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BMC Medical Imaging Sep 2020We compared the ultrasound features, superb microvascular imaging (SMI) and micro vessel density (MVD) of pleomorphic adenoma (PA), Warthin's tumor (WT) and basal cell... (Comparative Study)
Comparative Study
BACKGROUND
We compared the ultrasound features, superb microvascular imaging (SMI) and micro vessel density (MVD) of pleomorphic adenoma (PA), Warthin's tumor (WT) and basal cell adenoma (BCA) to explore the clinic value of SMI in differential diagnosis of benign tumors of parotid gland.
METHODS
The vascular distributions and grade by color doppler flow imaging (CDFI) and SMI, as well as vascular index (VI) of 249 parotid gland masses from 217 patients were analyzed.
RESULTS
The internal echogenicity of BCA are more homogeneous in comparing with WT and PA(P < 0.05). By SMI, the vascular distribution and vascular grade in PA were mainly peripheral (33.1%) and avascular (25.7%), Grade 1 (27.8%) and Grade 0 (25.7%). WT were mainly central (31.3%) and mixed distribution (34.9%), in Grade 3 (37.3%) and Grade 2 (36.2%). BCA was mainly peripheral (33.3%) and mixed distribution (33.3%), in Grade 2 (33.3%) and Grade 3 (33.3%). The overall detection rate of SMI for vascular Grade 2 and 3 was significantly higher than that of CDFI (P < 0.05). Both VI and MVD were lowest in PA, highest in WT (P < 0.001). The VI by SMI was correlated with MVD (P < 0.001). The correlation index between vascular distribution and grade by SMI and MVD were significantly higher than CDFI.
CONCLUSION
SMI can provide low-velocity blood flow information, which is helpful for the differential diagnosis of common benign tumors of parotid gland, and is expected to be more widely used.
Topics: Adenolymphoma; Adenoma, Pleomorphic; Adolescent; Adult; Aged; Blood Flow Velocity; Child; Diagnosis, Differential; Female; Humans; Male; Microvascular Density; Microvessels; Middle Aged; Parotid Gland; Ultrasonography, Doppler, Color; Young Adult
PubMed: 32938423
DOI: 10.1186/s12880-020-00506-y -
Academic Radiology Apr 2023To develop, validate, and test a comprehensive radiomics prediction model to distinguish parotid polymorphic adenomas (PAs) and warthin tumors (WTs) using clinical data... (Randomized Controlled Trial)
Randomized Controlled Trial
RATIONALE AND OBJECTIVES
To develop, validate, and test a comprehensive radiomics prediction model to distinguish parotid polymorphic adenomas (PAs) and warthin tumors (WTs) using clinical data and enhanced computed tomography (CT) from a multicenter cohort.
MATERIALS AND METHODS
A total of 267 patients with PAs (n =172) or WTs (n = 95) from two hospitals were randomly divided into training (n =188) and validation (n =79) datasets. Radiomics features were extracted from the enhanced CT (arterial phase) followed by dimensionality reduction. Clinical and CT features were combined to establish a prediction model. A radiomics nomogram was constructed by combining RadScore and clinical factors. Moreover, an independent dataset of 31 patients from a third hospital was employed to test the model. Thus, the performance of the nomogram, radiomics signature, and clinical models was evaluated on the training, validation, and the independent testing datasets. Receiver operating characteristic (ROC) curves were used to compare the performance, and decision curve analysis (DCA) was used to evaluate the clinical effectiveness of the model.
RESULTS
A total of 15 radiomics features were selected from CT data as the imaging markers to generate RadScores, and demographics or clinical data like age, sex, and smoking factors combined with RadScores were used to distinguish PAs and WTs based on multivariate logistic regression analyses. The results showed that radiomics nomograms combining clinical factors and RadScores provided satisfactory predictive values for distinguishing PAs from WTs, with areas under ROC curves (AUC) of 0.979, 0.922, and 0.903 for the training, validation, and the independent testing datasets, respectively. Decision curve analysis revealed that the radiomics nomogram outperformed the clinical factor models in terms of accuracy and effectiveness.
CONCLUSION
CT-based radiomics nomograms combining RadScores and clinical factors can be used to identify PAs and WTs, which may help tumor management by clinicians.
