive in 4 (3.9%) cases for detecting malignant tumors. Six of 20 (30%) malignant tumors (true positive) and 41 of 50 (82%) benign lesions (true negative) were classified accurately. The accuracy, sensitivity, and specificity were 84.3%, 68.9%, and 92.6%, respectively. Ultrasound guided FNAC was found to be highly specific for malignancy and its sensitivity for malignancy was good. It is a reliable and accurate diagnostic technique with minimal complications and easy to perform with high specificity 92.5% (95% CI: 82.09%-97.90%). It should be the preferred primary approach for initial investigation in diagnosing salivary gland tumors.
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Affiliation(s)
- Shahrzad Negahban
- Shiraz Molecular Pathology Research Center, Daneshbod Pathology Laboratory, Shiraz, Iran
| | - Sadegh Shirian
- Department of Pathology, School of Veterinary Medicine, Shahrekord University, Shahrekord, Iran
- Shefa Neuroscience Research Center, Khatam-Al-Anbia Hospital, Tehran, Iran
- Brain and Spinal Cord Research Center, Neuroscience Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Bijan Khademi
- Head and Neck Cancer, Endoscopic Sinus Surgery, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Ahmad Oryan
- Department of Pathology, School of Veterinary Medicine, Shiraz University, Shiraz Iran
| | - Roshanak Sadoughifar
- Department of Pathology, School of Veterinary Medicine, Shiraz University, Shiraz Iran
| | | | - Azita Aledavood
- Shiraz Molecular Pathology Research Center, Daneshbod Pathology Laboratory, Shiraz, Iran
| | - Khosrow Daneshbod
- Shiraz Molecular Pathology Research Center, Daneshbod Pathology Laboratory, Shiraz, Iran
| | - Yayha Daneshbod
- Shiraz Molecular Pathology Research Center, Daneshbod Pathology Laboratory, Shiraz, Iran
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Song IH, Song JS, Sung CO, Roh JL, Choi SH, Nam SY, Kim SY, Lee JH, Baek JH, Cho KJ. Accuracy of Core Needle Biopsy Versus Fine Needle Aspiration Cytology for Diagnosing Salivary Gland Tumors. J Pathol Transl Med 2015; 49:136-43. [PMID: 26148740 PMCID: PMC4367109 DOI: 10.4132/jptm.2015.01.03] [Citation(s) in RCA: 64] [Impact Index Per Article: 7.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/24/2014] [Revised: 12/16/2014] [Accepted: 01/03/2015] [Indexed: 12/16/2022] Open
Abstract
BACKGROUND Core needle biopsy is a relatively new technique used to diagnose salivary gland lesions, and its role in comparison with fine needle aspiration cytology needs to be refined. METHODS We compared the results of 228 ultrasound-guided core needle biopsy and 371 fine needle aspiration procedures performed on major salivary gland tumors with their postoperative histological diagnoses. RESULTS Core needle biopsy resulted in significantly higher sensitivity and more accurate tumor subtyping, especially for malignant tumors, than fine needle aspiration. No patient developed major complications after core needle biopsy. CONCLUSIONS We recommend ultrasoundguided core needle biopsy as the primary diagnostic tool for the preoperative evaluation of patients with salivary gland lesions, especially when malignancy is suspected.
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Affiliation(s)
- In Hye Song
- Department of Pathology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - Joon Seon Song
- Department of Pathology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - Chang Ohk Sung
- Department of Pathology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - Jong-Lyel Roh
- Department of Otorhinolaryngology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - Seung-Ho Choi
- Department of Otorhinolaryngology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - Soon Yuhl Nam
- Department of Otorhinolaryngology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - Sang Yoon Kim
- Department of Otorhinolaryngology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - Jeong Hyun Lee
- Department of Radiology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - Jung Hwan Baek
- Department of Radiology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - Kyung-Ja Cho
- Department of Pathology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
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10
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Eom HJ, Lee JH, Ko MS, Choi YJ, Yoon RG, Cho KJ, Nam SY, Baek JH. Comparison of fine-needle aspiration and core needle biopsy under ultrasonographic guidance for detecting malignancy and for the tissue-specific diagnosis of salivary gland tumors. AJNR Am J Neuroradiol 2015; 36:1188-93. [PMID: 25678480 DOI: 10.3174/ajnr.a4247] [Citation(s) in RCA: 33] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2014] [Accepted: 11/25/2014] [Indexed: 12/11/2022]
Abstract
