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Gonçalves DR, Braun LW, Fernandes ACP, Martins MAT, Martins MD, Carrard VC. Deep ulcerated lesion on hard palate. Oral Surg Oral Med Oral Pathol Oral Radiol 2024; 138:3-8. [PMID: 38604878 DOI: 10.1016/j.oooo.2023.12.797] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2023] [Revised: 11/30/2023] [Accepted: 12/24/2023] [Indexed: 04/13/2024]
Affiliation(s)
- Douglas Rodrigues Gonçalves
- Department of Oral Pathology, School of Dentistry, Universidade Federal do Rio Grande do Sul, Porto Alegre, Rio Grande do Sul, Brazil; Oral Medicine Unit, Otorhinolaryngology Service, Hospital de Clínicas de Porto Alegre, Porto Alegre, Rio Grande do Sul, Brazil
| | - Liliana Wolf Braun
- Department of Oral Pathology, School of Dentistry, Universidade Federal do Rio Grande do Sul, Porto Alegre, Rio Grande do Sul, Brazil; Oral Medicine Unit, Otorhinolaryngology Service, Hospital de Clínicas de Porto Alegre, Porto Alegre, Rio Grande do Sul, Brazil
| | | | - Marco Antônio Trevizani Martins
- Department of Oral Pathology, School of Dentistry, Universidade Federal do Rio Grande do Sul, Porto Alegre, Rio Grande do Sul, Brazil; Oral Medicine Unit, Otorhinolaryngology Service, Hospital de Clínicas de Porto Alegre, Porto Alegre, Rio Grande do Sul, Brazil
| | - Manoela Domingues Martins
- Department of Oral Pathology, School of Dentistry, Universidade Federal do Rio Grande do Sul, Porto Alegre, Rio Grande do Sul, Brazil
| | - Vinicius Coelho Carrard
- Department of Oral Pathology, School of Dentistry, Universidade Federal do Rio Grande do Sul, Porto Alegre, Rio Grande do Sul, Brazil; Oral Medicine Unit, Otorhinolaryngology Service, Hospital de Clínicas de Porto Alegre, Porto Alegre, Rio Grande do Sul, Brazil.
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Sasaki T, Kuno H, Hiyama T, Oda S, Masuoka S, Miyasaka Y, Taki T, Nagasaki Y, Ohtani-Kim SJY, Ishii G, Kaku S, Shroff GS, Kobayashi T. 2021 WHO Classification of Lung Cancer: Molecular Biology Research and Radiologic-Pathologic Correlation. Radiographics 2024; 44:e230136. [PMID: 38358935 DOI: 10.1148/rg.230136] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/17/2024]
Abstract
The 2021 World Health Organization (WHO) classification system for thoracic tumors (including lung cancer) contains several updates to the 2015 edition. Revisions for lung cancer include a new grading system for invasive nonmucinous adenocarcinoma that better reflects prognosis, reorganization of squamous cell carcinomas and neuroendocrine neoplasms, and description of some new entities. Moreover, remarkable advancements in our knowledge of genetic mutations and targeted therapies have led to a much greater emphasis on genetic testing than that in 2015. In 2015, guidelines recommended evaluation of only two driver mutations, ie, epidermal growth factor receptor (EGFR) mutations and anaplastic lymphoma kinase (ALK) fusions, in patients with nonsquamous non-small cell lung cancer. The 2021 guidelines recommend testing for numerous additional gene mutations for which targeted therapies are now available including ROS1, RET, NTRK1-3, KRAS, BRAF, and MET. The correlation of imaging features and genetic mutations is being studied. Testing for the immune biomarker programmed death ligand 1 is now recommended before starting first-line therapy in patients with metastatic non-small cell lung cancer. Because 70% of lung cancers are unresectable at patient presentation, diagnosis of lung cancer is usually based on small diagnostic samples (ie, biopsy specimens) rather than surgical resection specimens. The 2021 version emphasizes differences in the histopathologic interpretation of small diagnostic samples and resection specimens. Radiologists play a key role not only in evaluation of tumor and metastatic disease but also in identification of optimal biopsy targets. ©RSNA, 2024 Test Your Knowledge questions in the supplemental material and the slide presentation from the RSNA Annual Meeting are available for this article.
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Affiliation(s)
- Tomoaki Sasaki
- From the Departments of Diagnostic Radiology (T.S., H.K., T.H., S.O., S.M., Y.M., T.K.), Pathology and Clinical Laboratories (T.T., G.I.), and Thoracic Surgery (Y.N., S.J.Y.O.K.), National Cancer Center Hospital East, 6-5-1 Kashiwanoha, Kashiwa, Chiba 277-8577, Japan; Department of Diagnostic Radiology, National Cancer Center Hospital, Tokyo, Japan (S.K.); Department of General Thoracic Surgery, Juntendo University School of Medicine, Tokyo, Japan (Y.N.); and Department of Thoracic Imaging, The University of Texas MD Anderson Cancer Center, Houston, Tex (G.S.S.)
| | - Hirofumi Kuno
- From the Departments of Diagnostic Radiology (T.S., H.K., T.H., S.O., S.M., Y.M., T.K.), Pathology and Clinical Laboratories (T.T., G.I.), and Thoracic Surgery (Y.N., S.J.Y.O.K.), National Cancer Center Hospital East, 6-5-1 Kashiwanoha, Kashiwa, Chiba 277-8577, Japan; Department of Diagnostic Radiology, National Cancer Center Hospital, Tokyo, Japan (S.K.); Department of General Thoracic Surgery, Juntendo University School of Medicine, Tokyo, Japan (Y.N.); and Department of Thoracic Imaging, The University of Texas MD Anderson Cancer Center, Houston, Tex (G.S.S.)
| | - Takashi Hiyama
- From the Departments of Diagnostic Radiology (T.S., H.K., T.H., S.O., S.M., Y.M., T.K.), Pathology and Clinical Laboratories (T.T., G.I.), and Thoracic Surgery (Y.N., S.J.Y.O.K.), National Cancer Center Hospital East, 6-5-1 Kashiwanoha, Kashiwa, Chiba 277-8577, Japan; Department of Diagnostic Radiology, National Cancer Center Hospital, Tokyo, Japan (S.K.); Department of General Thoracic Surgery, Juntendo University School of Medicine, Tokyo, Japan (Y.N.); and Department of Thoracic Imaging, The University of Texas MD Anderson Cancer Center, Houston, Tex (G.S.S.)
| | - Shioto Oda
- From the Departments of Diagnostic Radiology (T.S., H.K., T.H., S.O., S.M., Y.M., T.K.), Pathology and Clinical Laboratories (T.T., G.I.), and Thoracic Surgery (Y.N., S.J.Y.O.K.), National Cancer Center Hospital East, 6-5-1 Kashiwanoha, Kashiwa, Chiba 277-8577, Japan; Department of Diagnostic Radiology, National Cancer Center Hospital, Tokyo, Japan (S.K.); Department of General Thoracic Surgery, Juntendo University School of Medicine, Tokyo, Japan (Y.N.); and Department of Thoracic Imaging, The University of Texas MD Anderson Cancer Center, Houston, Tex (G.S.S.)
