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Czarnywojtek A, Agaimy A, Pietrończyk K, Nixon IJ, Vander Poorten V, Mäkitie AA, Zafereo M, Florek E, Sawicka-Gutaj N, Ruchała M, Ferlito A. IgG4-related disease: an update on pathology and diagnostic criteria with a focus on salivary gland manifestations. Virchows Arch 2024; 484:381-399. [PMID: 38316669 DOI: 10.1007/s00428-024-03757-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2023] [Revised: 01/12/2024] [Accepted: 01/29/2024] [Indexed: 02/07/2024]
Abstract
Immunoglobulin G4-related disease (IgG4-RD) is a multi-organ disorder characterized by a highly variable clinical presentation depending on the affected organ/s, extent of tumefactive fibroinflammatory lesions, and associated functional impairment. The disease pursues a chronic, relapsing, often asymptomatic course and hence may pose a significant diagnostic challenge. Diagnostic delay can lead to progressive fibrosis and irreversible organ damage resulting into significant morbidity and even mortality. Given its broad clinical spectrum, physicians of all specialties may be the first clinicians facing this diagnostic challenge. Outside the pancreatobiliary system, the head and neck represents the major site of IgG4-RD with variable organ-specific diffuse or mass-forming lesions. In up to 75% of cases, elevated serum IgG4 levels are observed, but this figure possibly underestimates the fraction of seronegative cases, as the disease manifestations may present metachronously with significant intervals. Together with negative serology, this can lead to misdiagnosis of seronegative cases. A standardized nomenclature and diagnostic criteria for IgG4-RD were established in 2012 and revised in 2020 facilitating scientific research and expanding the range of diseases associated with IgG4 abnormalities. In addition to orbital pseudotumor, dacryoadenitis, Riedel thyroiditis, sinonasal manifestations, and rare miscellaneous conditions, IgG4-related sialadenitis is one of the most frequent presentations in the head and neck region. However, controversy still exists regarding the relationship between sialadenitis and IgG4-RD. This review focuses on the clinicopathological features of IgG4-related sialadenitis and its contemporary diagnostic criteria.
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Affiliation(s)
- Agata Czarnywojtek
- Department of Pharmacology, Poznan University of Medical Sciences, 60-806, Poznan, Poland
- Department of Endocrinology, Metabolism and Internal Medicine, Poznan University of Medical Sciences, 60-355, Poznan, Poland
| | - Abbas Agaimy
- Institute of Pathology, University Hospital Erlangen, Friedrich-Alexander University Erlangen-Nürnberg (FAU), 91054, Erlangen, Germany
| | | | - Iain J Nixon
- Department of Otorhinolaryngology Head and Neck Surgery, NHS Lothian, Edinburgh, EH8 9YL, UK
| | - Vincent Vander Poorten
- Otorhinolaryngology-Head and Neck Surgery, KU Leuven University Hospitals, 3000, Leuven, Belgium
- Department of Oncology, Section Head and Neck Oncology, KU Leuven, 3000, Leuven, Belgium
| | - Antti A Mäkitie
- Department of Otorhinolaryngology-Head and Neck Surgery, University of Helsinki and Helsinki University Hospital, and the Research Program in Systems Oncology, Faculty of Medicine, University of Helsinki, 00014, Helsinki, Finland
| | - Mark Zafereo
- Department of Head & Neck Surgery, MD Anderson Cancer Center, Houston, TX, 77005, USA
| | - Ewa Florek
- Laboratory of Environmental Research, Department of Toxicology, Poznan University of Medical Sciences, 60-806, Poznan, Poland.
| | - Nadia Sawicka-Gutaj
- Department of Endocrinology, Metabolism and Internal Medicine, Poznan University of Medical Sciences, 60-355, Poznan, Poland
| | - Marek Ruchała
- Department of Endocrinology, Metabolism and Internal Medicine, Poznan University of Medical Sciences, 60-355, Poznan, Poland
| | - Alfio Ferlito
- International Head and Neck Scientific Group, 35100, Padua, Italy
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Kazemi MA, Amini F, Kargar B, Lotfi M, Aghazadeh K, Sharifian H, Moradi B, Azadbakht J. The Value of Ultrasound-guided Core Needle Biopsy in Differentiating Benign from Malignant Salivary Gland Lesions. Indian J Otolaryngol Head Neck Surg 2023; 75:266-270. [PMID: 37275055 PMCID: PMC10235295 DOI: 10.1007/s12070-022-03148-4] [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: 12/31/2021] [Accepted: 08/19/2022] [Indexed: 06/07/2023] Open
Abstract
Purpose In recent years, core needle biopsy (CNB) technique has received much attention, being used as alternative method of tissue sampling for surgical biopsy of salivary gland tumors (SGTs). The present study aimed to evaluate the value of CNB in differentiating benign from malignant SGTs. Materials and methods Patients with suspected benign or malignant SGTs in imaging were enrolled in this study. All core needle biopsies were performed under ultrasound guidance, i.e. ultrasound-guided Core Needle Biopsy (USCNB). Histological examination of the specimen after surgical excision was regarded as gold standard test and set as reference standard to assess USCNB accuracy for discriminating between ultrasound-visible benign and malignant SGTs. Results Based on USCNB results, from 36 participants (14 women and 22 men) with SGTs, 44.4% of detected tumors were benign and 55.5% were malignant. Twenty-two patients underwent surgery and postoperative specimen histological examination showed that 59% of excised lesions were benign and 41% were malignant. USCNB and surgical biopsy (SB) findings were completely compatible for 21 patients. Sensitivity, specificity, positive predictive value, negative predictive value and diagnostic accuracy of USCNB were 100% in differentiating malignant from benign lesions. Conclusion USCNB is a valuable and accurate method of diagnosis with high sensitivity and specificity in distinguishing benign from malignant ultrasound-visible SGTs.