BACKGROUND AND PURPOSE Diagnostic test accuracy studies for ultrasonography-guided fine-needle aspiration and ultrasonography-guided core needle biopsy have shown inconclusive results due to their heterogenous study designs. Our aim was to compare the diagnostic accuracy of ultrasonography-guided fine-needle aspiration versus ultrasonography-guided core needle biopsy for detecting malignant tumors of the salivary gland and for the tissue-specific diagnosis of salivary gland tumors in a single tertiary hospital. MATERIALS AND METHODS This retrospective study was approved by our institutional review board and informed consent was waived. Four hundred twelve patients who underwent ultrasonography-guided fine-needle aspiration (n = 155) or ultrasonography-guided core needle biopsy (n = 257) with subsequent surgical confirmation or clinical follow-up were enrolled. We compared the diagnostic accuracy of ultrasonography-guided fine-needle aspiration and ultrasonography-guided core needle biopsy regarding malignant salivary gland tumors and the correct tissue-specific diagnosis of benign and malignant tumors. We also tested the difference between these procedures according to the operator's experience and lesion characteristics. RESULTS The inconclusive rates of ultrasonography-guided fine-needle aspiration and ultrasonography-guided core needle biopsy were 19% and 4%, respectively (P < .001). The overall accuracy of ultrasonography-guided core needle biopsy for diagnosing malignant tumors was significantly higher than that of ultrasonography-guided fine-needle aspiration (P = .024). The correct tissue-specific diagnosis rates of ultrasonography-guided fine-needle aspiration and ultrasonography-guided core needle biopsy were 95% versus 97% for benign tumors (P = .648) and 67% versus 80% for malignant tumors (P = .310). Trainees showed significantly lower accuracy with ultrasonography-guided fine-needle aspiration than with ultrasonography-guided core needle biopsy for diagnosing malignant tumors (P = .021). There was no difference between the diagnostic accuracy of ultrasonography-guided fine-needle aspiration and ultrasonography-guided core needle biopsy according to the internal composition of the lesions. There were no complications requiring intervention or hospitalization in our patients. CONCLUSIONS Ultrasonography-guided core needle biopsy is superior to ultrasonography-guided fine-needle aspiration in detecting and characterizing malignant tumors of the salivary gland and could emerge as the diagnostic method of choice for patients presenting with a salivary gland mass.
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Affiliation(s)
- H-J Eom
- From the Department of Radiology and Research Institute of Radiology (H.-J.E., J.H.L., Y.J.C., R.G.Y., J.H.B.)
| | - J H Lee
- From the Department of Radiology and Research Institute of Radiology (H.-J.E., J.H.L., Y.J.C., R.G.Y., J.H.B.)
| | - M-S Ko
- Departments of Health Medicine (M.-S.K.)
| | - Y J Choi
- From the Department of Radiology and Research Institute of Radiology (H.-J.E., J.H.L., Y.J.C., R.G.Y., J.H.B.)
| | - R G Yoon
- From the Department of Radiology and Research Institute of Radiology (H.-J.E., J.H.L., Y.J.C., R.G.Y., J.H.B.)
| | | | - S Y Nam
- Otolaryngology (S.Y.N.), Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - J H Baek
- From the Department of Radiology and Research Institute of Radiology (H.-J.E., J.H.L., Y.J.C., R.G.Y., J.H.B.)
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Gandage SG, Kachewar SG. An Imaging Panorama of Salivary Gland Lesions as seen on High Resolution Ultrasound. J Clin Diagn Res 2014; 8:RC01-13. [PMID: 25478426 PMCID: PMC4253244 DOI: 10.7860/jcdr/2014/9724.4928] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/22/2014] [Accepted: 07/21/2014] [Indexed: 11/24/2022]
Abstract
INTRODUCTION Lesions of salivary gland are quite common. Clinical examination alone is not able to differentiate between them and pinpoint the exact cause. It would definitely benefit the patient as well as the doctor if they could get an idea of the exact type of lesion affecting the salivary gland. Hence, this retrospective study was undertaken to demonstrate how high resolution ultrasound imaging (HRUSG) can be useful in evaluation of salivary gland lesions. MATERIALS AND METHODS In this retrospective study, imaging findings in patients who underwent HRUSG of salivary glands in the past five years were compiled. Analysis of the imaging findings and clinico-pathological correlation was then performed in this descriptive study. RESULTS Out of the 87 patients referred for HRUSG of salivary glands in the last five years, characteristic findings were found in 53 patients. HRUSG diagnosis of Acute Inflammation was made in 19 cases, Chronic Inflammation in 13 cases and Primary Neoplastic Lesions in 11 cases, Metastatic deposits in 3 cases and Salivary Calculus in 7 cases. No obvious abnormality was seen in rest of the 34 patients. HRUSG was found to be 93.33 % sensitive and 98.07% specific for diagnosing neoplastic lesions in salivary glands. CONCLUSION Patients with salivary gland pathologies may present either with clinically assessable symptoms or just with cosmetic deformities due to bulge in the salivary gland. Clinical examination alone cannot pinpoint the etiology. Sonography can satisfactorily enable visualization of the abnormality noninvasively. It not only confirms the presence or absence of pathology but also enables image guided tissue retrieval for final pathological diagnosis.