| | - Sota Masuoka
- From the Departments of Diagnostic Radiology (T.S., H.K., T.H., S.O., S.M., Y.M., T.K.), Pathology and Clinical Laboratories (T.T., G.I.), and Thoracic Surgery (Y.N., S.J.Y.O.K.), National Cancer Center Hospital East, 6-5-1 Kashiwanoha, Kashiwa, Chiba 277-8577, Japan; Department of Diagnostic Radiology, National Cancer Center Hospital, Tokyo, Japan (S.K.); Department of General Thoracic Surgery, Juntendo University School of Medicine, Tokyo, Japan (Y.N.); and Department of Thoracic Imaging, The University of Texas MD Anderson Cancer Center, Houston, Tex (G.S.S.)
| | - Yusuke Miyasaka
- From the Departments of Diagnostic Radiology (T.S., H.K., T.H., S.O., S.M., Y.M., T.K.), Pathology and Clinical Laboratories (T.T., G.I.), and Thoracic Surgery (Y.N., S.J.Y.O.K.), National Cancer Center Hospital East, 6-5-1 Kashiwanoha, Kashiwa, Chiba 277-8577, Japan; Department of Diagnostic Radiology, National Cancer Center Hospital, Tokyo, Japan (S.K.); Department of General Thoracic Surgery, Juntendo University School of Medicine, Tokyo, Japan (Y.N.); and Department of Thoracic Imaging, The University of Texas MD Anderson Cancer Center, Houston, Tex (G.S.S.)
| | - Tetsuro Taki
- From the Departments of Diagnostic Radiology (T.S., H.K., T.H., S.O., S.M., Y.M., T.K.), Pathology and Clinical Laboratories (T.T., G.I.), and Thoracic Surgery (Y.N., S.J.Y.O.K.), National Cancer Center Hospital East, 6-5-1 Kashiwanoha, Kashiwa, Chiba 277-8577, Japan; Department of Diagnostic Radiology, National Cancer Center Hospital, Tokyo, Japan (S.K.); Department of General Thoracic Surgery, Juntendo University School of Medicine, Tokyo, Japan (Y.N.); and Department of Thoracic Imaging, The University of Texas MD Anderson Cancer Center, Houston, Tex (G.S.S.)
| | - Yusuke Nagasaki
- From the Departments of Diagnostic Radiology (T.S., H.K., T.H., S.O., S.M., Y.M., T.K.), Pathology and Clinical Laboratories (T.T., G.I.), and Thoracic Surgery (Y.N., S.J.Y.O.K.), National Cancer Center Hospital East, 6-5-1 Kashiwanoha, Kashiwa, Chiba 277-8577, Japan; Department of Diagnostic Radiology, National Cancer Center Hospital, Tokyo, Japan (S.K.); Department of General Thoracic Surgery, Juntendo University School of Medicine, Tokyo, Japan (Y.N.); and Department of Thoracic Imaging, The University of Texas MD Anderson Cancer Center, Houston, Tex (G.S.S.)
| | - Seiyu Jeong-Yoo Ohtani-Kim
- From the Departments of Diagnostic Radiology (T.S., H.K., T.H., S.O., S.M., Y.M., T.K.), Pathology and Clinical Laboratories (T.T., G.I.), and Thoracic Surgery (Y.N., S.J.Y.O.K.), National Cancer Center Hospital East, 6-5-1 Kashiwanoha, Kashiwa, Chiba 277-8577, Japan; Department of Diagnostic Radiology, National Cancer Center Hospital, Tokyo, Japan (S.K.); Department of General Thoracic Surgery, Juntendo University School of Medicine, Tokyo, Japan (Y.N.); and Department of Thoracic Imaging, The University of Texas MD Anderson Cancer Center, Houston, Tex (G.S.S.)
| | - Genichiro Ishii
- From the Departments of Diagnostic Radiology (T.S., H.K., T.H., S.O., S.M., Y.M., T.K.), Pathology and Clinical Laboratories (T.T., G.I.), and Thoracic Surgery (Y.N., S.J.Y.O.K.), National Cancer Center Hospital East, 6-5-1 Kashiwanoha, Kashiwa, Chiba 277-8577, Japan; Department of Diagnostic Radiology, National Cancer Center Hospital, Tokyo, Japan (S.K.); Department of General Thoracic Surgery, Juntendo University School of Medicine, Tokyo, Japan (Y.N.); and Department of Thoracic Imaging, The University of Texas MD Anderson Cancer Center, Houston, Tex (G.S.S.)
| | - Sawako Kaku
- From the Departments of Diagnostic Radiology (T.S., H.K., T.H., S.O., S.M., Y.M., T.K.), Pathology and Clinical Laboratories (T.T., G.I.), and Thoracic Surgery (Y.N., S.J.Y.O.K.), National Cancer Center Hospital East, 6-5-1 Kashiwanoha, Kashiwa, Chiba 277-8577, Japan; Department of Diagnostic Radiology, National Cancer Center Hospital, Tokyo, Japan (S.K.); Department of General Thoracic Surgery, Juntendo University School of Medicine, Tokyo, Japan (Y.N.); and Department of Thoracic Imaging, The University of Texas MD Anderson Cancer Center, Houston, Tex (G.S.S.)
| | - Girish S Shroff
- From the Departments of Diagnostic Radiology (T.S., H.K., T.H., S.O., S.M., Y.M., T.K.), Pathology and Clinical Laboratories (T.T., G.I.), and Thoracic Surgery (Y.N., S.J.Y.O.K.), National Cancer Center Hospital East, 6-5-1 Kashiwanoha, Kashiwa, Chiba 277-8577, Japan; Department of Diagnostic Radiology, National Cancer Center Hospital, Tokyo, Japan (S.K.); Department of General Thoracic Surgery, Juntendo University School of Medicine, Tokyo, Japan (Y.N.); and Department of Thoracic Imaging, The University of Texas MD Anderson Cancer Center, Houston, Tex (G.S.S.)
| | - Tatsushi Kobayashi
- From the Departments of Diagnostic Radiology (T.S., H.K., T.H., S.O., S.M., Y.M., T.K.), Pathology and Clinical Laboratories (T.T., G.I.), and Thoracic Surgery (Y.N., S.J.Y.O.K.), National Cancer Center Hospital East, 6-5-1 Kashiwanoha, Kashiwa, Chiba 277-8577, Japan; Department of Diagnostic Radiology, National Cancer Center Hospital, Tokyo, Japan (S.K.); Department of General Thoracic Surgery, Juntendo University School of Medicine, Tokyo, Japan (Y.N.); and Department of Thoracic Imaging, The University of Texas MD Anderson Cancer Center, Houston, Tex (G.S.S.)
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Santos LAR, Brito MTV. Minor Salivary Gland Polymorphous Adenocarcinoma With Local Recurrence After Seven Years: A Case Report. Cureus 2023; 15:e40112. [PMID: 37425574 PMCID: PMC10329255 DOI: 10.7759/cureus.40112] [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] [Accepted: 06/08/2023] [Indexed: 07/11/2023] Open
Abstract
Polymorphous adenocarcinoma is a rare neoplasm of the minor salivary glands with an indolent behavior. Here, we report and describe the computed tomography (CT) and magnetic resonance imaging (MRI) of polymorphic adenocarcinoma in a 69-year-old patient who presented with local recurrence seven years after the initial treatment. On contrast CT, the primary lesion appeared heterogeneous and invaded the pterygopalatine fossa and the sphenopalatine foramen. The recurrent lesion on MRI showed a hypointense signal on the T1-weighted sequence, a hyperintense signal on the T2-weighted sequence, and heterogeneous enhancement with contrast. The patient underwent a new surgery for lesion resection and is currently under clinical and radiological follow-up. It is recommended to follow patients for at least 15 years after diagnosis, as local recurrences can occur up to 10 years after the initial treatment.