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Affiliation(s)
- Mohammad Ali Kazemi
- Department of Radiology, Amiralam Hospital, Tehran University of Medical Sciences, Tehran, Iran
- Department of radiology, Advanced Diagnostic and Interventional Radiology Research Center (ADIR), Medical Imaging Center, Imam Khomeini Hospital Complex, Tehran University of Medical Sciences, Tehran, Iran
| | - Farzaneh Amini
- Department of Radiology, Amiralam Hospital, Tehran University of Medical Sciences, Tehran, Iran
| | - Bita Kargar
- Faculty of medicine, Islamic Azad University Tehran Medical Sciences, Tehran, Iran
| | - Maryam Lotfi
- Department of Pathology, Amiralam Hospital Complexes, Tehran University of Medical Sciences, Tehran, Iran
| | - Keyvan Aghazadeh
- Otorhinolaryngology research center, Tehran University of Medical Sciences, Tehran, Iran
| | - Hashem Sharifian
- Department of Radiology, Amiralam Hospital, Tehran University of Medical Sciences, Tehran, Iran
- Department of radiology, Advanced Diagnostic and Interventional Radiology Research Center (ADIR), Medical Imaging Center, Imam Khomeini Hospital Complex, Tehran University of Medical Sciences, Tehran, Iran
| | - Behnaz Moradi
- Department of radiology, Advanced Diagnostic and Interventional Radiology Research Center (ADIR), Medical Imaging Center, Imam Khomeini Hospital Complex, Tehran University of Medical Sciences, Tehran, Iran
- Department of Radiology, Women’ Yas Hospital, Tehran University of Medical Sciences, Tehran, Iran
| | - Javid Azadbakht
- Department of Radiology, Faculty of Medicine, Kashan University of Medical Sciences, Shahid Beheshti Hospital, Qotb Ravandi Blvd, 8715981151 Kashan, Iran
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李 炳, 唐 祖, 胡 耒, 章 文, 于 尧, 俞 光, 彭 歆. [Clinicopathologic analysis of micro and mini parotid gland tumors]. BEIJING DA XUE XUE BAO. YI XUE BAN = JOURNAL OF PEKING UNIVERSITY. HEALTH SCIENCES 2022; 54:335-339. [PMID: 35435201 PMCID: PMC9069041 DOI: 10.19723/j.issn.1671-167x.2022.02.022] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Received: 10/13/2020] [Indexed: 06/14/2023]
Abstract
OBJECTIVE To investigate the clinicopathological characteristics of micro and mini parotid gland tumors and to provide reference for their clinical diagnosis and treatment. METHODS Patients with parotid gland tumors treated in the Department of Oral and Maxillofacial Surgery, Peking University School and Hospital of Stomatology from December 2012 to April 2020 were selected. Relevant clinical data of the patients with tumor diameter ≤20 mm detected by preoperative CT were collected to analyze the clinicopathological characteristics and prognosis of micro and mini parotid gland tumors. And the collected data were divided into two groups with diameter 11-20 mm and diameter ≤10 mm according to tumor diameter measured by preoperative CT. The clinicopathological differences between the two groups were statistically analyzed. RESULTS A total of 2 067 patients with primary epithelial parotid gland tumors were collected, and 685 patients with tumor diameter ≤20 mm were examined by CT, accounting for 33.1%. The ratio of male to female patients with micro and mini parotid gland tumors was 1 ∶1.93, the average age was (45.3±13.8) years (12-83 years), and the median course of disease was 12 months (1 week to 30 years). Among them, 635 cases (92.7%) were benign tumors, 50 cases (7.3%) were malignant tumors, and the ratio of benign to malignant was 12.7 ∶1. The most common benign tumor was pleomorphic adenoma, and the most common malignant tumor was mucoepidermoid carcinoma. The micro and mini parotid gland tumors were divided into 11-20 mm group (n=611) and ≤10 mm group (n=74), the clinical characteristics comparison of the two groups of gender ratio, average age, course of di-sease had no statistical difference (P>0.05). In the 11-20 mm diameter group, the percentage of benign and malignant tumor was 92.8% (567/611) and 7.2% (44/611) respectively, and the ratio of benign to malignant tumors was 12.9 ∶1. In the ≤10 mm diameter group, the percentage of benign and malignant tumor was 91.9% (68/74) and 8.1% (6/74) respectively, and the ratio of benign to malignant tumors was 11.3 ∶1. There was no significant difference between the two groups (P>0.05). Fifty patients with malignant tumor were followed up for the median follow-up period of 39.5 months (1-91 months). Local recurrence occurred in 2 patients with one death. The overall 2-year survival rate was 93.7% and the 5-year survival rate was 89.3%. CONCLUSION The majority of micro and mini parotid gland tumors was benign lesion. There was a good prognosis for micro and mini parotid gland carcinoma. Early surgical treatment was recommended for micro and mini parotid gland tumors.
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Affiliation(s)
- 炳雨 李
- />北京大学口腔医学院·口腔医院口腔颌面外科,国家口腔医学中心,国家口腔疾病临床医学研究中心,口腔生物材料和数字诊疗装备国家工程研究中心,口腔数字医学北京市重点实验室,北京 100081Department of Oral and Maxillofacial Surgery, Peking University School and Hospital of Stomatology & National Center of Stomatology & National Clinical Research Center for Oral Diseases & National Engineering Research Center of Oral Biomaterials and Digital Medical Devices & Beijing Key Laboratory of Digital Stomatology, Beijing 100081, China
| | - 祖南 唐
- />北京大学口腔医学院·口腔医院口腔颌面外科,国家口腔医学中心,国家口腔疾病临床医学研究中心,口腔生物材料和数字诊疗装备国家工程研究中心,口腔数字医学北京市重点实验室,北京 100081Department of Oral and Maxillofacial Surgery, Peking University School and Hospital of Stomatology & National Center of Stomatology & National Clinical Research Center for Oral Diseases & National Engineering Research Center of Oral Biomaterials and Digital Medical Devices & Beijing Key Laboratory of Digital Stomatology, Beijing 100081, China
| | - 耒豪 胡
- />北京大学口腔医学院·口腔医院口腔颌面外科,国家口腔医学中心,国家口腔疾病临床医学研究中心,口腔生物材料和数字诊疗装备国家工程研究中心,口腔数字医学北京市重点实验室,北京 100081Department of Oral and Maxillofacial Surgery, Peking University School and Hospital of Stomatology & National Center of Stomatology & National Clinical Research Center for Oral Diseases & National Engineering Research Center of Oral Biomaterials and Digital Medical Devices & Beijing Key Laboratory of Digital Stomatology, Beijing 100081, China
| | - 文博 章