Topics: Humans; Nomograms; Adenolymphoma; Tomography, X-Ray Computed; Arteries; Adenoma; Retrospective Studies
PubMed: 35953356
DOI: 10.1016/j.acra.2022.06.017 -
Wiadomosci Lekarskie (Warsaw, Poland :... 2021The aim is to give a morphological characteristic of tumors and tumor-like lesions of the salivary glands in the course of a comprehensive analysis of the surgical...
OBJECTIVE
The aim is to give a morphological characteristic of tumors and tumor-like lesions of the salivary glands in the course of a comprehensive analysis of the surgical material.
PATIENTS AND METHODS
Materials and methods: The study used surgical material from 67 patients with various pathologies of the salivary glands. The patients were treated at Kyiv City Clinical Hospital No. 12 (Ukraine, Kiev) from 2014 to 2018. The resulting material was fixed in a 10% solution of neutral formalin (pH 7.4) for 24-48 hours, carried out according to the generally accepted technique and embedded in paraffin. Serial sections 2 μm thick were made from paraffin blocks and stained with hematoxylin and eosin. Microspecimens were studied, using Olympus BX-41 microscope (Japan).
RESULTS
Results: A comprehensive morphological study of the surgical material of patients with salivary gland pathology undergoing treatment at Kyiv City Clinical Hospital No. 12 (Ukraine, Kiev) for the period from 2014 to 2018 revealed benign tumors and tumor-like lesions of these glands. Pleomorphic adenomas and adenolymphomas represented benign tumors of the salivary glands, while cysts represented tumor-like lesions. Different ratios of parenchymal and stromal components characterized pleomorphic adenomas of the salivary glands. On this basis, we identified three tumor variants (mesenchymal (15 cases, 50.0 %); mixed or classic (10 cases, 33.3 %); epithelial (5 cases, 16.7 %)). A characteristic microscopic feature of salivary gland adenolymphomas was a pronounced predominance of the parenchyma over the stroma. A well-defined wall, represented by connective tissue fibers and epithelial lining, characterized the cysts of the salivary glands. The connective tissue capsule separating the tumor tissue from the intact tissue of the salivary gland was clearly pronounced in adenolymphomas, and in pleomorphic adenomas it could be clearly expressed, intact, with tumor invasion or absent. In mesenchymal and mixed variants of pleomorphic adenomas, in comparison with the epithelial variant, there was a frequent tumor invasion of the capsule, thinning of the capsule or its absence.
CONCLUSION
Conclusions: Morphological examination of the surgical material allows us to diagnose tumors (pleomorphic adenomas and adenolymphomas) and non-tumor lesions (cysts) of the salivary glands. This, of course, is of great therapeutic, diagnostic and prognostic value. Among the identified pathology of the salivary glands, pleomorphic adenomas cause certain difficulties in morphological diagnosis due to their structural diversity and heterogeneity, sometimes requiring morphometric, immunohistochemical or genetic research.
Topics: Adenoma, Pleomorphic; Cysts; Humans; Salivary Gland Neoplasms; Salivary Glands; Ukraine
PubMed: 34156006
DOI: No ID Found -
Oral Surgery, Oral Medicine, Oral... Oct 2022The objective of this study was to evaluate the value of tumor morphology, long-to-short diameter ratio (L/S), and ultrasound gray-scale ratio (UGSR) in the differential...
OBJECTIVE
The objective of this study was to evaluate the value of tumor morphology, long-to-short diameter ratio (L/S), and ultrasound gray-scale ratio (UGSR) in the differential diagnosis of 3 parotid neoplasms.
STUDY DESIGN
Preoperative ultrasound images of 17 patients with a malignant tumor (MT), 48 patients with pleomorphic adenoma (PA), and 39 patients with adenolymphoma (AL) were analyzed for imaging features and gray-scale histograms. Tumor morphology, L/S, and UGSR of MT, PA, and AL were compared. Receiver operating characteristic analysis of area under the curve (AUC), sensitivity, and specificity were used to measure the differential diagnostic efficacy of L/S, UGSR, and both combined with tumor morphology.
RESULTS
Morphologic features, L/S, and UGSR differed significantly in various pairwise comparisons of the 3 tumor types. Acceptable discrimination was detected between MT and AL with UGSR alone (AUC = 0.771) and between PA and AL with L/S and UGSR combined (AUC = 0.741). The combination of tumor boundary with UGSR yielded excellent discrimination between MT and PA (AUC = 0.853) and between MT and AL (AUC = 0.885), with sensitivity and specificity values greater than 0.800.