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Liu L, Li Y, Zi Y, Rong D, Li Y, Li X, Xu F, Wu H. MRI findings of benign tumors and tumor-like diseases of the tongue with radiologic-pathologic correlation. Jpn J Radiol 2023; 41:19-26. [PMID: 36097236 DOI: 10.1007/s11604-022-01329-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/06/2022] [Accepted: 08/15/2022] [Indexed: 01/07/2023]
Abstract
Benign tumors or tumor-like lesions of the tongue are uncommon lesions that comprise a heterogeneous group of neoplasms. Although there are a variety of benign tumors or tumor-like lesions, the imaging appearance of these diseases is not well defined because of a paucity of scientific literature on this topic. Most benign tongue tumors usually appear as submucosal bulges located in the deep portion of the tongue. Their true features and extent may only be identified on cross-sectional images such as CT and MRI. Thus, CT and MRI play an important role in the diagnosis of these unusual lesions. It is important that radiologists be able to identify the characteristic CT and MR imaging features that can be used to narrow the differential diagnosis with increased diagnostic confidence, suggest specific histologic tumor types. In this pictorial essay, we provide insights into the MRI presentations of benign tongue tumors and tumor-like diseases and their radiologic-pathologic correlation. Benign tumors or tumor-like lesions of the tongue described herein include papilloma, lipoma, hemangioma, venous malformations, schwannoma, neurofibroma, epidermoid cyst, and dermoid cyst.
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Affiliation(s)
- Lin Liu
- Department of Radiology, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, Guangzhou, 510080, Guangdong, PR China.,Medical College Postgraduate College, Shantou University, Shantou, 515041, Guangdong, PR China.,Guangdong Provincial Key Laboratory of Artificial Intelligence in Medical Image Analysis and Application, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, Guangzhou, 510080, China
| | - Yulin Li
- Department of Radiology, Meizhou People's Hospital, Meizhou, 514011, Guangdong, PR China
| | - Yunyan Zi
- Department of Radiology, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, Guangzhou, 510080, Guangdong, PR China.,Guangdong Provincial Key Laboratory of Artificial Intelligence in Medical Image Analysis and Application, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, Guangzhou, 510080, China.,Graduate College, Southern Medical University, Guangzhou, 510515, Guangdong, PR China
| | - Dailin Rong
- Medical Imaging Center, The Third Affiliated Hospital, Sun Yat-Sen University, Guangzhou, 510630, PR China.,Medical Imaging Center, Sun Yat-Sen University Cancer Center, State Key Laboratory of Oncology in South China, 651 Dongfeng Rd E, Guangzhou, 510060, Guangdong, PR China
| | - Yanhui Li
- Department of Radiology, The Second Xiangya Hospital of Central South University, Changsha, 510235, Hunan, PR China
| | - Xiuhui Li
- Department of Information Media Industry, Guangzhou Public Utility Technician College, Guangzhou, 510080, Guangdong, PR China
| | - Fangping Xu
- Department of Pathology, Guangdong Provincial People's Hospital/Guangdong Academy of Medical Sciences, Guangzhou, 510080, Guangdong, PR China
| | - Haijun Wu
- Department of Radiology, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, Guangzhou, 510080, Guangdong, PR China. .,Medical College Postgraduate College, Shantou University, Shantou, 515041, Guangdong, PR China. .,Guangdong Provincial Key Laboratory of Artificial Intelligence in Medical Image Analysis and Application, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, Guangzhou, 510080, China.
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Utility of apparent diffusion coefficient histogram analysis in differentiating benign and malignant palate lesions. Eur J Radiol 2022; 157:110566. [DOI: 10.1016/j.ejrad.2022.110566] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/15/2022] [Revised: 10/06/2022] [Accepted: 10/13/2022] [Indexed: 11/30/2022]
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FAP-Specific Signalling Is an Independent Diagnostic Approach in ACC and Not a Surrogate Marker of MRI Sequences. Cancers (Basel) 2022; 14:cancers14174253. [PMID: 36077788 PMCID: PMC9454795 DOI: 10.3390/cancers14174253] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/21/2022] [Revised: 07/29/2022] [Accepted: 08/18/2022] [Indexed: 11/16/2022] Open
Abstract
Background: Fibroblast Activation Protein (FAP) is a new target for positron emission tomography and computed tomography (PET/CT) imaging of epithelial tumours embedded in a fibrous stroma. Adenoid cystic carcinomas (ACCs) have shown elevated tracer uptake in 68Gallium (68Ga)-labelled FAPIs in previous studies. The current gold standard for ACC imaging is contrast-enhanced (ce) MRI, where intertumoural heterogeneity leads to variable appearance on T1-weighted (T1w) and T2-weighted (T2w) images. In this retrospective analysis, we correlated 68Ga-FAPI PET signalling at three time points with ceT1w and T2w MRI signals to further characterise the significance of 68Ga-FAPI uptake in ACCs. Methods: Clinical PET/CT scans of 12 ACC patients were performed at 10, 60 and 180 min post i.v. administration of 68Ga-labelled-FAPI tracer molecules. 68Ga-PET- and corresponding MRI-scans were co-registered, and 3D volumetric segmentations were performed on ceT1w and T2w lesions of co-registered MRI slides. Signal intensity values of 68Ga-FAPI PET signalling and ceT1w/T2w MRI scans were analysed for their pixelwise correlation in each patient. Pooled estimates of the correlation coefficients were calculated using the Fisher z-transformation. Results: 68Ga-FAPI PET signals showed a very weak positive correlation with ceT1w values (pooled correlation 0.114, 0.147 and 0.162 at 10, 60 and 180 min) and a weak negative correlation with T2w values (pooled correlation −0.148, −0.121 and −0.225 at 10, 60 and 180 min). Individual r-values at 60 min ranged from −0.130 to 0.434 in ceT1w and from −0.466 to 0.637 in T2w MRI scans. Conclusion: There are only slight correlations between the intensity of 68Ga-FAPI PET signals and tumour appearance in ceT1w or T2w MRI scans, which underlines that 68Ga-FAPI PET signalling is not a surrogate marker of MRI sequences but an independent signal.