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Affiliation(s)
- Siddappa Gurubalappa Gandage
- Professor & Head, Department of Radio-diagnosis, Rural Medical College, PIMS (DU),Loni, Ta-Rahata, District-Ahmednagar, Maharashtra, India
| | - Sushil Ghanshyam Kachewar
- Professor, Department of Radio-diagnosis, Rural Medical College, PIMS (DU),Loni, Ta-Rahata, District-Ahmednagar, Maharashtra, India
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Diagnostic challenge of a deep minor salivary gland neoplasm. Case Rep Otolaryngol 2014; 2014:608267. [PMID: 25002981 PMCID: PMC4070476 DOI: 10.1155/2014/608267] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2014] [Accepted: 05/19/2014] [Indexed: 11/17/2022] Open
Abstract
Core needle biopsy represents a safe and cheap alternative diagnostic method to open biopsy and fine-needle aspiration cytology in head and neck tumors. There is little evidence in the literature about the use of core needle biopsy in minor salivary gland lesions. This single case report presents a 60-year-old woman with a painless swelling in the soft palate, breathing and swallowing difficulties, and a feeling of suffocation. Two open biopsies had inconclusive diagnosis and the lesion could only be assessed and diagnosed as pleomorphic adenoma through core needle biopsy. Recognizing the correct indication of core needle biopsy can benefit both health professionals and patients; thus, it is important to consider the possibility of performing this method to diagnose minor salivary gland tumors.
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Witt BL, Schmidt RL. Ultrasound-guided core needle biopsy of salivary gland lesions: a systematic review and meta-analysis. Laryngoscope 2013; 124:695-700. [PMID: 23929672 DOI: 10.1002/lary.24339] [Citation(s) in RCA: 56] [Impact Index Per Article: 5.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Revised: 07/12/2013] [Accepted: 07/12/2013] [Indexed: 12/23/2022]
Abstract
OBJECTIVES/HYPOTHESIS To obtain summary estimates of the sensitivity and specificity of core needle biopsy for assessment of salivary gland lesions and to investigate sources of variation in accuracy between study locations. STUDY DESIGN Data sources were PubMed, Embase, CAB Abstracts, CINAHL, BIOSIS, LILACS, PakMediNet, Trip Database, and the National Guideline Clearinghouse. Scopus was used to perform forward (citation) and backward (reference) searches of all potentially relevant studies. METHODS Screening, data extraction, and quality assessment were independently performed by two different assessors. Meta-analysis was performed using bivariate mixed-effects binary regression as implemented in Stata 12. Quality assessment was performed using the QUADAS-2. RESULTS The summary estimates of sensitivity and specificity of core needle biopsy for diagnosis of malignancy were 96% (95% confidence interval [CI] = 87-99) and 100% (95% CI = 84-100), respectively. There was no significant heterogeneity in accuracy between studies. The quality of included studies was high, with low risk of verification bias. The risk of hematoma was 1.6% per procedure. CONCLUSIONS Core needle biopsy has high sensitivity and specificity, and has low risk of complications. There is no significant variation in accuracy between study locations.
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Affiliation(s)
- Benjamin L Witt
- Department of Pathology and ARUP Laboratories, University of Utah, Salt Lake City, Utah, U. S. A
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Douville NJ, Bradford CR. Comparison of ultrasound-guided core biopsy versus fine-needle aspiration biopsy in the evaluation of salivary gland lesions. Head Neck 2012; 35:1657-61. [PMID: 23109044 DOI: 10.1002/hed.23193] [Citation(s) in RCA: 50] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/13/2012] [Indexed: 12/14/2022] Open
Abstract
Ultrasound-guided core biopsy provides many benefits compared with fine-needle aspiration cytology and has begun to emerge as part of the diagnostic work-up for a salivary gland lesion. Although the increased potential for tumor-seeding and capsule rupture has been extensively discussed, the safety of this procedure is widely accepted based on infrequent reports of tumor-seeding. In fact, a review of the literature shows only 2 cases of salivary tumor seeding following biopsy with larger-gauge needle characteristics, with 2 reported cases of salivary tumor seeding following fine-needle aspiration cytology. However, the follow-up interval of such studies (<7 years) is substantially less than the 20-year follow-up typically necessary to detect remote recurrence. Studies on tumor recurrence of pleomorphic adenoma, the most common salivary gland lesion, suggest that as many as 16% of tumor recurrences occur at least 10 years following initial surgery, with average time to recurrence ranging anywhere from 6.1 to 11.8 years postoperatively. Despite the benefits of ultrasound-guided core biopsy over fine-needle aspiration biopsy, which include both improved consistency and diagnostic accuracy, current studies lack adequate patient numbers and follow-up duration to confirm comparable safety profile to currently accepted fine-needle aspiration cytology. In this report we: (1) compare the relative benefits of each procedure, (2) review evidence regarding tumor seeding in each procedure, (3) discuss time course and patient numbers necessary to detect tumor recurrence, and (4) describe how these uncertainties should be factored into clinical considerations.