- />北京大学口腔医学院·口腔医院口腔颌面外科,国家口腔医学中心,国家口腔疾病临床医学研究中心,口腔生物材料和数字诊疗装备国家工程研究中心,口腔数字医学北京市重点实验室,北京 100081Department of Oral and Maxillofacial Surgery, Peking University School and Hospital of Stomatology & National Center of Stomatology & National Clinical Research Center for Oral Diseases & National Engineering Research Center of Oral Biomaterials and Digital Medical Devices & Beijing Key Laboratory of Digital Stomatology, Beijing 100081, China
| | - 尧 于
- />北京大学口腔医学院·口腔医院口腔颌面外科,国家口腔医学中心,国家口腔疾病临床医学研究中心,口腔生物材料和数字诊疗装备国家工程研究中心,口腔数字医学北京市重点实验室,北京 100081Department of Oral and Maxillofacial Surgery, Peking University School and Hospital of Stomatology & National Center of Stomatology & National Clinical Research Center for Oral Diseases & National Engineering Research Center of Oral Biomaterials and Digital Medical Devices & Beijing Key Laboratory of Digital Stomatology, Beijing 100081, China
| | - 光岩 俞
- />北京大学口腔医学院·口腔医院口腔颌面外科,国家口腔医学中心,国家口腔疾病临床医学研究中心,口腔生物材料和数字诊疗装备国家工程研究中心,口腔数字医学北京市重点实验室,北京 100081Department of Oral and Maxillofacial Surgery, Peking University School and Hospital of Stomatology & National Center of Stomatology & National Clinical Research Center for Oral Diseases & National Engineering Research Center of Oral Biomaterials and Digital Medical Devices & Beijing Key Laboratory of Digital Stomatology, Beijing 100081, China
| | - 歆 彭
- />北京大学口腔医学院·口腔医院口腔颌面外科,国家口腔医学中心,国家口腔疾病临床医学研究中心,口腔生物材料和数字诊疗装备国家工程研究中心,口腔数字医学北京市重点实验室,北京 100081Department of Oral and Maxillofacial Surgery, Peking University School and Hospital of Stomatology & National Center of Stomatology & National Clinical Research Center for Oral Diseases & National Engineering Research Center of Oral Biomaterials and Digital Medical Devices & Beijing Key Laboratory of Digital Stomatology, Beijing 100081, China
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Albosaily A, Aldrees T, Aldhahri S, Al-Qahtani K. Indications and Outcomes of Parotidectomy in Saudi Children: Experience From Two Tertiary Centers. Cureus 2021; 13:e19587. [PMID: 34926058 PMCID: PMC8671067 DOI: 10.7759/cureus.19587] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/13/2021] [Indexed: 11/29/2022] Open
Abstract
Introduction Children can present with a wide variety of parotid diseases. However, most of them do not require surgical treatment. The indications of parotid surgery in children may differ from those in adults. In this study, we aim to review the indications and outcomes of parotidectomy in our pediatric population. Methods Retrospective review of the medical records of patients who underwent parotid surgery at age <18 years in two tertiary centers over a 14-year period. Results A total of 18 parotidectomies were performed on 18 patients with a mean age of 13.5 years. All patients presented with a parotid mass. The most common procedure was superficial parotidectomy followed by total parotidectomy. Ten patients were diagnosed with a benign parotid disease (55.6%). The most common benign disease was pleomorphic adenoma. There were eight cases of parotid malignancy constituting 44.4% of all patients and 57% of patients presenting in the age range of 12-17 years. Mucoepidermoid carcinoma was the most common malignancy (six patients). Fine needle aspiration biopsy was performed in 12 children with a sensitivity, specificity, and overall accuracy of 62.5%, 50%, and 58.6%, respectively. The most common complication was temporary facial weakness (33.3%) which resolved in a mean time of 2.5 months. No disease recurrences were identified. Conclusions Parotidectomy is uncommon in the pediatric age group. Children with a solid parotid tumor have a higher risk of parotid malignancy when compared to adults. A parotid mass presenting in the second decade of life is more likely to be malignant than benign.
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Affiliation(s)
- Ahmad Albosaily
- Department of Otolaryngology, King Saud University, Riyadh, SAU
| | - Turki Aldrees
- Department of Otolaryngology, Prince Sattam Bin Abdulaziz University, Alkharj, SAU
| | - Saleh Aldhahri
- Department of Otolaryngology, King Saud University, Riyadh, SAU
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Chen Y, Wang X, Su T, Xu Z, Wang Y, Zhang Z, Xue H, Zhuo Z, Zhu Y, Jin Z, Zhang T. Feasibility evaluation of amide proton transfer-weighted imaging in the parotid glands: a strategy to recognize artifacts and measure APT value. Quant Imaging Med Surg 2021; 11:2279-2291. [PMID: 34079701 DOI: 10.21037/qims-20-675] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
Background The feasibility and image quality of three-dimensional (3D) amide proton transfer (APT)-weighted (APTw) in parotid tumor lesions have not been well established in previous studies. This study aimed to evaluate the utility of APT imaging in parotid lesions and glands. Methods Patients with parotid lesions received 3D turbo spin echo (TSE) APTw on a 3.0T scanner. Two radiologists, who were blinded to the clinical data, independently evaluated the APTw image quality using 4-point Likert scales (1= poor, 4= excellent) in terms of integrity and hyperintensity artifacts. An image quality selection protocol was built based on the two scores. Evaluable images (integrity score >1) and trustable images (integrity score >3 and hyperintensity artifacts score >2) were then enrolled for APTw value comparison between parotid lesions and glands. Results Forty consecutive patients were included in this study. Four patients were excluded due to severe motion (n=3) or dental (n=1) artifacts, and 36 patients received the APT sequence. Among these, more parotid tumor lesions (34/36, 94.4%) than normal parotid glands (23/31, 74.2%) revealed excellent integrity scores (score =4) (P=0.034). Most parotid tumor lesions (24/34, 70.6%) and glands (16/28, 57.1%) revealed no or little hyperintensity artifacts for diagnosis (scores 3 and 4). APT values of parotid lesions and glands in the evaluable groups were 2.11%±1.15% and 1.60%±1.56%, respectively, and the difference was not significant (P=0.197). APT values of parotid lesions and glands in the trustable groups were 1.99%±1.18% and 1.03%±1.09%, respectively, and the difference was statistically significant (P=0.018). Conclusions 3D APTw could be used to differentiate parotid tumors and normal parotid glands; however, the technology still needs to be improved to remove artifacts. In our study, most APTw images of tumor lesions in parotid glands had acceptable image quality, and these APTw images are feasible for diagnostic use.