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7
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Multimodality imaging of extra-nodal lymphoma in the head and neck. Clin Radiol 2022; 77:e549-e559. [DOI: 10.1016/j.crad.2022.04.017] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/21/2022] [Accepted: 04/22/2022] [Indexed: 11/19/2022]
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8
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A Huge Lesion in the Maxillary Posterior Region Diagnosed High Grade Mucoepidermoid Carcinoma of Minor Salivary Glands: A Case Report. JOURNAL OF BASIC AND CLINICAL HEALTH SCIENCES 2022. [DOI: 10.30621/jbachs.1017162] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
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9
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Swain S. A giant pyogenic granuloma on the hard palate. APOLLO MEDICINE 2022. [DOI: 10.4103/am.am_1_22] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
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Lee PP, Guess GC, Schumacher AE, Dalley RW. Delayed diagnosis of palatal adenoid cystic carcinoma: Review of diagnostic workup and image features of perineural spread. Oral Oncol 2021; 121:105501. [PMID: 34438281 DOI: 10.1016/j.oraloncology.2021.105501] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/07/2021] [Revised: 08/12/2021] [Accepted: 08/14/2021] [Indexed: 11/19/2022]
Abstract
OBJECTIVES Adenoid cystic carcinoma (ACC) is the malignancy most likely to spread perineurally. Delayed diagnosis often leads to undetected perineural spread (PNS). Better understanding of diagnostic processes, clinical and imaging features in ACC may allow earlier diagnoses. MATERIALS AND METHODS A retrospective records search of the University of Washington Radiology archive identified patients with palatal ACC diagnosis and pre-treatment MDCT and/or MRI. Demographic data, clinical findings, diagnostic workup history and image features including the presence of PNS were recorded. RESULTS 44 patients met inclusion and exclusion criteria. Symptoms included pain, mass, numbness, and sinonasal congestion. The most common finding on clinical examination was visible or palpable palatal mass. 55% of patients were evaluated by a dentist pre-diagnosis. Most common initial impressions were infection and/or dental disease. PNS was identified in 81.8% of patients, most commonly at pterygopalatine fossa, palatine foramina/canals, Vidian canal, or foramen rotundum. PNS was statistically significantly associated with paresthesia (p = 0.003) but not with tumor size, age, gender, or tobacco history. 44% of patients were diagnosed ≥1 year from initial symptoms, with a mean delay of 18.3 (range < 1-72) months. CONCLUSIONS This study represents the first analysis of the nature of the diagnostic process of palatal ACC. Majorities of patients were evaluated by a general dentist pre-diagnosis. PNS was identified in a majority of patients and all the patients who presented with paresthesia had evidence of PNS. Despite patients presenting with paresthesia, palatal ACC is often initially misdiagnosed resulting in delayed diagnosis.
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Affiliation(s)
- Peggy P Lee
- Department of Oral Medicine, Box 356370, 1959 NE Pacific St, University of Washington, Seattle, WA 98195, United States.
| | - Griffin C Guess
- Department of Oral Medicine, 1959 NE Pacific St, University of Washington, Seattle, WA 98195, United States.
| | - Austin E Schumacher
- Department of Biostatistics, Box 357232, University of Washington, Seattle, WA 98195-7232, United States.
| | - Roberta W Dalley
- Department of Radiology, Box 357115, 1959 NE Pacific St, University of Washington, Seattle, WA 98195, United States.
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Pyogenic Granuloma of the Hard Palate. J Craniofac Surg 2021; 31:e612-e614. [PMID: 32649529 DOI: 10.1097/scs.0000000000006697] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022] Open
Abstract
As the authors recently experienced a patient with pyogenic granuloma arising from the hard palate, they tried to review all the previously reported literatures with the emphasis on its clinical characteristics that can help the accurate diagnosis of this unusual lesion. Based on our experience and literatures review, clinicians should keep in mind that pyogenic granuloma should be taken into consideration in the differential diagnosis of the hard palatal mass despite its rarity. Although histopathological examination of the mass is the only way to arrive at a definitive diagnosis, the knowledge of the gross appearances of pyogenic granuloma with clinical features may be helpful for differential diagnosis.
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Hiyama T, Kuno H, Sekiya K, Oda S, Kobayashi T. Imaging of Malignant Minor Salivary Gland Tumors of the Head and Neck. Radiographics 2020; 41:175-191. [PMID: 33245669 DOI: 10.1148/rg.2021200062] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/29/2022]
Abstract
Minor salivary gland carcinomas (MSGCs) are nonminor tumors in the head and neck region and account for about half of all salivary gland carcinomas. Imaging evaluation based on the anatomy of minor salivary and mucous glands in the head and neck region as well as invasion patterns in each site helps in identifying optimal treatment modalities and planning suitable treatment strategies. MSGCs can be divided radiologically into localized and invasive subtypes on the basis of the clinical utility of such categorization. Characteristic invasion patterns of the invasive type include deep submucosal extension, bone marrow infiltration, and perineural spread, which are difficult to assess clinically. MSGCs easily invade adjacent structures because of their submucosal location and may spread along the muscles, nerves, periosteum, and dura mater. Moreover, the tumor may spread into the bone marrow without obvious bone destruction. In addition to imaging classification, examining the anatomy and distribution of the minor salivary glands, including the palatal, lingual, buccal, labial, and retromolar glands, as well as other mucous glands, including the glands of the sinonasal cavity and nasopharynx, lacrimal glands, ceruminous glands, laryngeal glands, and tracheal glands, facilitates MSGC diagnosis and tumor extension assessment. The authors review the precise anatomy of the minor salivary and mucous glands in the head and neck region, discuss the MSGC imaging classifications, and describe how to evaluate the extent of MSGCs in each site on the basis of the imaging classification and invasion patterns. ©RSNA, 2020.
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Affiliation(s)
- Takashi Hiyama
- From the Department of Diagnostic Radiology, National Cancer Center Hospital East, 6-5-1 Kashiwanoha, Kashiwa, Chiba 277-8577, Japan
| | - Hirofumi Kuno
- From the Department of Diagnostic Radiology, National Cancer Center Hospital East, 6-5-1 Kashiwanoha, Kashiwa, Chiba 277-8577, Japan
| | - Kotaro Sekiya
- From the Department of Diagnostic Radiology, National Cancer Center Hospital East, 6-5-1 Kashiwanoha, Kashiwa, Chiba 277-8577, Japan
| | - Shioto Oda
- From the Department of Diagnostic Radiology, National Cancer Center Hospital East, 6-5-1 Kashiwanoha, Kashiwa, Chiba 277-8577, Japan
| | - Tatsushi Kobayashi
- From the Department of Diagnostic Radiology, National Cancer Center Hospital East, 6-5-1 Kashiwanoha, Kashiwa, Chiba 277-8577, Japan
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13
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Asai S, Nakamura S, Kuribayashi A, Sakamoto J, Yoshino N, Kurabayashi T. Effective combination of 3 imaging modalities in differentiating between malignant and benign palatal lesions. Oral Surg Oral Med Oral Pathol Oral Radiol 2020; 131:256-264. [PMID: 32861665 DOI: 10.1016/j.oooo.2020.07.011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/16/2020] [Revised: 07/10/2020] [Accepted: 07/18/2020] [Indexed: 10/23/2022]
Abstract
OBJECTIVE The aim of this study was to evaluate whether computed tomography (CT), magnetic resonance imaging (MRI), and positron emission tomography/computed tomography (PET/CT) can effectively differentiate between malignant and benign palatal lesions. STUDY DESIGN In total, 59 patients with palatal lesions (32 malignant and 27 benign), who underwent CT, MRI, and/or PET/CT imaging examinations and had histopathological diagnoses, were divided into an analysis group (n = 46) and a validation group (n = 13). Bone changes adjacent to the lesion, MRI signal intensity, apparent diffusion coefficient (ADC), time to peak enhancement (Tpeak), and maximum standardized uptake values (SUVmax) were evaluated in the analysis group. Diagnostic performance was individually assessed for each parameter for differentiating between malignant and benign lesions. A diagnostic decision tree was constructed by using useful parameters and its accuracy tested in the validation group. RESULTS The frequency distribution of bone change types and Tpeak differed significantly between malignant and benign lesions. The ADC of malignant lymphoma was significantly lower than that of other lesions. The other parameters did not distinguish between lesion types. The accuracy of the decision tree, constructed by using bone change types, ADC, and Tpeak, was 87.5%. CONCLUSIONS Bone change types, ADC values, and Tpeak are useful for differentiating between malignant and benign palatal lesions.
