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Dento Maxillo Facial Radiology May 2021The aim of this study was to investigate the relationship between pathological classification of parotid gland tumors and conventional MRI - diffusion-weighted imaging...
OBJECTIVES
The aim of this study was to investigate the relationship between pathological classification of parotid gland tumors and conventional MRI - diffusion-weighted imaging findings and also contribute the possible effect of apparent diffusion coefficient (ADC) to diagnosis.
METHODS
60 patients with parotid masses diagnosed using histopathology and/or cytology were enrolled in this retrospective study. All patients were evaluated using a 1.5 T MRI. Demographic features, conventional MRI findings, and ADC values (mean, minimum, maximum, and relative) were recorded. MRI findings and ADC values were compared between benign-malignant groups and pleomorphic adenoma Warthin's tumor groups.
RESULTS
60 tumors (48 benign, 12 malignant) were evaluated in a total of 60 patients (39 males, 21 females). The mean age was 59 (±14, 18-86) years old; the mean lesion size was 26 (±10, 11-61) mm. On the texture of conventional MRI, T2 dominantly hyperintense/with hypointensity signal was seen in 87% of pleomorphic adenomas and T2 dominantly hypointense/with hyperintesity signal was encountered in 64% of all Warthin's tumors. Seven (28%) Warthin's tumors were misdiagnosed as pleomorphic adenomas and two others (8%) as malignant tumors. The commonly used mean ADC value was 1.6 ± 0.6 × 10 mm s for benign tumors, 0.8 ± 0.3 × 10 mm s for malign tumors, 1 (0.9-1.8) × 10 mm s for Warthin's tumors, and 1.9 ± 0.3 × 10 mm s for pleomorphic adenomas. There was a statistically significant difference in ADC values between benign-malignant tumors and pleomorphic adenomas-Warthin's tumors.
CONCLUSIONS
Warthin's tumor may occasionally be misdiagnosed as pleomorphic adenoma and malignant tumor because of variable morphologic features. In addition to benign-malignant differentiation, the added ADC measurement may also be useful for differentiating Warthin's tumors from pleomorphic adenomas.
Topics: Adenolymphoma; Adenoma, Pleomorphic; Adolescent; Adult; Aged; Aged, 80 and over; Diagnosis, Differential; Female; Humans; Magnetic Resonance Imaging; Male; Middle Aged; Parotid Gland; Parotid Neoplasms; Retrospective Studies; Young Adult
PubMed: 33237812
DOI: 10.1259/dmfr.20200391 -
Journal of Medical Case Reports Jan 2019Warthin tumor is a common, benign, painless salivary gland neoplasm. Rarely, Warthin tumors show large areas of squamous metaplasia; such Warthin tumors are called... (Review)
Review
BACKGROUND
Warthin tumor is a common, benign, painless salivary gland neoplasm. Rarely, Warthin tumors show large areas of squamous metaplasia; such Warthin tumors are called metaplastic or infarcted Warthin tumors because they are occasionally accompanied with tumor necrosis. The histological distinction between mucoepidermoid carcinomas and the metaplastic portions of Warthin tumors can be challenging; without a genetic study, mucoepidermoid carcinomas can be misdiagnosed as metaplastic Warthin tumors. We report a case of infarcted Warthin tumor partly showing mucoepidermoid carcinoma-like epithelial metaplasia. Only two cases of infarcted Warthin tumor similar to our case have been reported.
CASE PRESENTATION
A 69-year-old Japanese man presented with a right parotid tumor. He had noticed the swelling on his right buccal region 1 year previously; the lesion had rapidly enlarged, with associated pain, 1 month previously. A radiological examination revealed a mass in the tail of the right parotid gland. Superficial parotidectomy was performed. On histological examination, the mass showed typical focal features of Warthin tumor; other areas showed coagulation necrosis of the tumor. These areas were surrounded by non-oncocytic epithelium comprising squamous and mucinous epithelial cells. Although cellular atypia of the non-oncocytic epithelium was not observed, a mixture of squamous and mucinous cells and lack of abundant lymphoid tissue mimicked low-grade mucoepidermoid carcinoma. Based on the results of fluorescence in situ hybridization, MAML2 gene rearrangement was not present in the typical portions of Warthin tumor and the mucoepidermoid carcinoma-like lesion. Therefore, a metaplastic or infarcted Warthin tumor was diagnosed. Our patient was disease-free 8 months after surgery.
