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2.
Orv Hetil ; 161(3): 83-94, 2020 Jan.
Artigo em Húngaro | MEDLINE | ID: mdl-31928058

RESUMO

Renal cell carcinoma (RCC) represents a heterogenous group of malignant tumors that originate from the kidney parenchyma. The different entities have their own specific epidemiological, morphological, immunohistochemical, genetic and clinical characteristics. The new WHO classification of renal tumors was published in 2016, and it takes all of these features together into account. Although in the past three years, several emerging subtypes have been described, these are not yet included in the current classification. In this review paper, these entities are summarized in details including the following emerging subsets: thyroid-like follicular carcinoma, ALK rearrangement-associated RCC, renal cell carcinoma with prominent smooth muscle stroma, fumarate hydratase-deficient RCC, biphasic squamoid papillary RCC, eosinophilic solid and cystic RCC, atrophic kidney-like RCC, clear cell RCC with giant cells and emperipolesis, Warthin-like papillary RCC, low-grade oncocytic renal tumor (CD117-negative; CK7-positive), high-grade oncocytic renal tumor, TCEB1-mutated RCC and chromophobe RCC with neuroendocrine features. These entities are mostly diagnosed as RCC unclassified. The aim of this study is to introduce these subsets to the Hungarian pathologists, oncologists and urologists, to prompt diagnostic accuracy and to facilitate a collection along with a consecutive analysis of these cases. Orv Hetil. 2020; 161(3): 83-94.


Assuntos
Carcinoma de Células Renais , Neoplasias Renais , Biomarcadores Tumorais , Humanos , Hungria , Rim
3.
World J Clin Cases ; 7(22): 3895-3903, 2019 Nov 26.
Artigo em Inglês | MEDLINE | ID: mdl-31799320

RESUMO

BACKGROUND: Warthin's tumor (WT) is composed of several cysts that are lined with tall, bilayered oncocytic columnar cells and lymphoid stroma. Within WT, the two components rarely transform into carcinoma or lymphoma, and when it does, carcinoma is the most common type. Approximately 28 cases of lymphoma with WT have been reported, most of which were non-Hodgkin lymphomas, and only a few cases were Hodgkin lymphomas. In the present report, we studied a case of diffuse large B cell lymphoma (DLBCL) arising from follicular lymphoma (FL) with WT in the parotid gland and its immunophenotypic and genetic features. CASE SUMMARY: A 67-year-old man presented with a slowly enlarging right cheek mass for 12 years, and the mass began to change in size over a 2-mo time period. Over time, the patient felt mild local pain and right cheek discomfort. His medical history included a hepatitis B virus infection for 20 years and 30 years of smoking. Gross examination of the excised specimen showed a gray-red and gray-white appearance and a soft texture lobulated external surface neoplasm that measured 9 cm × 8 cm × 7 cm and was well circumscribed by relative normal parotid gland tissue. In cross section, the cut surfaces of the neoplasm were multicystic and had a homogeneous scaly appearance. A small fluid was discovered in the cyst. Bilateral oxyphilic, cuboidal or polygonal epithelium cells and lymphoid intraparenchymal components were observed. Many medium- to large-sized lymphoid cells were observed diffusely in part of the neoplasm, and a few secondary lymphoid follicles were observed at the center or edge of the neoplasm. Immunohistochemical staining showed that the columnar oncocytic cells were positive for AE1/AE3; neoplastic cells located in coarctate follicular were positive for CD20, Pax-5, bcl-2 and bcl-6; and the adjacent diffusely medium- to large-sized lymphoid cells were positive for Pax-5, bcl-6, CD20, MUM-1, bcl-2 and CD79a. The bcl-6 (3q27) break-apart rearrangement was observed, and an Epstein Barr virus test was negative in the tumor cells. The patient survived 6 months after being diagnosed without any treatment. CONCLUSION: WT-associated lymphoma is a very rare neoplasm in the parotid gland. Most cases are B cell non-Hodgkin lymphomas and involve middle-age and older males. This case highlights the extremely rare association of DLBCL arising from FL with WT and the importance of deliberate evaluation of the WT intraparenchymal stroma. Molecular detection techniques have potential advantages in the diagnosis of lymphoma with WT.