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Affiliation(s)
- Sakurako Asai
- Department of Oral and Maxillofacial Radiology, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, Tokyo, Japan
| | - Shin Nakamura
- Department of Oral and Maxillofacial Radiology, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, Tokyo, Japan.
| | - Ami Kuribayashi
- Department of Oral and Maxillofacial Radiology, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, Tokyo, Japan
| | - Junichiro Sakamoto
- Department of Oral and Maxillofacial Radiology, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, Tokyo, Japan
| | - Norio Yoshino
- Department of Oral and Maxillofacial Radiology, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, Tokyo, Japan
| | - Tohru Kurabayashi
- Department of Oral and Maxillofacial Radiology, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, Tokyo, Japan
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Zabaleta-López M, Ramos-Casademont L, Gómez-Tomé E, Diaz De Cerio Canduela P, Ibáñez-Muñoz C, Martínez-Torre MI. Carcinoma de paladar blando. Descripción de una serie de casos. REVISTA ORL 2020. [DOI: 10.14201/orl.23565] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022] Open
Abstract
Introducción y objetivo: Describir las características clínicas, anatómicas y el trata-miento quirúrgico, incluyendo las distintas opciones de reconstrucción de los tumo-res de paladar blando. Descripción: Estudio retrospectivo de 6 pacientes diagnosti-cados y tratados en el servicio de Otorrinolaringología del hospital San Pedro de Logroño entre los años 2018 y 2019. Discusión: Exponemos los resultados de nues-tros pacientes y realizamos una revisión de los tumores de orofaringe localizados en el paladar blando, los detalles anatómicos y técnicas quirúrgicas reconstructivas más utilizadas en el tratamiento quirúrgico de los tumores de paladar blando. Conclusio-nes: La prevalencia de los tumores de orofaringe ha aumentado en los últimos años a expensas de la infección por el virus del papiloma humano (VPH). Sin embargo, los carcinomas de paladar blando son mayoritariamente P16 negativos. Estos tumores son poco sintomáticos en fases iniciales y es necesario un alto índice de sospecha para evitar diagnósticos tardíos. El desarrollo de la cirugía transoral ha impulsado el tratamiento quirúrgico de los tumores de paladar blando y puede reducir la necesidad de tratamientos complementarios hasta en un 40% de los casos. La reconstrucción se hace necesaria en resecciones mayores del 50%.
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15
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Baba A, Matsushima S, Toyoda K, Yamauchi H, Ikeda K, Sugimoto K, Ojiri H. MR imaging of palatine gland lesion-associated IgG4-related disease: a preliminary study. Jpn J Radiol 2020; 38:746-752. [PMID: 32253653 DOI: 10.1007/s11604-020-00968-8] [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] [Received: 12/12/2019] [Accepted: 03/30/2020] [Indexed: 12/12/2022]
Abstract
PURPOSE The purpose of this study was to present the novel MRI findings of palatine gland lesion-associated IgG4-related disease (PGL-IgG4-RD) and to compare the imaging features with those in normal individuals. MATERIALS AND METHODS We retrospectively evaluated the MRI scans of 12 patients with PGL-IgG4-RD and 12 control individuals. We measured the thickness of the palatal regions and calculated the T2-weighted signal intensity ratio of palatal regions to cerebral white matter (HWR) and compared them between the PGL-IgG4-RD and control groups. RESULTS In univariate analysis, the HWR of the palatal regions on T2-weighted imaging was smaller in the PGL-IgG4-RD group than in the control group (average = 1.2 vs. 1.9, p < 0.001). The palate thickness in patients with PGL-IgG4-RD was significantly greater than that in controls (average = 12 vs 6 mm, p < 0.001). The cut-off value of the between-group palate thickness on coronal MRI was 8 mm. CONCLUSION The thickening of the palatal regions seen with low signal intensity on T2-weighted imaging may be a characteristic imaging feature of PGL-IgG4-RD. Such findings will be useful for the timely diagnosis and subsequent treatment planning of IgG4-RDHP.
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Affiliation(s)
- Akira Baba
- Department of Radiology, Jikei University School of Medicine, 3-25-8 Nishi-Shimbashi, Minato-ku, Tokyo, 105-8461, Japan.
| | - Satoshi Matsushima
- Department of Radiology, Jikei University School of Medicine, 3-25-8 Nishi-Shimbashi, Minato-ku, Tokyo, 105-8461, Japan
| | - Keiko Toyoda
- Department of Radiology, Daisan Hospital, The Jikei University School of Medicine, Tokyo, Japan
| | - Hideomi Yamauchi
- Department of Radiology, Jikei University School of Medicine, 3-25-8 Nishi-Shimbashi, Minato-ku, Tokyo, 105-8461, Japan
| | - Koshi Ikeda
- Department of Radiology, Jikei University School of Medicine, 3-25-8 Nishi-Shimbashi, Minato-ku, Tokyo, 105-8461, Japan
| | - Koichiro Sugimoto
- Department of Radiology, Jikei University School of Medicine, 3-25-8 Nishi-Shimbashi, Minato-ku, Tokyo, 105-8461, Japan
| | - Hiroya Ojiri
- Department of Radiology, Jikei University School of Medicine, 3-25-8 Nishi-Shimbashi, Minato-ku, Tokyo, 105-8461, Japan
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16
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Oren N, Vaysberg A, Ginat DT. Updated WHO nomenclature of head and neck lesions and associated imaging findings. Insights Imaging 2019; 10:72. [PMID: 31312967 PMCID: PMC6635538 DOI: 10.1186/s13244-019-0760-4] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/10/2019] [Accepted: 06/18/2019] [Indexed: 12/22/2022] Open
Abstract
This article reviews the imaging features of head and neck lesions with updated 2017 World Health Organization (WHO) nomenclature. The major WHO changes include refined terminology of existing entities, descriptions of new tumor types, elimination of defunct categories, and updated biological characterization of various tumor types. In particular, the updates pertaining to the following conditions will be reviewed: tumors of the oral cavity and oropharynx, including HPV-positive or HPV-negative squamous cell carcinoma, small cell carcinoma; tumors of the hypopharynx, larynx, trachea, and parapharyngeal space, including nomenclature revisions for laryngeal neuroendocrine tumors; tumors of the nasal cavity and paranasal sinuses including newly added entities such as NUT carcinoma and biphenotypic sinonasal sarcoma; odontogenic and maxillofacial bone tumors, including the reversal of terminology for certain cystic lesions; tumors of the salivary glands, including updated terminology related to high-grade transformation and polymorphous adenocarcinomas tumors; temporal bone lesions including modifications of the nomenclature and classification criteria; tumor-like lesions of the neck and lymph nodes, with a discussion encompassing developmental cysts, metastases of unknown primary, and heterotopia-associated neoplasia; and mucosal melanoma. Familiarity with the proper WHO terminology for conditions that might be mentioned in differential diagnoses and a general understanding of the behavior of head and neck lesions can help optimize imaging assessment and reporting.
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Affiliation(s)
- Nisa Oren
- Department of Radiology, Section of Neuroradiology, University of Chicago, 5841 S Maryland Avenue, Chicago, IL, 60637, USA
| | - Anatoliy Vaysberg
- Department of Radiology, Section of Neuroradiology, University of Chicago, 5841 S Maryland Avenue, Chicago, IL, 60637, USA
| | - Daniel T Ginat
- Department of Radiology, Section of Neuroradiology, University of Chicago, 5841 S Maryland Avenue, Chicago, IL, 60637, USA.