CONCLUSIONS
These ultrasound parameters, alone or in combination, can provide a method for accurate presurgical differential diagnosis of parotid tumors.
Topics: Adenolymphoma; Adenoma, Pleomorphic; Diagnosis, Differential; Humans; Parotid Neoplasms; Retrospective Studies; Sensitivity and Specificity; Ultrasonography
PubMed: 35872087
DOI: 10.1016/j.oooo.2022.05.012 -
Science Progress 2021The purpose of this study was to explore conventional, diffusion, and dynamic contrast-enhanced MRI (DCE-MRI) characteristics for differentiating metaplastic Warthin's...
The purpose of this study was to explore conventional, diffusion, and dynamic contrast-enhanced MRI (DCE-MRI) characteristics for differentiating metaplastic Warthin's tumor (MWT) from other tumor types of the parotid gland, including non-metaplastic Warthin's tumor (non-MWT), pleomorphic adenoma (PA), and malignant tumor (MT). A total of 178 patients with histologically proven tumors of the parotid gland, including 21 MWTs, 49 non-MWTs, 66 PAs, and 42 MTs, were enrolled in the study. Conventional MRI was performed in all patients. One hundred and fifty patients had preoperative diffusion-weighted MR imaging (DWI), and 62 patients had preoperative DCE-MRI. The differences in the conventional, DCE-MRI, and DWI records between MWTs and the other three tumor types were statistically evaluated. Compared with non-MWTs and PAs, there was a statistically significant difference in circumscription ( < 0.01). The ill-defined circumscription was more common in MWTs than non-MWTs and PAs. Compared with PAs, there was a statistically significant difference in morphology ( < 0.05). The lobulated morphology was more common in PAs than MWTs. Compared with PAs and MTs, there was a statistically significant difference in the signal of the solid component ( < 0.01). The moderate intensity of solid components was more common in MWTs than PAs and MTs. The solid components of PAs mostly showed hyperintense on -weighted imaging. Cyst/necrosis was more common in MWTs than PAs and MTs. Hyperintense of cyst/necrosis was more common in MWTs and non-MWTs. With respect to contrast enhancement, 52.4% MWTs exhibited moderate or marked enhancement, and most non-MWTs (81.6%) exhibited mild enhancement. Most PAs (84.8%) exhibited marked enhancement. The mean ADC value of MWTs (0.94 × 10 ± 0.11 mm/s) was significantly lower than that of the PAs (1.60 × 10 ± 0.17 mm/s) ( < 0.001). On DCE-MRI, six of eight MWTs demonstrated TIC of type B. Although MWT is rare, conventional MRI characteristics, DWI and DCE-MRI can provide useful information for differentiating MWT from other parotid mass.
Topics: Adenolymphoma; Cysts; Diagnosis, Differential; Humans; Magnetic Resonance Imaging; Metaplasia; Necrosis; Neuroblastoma; Parotid Gland; Parotid Neoplasms; Retrospective Studies
PubMed: 34003684
DOI: 10.1177/00368504211018583 -
BMC Medical Imaging Mar 2021Distinguishing parotid pleomorphic adenoma (PPA) from parotid adenolymphoma (PA) is important for precision treatment, but there is a lack of readily available... (Randomized Controlled Trial)
Randomized Controlled Trial
BACKGROUND
Distinguishing parotid pleomorphic adenoma (PPA) from parotid adenolymphoma (PA) is important for precision treatment, but there is a lack of readily available diagnostic methods. In this study, we aimed to explore the diagnostic value of radiomic signatures based on magnetic resonance imaging (MRI) for PPA and PA.
METHODS
The clinical characteristic and imaging data were retrospectively collected from 252 cases (126 cases in the training cohort and 76 patients in the validation cohort) in this study. Radiomic features were extracted from MRI scans, including T1-weighted imaging (T1WI) sequences and T2-weighted imaging (T2WI) sequences. The radiomic features from three sequences (T1WI, T2WI and T1WI combined with T2WI) were selected using univariate analysis, LASSO correlation and Spearman correlation. Then, we built six quantitative radiomic models using the selected features through two machine learning methods (multivariable logistic regression, MLR, and support vector machine, SVM). The performances of the six radiomic models were assessed and the diagnostic efficacies of the ideal T1-2WI radiomic model and the clinical model were compared.