4.
Autops. Case Rep ; 9(4): e2019122, Oct.-Dec. 2019. ilus, tab
Artigo em Inglês | LILACS | ID: biblio-1024306

RESUMO

Mucoepidermoid carcinoma (MEC) is the most common malignant salivary gland tumor. Although the parotid gland is the most common site of involvement, other major salivary glands and the minor salivary glands­most commonly of the palate­also can be involved. The management of mucoepidermoid carcinoma depends on the grade of the tumor and the adequacy of resection. We present the case of a 56-year-old female presenting a painless progressive cheek mass over 2 months. Imaging and fine-needle aspiration cytology provided the diagnosis of Mucoepidermoid carcinoma. A superficial parotidectomy was done, and the histopathology revealed a predominantly cystic tumor with a bilayered epithelium of oncocytic and basal cells. Moderate nuclear pleomorphism with infiltration of atypical squamous cells in few glandular cysts was seen. Special staining revealed the presence of intracellular mucin. A diagnosis of Warthin-like variant of MEC was made, based on these findings. After the surgical procedures, the patient is disease-free at 8 months of follow-up. The Warthin-like variant is a rare variant of MEC with fewer than 10 cases described in the English literature. Various differential diagnoses include the malignant transformation of Wartin tumor (WT), squamous metaplasia of WT, and metastasis from a distant primary. We emphasize the role of routine microscopy in identifying rare variants of common malignancies. Even though translocation studies are helpful in diagnosis, the typical histopathological findings should confirm it.


Assuntos
Humanos , Feminino , Pessoa de Meia-Idade , Neoplasias Parotídeas/patologia , Carcinoma Mucoepidermoide/patologia , Carcinoma Mucoepidermoide/cirurgia , Carcinoma Mucoepidermoide/terapia
5.
Hua Xi Kou Qiang Yi Xue Za Zhi ; 37(6): 631-635, 2019 Dec 01.
Artigo em Chinês | MEDLINE | ID: mdl-31875442

RESUMO

OBJECTIVE: This study aimed to investigate the value of normalized iodine concentration (NIC), spectral attenuation curve slope (SACS), area under curve (AUC), and iodine concentration difference (ICD) generated from spectral CT in the assessment of parotid gland tumors. METHODS: Ninety-two patients with pathologically confirmed parotid gland tumors underwent arterial phase- and venous phase-enhanced CT in spectral CT. The patients were divided into the pleomor-phic adenoma group (group A), Warthin tumor group (group B), basal cell tumor group (group C), and malignant tumor group (group D). The SACS, AUC, NIC, ICD were measured and analyzed. Statistical analyses were performed by one-way ANOVA, and statistical significance was set at P<0.05. RESULTS: SACS(AP), AUC(AP), and NIC(AP) in group A were lower than those in other groups; SACS(VP) and AUC(VP) in group C were higher than those in other groups; NIC(AP) and NIC(VP) in group D were higher than those in other groups; and ICD in group B was a positive number. The difference in SACS(AP) and AUC(AP) in groups B and C, SACS(VP) and AUC(VP) in groups C and D, and ICD in groups A and C were not statistically significant. By contrast, the diffe-rence between the other groups was statistically significant (P<0.05). The difference in NIC(AP) between groups A and B and groups C and D and the difference in NIC(VP) between groups A and C, groups A and D, and groups B and C were statistically significant (P=0.005, 0.025, 0.002, 0.038, and 0.049, respectively). CONCLUSIONS: Multi-quantitative parameters from spectral CT might be helpful in differentiating various types of parotid gland tumors.