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17
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Ju WT, Zhao TC, Liu Y, Tan YR, Dong MJ, Sun Q, Wang LZ, Li J, Zhong LP. Computed tomographic features of adenoid cystic carcinoma in the palate. Cancer Imaging 2019; 19:3. [PMID: 30704527 PMCID: PMC6357373 DOI: 10.1186/s40644-019-0190-z] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/11/2018] [Accepted: 01/23/2019] [Indexed: 02/07/2023] Open
Abstract
Background To evaluate the computed tomographic features and create a prediction model for clinical diagnosis of adenoid cystic carcinoma (ACC) in the palate with intact mucosa. Methods From March 2016 to May 2018, 102 patients with palatal tumors and intact mucosa, including 28 patients with a pathological diagnosis of ACC after surgery, were enrolled in this study. The patients’ clinical symptoms, computed tomographic features and pathological diagnoses were recorded and analyzed. Independent predictors of ACC were determined by using univariate analysis and multivariate logistic regression, and the discrimination and calibration of the prediction model was evaluated, and internal validation was performed. Results Univariate analysis of patients showed that ACC patients were more likely than non-ACC patients to be older (P = 0.019); to have palatine bone destruction (P<0.001) and greater palatine foramen (GPF) enlargement (P<0.001); to have involvement of the pterygopalatine fossa (P<0.001), foramen rotundum (P<0.001), nasal cavity (P<0.001) and maxillary bone (P<0.001); and to have numbness (P = 0.007) and pain (P<0.001). Multivariate logistic analysis showed that age and GPF enlargement were independent predictors of ACC in palatal tumors. The diagnostic prediction model showed good discrimination and calibration, as evaluated by the area under the receiver operating characteristic curve (0.98) and the Hosmer-Lemeshow goodness-of-fit test (P = 0.927). Conclusions The palate ACC prediction model based on age and GPF enlargement shows excellent discrimination with no evidence of poor calibration. Older patients with palatal tumors and intact mucosa should be considered for ACC when they have GPF enlargement. Electronic supplementary material The online version of this article (10.1186/s40644-019-0190-z) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Wu-Tong Ju
- Department of Oral and Maxillofacial-Head and Neck Oncology, Ninth Peoples Hospital, College of Stomatology Shanghai Jiao Tong University School of Medicine, No. 639 Zhizaoju Road, Shanghai, 200011, China
| | - Tong-Chao Zhao
- Department of Oral and Maxillofacial-Head and Neck Oncology, Ninth Peoples Hospital, College of Stomatology Shanghai Jiao Tong University School of Medicine, No. 639 Zhizaoju Road, Shanghai, 200011, China
| | - Ying Liu
- Department of Oral and Maxillofacial-Head and Neck Oncology, Ninth Peoples Hospital, College of Stomatology Shanghai Jiao Tong University School of Medicine, No. 639 Zhizaoju Road, Shanghai, 200011, China
| | - Yi-Ran Tan
- Department of Oral and Maxillofacial-Head and Neck Oncology, Ninth Peoples Hospital, College of Stomatology Shanghai Jiao Tong University School of Medicine, No. 639 Zhizaoju Road, Shanghai, 200011, China
| | - Min-Jun Dong
- Department of Oral Radiology, Ninth Peoples Hospital Shanghai Jiao Tong University School of Medicine, No. 639 Zhizaoju Road, Shanghai, 200011, China.
| | - Qi Sun
- Department of Oral Radiology, Ninth Peoples Hospital Shanghai Jiao Tong University School of Medicine, No. 639 Zhizaoju Road, Shanghai, 200011, China
| | - Li-Zhen Wang
- Department of Oral Pathology, Ninth Peoples Hospital, College of Stomatology Shanghai Jiao Tong University School of Medicine, National Clinical Research Center for Oral Diseases Key Laboratory of Stomatology, Shanghai, China
| | - Jiang Li
- Department of Oral Pathology, Ninth Peoples Hospital, College of Stomatology Shanghai Jiao Tong University School of Medicine, National Clinical Research Center for Oral Diseases Key Laboratory of Stomatology, Shanghai, China
| | - Lai-Ping Zhong
- Department of Oral and Maxillofacial-Head and Neck Oncology, Ninth Peoples Hospital, College of Stomatology Shanghai Jiao Tong University School of Medicine, No. 639 Zhizaoju Road, Shanghai, 200011, China.
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18
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A Review of Salivary Gland Malignancies: Common Histologic Types, Anatomic Considerations, and Imaging Strategies. Neuroimaging Clin N Am 2018; 28:171-182. [PMID: 29622112 DOI: 10.1016/j.nic.2018.01.011] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/17/2023]
Abstract
Major and minor salivary gland malignancies come in various shapes and sizes. They can present as palpable masses or can be detected incidentally when imaging patients for other indications. A complete evaluation of salivary gland malignancies requires knowledge of the anatomy and various routes of spread of neoplasias. Computed tomography (CT) and MR imaging are complementary tools in this respect and offer useful information to the proceduralist. Advanced imaging (diffusion-weighted imaging and PET-CT) and other modalities (eg, ultrasound) help with characterization, although biopsy or excision is often needed for definitive tissue diagnosis.
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19
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Improved detection rates and treatment planning of head and neck cancer using dual-layer spectral CT. Eur Radiol 2018; 28:4925-4931. [DOI: 10.1007/s00330-018-5511-2] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2018] [Revised: 04/17/2018] [Accepted: 04/20/2018] [Indexed: 12/19/2022]
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20
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Vander Poorten V, Triantafyllou A, Skálová A, Stenman G, Bishop JA, Hauben E, Hunt JL, Hellquist H, Feys S, De Bree R, Mäkitie AA, Quer M, Strojan P, Guntinas-Lichius O, Rinaldo A, Ferlito A. Polymorphous adenocarcinoma of the salivary glands: reappraisal and update. Eur Arch Otorhinolaryngol 2018; 275:1681-1695. [PMID: 29761209 DOI: 10.1007/s00405-018-4985-5] [Citation(s) in RCA: 28] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/16/2018] [Accepted: 04/26/2018] [Indexed: 12/29/2022]
Abstract
Although relatively rare, polymorphous adenocarcinoma (PAC) is likely the second most common malignancy of the minor salivary glands (MiSG). The diagnosis is mainly based on an incisional biopsy. The optimal treatment comprises wide surgical excision, often with adjuvant radiotherapy. In general, PAC has a good prognosis. Previously, PAC was referred to as polymorphous low-grade adenocarcinoma (PLGA), but the new WHO classification of salivary gland tumours has also included under the PAC subheading, the so-called cribriform adenocarcinoma of minor salivary glands (CAMSG). This approach raised controversy, predominantly because of possible differences in clinical behaviour. For example, PLGA (PAC, classical variant) only rarely metastasizes, whereas CAMSG often shows metastases to the neck lymph nodes. Given the controversy, this review reappraises the definition, epidemiology, clinical presentation, diagnostic work-up, genetics, treatment modalities, and prognosis of PAC of the salivary glands with a particular focus on contrasting differences with CAMSG.