RESULTS
The T1-2WI radiomic model using MLR showed optimal discriminatory ability (accuracy = 0.87 and 0.86, F-1 score = 0.88 and 0.86, sensitivity = 0.90 and 0.88, specificity = 0.82 and 0.80, positive predictive value = 0.86 and 0.84, negative predictive value = 0.86 and 0.84 in the training and validation cohorts, respectively) and its calibration was observed to be good (p > 0.05). The area under the curve (AUC) of the T1-2WI radiomic model was significantly better than that of the clinical model for both the training (0.95 vs. 0.67, p < 0.001) and validation (0.90 vs. 0.68, p = 0.001) cohorts.
CONCLUSIONS
The T1-2WI radiomic model in our study is complementary to the current knowledge of differential diagnosis for PPA and PA.
Topics: Adenolymphoma; Adenoma, Pleomorphic; Adolescent; Adult; Aged; Aged, 80 and over; Analysis of Variance; Area Under Curve; Diagnosis, Differential; Female; Humans; Logistic Models; Magnetic Resonance Imaging; Male; Middle Aged; Models, Theoretical; Observer Variation; Parotid Neoplasms; Retrospective Studies; Sensitivity and Specificity; Support Vector Machine; Young Adult
PubMed: 33743615
DOI: 10.1186/s12880-021-00581-9 -
Annals of Palliative Medicine Aug 2022Multiple synchronous neoplasms in the ipsilateral parotid gland are very rare. We intend to analyze the clinical characteristics and treatment results of multiple...
BACKGROUND
Multiple synchronous neoplasms in the ipsilateral parotid gland are very rare. We intend to analyze the clinical characteristics and treatment results of multiple synchronous neoplasms in the ipsilateral parotid gland managed at our hospital.
METHODS
The study included 21 patients of multiple synchronous neoplasms in the ipsilateral parotid gland from January 2010 to December 2020.
RESULTS
Twenty-one cases of multiple synchronous neoplasms in the ipsilateral parotid gland were identified among 994 cases of parotid surgery, with a frequency of 2.1%. Multiple synchronous neoplasms in the ipsilateral parotid gland occurred in all males and one female. Except for one case, all of them involved histopathologic neoplasms. Warthin tumor (n=19, 90.5%) was the most common. Among 21 lesions, there were 9 patients of right parotid gland, 4 patients of left parotid gland, and 4 patients of bilateral parotid gland. The main symptoms were slowly enlarging mass within the parotid gland (n=20), followed by incidental detection (n=1).
CONCLUSIONS
Clinicians should be aware of the possibility of multiple synchronous neoplasms in the ipsilateral parotid gland. Preoperative imaging tests, clinical examinations, and careful palpation during surgery are important for accurate diagnosis and treatment.
Topics: Adenolymphoma; Female; Humans; Male; Neoplasms, Multiple Primary; Parotid Gland; Parotid Neoplasms; Tomography, X-Ray Computed
PubMed: 35815451
DOI: 10.21037/apm-22-307 -
Head and Neck Pathology Sep 2023The eponymous history of Warthin tumor (WT) is a fascinating issue in the field of salivary gland pathology. The late decades of the nineteenth century and the turn of...
The eponymous history of Warthin tumor (WT) is a fascinating issue in the field of salivary gland pathology. The late decades of the nineteenth century and the turn of the century saw notable German and French contributions on WT. Especially, the seminal 1910 paper of Albrecht and Arzt of Vienna is the foundation for the current knowledge of WT. It is generally believed that prior to this pioneering study, Hildebrand of Göttingen accurately described the lesion of WT in 1895. However, the historical origins of WT appear to be unsettled, and only a few German pathologists and surgeons are aware that dating back to 1885, the first recognizable reference to WT was that by the renowned German-Swiss pathologist Zahn, whose name is eponymously associated with "Zahn infarct" and "lines of Zahn". Two noted French surgeons with a major interest in pathology, Albarrán in 1885 and Lecéne in 1908, did not contribute to the topic. Since the 1950s, a mostly American group of pathologists and surgeons gradually adopted the term WT to replace the very accurate histologic descriptor "papillary cystadenoma lymphomatosum" coined by Warthin himself in 1929. It is our opinion that from a historical viewpoint, there is no particular reason why this tumor should have been named WT.
Topics: Humans; Adenolymphoma; Parotid Neoplasms; Eponyms; Parotid Gland
PubMed: 37227678
DOI: 10.1007/s12105-023-01559-5 -
Dento Maxillo Facial Radiology 2016To explore the utility of diffusion tensor imaging (DTI) and acoustic radiation force impulse (ARFI) imaging in the diagnosis of parotid tumours.