Assuntos
Iodo , Tomografia Computadorizada por Raios X , Diagnóstico Diferencial , Humanos , Glândula Parótida
6.
Head Neck ; 2019 Nov 24.
Artigo em Inglês | MEDLINE | ID: mdl-31762130

RESUMO

INTRODUCTION: Warthin's tumor (WT) is a common benign salivary gland neoplasm with a negligible risk of malignant transformation. However, there is a risk of malignant tumors being misdiagnosed as WT on cytology and inappropriately managed conservatively. METHODS: Patients from nine centers in Italy and the United Kingdom undergoing parotid surgery for cytologically diagnosed WT were included in this multicenter retrospective series. Definitive histology was compared with preoperative cytological diagnoses. Surgical complications were recorded. RESULTS: A total of 496 tumors were identified. In 88.9%, the final histological diagnosis was WT. In 21 cases (4.2%) a malignant neoplasm was diagnosed, which had been incorrectly labeled as WT on cytology. CONCLUSIONS: The risk of undiagnosed malignancy should be balanced against surgical risks when considering the management of WT. Although nonsurgical management remains an appropriate option, there may be a rationale for serial clinical or radiological evaluation if surgical excision is not performed.

7.
Int J Surg Pathol ; : 1066896919886370, 2019 Nov 07.
Artigo em Inglês | MEDLINE | ID: mdl-31698976

RESUMO

Warthin tumor (WT) is the second most common benign salivary gland neoplasm. It is also the most frequent salivary gland tumor to occur synchronously or metachronously with another salivary gland neoplasm, in the same gland or on the other side. Oncocytic papillary cystadenomas (OPCs) are rare neoplasms that are more common in minor salivary gland locations and in women. We describe in detail the case of a 73-year-old male smoker with synchronous OPC and WT of the parotid gland. On microscopy, both tumors resembled each other considerably, with the only difference being that the OPC lacked the tumor-associated lymphoid proliferation characteristic of WT. These findings highlight that OPC bears considerable similarity to WT. While this morphological similarity may lead to misdiagnosis on rare occasions, it does not affect patient management, as clinical behavior of both these tumors is similar.

8.
Turk J Med Sci ; 2019 Nov 26.
Artigo em Inglês | MEDLINE | ID: mdl-31769640

RESUMO

BACKGROUND/AIM: To define the cytomorphologic findings leading to difficulties in diagnosis of Warthin tumors (WT). MATERIALS AND METHODS: Forty-eight histopathologically diagnosed WT patients who had fine needle aspiration cytology (FNAC) preoperatively were re-evaluated for defining the presence or absence of lymphocytes, oncocytic cell layer, oncocytic cell papillae, granular debris background, mucoid background, macrophages, polymorphonuclear cells (PMN), mast cells, squamous like cells, atypical vacuolar cytoplasmic cell and giant cell. RESULTS: Forty-seven tumors were in parotid gland and one in submandibulary gland. There were 37(77%) male and 11(23%) female patients. Cytopathologically in 36 patients the diagnosis was benign neoplasm (WT), in 6 other benign entities and in 6 suspicious for malignancy. The main characteristic cytomorphologic features of WT were as follows: 92% lymphoid cells, 83% oncocytic cell layers and 67% granular debris background. These percentages were 67%, 17%, 17% in benign cytology group and 67%, 50%, 17% in suspicious for malignancy group respectively. CONCLUSION: Absence or lack of main features of WT with or without presence of squamous like cells, vacuolized cytoplasmic cells and inflammatory reaction may cause diagnostic dilemma. The presence of the mast cells accompanied by epithelial tissue was striking for WT diagnosis.