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Affiliation(s)
- Yu Chen
- Department of Radiology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences, Beijing, China
| | | | - Tong Su
- Department of Radiology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences, Beijing, China
| | - Zhentan Xu
- Department of Radiology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences, Beijing, China
| | - Yunting Wang
- Department of Stomatology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences, Beijing, China
| | - Zhuhua Zhang
- Department of Radiology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences, Beijing, China
| | - Huadan Xue
- Department of Radiology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences, Beijing, China
| | | | - Yuanli Zhu
- Department of Radiology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences, Beijing, China
| | - Zhengyu Jin
- Department of Radiology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences, Beijing, China
| | - Tao Zhang
- Department of Stomatology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences, Beijing, China
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Boldes T, Hilly O, Alkan U, Shkedy Y, Morgenstern S, Shpitzer T, Bachar G, Mizrachi A. Accuracy, predictability and prognostic implications of fine-needle aspiration biopsy for parotid gland tumours: A retrospective case series. Clin Otolaryngol 2021; 46:1065-1072. [PMID: 33942516 DOI: 10.1111/coa.13795] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2020] [Revised: 03/06/2021] [Accepted: 04/18/2021] [Indexed: 11/28/2022]
Abstract
OBJECTIVE To evaluate the precision and utility of fine-needle aspiration (FNA) in differentiating between benign and malignant parotid tumours, and the implications of FNA results on management and outcomes. DESIGN Retrospective case series. SETTING Tertiary medical centre. PARTICIPANTS All adults who underwent preoperative FNA, followed by postoperative histological examination, between 1986 and 2014. MAIN OUTCOME MEASURES Differences in clinical management and outcomes of patients with parotid masses in light of FNA results. RESULTS We analysed 505 samples from 485 patients. According to histopathological results, preoperative FNA successfully identified benign tumours in 89% of the cases (362/405) and only 59% of malignant tumours (59/100). Overall sensitivity and specificity of FNA in distinguishing between different subtypes of benign lesions were 80% and 99%, respectively, whereas positive predictive value (PPV) and negative predictive value (NPV) were 85% and 98%. Moreover, malignant lesions subtyping had high false-positive and false-negative rates with sensitivity, specificity, PPV and NPV of 44%, 100%, 75% and 99%, respectively. Additionally, when FNA falsely classified malignant tumours as benign, surgeries were inappropriately delayed and the durations of surgeries and hospitalisations were shorter, compared to true malignant FNA results. Interestingly, survival was not affected in falsely benign lesions that were mostly low-grade, conversely non-diagnostic FNA for malignant tumours resulted in decreased survival. CONCLUSIONS Our findings highlight the limitations of FNA as a decision-making tool in preoperative evaluation of parotid masses. Clinicians should take into account that FNA is inaccurate for identifying specific subtypes of malignant lesions, which may eventually delay treatment and influence outcome.
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Affiliation(s)
- Tomer Boldes
- Department of Otolaryngology - Head and Neck Surgery, Rabin Medical Center, Petah Tikva, Israel.,Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Ohad Hilly
- Department of Otolaryngology - Head and Neck Surgery, Rabin Medical Center, Petah Tikva, Israel.,Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Uri Alkan
- Department of Otolaryngology - Head and Neck Surgery, Rabin Medical Center, Petah Tikva, Israel.,Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Yotam Shkedy
- Department of Otolaryngology - Head and Neck Surgery, Rabin Medical Center, Petah Tikva, Israel.,Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Sara Morgenstern
- Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel.,Department of Pathology, Rabin Medical Center, Petah Tikva, Israel
| | - Thomas Shpitzer
- Department of Otolaryngology - Head and Neck Surgery, Rabin Medical Center, Petah Tikva, Israel.,Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Gideon Bachar
- Department of Otolaryngology - Head and Neck Surgery, Rabin Medical Center, Petah Tikva, Israel.,Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Aviram Mizrachi
- Department of Otolaryngology - Head and Neck Surgery, Rabin Medical Center, Petah Tikva, Israel.,Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
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Martino M, Fodor D, Fresilli D, Guiban O, Rubini A, Cassoni A, Ralli M, De Vincentiis C, Arduini F, Celletti I, Pacini P, Polti G, Polito E, Greco A, Valentini V, Sorrenti S, D'Andrea V, Masciocchi C, Barile A, Cantisani V. Narrative review of multiparametric ultrasound in parotid gland evaluation. Gland Surg 2020; 9:2295-2311. [PMID: 33447581 DOI: 10.21037/gs-20-530] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022]
Abstract
Disorders affecting parotid gland represent a heterogeneous group comprising congenital, inflammatory and neoplastic diseases which show a focal or diffuse pattern of appearance. The differentiation of neoplastic from non-neoplastic conditions of parotid glands is pivotal for the diagnostic imaging. Frequently there is evidence of overlapping between the clinical and the imaging appearance of the various pathologies. The parotid gland is also often object of study with the combination of different techniques [ultrasound-computed tomography-magnetic resonance imaging (US-CT-MRI), ex.]. Compared to other dominant methods of medical imaging, US has several advantages providing images in real-time at lower cost, and without harmful use of ionizing radiation and of contrast enhancement. B-mode US, and the microvascular pattern color Doppler are usually used as first step evaluation of parotid lesions. Elastography and contrast-enhanced US (CEUS) has opened further possible perspectives to improve the differentiation between benign and malignant parotid lesions. The characterization of the parotid tumors plays a crucial role for their treatment planning and for the prediction of possible surgical complications. We present, here an updated review of the most recurrent pathologies of parotid gland focusing on the diagnostic power of multiparametric US including CEUS and ultrasound elastography (USE); limitations, advantages and the main key-points will be presented.
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Affiliation(s)
- Milvia Martino
- Department of Biotechnological and Applied Clinical Sciences, University of L'Aquila, L'Aquila, Italy
| | - Daniela Fodor
- 2nd Internal Medicine Department, "Iuliu Hațieganu" University of Medicine and Pharmacy, Cluj-Napoca, Romania
| | - Daniele Fresilli
- Department of Radiological Sciences, Oncology and Pathology, Policlinico Umberto I "Sapienza" University of Rome, Rome, Italy
| | - Olga Guiban
- Department of Radiological Sciences, Oncology and Pathology, Policlinico Umberto I "Sapienza" University of Rome, Rome, Italy
| | | | - Andrea Cassoni