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Affiliation(s)
- Vincent Vander Poorten
- Department of Oncology-Section Head and Neck Oncology, Otorhinolaryngology-Head and Neck Surgery and Leuven Cancer Institute, University Hospitals Leuven, KU Leuven, Leuven, Belgium. .,Multidisciplinary Salivary Gland Society, Geneva, Switzerland.
| | - Asterios Triantafyllou
- School of Dentistry, University of Liverpool, Liverpool, UK.,Pathology Department, Liverpool Clinical Laboratories, Liverpool, UK
| | - Alena Skálová
- Multidisciplinary Salivary Gland Society, Geneva, Switzerland.,Department of Pathology, Charles University, Faculty of Medicine in Plzen, Plzen, Czech Republic
| | - Göran Stenman
- Multidisciplinary Salivary Gland Society, Geneva, Switzerland.,Department of Pathology and Genetics, Sahlgrenska Cancer Center, University of Gothenburg, Gothenburg, Sweden
| | - Justin A Bishop
- Department of Pathology, University of Texas Southwestern Medical Center, Dallas, TX, USA
| | - Esther Hauben
- Department of Imaging and Pathology, University Hospitals Leuven, KU Leuven, Leuven, Belgium
| | - Jennifer L Hunt
- Department of Pathology, University of Arkansas for Medical Sciences, Little Rock, AR, USA
| | - Henrik Hellquist
- Epigenetics and Human Disease Laboratory, CBMR, Department of Biomedical Sciences and Medicine, University of Algarve, Faro, Portugal
| | - Simon Feys
- Department of Oncology-Section Head and Neck Oncology, Otorhinolaryngology-Head and Neck Surgery and Leuven Cancer Institute, University Hospitals Leuven, KU Leuven, Leuven, Belgium
| | - Remco De Bree
- Department of Head and Neck Surgical Oncology, University Medical Center Utrecht, Utrecht, The Netherlands
| | - Antti A Mäkitie
- Department of Otorhinolaryngology-Head and Neck Surgery, University of Helsinki and Helsinki University Hospital, Helsinki, Finland.,Division of Ear, Nose and Throat Diseases, Department of Clinical Sciences, Intervention and Technology, Karolinska Institutet, Karolinska University Hospital, Stockholm, Sweden
| | - Miquel Quer
- Multidisciplinary Salivary Gland Society, Geneva, Switzerland.,Department of Otolaryngology, Hospital Santa Creu i Sant Pau, Barcelona, Spain
| | - Primož Strojan
- Department of Radiation Oncology, Institute of Oncology, Ljubljana, Slovenia
| | - Orlando Guntinas-Lichius
- Multidisciplinary Salivary Gland Society, Geneva, Switzerland.,Department of Otorhinolaryngology, Institute of Phoniatry/Pedaudiology, Jena University Hospital, Jena, Germany
| | | | - Alfio Ferlito
- International Head and Neck Scientific Group, Padua, Italy
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21
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Imaging of Sjögren Syndrome and Immunoglobulin G4-Related Disease of the Salivary Glands. Neuroimaging Clin N Am 2018; 28:183-197. [DOI: 10.1016/j.nic.2018.01.003] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
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22
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23
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Zheng Y, Xiao Z, Zhang H, She D, Lin X, Lin Y, Cao D. Differentiation between benign and malignant palatal tumors using conventional MRI: a retrospective analysis of 130 cases. Oral Surg Oral Med Oral Pathol Oral Radiol 2018; 125:343-350. [DOI: 10.1016/j.oooo.2018.01.006] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2017] [Revised: 11/24/2017] [Accepted: 01/07/2018] [Indexed: 12/16/2022]
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24
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Vogl TJ, Albrecht MH, Nour-Eldin NEDA, Ackermann H, Maataoui A, Stöver T, Bickford MW, Stark-Paulsen T. Assessment of salivary gland tumors using MRI and CT: impact of experience on diagnostic accuracy. Radiol Med 2017; 123:105-116. [PMID: 28948489 DOI: 10.1007/s11547-017-0813-z] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/23/2017] [Accepted: 09/13/2017] [Indexed: 01/05/2023]
Abstract
RATIONALE AND OBJECTIVES To analyze the accuracy of radiological diagnosis in MRI and CT studies of salivary gland tumors depending on the radiologist's experience. MATERIALS AND METHODS Three radiologists with differing experience (R1 > 20, R2 > 11, and R3 > 7 years, respectively) retrospectively reviewed 128 cases (116 MRI, 12 CT studies) with suspected salivary gland tumors regarding dignity and classification using histopathology as a reference standard. Sensitivity, specificity, positive/negative predictive value and inter-observer agreement (using Cohen's κ) were calculated to compare diagnostic performance. RESULTS Lesions were benign in 87 and in 23 cases malignant. Neoplasia was absent in 18 cases (15 cases without neoplasia and 3 cases without disease). The highest inter-observer agreement for determining dignity using CT was found between R1 and R2 (κ = 0.74, p < 0.001), and the lowest between R2 and R3 (κ = 0.28, p < 0.001). MRI sensitivity/specificity for classifying pleomorphic adenomas was as follows: R1 (100%/100%), R2 (76.92%/87.01%), R3 (43.53%/67.53%), and for CT: R1 (100%/100%), R2 (100%/88.89%), R3 (66.67%/88.89%; for Warthin's tumor using MRI: R1 (100%/97.44%), R2 (68.42%/83.33%), R3 (50.00%/67.95%), and using CT: R1 (100%/100%), R2 (50.00%/100%), R3 (100%/100%; for squamous cell carcinomas using MRI: R1 (100%/100%), R2 (75.00%/97.12%), R3 (75.00%/99.04%), and using CT: R1 (100%/100%), R2 (66.67%/88.89%), R3 (66.67%/66.67%). The highest agreement was found between R1 and R2 for MRI (κ = 0.62, p < 0.001), and the lowest between R1 and R3 at MRI (κ = 0.28, p < 0.001). CONCLUSION Diagnostic accuracy in the assessment of salivary gland tumors strongly depends on the observer's expertise and increases with higher experience.
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Affiliation(s)
- Thomas J Vogl
- Department of Diagnostic and Interventional Radiology, University Hospital Frankfurt, Theodor-Stern-Kai 7, 60590, Frankfurt Am Main, Germany.
| | - Moritz H Albrecht
- Department of Diagnostic and Interventional Radiology, University Hospital Frankfurt, Theodor-Stern-Kai 7, 60590, Frankfurt Am Main, Germany
| | - Nour-El-Din A Nour-Eldin
- Department of Diagnostic and Interventional Radiology, University Hospital Frankfurt, Theodor-Stern-Kai 7, 60590, Frankfurt Am Main, Germany
| | - Hanns Ackermann
- Department of Biostatistics and Medical Information, University Hospital Frankfurt, Theodor-Stern-Kai 7, 60590, Frankfurt Am Main, Germany
| | - Adel Maataoui
- Department of Diagnostic and Interventional Radiology, University Hospital Frankfurt, Theodor-Stern-Kai 7, 60590, Frankfurt Am Main, Germany
| | - Timo Stöver
- Department of Head and Neck Surgery, University Hospital Frankfurt, Theodor-Stern-Kai 7, 60590, Frankfurt Am Main, Germany
| | - Matthew W Bickford
- Department of Radiology and Radiological Science, Medical University of South Carolina, 171 Ashley Ave, Charleston, SC, 29425, USA
| | - Tatjana Stark-Paulsen
- Department of Diagnostic and Interventional Radiology, University Hospital Frankfurt, Theodor-Stern-Kai 7, 60590, Frankfurt Am Main, Germany
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25
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Kane LP, Hague DW, Lundberg A, Joslyn S. What Is Your Neurologic Diagnosis? Squamous cell carcinomas. J Am Vet Med Assoc 2017; 251:277-280. [PMID: 28703674 DOI: 10.2460/javma.251.3.277] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
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26
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Gamoh S, Akiyama H, Tsuji K, Nakazawa T, Morita S, Tanaka A, Shimizutani K. Non-contrast computed tomography and magnetic resonance imaging features of mucoepidermoid carcinoma in the salivary glands. Oral Radiol 2017; 34:24-30. [PMID: 30484090 DOI: 10.1007/s11282-017-0281-0] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2017] [Accepted: 02/15/2017] [Indexed: 11/27/2022]
Abstract
BACKGROUND Use of contrast-enhanced cross-sectional imaging is considered standard practice for investigating mucoepidermoid carcinoma (MEC) in the salivary glands. The purpose of this study was to present the common features of MEC on computed tomography (CT) and magnetic resonance imaging (MRI) without contrast enhancements, and to investigate the possibility of discriminating between MEC and pleomorphic adenoma based on the features observed on both modalities. METHODS Twenty cases of biopsy-confirmed MEC originating in the salivary glands were reviewed and characterized by two oral and maxillofacial radiologists with regard to the following aspects: detectability, margin, border, encapsulation, content, contrast between lesion and masticator muscle, and bone changes. RESULTS Ninety percent of bone changes caused by MEC were detected by CT and sixty-nine percent of tumor existences were detected by MRI. The lesion border could provide a clue to distinguish MEC from pleomorphic adenoma. CONCLUSIONS Observation of MEC features was possible by both CT and MRI. Among the features, the lesion border could be a clue to distinguish MEC from pleomorphic adenoma.