9.
Rom J Morphol Embryol ; 60(2): 445-453, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31658317

RESUMO

Warthin tumor is described using various terms, such as papillary cystadenoma lymphomatosum, adenolymphoma or monomorphic adenoma. It is a medical condition related to the salivary glands, namely a benign cystic tumor which contains an epithelial component and an abundant lymphoid stroma. It is also named Warthin tumor after Aldred Scott Warthin, the pathologist who described this entity in 1929 by observing it in two patients. Warthin tumor is a benign one and ranks secondly in terms of the most common not malignant salivary gland tumor located in the parotid gland. Because of its cystic nature, from the clinical point of view, it appears to be a slow-growing tumor often fluctuant on palpation. In terms of the treatment of choice, complete excision with wide tumor-free margins is preferred. The aim of the present article is to evaluate possible correlations between clinical-pathological features and postoperative complications in a target group made up of 10 patients diagnosed with Warthin tumor of the parotid gland admitted for surgery in a period of 21 years and to compare the results with literature.

10.
Autops Case Rep ; 9(4): e2019122, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31641663

RESUMO

Mucoepidermoid carcinoma (MEC) is the most common malignant salivary gland tumor. Although the parotid gland is the most common site of involvement, other major salivary glands and the minor salivary glands-most commonly of the palate-also can be involved. The management of mucoepidermoid carcinoma depends on the grade of the tumor and the adequacy of resection. We present the case of a 56-year-old female presenting a painless progressive cheek mass over 2 months. Imaging and fine-needle aspiration cytology provided the diagnosis of Mucoepidermoid carcinoma. A superficial parotidectomy was done, and the histopathology revealed a predominantly cystic tumor with a bilayered epithelium of oncocytic and basal cells. Moderate nuclear pleomorphism with infiltration of atypical squamous cells in few glandular cysts was seen. Special staining revealed the presence of intracellular mucin. A diagnosis of Warthin-like variant of MEC was made, based on these findings. After the surgical procedures, the patient is disease-free at 8 months of follow-up. The Warthin-like variant is a rare variant of MEC with fewer than 10 cases described in the English literature. Various differential diagnoses include the malignant transformation of Wartin tumor (WT), squamous metaplasia of WT, and metastasis from a distant primary. We emphasize the role of routine microscopy in identifying rare variants of common malignancies. Even though translocation studies are helpful in diagnosis, the typical histopathological findings should confirm it.

11.
Braz. j. otorhinolaryngol. (Impr.) ; 85(5): 546-550, Sept.-Oct. 2019. tab, graf
Artigo em Inglês | LILACS-Express | ID: biblio-1039281

RESUMO

Abstract Introduction: Warthin tumors are the second most common benign tumors of the parotid gland. We examined the clinical features of Warthin tumors in our hospital, and analyzed the consistency within the literatures. Objective: The aim of this study is to analyze the clinical features of Warthin tumors in our 10-year experience of 118 Warthin tumors undergoing surgery at a single institute. Methods: From December 2006 to December 2016, 110 patients who underwent surgical treatment for Warthin tumors were identified based on their medical records. Results: A total of 118 parotid gland operations were performed in 110 patients. Almost 90% of Warthin tumors were found in males, and average patient age was 66.1 ± 6.1 years. The prevalence of smoking history was 89.1% (98/110). Eight patients (7.3%) had bilateral Warthin tumors. Seventy-seven lesions (65.3%) were located in the parotid tail portion, followed by 34 lesions in the superficial lobe (28.8%) and 7 lesions in the deep lobe (5.9%). Conclusion: We determined the appropriate extent of surgery depending on the fine needle aspiration cytology and tumor location by computed tomography scans. Partial facial dysfunction after the operation was detected in 12 cases, and facial nerve function recovered within 3 months. Only one patient experienced a recurrence, and was disease free after the re-operation. We suggest that our treatment algorithm, depending on the location of tumors and the result of fine needle aspiration cytology, can be useful to determine the appropriate extent of surgery for Warthin tumors.