- Department of Maxillofacial Surgery, Policlinico Umberto I "Sapienza" University of Rome, Rome, Italy
| | - Massimo Ralli
- Department of Sense Organs, Sapienza University of Rome, Rome, Italy
| | | | - Federico Arduini
- Department of Radiology, Ospedale Santa Maria del Carmine, Rovereto, Italy
| | - Ilaria Celletti
- Department of Radiological Sciences, Oncology and Pathology, Policlinico Umberto I "Sapienza" University of Rome, Rome, Italy
| | - Patrizia Pacini
- Department of Radiological Sciences, Oncology and Pathology, Policlinico Umberto I "Sapienza" University of Rome, Rome, Italy
| | - Giorgia Polti
- Department of Radiological Sciences, Oncology and Pathology, Policlinico Umberto I "Sapienza" University of Rome, Rome, Italy
| | - Eleonora Polito
- Department of Radiological Sciences, Oncology and Pathology, Policlinico Umberto I "Sapienza" University of Rome, Rome, Italy
| | - Antonio Greco
- Department of Sense Organs, Sapienza University of Rome, Rome, Italy
| | - Valentino Valentini
- Department of Maxillofacial Surgery, Policlinico Umberto I "Sapienza" University of Rome, Rome, Italy
| | - Salvatore Sorrenti
- Department of Surgical Sciences, "Sapienza" University of Rome, Rome, Italy
| | - Vito D'Andrea
- Department of Surgical Sciences, "Sapienza" University of Rome, Rome, Italy
| | - Carlo Masciocchi
- Department of Biotechnological and Applied Clinical Sciences, University of L'Aquila, L'Aquila, Italy
| | - Antonio Barile
- Department of Biotechnological and Applied Clinical Sciences, University of L'Aquila, L'Aquila, Italy
| | - Vito Cantisani
- Department of Radiological Sciences, Oncology and Pathology, Policlinico Umberto I "Sapienza" University of Rome, Rome, Italy
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Soumya, Whitehorn A, Ooi EH, Lockwood C. Accuracy of core needle biopsy compared to fine needle biopsy for the diagnosis of neoplasm in patients with suspected head and neck cancers: a systematic review protocol of diagnostic test accuracy. JBI Evid Synth 2020; 18:1602-1608. [PMID: 32813401 DOI: 10.11124/jbisrir-d-19-00225] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/01/2023]
Abstract
OBJECTIVE The objective of this review is to determine the difference in diagnostic accuracy of core needle biopsy and fine needle aspiration for patients with a head and neck mass using surgical histopathology as a reference test. The risks and adverse events associated with each technique will also be compared. INTRODUCTION Tissue diagnosis is critical in evaluation of head and neck lesions to guide management. Options for tissue biopsy include surgical biopsy, fine needle aspiration and core needle biopsy. INCLUSION CRITERIA Studies that compare ultrasound-guided core needle biopsy and/or fine needle aspiration to investigate lumps in the thyroid, cervical lymph nodes, or salivary glands for malignancy in adult patients will be included. The comparator test will be definitive histology in form of surgical biopsy/excision. METHODS MEDLINE, Emcare, Embase, Web of Science and Cochrane Register of Diagnostic Accuracy Studies will be searched. Studies will be critically appraised by two independent reviewers for methodological quality, using the modified critical appraisal instrument QUADAS-2 and JBI SUMARI software. Two independent reviewers will extract data from papers included in the review using the standardized data extraction tool available in the JBI Reviewer's Manual. SYSTEMATIC REVIEW REGISTRATION NUMBER PROSPERO CRD42020140005.
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Affiliation(s)
- Soumya
- 1Division of Surgery and Perioperative Medicine, Flinders Medical Centre, Bedford Park, Australia 2JBI, Faculty of Health and Medical Sciences, The University of Adelaide, Adelaide, Australia 3Department of Otolaryngology and Head and Neck Surgery, Flinders Medical Centre, Bedford Park, Australia 4Department of Surgery, Flinders University, Bedford Park, Australia
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Tuma J. [CME Sonography 92: Nodes on the Neck]. PRAXIS 2020; 109:763-770. [PMID: 32752966 DOI: 10.1024/1661-8157/a003545] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/11/2023]
Abstract
CME Sonography 92: Nodes on the Neck Abstract. Nodules on the neck can be discovered accidentally when looking in the mirror, or due to pain that may be acute or gradual. The clinical examination is helpful to estimate the localization or to assign the nodule to a specific organ and assess its consistency and mobility. A sonography is very helpful in most cases as there are typical findings related to the thyroid gland, findings based on lymph nodes, changes in the tonsils, vessels and salivary glands. In some cases, the ultrasound must be supplemented by fine needle puncture.
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Affiliation(s)
- Jan Tuma
- Ultrasound Learning Center (ULC) der European Federation of Ultrasound in Medicine and Biology (EFSUMB) am Institut für Allgemeine Innere Medizin und Nephrologie, Klinik Hirslanden, Zürich
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Dostalova L, Kalfert D, Jechova A, Koucky V, Novak S, Kuchar M, Zabrodsky M, Novakova Kodetova D, Ludvikova M, Kholova I, Plzak J. The role of fine-needle aspiration biopsy (FNAB) in the diagnostic management of parotid gland masses with emphasis on potential pitfalls. Eur Arch Otorhinolaryngol 2020; 277:1763-1769. [PMID: 32107613 DOI: 10.1007/s00405-020-05868-1] [Citation(s) in RCA: 20] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/01/2019] [Accepted: 02/16/2020] [Indexed: 12/17/2022]
Abstract
PURPOSE The treatment strategy of parotid gland tumours depends mainly on the histopathological type of the lesion. Fine-needle aspiration biopsy (FNAB) is recommended in preoperative diagnostics. The aim of the study was to evaluate the FNAB standing in the diagnostic algorithm of parotid gland lesions and to correlate FNAB results in relation to the definitive histopathological diagnosis. MATERIAL AND METHODS The retrospective analyses of 651 examined and consequently surgically treated parotid gland lesions at the Department of Otorhinolaryngology and Head and Neck Surgery, 1st Faculty of Medicine, Charles University in Prague between 2006 and 2016 were used. Preoperative cytological results were consequently evaluated in relation to the definitive histopathological diagnosis. RESULTS The cohort consisted of 367 women and 284 men (average age 58 years). FNAB was diagnostic in 604 (92.8%) patients and non-diagnostic in 47 (7.2%) patients. The result of FNAB was positive (suspicious for malignant tumour) in 89 (14.7%) patients and negative (benign) in 515 (85.3%) patients. Sensitivity of the examination was 80.00%, specificity was 93.82%, PPV 62.92%, NPV 97.28%, and LR + and LR- were 12.95 and 0.21, respectively, with an accuracy of 92.22%. CONCLUSION Our results confirm the significant role of FNAB in the diagnostic algorithm of parotid gland lesions.
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Affiliation(s)
- Lucie Dostalova
- Department of Otorhinolaryngology and Head and Neck Surgery, First Faculty of Medicine, University Hospital Motol, Charles University, V Uvalu 84, 150 06, Prague, Czech Republic
| | - David Kalfert
- Department of Otorhinolaryngology and Head and Neck Surgery, First Faculty of Medicine, University Hospital Motol, Charles University, V Uvalu 84, 150 06, Prague, Czech Republic.