CONCLUSIONS
Clinicians need to know that pain is a clinical symptom of infarcted/metaplastic Warthin tumor. Pathologists should be aware that a metaplastic Warthin tumor can mimic a low-grade mucoepidermoid carcinoma. Our case showed a mucoepidermoid carcinoma-like lesion that was confined near the area of tumor necrosis, and neither cytological atypia nor apparent invasive growth was present. These findings appeared to be histological clues of a metaplastic Warthin tumor rather than a mucoepidermoid carcinoma. Careful clinicopathological evaluation as well as genetic studies are needed to clarify the distinction between mucoepidermoid carcinoma and metaplastic portions of Warthin tumors.
Topics: Adenolymphoma; Aged; Carcinoma, Mucoepidermoid; Humans; In Situ Hybridization, Fluorescence; Male; Metaplasia; Salivary Gland Neoplasms; Salivary Glands
PubMed: 30636634
DOI: 10.1186/s13256-018-1941-3 -
Beijing Da Xue Xue Bao. Yi Xue Ban =... Jun 2017To evaluate the feasibility of fine-needle aspiration cytology (FNAC) in diagnosing vascular abnormality in oral and maxillofacial region.
OBJECTIVE
To evaluate the feasibility of fine-needle aspiration cytology (FNAC) in diagnosing vascular abnormality in oral and maxillofacial region.
METHODS
The method of retrospective study was used. The data from the patients who underwent FNAC from 2011 to 2014 in Department of Oral and Maxillofacial Surgery, Peking University School of Stomatology were collected. All the included patients were divided into surgery group and non-surgery group. The patients in surgery group underwent lesion resection and the postoperative pathological results were gained. The patients in non-surgery group underwent periodical sclerotherapy. The accuracy of FNAC was identified by histopathologic diagnosis in surgery group and the effect of sclerotherapy in non-surgery group.
RESULTS
In this study, 93 patients were involved, including 51 males and 42 females. The median age was 2.5 years. Among them, 67 cases were judged as vascular abnormality by FNAC, and 63 cases were in consistent with final diagnosis and 4 cases were not. Among the other 26 cases which were diagnosed as other diseases by FNAC, 5 cases were accorded with final diagnosis. Therefore, the sensitivity of FNAC on diagnosis of vascular abnormity was 93% and its specificity was 84%. Among them, there were 29 cases in the surgery group and 64 cases in the non-surgery group. FNAC results were in consistent with the postoperative pathological results in 20 cases in surgery group (69%), and not consistent with pathological results in 9 cases . The pathological diagnoses included vascular malformations (3 cases), neurofibromas (2 cases), hamartoma (1 case), sebaceous cyst (1 case), adenolymphoma (1 case), and descriptive diagnosis (1 case). In non-surgery group, FNAC results were in consistent with the clinical effect of sclerotherapy in 61 cases (95%). There were 3 misdiagnosed cases. The coincident rate between the result of FNAC and that of pathological or clinical diagnosis was 86%.
CONCLUSION
FNAC is a feasible and minimal invasive method to diagnose vascular abnormality in oral and maxillofacial region.
Topics: Biopsy, Fine-Needle; Child, Preschool; Diagnostic Errors; Female; Humans; Male; Mouth; Retrospective Studies; Sensitivity and Specificity; Vascular Diseases
PubMed: 28628159
DOI: No ID Found -
Medical Ultrasonography Sep 2010The purpose of this pictorial essay is to illustrate the ultrasonographic aspects of the most common benign tumors of the parotid gland: pleomorphic adenoma and... (Review)
Review
The purpose of this pictorial essay is to illustrate the ultrasonographic aspects of the most common benign tumors of the parotid gland: pleomorphic adenoma and Warthin's tumor. The gray scale and Doppler ultrasonographic findings of the two tumors are reviewed and exemplified.
Topics: Adenolymphoma; Adenoma, Pleomorphic; Humans; Parotid Neoplasms; Ultrasonography, Doppler
PubMed: 21203603
DOI: No ID Found -
Head and Neck Pathology Dec 2020Non-sebaceous lymphadenoma is a sporadic benign tumor of salivary glands. Histopathologic and immunohistochemical properties, diagnostic criteria, and theories for the... (Review)
Review
Non-sebaceous lymphadenoma is a sporadic benign tumor of salivary glands. Histopathologic and immunohistochemical properties, diagnostic criteria, and theories for the histologic origin of the disease have been defined and well-discussed in the literature. However, none of the cases showed malignant transformation to date. We reported a case of 54 years old female patient with a right preauricular mass. Magnetic resonance imaging demonstrated a 2 cm, well-defined contrast-enhanced mass in the right parotid gland. Fine needle aspiration cytology was undiagnostic but suspicious for malignancy. Total parotidectomy with facial nerve preservation was done. In the histopathological examination, non-sebaceous lymphadenoma regions and malignant cells with abundant cytoplasm, large vesicular nuclei, and prominent nucleoli, which occupied approximately 70% of the mass, were seen. The diagnosis was undifferentiated carcinoma arisen from non-sebaceous lymphadenoma. Adjuvant radiotherapy was given. No recurrence was detected during ten months of follow-up. This case is the first case of a malignancy developed from non-sebaceous lymphadenoma.