Resumo Introdução: Os tumores de Warthin são os segundos tumores benignos mais comuns da glândula parótida. Avaliamos as características clínicas dos tumores de Warthin em nosso hospital e analisamos a consistência com a literatura. Objetivo: Analisar as características clínicas dos tumores de Warthin em nossa experiência de 10 anos de 118 tumores de Warthin submetidos a tratamento cirúrgico em um único instituto. Método: De dezembro de 2006 a dezembro de 2016, 110 pacientes que receberam tratamento cirúrgico para tumores de Warthin foram identificados com base em seus prontuários médicos. Resultados: Foram feitas 118 cirurgias na glândula parótida em 110 pacientes. Quase 90% dos tumores de Warthin foram encontrados em homens e a média da idade dos pacientes foi de 66,1 ± 6,1 anos. A prevalência de tabagismo foi de 89,1% (98/110). Oito pacientes (7,3%) tinham tumores de Warthin bilaterais na glândula parótida. Das lesões, 77 (65,3%) localizavam-se na porção da cauda da parótida, seguidas por 34 no lobo superficial (28,8%) e 7 no lobo profundo (5,9%). Conclusão: Determinamos a extensão apropriada da cirurgia de acordo com a punção aspirativa com agulha fina e localização do tumor por tomografia computadorizada. Disfunção facial parcial após a cirurgia foi detectada em 12 casos e a função do nervo facial foi recuperada em 3 meses. Apenas um paciente apresentou recidiva e ficou livre da doença após reoperação. Sugerimos que nosso algoritmo de tratamento, a depender da localização dos tumores e do resultado da PAAF, pode ser útil para determinar a extensão apropriada da cirurgia para os tumores de Warthin.

12.
Vet Pathol ; : 300985819875749, 2019 Sep 24.
Artigo em Inglês | MEDLINE | ID: mdl-31551021

RESUMO

Primary epithelial tumors of the gallbladder are rarely reported in animals. In this study, 9 aged pigs (6-12 years old) were histopathologically examined for gallbladder proliferative lesions. At necropsy, a large gallstone occupied the lumen of the gallbladder of 3 pigs. Histopathological examination revealed chronic cholecystitis in all 9 pigs, mucosal hyperplasia in 2 pigs, adenoma in 1 pig, and adenocarcinoma in 2 pigs. Bacilli were detected in the gallbladder lumen of 6 pigs by Warthin-Starry stain. Mucosal hyperplasia, adenoma, and adenocarcinoma were characterized by papillary projections of the mucosa with occasional acinar structures. Tumor invasion of the surrounding tissue was observed in the cases of adenocarcinoma. On Alcian blue and periodic acid-Schiff double-stained sections, the acinar structure of gallbladder mucosa in chronic cholecystitis and mucosal hyperplasia was stained in a mosaic pattern, indicating pyloric gland metaplasia. The results of immunohistochemistry revealed a CD10-positive epithelial brush border and mucin (MUC) 2-positive goblet cells in chronic cholecystitis, adenoma, and adenocarcinomas, indicating intestinal metaplasia. Immunoreactivity of MUC5 AC and cytokeratin 19 was weaker in adenoma and adenocarcinomas compared with the normal and hyperplastic gallbladder mucosa. The number of p53-positive nuclei and the Ki-67 index were higher in adenocarcinomas compared with benign lesions. These results suggest that chronic cholecystitis associated with gallstones and/or bacterial infections may contribute to metaplastic changes and development of gallbladder tumors in aged pigs. Alteration of mucin, cytokeratin, and p53 profiles in gallbladder proliferative lesions in pigs were similar to that in humans, suggesting a common pathogenesis in tumor development.