| | - Alzbeta Jechova
- Department of Otorhinolaryngology and Head and Neck Surgery, First Faculty of Medicine, University Hospital Motol, Charles University, V Uvalu 84, 150 06, Prague, Czech Republic
| | - Vladimir Koucky
- Department of Otorhinolaryngology and Head and Neck Surgery, First Faculty of Medicine, University Hospital Motol, Charles University, V Uvalu 84, 150 06, Prague, Czech Republic
| | - Stepan Novak
- Department of Otorhinolaryngology and Head and Neck Surgery, First Faculty of Medicine, University Hospital Motol, Charles University, V Uvalu 84, 150 06, Prague, Czech Republic
| | - Martin Kuchar
- Department of Otorhinolaryngology and Head and Neck Surgery, First Faculty of Medicine, University Hospital Motol, Charles University, V Uvalu 84, 150 06, Prague, Czech Republic
| | - Michal Zabrodsky
- Department of Otorhinolaryngology and Head and Neck Surgery, First Faculty of Medicine, University Hospital Motol, Charles University, V Uvalu 84, 150 06, Prague, Czech Republic
| | - Daniela Novakova Kodetova
- Department of Pathology and Molecular Medicine, Second Faculty of Medicine, University Hospital Motol, Charles University and Motol University Hospital, Prague, Czech Republic
| | - Marie Ludvikova
- Department of Biology, Faculty of Medicine in Pilsen, Charles University, Prague, Czech Republic
| | - Ivana Kholova
- Department of Pathology, Faculty of Medicine and Health Technology, Fimlab Laboratories and Tampere University, Tampere, Finland
| | - Jan Plzak
- Department of Otorhinolaryngology and Head and Neck Surgery, First Faculty of Medicine, University Hospital Motol, Charles University, V Uvalu 84, 150 06, Prague, Czech Republic
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Farahani SJ, Baloch Z. Retrospective assessment of the effectiveness of the Milan system for reporting salivary gland cytology: A systematic review and meta-analysis of published literature. Diagn Cytopathol 2018; 47:67-87. [DOI: 10.1002/dc.24097] [Citation(s) in RCA: 47] [Impact Index Per Article: 7.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/25/2018] [Accepted: 09/28/2018] [Indexed: 01/20/2023]
Affiliation(s)
- Sahar J Farahani
- Department of Pathology and Laboratory Medicine, Hospital of the University of Pennsylvania; University of Pennsylvania; Philadelphia Pennsylvania
| | - Zubair Baloch
- Department of Pathology and Laboratory Medicine, Hospital of the University of Pennsylvania; University of Pennsylvania; Philadelphia Pennsylvania
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Non-enhanced MRI in combination with color Doppler flow imaging for improving diagnostic accuracy of parotid gland lesions. Eur Arch Otorhinolaryngol 2018; 275:987-995. [PMID: 29430614 DOI: 10.1007/s00405-018-4895-6] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/23/2017] [Accepted: 01/30/2018] [Indexed: 01/05/2023]
Abstract
PURPOSE To determine the value of non-enhanced MRI in combination with color Doppler flow imaging (CDFI) for differentiating malignant parotid tumors from benign ones. METHODS This retrospective study analyzed 51 parotid gland lesions (39 benign and 12 malignant) in 51 patients who underwent preoperative CDFI as well as non-enhanced MRI including T1-weighted, T2-weighted, and diffusion-weighted imaging (DWI). Degrees of intratumor vascularity were categorized into four grades basing on CDFI findings. The relationships between the lesion and its adjacent external carotid artery and retromandibular vein were inspected on T1-weighted and T2-weighted images. Apparent diffusion coefficient (ADC) values were calculated from diffusion-weighted images, and were used to classify the parotid gland lesions with and without reference to the CDFI findings. The classification results were compared using the McNemar test. Sensitivity, specificity, and accuracy percentages were calculated when the non-enhanced MRI/CDFI findings were used to differentiate benign lesions from malignant ones. RESULTS The diagnostic accuracy (96.1 vs 82.4%) was significantly improved when ADCs were used together with CDFI findings for classifying parotid gland lesions compared to when ADCs were used alone. Pleomorphic adenomas had the highest ADCs. The ADC thresholds were 1.425 × 10-3 mm2/s for differentiating pleomorphic adenomas from carcinomas, 0.999 × 10-3 mm2/s for differentiating pleomorphic adenomas from other benign lesions, and 0.590 × 10-3 mm2/s for differentiating benign lesions other than pleomorphic adenomas from lymphomas. CONCLUSION Combining CDFI with non-enhanced MRI can improve the diagnostic accuracy of MRI for classifying parotid gland lesions.
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Accuracy and effectiveness of ultrasound-guided core-needle biopsy in the diagnosis of focal lesions in the salivary glands. Eur Radiol 2018; 28:2934-2941. [DOI: 10.1007/s00330-017-5295-9] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2017] [Revised: 11/25/2017] [Accepted: 12/27/2017] [Indexed: 01/07/2023]
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McCrary HC, Krate J, Savilo CE, Tran MH, Ho HT, Adamas-Rappaport WJ, Viscusi RK. Development of a fresh cadaver model for instruction of ultrasound-guided breast biopsy during the surgery clerkship: pre-test and post-test results among third-year medical students. Am J Surg 2016; 212:1020-1025. [DOI: 10.1016/j.amjsurg.2016.02.008] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2016] [Revised: 02/06/2016] [Accepted: 02/27/2016] [Indexed: 01/15/2023]
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Zajkowski P, Ochal-Choińska A. Standards for the assessment of salivary glands - an update. J Ultrason 2016; 16:175-90. [PMID: 27446602 PMCID: PMC4954863 DOI: 10.15557/jou.2016.0019] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/11/2016] [Revised: 05/02/2016] [Accepted: 05/07/2016] [Indexed: 11/22/2022] Open
Abstract
The paper is an update of 2011 Standards for Ultrasound Assessment of Salivary Glands, which were developed by the Polish Ultrasound Society. We have described current ultrasound technical requirements, assessment and measurement techniques as well as guidelines for ultrasound description. We have also discussed an ultrasound image of normal salivary glands as well as the most important pathologies, such as inflammation, sialosis, collagenosis, injuries and proliferative processes, with particular emphasis on lesions indicating high risk of malignancy. In acute bacterial inflammation, the salivary glands appear as hypoechoic, enlarged or normal-sized, with increased parenchymal flow. The echogenicity is significantly increased in viral infections. Degenerative lesions may be seen in chronic inflammations. Hyperechoic deposits with acoustic shadowing can be visualized in lithiasis. Parenchymal fibrosis is a dominant feature of sialosis. Sjögren syndrome produces different pictures of salivary gland parenchymal lesions at different stages of the disease. Pleomorphic adenomas are usually hypoechoic, well-defined and polycyclic in most cases. Warthin tumor usually presents as a hypoechoic, oval-shaped lesion with anechoic cystic spaces. Malignancies are characterized by blurred outlines, irregular shape, usually heterogeneous echogenicity and pathological neovascularization. The accompanying metastatic lesions are another indicator of malignancy, however, final diagnosis should be based on biopsy findings.