Topics: Adenolymphoma; Carcinoma; Cell Transformation, Neoplastic; Female; Humans; Middle Aged; Parotid Neoplasms
PubMed: 31997132
DOI: 10.1007/s12105-020-01133-3 -
Scientific Reports Feb 2021The purpose of this study is to determine whether multiparametric non-contrast MR imaging including diffusion-weighted imaging (DWI), arterial spin labeling (ASL), and...
The purpose of this study is to determine whether multiparametric non-contrast MR imaging including diffusion-weighted imaging (DWI), arterial spin labeling (ASL), and amide proton transfer (APT) weighted imaging can help differentiate malignant from benign salivary gland lesions. The study population consisted of 42 patients, with 31 benign and 11 malignant salivary gland lesions. All patients were evaluated using DWI, three-dimensional pseudo-continuous ASL, and APT-weighted imaging on 3 T MR imaging before treatment. Apparent diffusion coefficient (ADC), tumor blood flow (TBF), and APT-related signal intensity (APTSI) values within the lesion were compared between the malignant and benign lesions by Mann-Whitney U test. For each parameter, optimal cutoff values were chosen using a threshold criterion that maximized the Youden index for predicting malignant lesions. The performance of ADC, TBF, APTSI, individually and combined, was evaluated in terms of diagnostic ability for malignant lesions. Diagnostic performance was compared by McNemar test. APTSI was significantly higher in malignant lesions (2.18 ± 0.89%) than in benign lesions (1.57 ± 1.09%, p = 0.047). There was no significant difference in ADC or TBF between benign and malignant lesions (p = 0.155 and 0.498, respectively). The accuracy of ADC, TBF, and APTSI for diagnosing malignant lesions was 47.6%, 50.0%, and 66.7%, respectively; whereas the accuracy of the three parameters combined was 85.7%, which was significantly higher than that of each parameter alone (p = 0.001, 0.001, and 0.008, respectively). Therefore, the combination of ADC, TBF, and APTSI can help differentiate malignant from benign salivary gland lesions.
Topics: Adenolymphoma; Adolescent; Adult; Aged; Aged, 80 and over; Child; Diagnosis, Differential; Diffusion Magnetic Resonance Imaging; Female; Humans; Male; Middle Aged; Retrospective Studies; Salivary Glands; Sensitivity and Specificity; Young Adult
PubMed: 33531644
DOI: 10.1038/s41598-021-82455-2 -
Dento Maxillo Facial Radiology Jul 2018To study the value of diffusion kurtosis imaging (DKI) in diagnosis of parotid gland disease (PGD) with different pathological patterns and parotid adenolymphoma (PAL).
OBJECTIVES
To study the value of diffusion kurtosis imaging (DKI) in diagnosis of parotid gland disease (PGD) with different pathological patterns and parotid adenolymphoma (PAL).
METHODS
57 patients with different kinds of PGD were enrolled and underwent DKI and conventional diffusion-weighted imaging (DWI). All patients were categorized into different groups according to their pathological patterns. The result of calculating the value of DKI-derived parameters (K, K, K, D, D, D, and FA) and apparent diffusion coefficient (ADC) of DWI were used to study their diagnostic accuracy in PGD with different pathological patterns. The binary logistic regression method was used to confirm clinical valuable diffusion parameters (obtained with DKI and DWI models) for diagnosing PAL. Using MedCalc 13.0, receiver operating characteristic (ROC) analysis was conducted to evaluate the diagnostic value of confirmed parameters based on the logistic regression equation.
RESULTS
Both DKI parameters and conventional ADC showed statistical significance in diagnosing PGD with different pathological patterns (p < .01). By using the DKI model, kurtosis coefficients showed higher diagnostic capability than diffusion coefficients ([K+K + K] vs [D +D + D]: 22 vs 15, p < .01) did in the differential diagnosis among different PGD groups. In the diagnosis of PAL among all PGD patterns, the ROC analysis demonstrated that the area under curve (AUC) FA +K [0.881 ± 0.057 (0.824 to 0.938)] is higher than that when using FA [0.629 ± 0.095 (0.534 to 0.724)] and K [0.800 ± 0.070 (0.730 to 0.870)] alone (p < .05), with sensitivity, specificity, accuracy, and both positive and negative predictive values of 71.43, 95.78, 91.77, 76.92, and 94.44%, respectively.