13.
Gland Surg ; 8(Suppl 3): S130-S135, 2019 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-31559179

RESUMO

Background: Multi-phasic Computed Tomography (CT) evaluation allows to study the enhancement features of parotid gland masses. The aim of our study was to evaluate the role of delayed enhancement in the characterization of different histologic types of parotid tumours. Methods: Forty-eight patients (22 male and 26 female) with at least one parotid gland tumor, were included in our study. Multi-phase CT images were obtained before and 30, 120 s and 8 minutes after intravenous contrast injection. The images were evaluated by two radiologists for lesion enhancement degree. A quantitative assessment was performed using a region of interest on each lesion and density changes between different phases were compared. The tumoral enhancement ratio was calculated between the 8 minutes delayed and the early (30 s) phase. The pathological diagnosis was confirmed in all patients after surgery. Results: All patients had unilateral lesion for a total of 48 lesions. Twenty-eight were pleomorphic adenomas, 15 Warthin's tumours and 5 carcinomas. All Warthin tumours showed a rapid contrast enhancement at the early phase (30 sec) followed by a progressive wash-out during the delayed scans. Most of pleomorphic adenomas (89.2%) showed the highest density at the 8-minutes delayed phase. Malignant tumours showed slower contrast enhancement and 3 out of 5 (60%) showed a marked decrease at the 8 minutes delayed phase while the remaining 2 (40%), did not show any density reduction. The tumoral enhancement ratio was significantly different between Warthin tumours and pleomorphic adenomas and between Warthin's and malignant tumours. Conclusions: Multi-phasic CT examination with 8 minutes delayed acquisition has shown to be useful in parotid gland lesion differentiation.

14.
Artigo em Inglês | MEDLINE | ID: mdl-31540870

RESUMO

INTRODUCTION: Salivary gland tumors are a diverse group of lesions, with various origins and extremely different behaviors, leading to a variety of outcomes for patients. Therefore, the need to discover novel markers with the ability to predict the behavior of benign and malignant salivary gland neoplasms is crucial. Syndecan-1 is a cell-surface protein with significant roles in various aspects of tumor function. Its expression in salivary gland neoplasms, especially their stromal component, has not been investigated. OBJECTIVES: We aimed to assess the immunopositivity of syndecan-1 in epithelial and stromal components of salivary gland neoplasms and to compare it between benign and malignant subtypes in addition to evaluating its correlation with clinicopathologic parameters. METHODS: 133 salivary gland tumors were immunohistochemically stained with syndecan-1 and the intensity and percentage of this protein was determined, compared between the tumors and correlated with clinicopathologic factors. RESULTS: Statistical analysis of lesions with a sufficient sample size showed significant differences in percentage and intensity between both epithelial and stromal components of all tumors (p<0.05). Pairwise-comparisons demonstrated significantly higher staining-percentage of epithelial cells (p=0.02) in Warthin's tumor compared to pleomorphic adenoma and adenoid cystic carcinoma. Similarly, significantly higher staining intensities and/or percentages was observed in mucoepidermoid carcinoma and adenoid cystic carcinoma compared to pleomorphic adenoma and Warthin's tumor (p<0.05). Of the clinicopathologic factors, there was only a significant negative correlation between stromal percentage of mucoepidermoid carcinoma and age and a significant difference between stromal intensity+percentage of adenoid cystic carcinoma and gender (p<0.05). CONCLUSIONS: According to our findings we postulate that stromal syndecan-1 correlates with the behavior of salivary gland tumors, with malignant neoplasms demonstrating a higher expression, indicating a role for syndecan-1 in invasion and metastasis.