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Affiliation(s)
- Piotr Zajkowski
- Department of Diagnostic Imaging, the Second Faculty of Medicine, Medical University of Warsaw, Poland
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Kim MW, Kim DW, Jung HS, Choo HJ, Park YM, Jung SJ, Baek HJ. Factors Influencing the Outcome of Ultrasound-Guided Fine-Needle Aspiration for Salivary Gland Lesion Diagnosis. JOURNAL OF ULTRASOUND IN MEDICINE : OFFICIAL JOURNAL OF THE AMERICAN INSTITUTE OF ULTRASOUND IN MEDICINE 2016; 35:877-883. [PMID: 27022169 DOI: 10.7863/ultra.15.06062] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/16/2015] [Accepted: 08/01/2015] [Indexed: 06/05/2023]
Abstract
OBJECTIVES This study aimed to assess multiple factors influencing the outcomes of ultrasound (US)-guided fine-needle aspiration (FNA) of salivary gland lesions. METHODS From 2008 to 2013, a single radiologist performed US-guided FNA of salivary gland lesions in 243 patients. With the exclusion of pure cysts, poor image quality, and insufficient static image cases, 218 salivary gland lesions in 218 patients were included. The composition, size, location, and vascularity of the lesions were retrospectively investigated on the basis of sonographic findings by the same radiologist. The relationship between sampling adequacy and multiple factors was compared, and the diagnostic accuracy of US-guided FNA of salivary gland lesions was calculated by using the final diagnosis as a reference standard. RESULTS The sampling adequacy rate for US-guided FNA of the 218 salivary gland lesions was 96.8% (211 of 218). A significant difference was observed in the composition and vascularity of the lesions (P < .0001), whereas there was no significant difference in the patient age and sex, lesion size, lesion location, and needle size. The rate of inadequate sampling increased in predominantly cystic lesions compared with solid lesions as well as in low-vascularity lesions compared with high-vascularity lesions. Of the 218 lesions, 178 (81.7%) were ultimately diagnosed, and most were benign (162 of 178 [91.0%]). When 3 cases with indeterminate cytologic results were excluded, the sensitivity, specificity, positive and negative predictive values, and accuracy of US-guided FNA of salivary gland lesions were 64.3%, 98.8%, 81.8%, 97.0%, and 96.0%, respectively. CONCLUSIONS When using US-guided FNA to diagnose salivary gland lesions, sampling adequacy depends on the composition or vascularity of the lesions.
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Affiliation(s)
- Min Woo Kim
- Department of Radiology, Busan Paik Hospital, Inje University College of Medicine, Busan, Korea
| | - Dong Wook Kim
- Department of Radiology, Busan Paik Hospital, Inje University College of Medicine, Busan, Korea
| | - Hyun Seok Jung
- Department of Radiology, Busan Paik Hospital, Inje University College of Medicine, Busan, Korea
| | - Hye Jung Choo
- Department of Radiology, Busan Paik Hospital, Inje University College of Medicine, Busan, Korea
| | - Young Mi Park
- Department of Radiology, Busan Paik Hospital, Inje University College of Medicine, Busan, Korea
| | - Soo Jin Jung
- Department of Pathology, Busan Paik Hospital, Inje University College of Medicine, Busan, Korea
| | - Hye Jin Baek
- Department of Radiology, Gyeongsang National University School of Medicine and Gyeongsang National University Changwon Hospital, Changwon, 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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Kikuchi M, Koyasu S, Shinohara S, Imai Y, Hino M, Naito Y. Preoperative Diagnostic Strategy for Parotid Gland Tumors Using Diffusion-Weighted MRI and Technetium-99m Pertechnetate Scintigraphy: A Prospective Study. PLoS One 2016; 11:e0148973. [PMID: 26849569 PMCID: PMC4744013 DOI: 10.1371/journal.pone.0148973] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/16/2015] [Accepted: 01/26/2016] [Indexed: 11/29/2022] Open
Abstract
Objective Fine needle aspiration cytology (FNAC) for diagnosis of a parotid gland tumor is widely used but its sensitivity is low and non-diagnostic rate is relatively high. In contrast, core needle biopsy (CNB) has a higher sensitivity and lower rate of sampling errors but has a higher risk of injury to adjacent organs such as facial nerve than FNAC. Screening of patients with parotid gland tumors to identify cases of pleomorphic adenoma (PA) and Warthin tumor (WT) may allow CNB to be confined to patients without PA and WT. We established an algorithm for preoperative diagnosis and management of parotid gland tumor using diffusion-weighted MRI and 99mTc pertechnetate scintigraphy. This algorithm was developed with the goal of maximal reduction of the number of patients in whom CNB is required. The purpose of the study is to validate our algorithm prospectively. Methods A prospective study was conducted in 71 cases who were newly diagnosed with parotid gland tumor and 53 cases were enrolled in the study. In the algorithm, PA (high apparent diffusion coefficient (ADC) mean≥1.5×10−3 mm2/s) and non-PA (low ADCmean<1.5×10−3 mm2/s) cases are first distinguished based on the ADCmean on diffusion-weighed MRI. Second, among suspected non-PA cases, WT and non-WT are distinguished using technetium-99m pertechnetate scintigraphy. CNB is then performed only in probable non-PA and non-WT cases. Results Although CNB was only required in 40% (21/53) of all cases, we made a preoperative histopathological diagnosis with an accuracy of 87% (46/53) and we correctly diagnosed whether a tumor was benign or malignant with an accuracy of 96% (51/53). Preoperative surgical planning had to be changed during surgery in only one case (2%) Conclusions Our algorithm is valuable in terms of clinical practice with highly potential for preoperative diagnosis and with less risk of CNB procedure.
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Affiliation(s)
- Masahiro Kikuchi
- Department of Otolaryngology-Head and Neck Surgery, Kobe City Medical Center General Hospital, Kobe, Hyogo, Japan
- * E-mail:
| | - Sho Koyasu
- Department of Radiology, Kobe City Medical Center General Hospital, Kobe, Hyogo, Japan
| | - Shogo Shinohara
- Department of Otolaryngology-Head and Neck Surgery, Kobe City Medical Center General Hospital, Kobe, Hyogo, Japan
| | - Yukihiro Imai
- Department of Clinical Pathology, Kobe City Medical Center General Hospital, Kobe, Hyogo, Japan
| | - Megumu Hino
- Department of Radiology, Kobe City Medical Center General Hospital, Kobe, Hyogo, Japan
| | - Yasushi Naito
- Department of Otolaryngology-Head and Neck Surgery, Kobe City Medical Center General Hospital, Kobe, Hyogo, Japan
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Lennon P, Silvera VM, Perez-Atayde A, Cunningham MJ, Rahbar R. Disorders and tumors of the salivary glands in children. Otolaryngol Clin North Am 2015; 48:153-73. [PMID: 25439553 DOI: 10.1016/j.otc.2014.09.011] [Citation(s) in RCA: 32] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Salivary gland neoplasms are rare in children. In infants most tumors are benign hemangiomas, with some notable exceptions, such as sialoblastomas. An asymptomatic swelling in the periauricular region is the most common presenting complaint in older children. Approximately 50% of these lesions are malignant, which dictates a thorough diagnostic evaluation by a head and neck surgeon. Surgical excision is the primary treatment modality. Prognosis is primarily determined by histopathologic findings. This review discusses neoplastic lesions of the salivary glands in children, and malignant epithelial tumors in particular.