OBJECTIVES
To explore the utility of diffusion tensor imaging (DTI) and acoustic radiation force impulse (ARFI) imaging in the diagnosis of parotid tumours.
METHODS
51 patients with parotid tumours were examined with DTI on 3.0-T MRI and ARFI imaging on an ultrasound scanner before surgery. Values of apparent diffusion coefficient (ADC), fractional anisotropy (FA) and shear-wave velocity (SWV) were calculated and analyzed with independent samples Wilcoxon-Mann-Whitney test. Cut-off values, sensitivity and specificity were calculated with receiver-operating characteristic (ROC) curve analysis. The value of combination was calculated through parallel test for the cut-off value of ADC, FA and SWV (combination = 0 or 1); then, ROC analysis was performed with pathological results as the gold standard to calculate the sensitivity and specificity for the combination of the three parameters distinguishing benign and malignant parotid tumours. Pathological diagnosis for every patient was made post-operatively from the tumour tissue taken during operation.
RESULTS
There was a significant difference between benign and malignant tumours in the values of ADC, FA and SWV (p = 0.032, p = 0.011 and p < 0.0001); a significant difference in the values was also found between pleomorphic adenoma and malignant tumour (p = 0.0012, p < 0.0001 and p = 0.0002). The diagnosis cut-off points between benign and malignant tumours for ADC, FA and SWV were 1.02 × 10(-3) mm(2) s(-1), 0.24 and 2.76 m s(-1), respectively; the sensitivity for ADC, FA and SWV was 87.50, 62.50 and 68.75%; the specificity was 45.71, 82.86 and 97.14%. Analysis of the combination of the three parameters increased the sensitivity, specificity, Youden index and area under the ROC curve compared with analysis of each parameter alone for distinguishing benign and malignant tumours.
CONCLUSIONS
The diagnostic value of the combination of the three parameters for distinguishing benign and malignant parotid tumours is the best; SWV is the preferred indicator. Parameters of DTI and ARFI may reflect the histological characteristics of parotid tumours and predict benignancy and malignancy and could provide quantitative information about the tumour. Combination of DTI with ARFI imaging had obvious advantage for the diagnosis of parotid tumours than each alone.
Topics: Adenolymphoma; Adenoma, Pleomorphic; Adolescent; Adult; Aged; Biopsy; Child; Diagnosis, Differential; Diffusion Tensor Imaging; Elasticity Imaging Techniques; Feasibility Studies; Female; Humans; Image Processing, Computer-Assisted; Male; Middle Aged; Parotid Neoplasms; ROC Curve; Sensitivity and Specificity; Young Adult
PubMed: 27351345
DOI: 10.1259/dmfr.20160100 -
Science Progress 2023Warthin tumor (WT)-like mucoepidermoid carcinoma resembles the histologic pattern of WT and pathologists unaware of this possibility may misdiagnose it as WT with... (Review)
Review
Warthin tumor (WT)-like mucoepidermoid carcinoma resembles the histologic pattern of WT and pathologists unaware of this possibility may misdiagnose it as WT with squamous and mucous epithelium metaplasia or WT malignant transfer into mucoepidermoid carcinoma. The present study reported a case of a 41-year-old Chinese female with a solitary mass in the left parotid gland. In this case, microscopic observation revealed prominent lymph node stroma and multiple cystic structures similar to those seen in WT. However, it lacked the two layers of oncocytic epithelial tissue characteristic of WT. Furthermore, fluorescence hybridization detected MAML2 rearrangement in the case. Considering the histological findings, this case was diagnosed as WT-like mucoepidermoid carcinoma. The present case report provides pathological and clinical features to differentiate it from WT malignant transition into mucoepidermoid carcinoma, WT with squamous and mucous epithelium metaplasia and non-sebaceous lymphadenoma-like mucoepidermoid carcinoma. In conclusion, WT-like mucoepidermoid carcinoma as a special subtype of mucoepidermoid carcinoma has special histological characteristics, which required further observations and more case reports to clearly define this variant.
Topics: Female; Humans; Adult; Parotid Gland; Carcinoma, Mucoepidermoid; In Situ Hybridization, Fluorescence; Adenolymphoma; Metaplasia; Carcinoma, Squamous Cell
PubMed: 37335119
DOI: 10.1177/00368504231179816