16.
J Vasc Interv Radiol ; 30(10): 1574-1580, 2019 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-31471194

RESUMO

PURPOSE: To evaluate efficacy and safety of radiofrequency (RF) ablation for parotid Warthin tumor. MATERIALS AND METHODS: From September 2016 to August 2017, 7 consecutive patients with biopsy-proven parotid Warthin tumors who did not undergo surgery presented with symptoms or cosmetic concerns and underwent US-guided percutaneous RF ablation treatment. RF ablation procedures were performed using the moving shot technique. US, contrast-enhanced CT, or MR imaging was performed 6-12 months after each procedure. Complications and cosmetic scale improvement after RF ablation were also evaluated. RESULTS: There was a significant reduction in mean tumor volume from 14.6 cm3 ± 13.1 (range, 1.9-35.5 cm3) to 0.8 cm3 ± 0.5 (range, 0.2-1.54 cm3) and a mean cosmetic scale improvement (from 4 to 1) on imaging studies 6-12 months after RF ablation compared with before RF ablation (P < .05). Volume reduction ratios at 1-2 months, 5-6 months, and 10-12 months after RF ablation were 51.2% ± 18.1%, 87.8% ± 10.6%, and 94.3% ± 2.0%. There was no facial nerve injury. One patient with parotitis and hematoma recovered in 1 week. CONCLUSIONS: RF ablation using the moving shot technique could be an effective and safe alternative treatment for parotid tail Warthin tumors in patients unsuitable for or unwilling to undergo surgical resection.

17.
Head Neck Pathol ; 2019 Aug 31.
Artigo em Inglês | MEDLINE | ID: mdl-31473936

RESUMO

Xanthogranulomatous sialadenitis (XGS) is rare in salivary glands and only reported in the literature as single cases. Here we report a cohort of four cases with XGS and summarize the clinicopathologic features of these cases. All four patients had persistent mass lesions concerning for neoplasm. In two patients (patient 1 and 3), the initial fine needle aspirations (FNAs) contained oncocytic cells consistent with or suspicious for Warthin's tumor, but follow-up FNAs showed only inflammation and/or debris indicating tumor infarction after FNA. All patients eventually had surgical resection. Histologically, all cases contained abundant macrophages with necrosis and fibroblastic proliferation. Warthin's tumor with a grossly identifiable tumor nodule (0.7 cm) was noted in patient 1 and a microscopic focus (0.2 cm) of Warthin's tumor was identified in patient 3. No identifiable tumor was observed in patient 2 and 4. There are a total of 10 XGS cases in the literature (including four from this series) and Warthin tumor was identified in 50% of reported cases of XGS, suggesting that XGS is an uncommon reactive process to spontaneous or procedure-induced infarction of Warthin tumor. As a diagnostic mimicker for malignancy, a thorough examination and generous sampling of surgical resection specimen is warranted, although a benign salivary gland neoplasm, commonly Warthin's tumor, is often identified.

18.
J Oral Maxillofac Pathol ; 23(2): 218-223, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31516227

RESUMO

Objective: The aim of this study is to analyze the utility of immunohistochemical markers such as CD117 and smooth muscle actin (SMA) in the diagnosis of various benign and malignant salivary gland neoplasms. Materials and Methods: The study comprises 17 samples categorized into three groups: Group I consisted of 5 histopathologically normal salivary gland tissue; Group II comprised 7 cases, of which 3 cases were pleomorphic adenoma, 3 cases were myoepithelioma and 1 case was Warthin's tumor; and Group III consisted of 5 cases, of which 1 was mucoepidermoid carcinoma and 4 cases were adenoid cystic carcinoma. The selected cases were subjected to immunohistochemistry (IHC) procedure to assess the expression pattern of CD117 and SMA. Results: In SMA, 85.8% showed severe-to-moderate intense expression among the tumor cells in benign salivary gland tumor. All the 5 malignant tumors showed the expression of SMA and 3 cases demonstrated severe expression among the tumor cells. An intense expression pattern of SMA was observed in both benign and malignant neoplasms in the periphery and stromal components of the tumor. Only two cases were positive for CD117, and connective tissue components were completely negative in both malignant and benign salivary gland neoplasms. Conclusion: Alpha-SMA can be utilized as reliable IHC markers for salivary gland neoplasms due to its diagnostic importance in tumors with myoepithelial origin indicative of the histogenesis of salivary gland tumors.