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Affiliation(s)
- Paul Lennon
- Department of Otolaryngology, Head and Neck Surgery, St. James's Hospital, James's Street, Dublin 8, Ireland
| | - V Michelle Silvera
- Boston Children's Hospital, Department of Radiology 300 Longwood Avenue Main Building, 2nd Floor, Boston, MA 02115, USA
| | - Antonio Perez-Atayde
- Boston Children's Hospital, Department of Pathology, 300 Longwood Avenue, Bader, 1st Floor, Boston, MA 02115, USA
| | - Michael J Cunningham
- Boston Children's Hospital, Department of Otolaryngology & Communication Enhancement, 333 Longwood Avenue, 3rd Floor, Boston, MA 02115, USA
| | - Reza Rahbar
- Boston Children's Hospital, Department of Otolaryngology & Communication Enhancement, 333 Longwood Avenue, 3rd Floor, Boston, MA 02115, USA.
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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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Arslan IB, Uluyol S, Genc S, Eruyar T, Bulgurcu S, Cukurova I. Diagnostic dilemma of parotid lipomas: imaging versus fine needle aspiration cytology. Bosn J Basic Med Sci 2014; 14:250-3. [PMID: 25428679 DOI: 10.17305/bjbms.2014.4.58] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2014] [Revised: 09/21/2014] [Accepted: 09/21/2014] [Indexed: 02/07/2023] Open
Abstract
Lipomas are common soft tissue neoplasms; however, they are found rarely in the parotid gland region. The purpose of this study was to analyze the diagnostic challenges of this rare condition. We performed a retrospective analysis of 11 patients with parotid lipomas, treated from November 2009 to February 2014. The mean age at diagnosis was 46.6 ± 2.9 years, and the study population included 8 males and 3 females. Computed tomography (CT) and/or magnetic resonance imaging (MRI) were performed in radiological diagnosis. Fine needle aspiration (FNA) was performed in all cases (including two times in five patients, for a total of 16 biopsies) and results were diagnostic in four instances. Specificities of the CT, MRI, and FNA cytology tests were 100%, 100%, and 25% respectively. CT and/or MRI scans were more reliable than FNA cytologies for accurate diagnosis of parotid lipomas.
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Affiliation(s)
- Ilker Burak Arslan
- Tepecik Training and Research Hospital Head & Neck Surgery Clinic, Izmir/Turkey.
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Rastogi R, Bhargava S, Mallarajapatna GJ, Singh SK. Pictorial essay: Salivary gland imaging. Indian J Radiol Imaging 2013; 22:325-33. [PMID: 23833425 PMCID: PMC3698896 DOI: 10.4103/0971-3026.111487] [Citation(s) in RCA: 30] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022] Open
Abstract
Salivary glands are the first organs of digestion secreting their digestive juices into the oral cavity. Parotid, submandibular, and sublingual glands are the major paired salivary glands in the decreasing order of their size. In addition, multiple small minor salivary glands are noted randomly distributed in the upper aerodigestive tract, including paranasal sinuses and parapharyngeal spaces. The imaging is directed to the major salivary glands. Commonly used imaging methods include plain radiography and conventional sialography. Recently, high-resolution ultrasonography (HRUS) is being increasingly used for targeted salivary gland imaging. However, the advent of cross-sectional imaging techniques such as computed tomography (CT) and magnetic resonance imaging (MRI) have revolutionized the imaging of salivary glands. This article illustrates the role of imaging in evaluating the variegated disease pattern of the major salivary glands.
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Affiliation(s)
- Rajul Rastogi
- Yash Diagnostic Center, Yash Hospital and Research Center, Moradabad, India
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25
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Ryu IS, Roh JL, Cho KJ, Lee SW, Choi SH, Nam SY, Kim SY. Clinical outcomes of patients with salivary gland carcinomas preoperatively misdiagnosed as benign lesions. Head Neck 2013; 35:1764-70. [DOI: 10.1002/hed.23228] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/26/2012] [Indexed: 01/17/2023] Open
Affiliation(s)
- In Sun Ryu
- Department of Otolaryngology; Asan Medical Center; University of Ulsan College of Medicine; Seoul Republic of Korea
| | - Jong-Lyel Roh
- Department of Otolaryngology; Asan Medical Center; University of Ulsan College of Medicine; Seoul Republic of Korea
| | - Kyung-Ja Cho
- Department of Pathology; Asan Medical Center; University of Ulsan College of Medicine; Seoul Republic of Korea
| | - Sang-wook Lee
- Department of Radiation Oncology; Asan Medical Center; University of Ulsan College of Medicine; Seoul Republic of Korea
| | - Seung-Ho Choi
- Department of Otolaryngology; Asan Medical Center; University of Ulsan College of Medicine; Seoul Republic of Korea
| | - Soon Yuhl Nam
- Department of Otolaryngology; Asan Medical Center; University of Ulsan College of Medicine; Seoul Republic of Korea
| | - Sang Yoon Kim
- Department of Otolaryngology; Asan Medical Center; University of Ulsan College of Medicine; Seoul Republic of Korea
- Biomedical Research Institute; Korea Institute of Science and Technology; Seoul Republic of Korea
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Sumi M, Van Cauteren M, Sumi T, Obara M, Ichikawa Y, Nakamura T. Salivary Gland Tumors: Use of Intravoxel Incoherent Motion MR Imaging for Assessment of Diffusion and Perfusion for the Differentiation of Benign from Malignant Tumors. Radiology 2012; 263:770-7. [DOI: 10.1148/radiol.12111248] [Citation(s) in RCA: 146] [Impact Index Per Article: 12.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
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Reply. AJR Am J Roentgenol 2012. [DOI: 10.2214/ajr.11.7681] [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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28
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Bigorgne C, Hans S, Brasnu D. [Fine needle aspiration in management of salivary gland tumors. The clinician point of view]. Ann Pathol 2011; 31:S97-9. [PMID: 22054476 DOI: 10.1016/j.annpat.2011.08.013] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/22/2011] [Accepted: 08/24/2011] [Indexed: 11/19/2022]
Affiliation(s)
- Claude Bigorgne
- Centre de pathologie et d'imagerie, 14, avenue René-Coty, 75014 Paris, France.
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