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Affiliation(s)
- Nicholas J Douville
- Department of Biomedical Engineering, University of Michigan, Ann Arbor, Michigan; Medical Scientist Training Program, University of Michigan, Ann Arbor, Michigan
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Han MW, Cho KJ, Roh JL, Choi SH, Nam SY, Kim SY. Patterns of lymph node metastasis and their influence on outcomes in patients with submandibular gland carcinoma. J Surg Oncol 2012; 106:475-80. [DOI: 10.1002/jso.23100] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/18/2011] [Accepted: 02/26/2012] [Indexed: 11/09/2022]
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Schmidt RL, Hall BJ, Layfield LJ. A systematic review and meta-analysis of the diagnostic accuracy of ultrasound-guided core needle biopsy for salivary gland lesions. Am J Clin Pathol 2011; 136:516-26. [PMID: 21917673 DOI: 10.1309/ajcp5ltq4rvoqait] [Citation(s) in RCA: 51] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/28/2023] Open
Abstract
Core needle biopsy (CNB) of salivary gland lesions is a relatively new technique that may offer benefits for diagnosis of the lesions. We conducted a systematic literature review to identify studies published between January 1, 1985, and March 15, 2011. Summary estimates of sensitivity and specificity were obtained by using a summary receiver-operating characteristic (SROC) curve. Study quality was assessed by using the QUADAS survey. We identified 5 studies (277 cases) for inclusion. The area under the SROC for CNB was 1.00 (95% confidence interval [CI], 0.99-1.00). Based on histologically verified cases, the sensitivity of CNB is 0.92 (95% CI, 0.77-0.98) and the specificity is 1.00 (95% CI, 0.76-1.00). We conclude that CNB has high accuracy and a low (1.2%) inadequacy rate. CNB is more accurate than fine-needle aspiration, at least in some settings, but the best selection of which test to use for an individual patient and setting remains to be defined.
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Affiliation(s)
| | - Brian J. Hall
- Department of Pathology, University of Utah, Salt Lake City
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Novoa E, Gürtler N, Arnoux A, Kraft M. Role of ultrasound-guided core-needle biopsy in the assessment of head and neck lesions: a meta-analysis and systematic review of the literature. Head Neck 2011; 34:1497-503. [PMID: 22127851 DOI: 10.1002/hed.21821] [Citation(s) in RCA: 132] [Impact Index Per Article: 10.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/05/2011] [Indexed: 01/12/2023] Open
Abstract
BACKGROUND Core-needle biopsy (CNB) has occasionally been used in the work-up of head and neck lesions. However, no systematic review of this simple, minimally invasive method has yet been performed. METHODS A systematic review of the literature and meta-analysis of data extracted from 16 included studies were performed. A total of 1291 cervical lesions in 1267 patients were examined by CNB. This resulted in 1232 adequate samples, from which 554 were subsequently confirmed by excisional biopsy. RESULTS CNB was able to identify true neoplasms and detect malignancy in head and neck lesions with an overall accuracy of 94% and 96%, respectively, even though there was a significant difference between the histologically verified and all adequate samples. CNB provided a correct specific diagnosis in 87% of cases without major complications and achieved a higher accuracy than that of fine-needle aspiration in detecting malignancy. CONCLUSIONS This meta-analysis confirms that CNB is an excellent method in the assessment of salivary gland lesions and lymphadenopathies inclusive of malignant lymphoma, but it is not ideal for evaluating thyroid lesions.
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Affiliation(s)
- Eva Novoa
- Department of Otorhinolaryngology, Head and Neck Surgery, Kantonsspital AG, Aarau, Switzerland.
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Wittekindt C, Burmeister H, Guntinas-Lichius O. Diagnostik und Therapie von Speicheldrüsenerkrankungen. DER PATHOLOGE 2009; 30:424-31. [DOI: 10.1007/s00292-009-1202-8] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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Fine-Needle Aspiration Cytology Versus Core Needle Biopsy in the Evaluation of Thyroid and Salivary Gland Lesions. AJSP-REVIEWS AND REPORTS 2007. [DOI: 10.1097/01.pcr.0000252856.19283.3f] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
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