19.
Eur J Nucl Med Mol Imaging ; 46(11): 2228-2234, 2019 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-31372671

RESUMO

BACKGROUND: Recently, semiquantitative time-intensity curve (TIC) analysis based on DCE-MRI and apparent diffusion coefficient (ADC) value-based diffusion-weighted imaging (DWI) were used to improve the diagnostic efficiency when diagnosing parotid tumors (PTs). However, quantitative DCE-MRI biomarkers have not been emphasized previously. PURPOSE: To explore the diagnostic efficiency of perfusion parameters alone or in combination based on quantitative DCE-MRI and DWI in the differential diagnosis of PTs. METHODS: In total, 112 patients with parotid masses were prospectively recruited in our hospital from August 2013 to March 2017. All patients were evaluated with DCE-MRI and DWI before surgery. TIC and quantitative parameters based on DCE MRI and ADCs were analyzed. Receiver operating characteristic analysis and linear discriminant analysis (LDA) was used to determine their diagnostic performance. RESULTS: In total, 87% (27/31) of pleomorphic adenoma (PA) showed type A TIC, 74% (65/88) of Warthin's tumors showed type B TIC, and 95% (19/20) of malignant tumors showed TIC type C. Pearson X2 test showed a significant difference between TIC patterns in benign and malignant tumors (X2 = 38.78, p < 0.001). ROC analysis revealed that ADC achieved the best diagnostic performance for distinguishing PA and Warthin's tumor from others, with area under the curve (AUC) values of 0.945 and 0.925 (p < 0.01), respectively. Furthermore, the TIC type was the only useful biomarker for distinguishing malignant from benign PTs, with an AUC of 0.846 (p < 0.01). Concerning the accuracy of the combined application of multiple parameters of DCE-MRI and ADC values, a combination of TIC pattern and extracellular volume ratio (Ve) provided the best results among five protocols, producing the highest accuracy of 0.75, followed by the combined use of the TIC pattern and ADC (accuracy was 0.70). CONCLUSION: TIC pattern in combination with the Ve biomarker based on DCE-MRI could achieve optimal diagnostic accuracy in the differential diagnosis of PTs.

20.
Laryngorhinootologie ; 98(10): 701-707, 2019 Oct.
Artigo em Alemão | MEDLINE | ID: mdl-31378851

RESUMO

AIM: To evaluate ultrasonographic hypoechoic lesions (HEL) of the head and neck region to predict their entity and plan surgery. METHODS: Patients with HEL were included that were further analysed by B-mode ultrasound (US), colour-coded duplex sonography (CDS), contrast enhanced US (CEUS), and strain elastography (SE). RESULTS: 184 patients were included. Level VIII, II, and I were affected frequently with 103, 40, and 21 HEL. The cohort comprised 40 lymph node disorders, 101 salivary gland diseases, 31 cystic lesions, and 12 other rarer entities. HEL in level II were significantly larger than in level I and VIII (p < 0.001). HEL in level VI showed less vascularisation than in level VIII in CDS (p < 0.01). There were no differences in B-mode criteria, SE, or CEUS between HEL in the different neck levels. Patients with cystic lesions were significantly younger than patients with metastases or Warthin's tumours (p = 0.026, 0.028). Pleomorphic adenomas were significantly smaller than cystic lesions (p < 0.0006), lymphomas (p = 0.026), metastases (p = 0.0003), or Warthin's tumours (p = 0.034). In CDS and CEUS, cystic lesions showed significantly less vascularisation and perfusion than lymphomas (p = 0.014) and Warthin's tumours (p < 0.0001), while pleomorphic adenomas were stiffer than cystic lesions in SE (p = 0.0006). CONCLUSION: Predicting lesion's entity is still challenging. The combination of different ultrasonographic criteria helped selecting patients that needed intraoperative fresh frozen section with possible extended surgery and profited from intraoperative nerve monitoring.


Assuntos
Adenolinfoma , Adenoma Pleomorfo , Técnicas de Imagem por Elasticidade , Neoplasias Parotídeas , Ultrassonografia , Humanos , Neovascularização Patológica
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