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Affiliation(s)
- Shoko Gamoh
- Department of Oral Radiology, Osaka Dental University, 1-5-17, Otemae, Chuo-ku, Osaka, 540-0008, Japan.
| | - Hironori Akiyama
- Department of Oral Radiology, Osaka Dental University, 1-5-17, Otemae, Chuo-ku, Osaka, 540-0008, Japan
| | - Kaname Tsuji
- First Department of Oral and Maxillofacial Surgery, Osaka Dental University, 1-5-17, Otemae, Chuo-ku, Osaka, 540-0008, Japan
| | - Tetsuro Nakazawa
- Department of Radiology, Osaka Medical Center for Cancer and Cardiovascular Diseases, 1-3-3, Nakamichi, Higashinari-ku, Osaka, 537-8511, Japan
| | - Shosuke Morita
- First Department of Oral and Maxillofacial Surgery, Osaka Dental University, 1-5-17, Otemae, Chuo-ku, Osaka, 540-0008, Japan
| | - Akio Tanaka
- Department of Oral Pathology, Osaka Dental University, 1-5-17, Otemae, Chuo-ku, Osaka, 540-0008, Japan
| | - Kimishige Shimizutani
- Department of Oral Radiology, Osaka Dental University, 1-5-17, Otemae, Chuo-ku, Osaka, 540-0008, Japan
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Yuan Y, Tang W, Jiang M, Tao X. Palatal lesions: discriminative value of conventional MRI and diffusion weighted imaging. Br J Radiol 2016; 89:20150911. [PMID: 26764280 DOI: 10.1259/bjr.20150911] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/10/2023] Open
Abstract
OBJECTIVE To evaluate and compare the ability of conventional MRI, diffusion-weighted imaging (DWI) and a combination of both MRI techniques to differentiate malignant and benign palatal lesions. METHODS A retrospective review of MRI findings was performed in patients with pathologically confirmed palatal lesions between January 2012 and December 2014. Each lesion was evaluated with conventional MRI characteristics, including enhancement, inner texture, margin, adjacent soft-tissue involvement and cervical lymph node, and/or apparent diffusion coefficient (ADC) value. Statistical analyses were performed to assess the differential performance of each parameter separately and together. RESULTS A total of 42 patients (24 males, 18 females; age: 54.9 ± 16.4 years) were investigated. The optimal cut-off ADC value to distinguish malignant from benign lesions was 1.02 × 10(-3) mm(2) s(-1), with a sensitivity of 87.5% and a specificity of 75.0%. Conventional MRI showed a sensitivity of 87.1% and a specificity of 63.6%. Combination of conventional MRI and ADC scores increased sensitivity to 100% and specificity to 75.0%. The AUCs did not differ significantly between conventional MRI alone, DWI alone and integration of both. CONCLUSION Additional DWI does not substantially improve differential ability of conventional MRI. However, combining ADC values with conventional MRI improves both sensitivity and specificity, which is of worth to be further validated in prospective studies with larger sample sizes. ADVANCES IN KNOWLEDGE Combination of conventional MRI and ADC scores could increase the ability to differentiate malignant from benign palatal lesions, with a sensitivity of 100% and specificity of 75.0%, although without statistical significance.
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Affiliation(s)
- Ying Yuan
- Department of Radiology, Shanghai Ninth People's Hospital, Affiliated to Shanghai JiaoTong University School of Medicine, Shanghai, China
| | - Weiqing Tang
- Department of Radiology, Shanghai Ninth People's Hospital, Affiliated to Shanghai JiaoTong University School of Medicine, Shanghai, China
| | - Mengda Jiang
- Department of Radiology, Shanghai Ninth People's Hospital, Affiliated to Shanghai JiaoTong University School of Medicine, Shanghai, China
| | - Xiaofeng Tao
- Department of Radiology, Shanghai Ninth People's Hospital, Affiliated to Shanghai JiaoTong University School of Medicine, Shanghai, China
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Inglehart RC, Scanlon CS, D'Silva NJ. Reviewing and reconsidering invasion assays in head and neck cancer. Oral Oncol 2014; 50:1137-43. [PMID: 25448226 DOI: 10.1016/j.oraloncology.2014.09.010] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/14/2014] [Revised: 09/11/2014] [Accepted: 09/17/2014] [Indexed: 01/21/2023]
Abstract
Head and neck squamous cell carcinomas (HNSCC) are malignant tumors that arise from the surface epithelium of the oral cavity, oropharynx and larynx, primarily due to exposure to chemical carcinogens or the human papilloma virus. Due to their location, dental practitioners are well-positioned to detect the lesions. Deadlier than lymphoma or melanoma, HNSCC is incompletely understood. For these reasons, dental practitioners and researchers are focused on understanding HNSCC and the processes driving it. One of these critical processes is invasion, the degradation of the basement membrane by HNSCC cells with subsequent movement into the underlying connective tissue, blood vessels or nerves. Cancer cells metastasize to distant sites via the blood vessels, lymphatics and nerves. Metastasis is associated with poor survival. Since invasion is essential for development and metastasis of HNSCC, it is essential to understand the mechanism(s) driving this process. Elucidation of the mechanisms involved will facilitate the development of targeted treatment, thereby accelerating development of precision/personalized medicine to treat HNSCC. Robust in vitro and in vivo assays are required to investigate the mechanistic basis of invasion. This review will focus on in vitro and in vivo assays used to study invasion in HNSCC, with special emphasis on some of the latest assays to study HNSCC.
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Affiliation(s)
- Ronald C Inglehart
- Department of Periodontics and Oral Medicine, School of Dentistry, University of Michigan, Ann Arbor, USA
| | - Christina S Scanlon
- Department of Periodontics and Oral Medicine, School of Dentistry, University of Michigan, Ann Arbor, USA
| | - Nisha J D'Silva
- Department of Periodontics and Oral Medicine, School of Dentistry, University of Michigan, Ann Arbor, USA; Department of Pathology, University of Michigan Medical School, University of Michigan, Ann Arbor, USA.
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