CONCLUSIONS
DKI showed higher diagnostic capacity in the differential diagnosis of PGD with different pathological patterns. Combined parameters of DKI can differentiate PAL from other PGD pathological patterns with a high degree of accuracy. This technique shows great potential for DKI in the differential diagnosis of PGD within a certain pathological category.
Topics: Adenolymphoma; Adult; Aged; Aged, 80 and over; Diagnosis, Differential; Diffusion Magnetic Resonance Imaging; Diffusion Tensor Imaging; Female; Humans; Male; Middle Aged; Parotid Diseases; Retrospective Studies; Young Adult
PubMed: 29676939
DOI: 10.1259/dmfr.20170388 -
Experimental and Therapeutic Medicine Jul 2012Recent studies have proposed that the chemokine CCL28 is constitutively expressed by epithelial cells in salivary glands and play an important role in lymphocyte...
Recent studies have proposed that the chemokine CCL28 is constitutively expressed by epithelial cells in salivary glands and play an important role in lymphocyte trafficking in oral immunity. To date, there is little information on the expression pattern of CCL28 in salivary gland tumors. The purpose of this study was to determine the expression of CCL28 in pleomorphic adenoma and adenolymphoma and to evaluate its potential function in regulating oral carcinogenesis. Immunohistochemical reactivity revealed CCL28 protein expression in the cytoplasm of acinar epithelial cells, both in tumorous tissues and normal adjacent tissues. The level of CCL28 mRNA was markedly reduced in 70% (28/40) of pleomorphic adenomas, and in 81% (26/32) of adenolymphomas, compared to the normal adjacent tissue. CCL28 protein expression was significantly lower in pleomorphic adenomas (P=0.0027, n=40) and in adenolymphomas (P=0.0003, n=32) compared to their normal adjacent tissues. Additionally, the CCL28 protein levels in saliva in the aforementioned patients were lower than those in healthy volunteers. Our study indicated that the reduced expression of CCL28 could possibly be a strategy by recruiting fewer antitumor immunocompetent cells to salivary glands. The expression and secretion of CCL28 may be associated with the pathogenesis of pleomorphic adenoma and adenolymphoma.
PubMed: 23060924
DOI: 10.3892/etm.2012.544 -
Journal of Medical Case Reports Jan 2023Warthin tumor (WT) is a common benign salivary tumor of the parotid gland. Clinically, it occurs in men in their fifth to seventh decades who typically smoke cigarettes....
BACKGROUND
Warthin tumor (WT) is a common benign salivary tumor of the parotid gland. Clinically, it occurs in men in their fifth to seventh decades who typically smoke cigarettes. WTs have been reported with different head and neck neoplasms and other salivary gland tumors within the same or another salivary gland. Kimura disease (KD) is a rare chronic inflammatory disease with unknown etiology affecting young to middle-aged Asian men. KD presents as an asymptomatic nodule in the head and neck area, with regional lymphadenopathy and salivary gland involvement.
CASE PRESENTATION
A 64-year-old Arabic man presented with a 10-year history of an asymptomatic swelling of the left face. Computed tomography showed a well-defined, multicystic mass with heterogeneous enhancement. The resected mass was composed of two distinct components. There was a well-demarcated proliferation of papillary and cystic oncocytic epithelium with lymphoid stroma, consistent with WT. Some areas exhibited sclerotic fibrosis, with multiple lymphoid follicles showing folliculolysis, follicular hyperplasia, and eosinophilic infiltrate. The patient's immunoglobulin E level serum was elevated, confirming a coexisting KD. The patient underwent a left superficial parotidectomy, with no recurrence at a 30-month follow-up.
CONCLUSION
This report describes the first concurrent case of WT and KD in the parotid gland.
Topics: Male; Middle Aged; Humans; Adenolymphoma; Parotid Neoplasms; Kimura Disease; Parotid Gland; Salivary Glands
PubMed: 36611215
DOI: 10.1186/s13256-022-03729-5 -
Ear, Nose, & Throat Journal Dec 2021
Topics: Adenolymphoma; Aged; Biopsy; Female; Head and Neck Neoplasms; Humans; Neoplasms, Multiple Primary
PubMed: 32579392
DOI: 10.1177/0145561320935851