PubMed · 12909837
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Denis Chatelain, Stéphane Ayache, Alexis Bruniau, Cyril Page, Carole Cordonnier, Vladimir Strunski. 2003. [A thyroid neoplasm].. https://pubmed.ncbi.nlm.nih.gov/12909837/
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BACKGROUND: Despite its well-defined histologic appearance, the often variegated cytomorphologic appearance of Warthin tumor (WT) on fine-needle aspiration (FNA) may lead to an erroneous cytopathologic interpretation. In this study, the authors analyzed the potential sources of diagnostic errors and overall accuracy of FNA diagnosis of WT. METHODS: A retrospective search of The Johns Hopkins Hospital Surgical Pathology files (1985-2001) revealed 97 patients with WT, including 31 patients who underwent prior FNA. A comprehensive review of cytopathologic material was undertaken to calculate the overall accuracy of FNA and to identify sources of diagnostic error. RESULTS: All tumors presented in the parotid gland. Four tumors (13%) were deemed inadequate for interpretation due to insufficient material. The FNA diagnosis of WT was rendered in only 20 tumors (74%). The remaining 7 tumors (26%) were misdiagnosed on FNA as consistent with or suspicious for carcinoma or some other neoplastic process. A retrospective review of the tumors, which were over-called on FNA, showed a predominance of necrotic or cellular debris (n = 6 tumors; 22%), significant epithelial metaplasia with atypia (n = 4 tumors; 15%), background inflammation suspicious for tumor diathesis (n = 3 tumors; 11%), spindle cells (n = 1 tumor; 4%), and abundant mucin with keratinized squamous cells (n = 1 tumor; 4%). CONCLUSIONS: FNA is moderately accurate for diagnosing WT, with a 74% accuracy rate in the current series. Cytologic misinterpretation may occur due to a lack of characteristic cytomorphologic features of WT and overabundance of one or more of the following: squamous metaplasia/atypia, mucoid/mucinous background, spindle-shaped cells, and cystic/inflammatory debris. An adequate awareness of these potential sources of erroneous diagnoses, coupled with appropriate clinical findings, may result in a higher accuracy rate.
UNLABELLED: Salivary gland tumors constitute a highly heterogeneous histopathologic group. There are few epidemiological studies of large series of benign and malignant salivary gland tumors in Brazil. MATERIAL AND METHODS: Hospital records of 124 patients with salivary gland tumors diagnosed from January 1993 to December 1999 were reviewed. The patients were analyzed according to gender, age, size, location, and histopathology of the tumor. RESULTS AND CONCLUSIONS: Patients with benign and malignant tumors presented with a mean age of 47.7 and 48.8 years, respectively. The frequency of benign tumors was 80% (n = 99) and malignant tumors 20% (n = 25). Tumors were localized in the parotid gland 71% (n = 88), in the submandibular gland 24% (n = 30), and in the minor salivary glands 5% (n = 6). The most common benign tumors were pleomorphic adenoma in 84% (n = 84) and Warthin's tumor in 13% (n = 13). Among malignant tumors, mucoepidermoid carcinoma was the most common in 52% (n = 13), adenoid cystic carcinoma occurred in 20% (n = 5), and carcinoma ex pleomorphic adenoma was detected in 12% (n = 3).
The objective of the present study is to assess the potential of color Doppler sonography in imaging tumors of the parotid gland enhanced by application of ultrasound contrast agents. To this end 26 patients with tumors of the parotid gland were investigated. The color Doppler signal areas before and after administration of Doppler signal-enhancing agent (Levovist, Schering, Germany) were determined by means of computer-assisted analysis, and the relevant parameters were evaluated. The tumors can be classified as follows: 11 pleomorphic adenomas, 8 adenolymphomas and two squamous cell carcinomas of the parotid gland, two lymph nodes, one adenoma, one neurinoma of the facial nerve and one non-Hodgkin's lymphoma. Before the administration of Doppler signal-enhancing agent, the adenolymphomas showed a significantly stronger Doppler signal area as compared to the pleomorphic adenomas. The maximum color Doppler signal area after administration of Doppler signal-enhancing agent showed no difference within both groups. If one considers the relative change in the Doppler signal area before and after applying enhancing agent, however, a significantly stronger enhancement of perfusion (increase in Doppler signal area) is noted within pleomorphic adenomas. The changes in the Doppler signal area after administration of signal-enhancing agent show a different course depending on the histology of the investigated tumors.