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腭部小涎腺腺样囊性癌与多形性腺瘤的鉴别诊断。

Differential diagnosis between adenoid cystic carcinoma and pleomorphic adenoma of the minor salivary glands of palate.

作者信息

Cerulli Giulio, Renzi Giancarlo, Perugini Maurizio, Becelli Roberto

机构信息

Maxillofacial Surgery Department, I Faculty of Medicine and Surgery, University of Rome La Sapienza, Policlinic Umberto I, Rome, Italy.

出版信息

J Craniofac Surg. 2004 Nov;15(6):1056-60. doi: 10.1097/00001665-200411000-00036.

Abstract

Tumors arising from minor salivary glands of the palate may exhibit an overlap of clinical and biologic features that may produce diagnostic and therapeutic dilemmas. Surgical treatment can be very different, depending on the dimensions and malignant or benign nature of the tumors, and therefore should be planned on the basis of an accurate differential diagnosis. A retrospective analysis in 24 patients with pleomorphic adenoma and adenoid cystic carcinoma of minor salivary glands of the palate was performed to investigate the accuracy of fine needle aspiration cytology (FNAC) and biopsy with histology in the preoperative diagnosis. Preoperative diagnoses obtained with FNAC and biopsy were compared with findings of the definitive histopathologic examination performed on the resected mass. Correspondence between the preoperative diagnoses determined by FNACs and the definitive histopathologic results was observed in 22 of 24 cases, whereas a complete equivalence was found with regards to histology. In the analysis, FNAC was associated with 91.6% accuracy and an error rate of 8.4% in the diagnosis of pleomorphic adenoma and adenoid cystic carcinoma of the palate. From the results of the analysis, histologic examination is still the most accurate diagnostic tool in such tumors. FNAC can be considered in tumors of the head and neck regions that are difficult to reach by means of a common biopsy.

摘要

起源于腭部小唾液腺的肿瘤可能表现出临床和生物学特征的重叠,这可能导致诊断和治疗上的困境。手术治疗可能因肿瘤的大小以及恶性或良性性质而有很大差异,因此应在准确的鉴别诊断基础上进行规划。对24例腭部小唾液腺多形性腺瘤和腺样囊性癌患者进行回顾性分析,以研究细针穿刺细胞学检查(FNAC)和组织活检在术前诊断中的准确性。将通过FNAC和活检获得的术前诊断与对切除肿块进行的最终组织病理学检查结果进行比较。在24例病例中的22例中观察到FNAC确定的术前诊断与最终组织病理学结果之间的一致性,而在组织学方面发现完全一致。在该分析中,FNAC在腭部多形性腺瘤和腺样囊性癌的诊断中准确率为91.6%,错误率为8.4%。从分析结果来看,组织学检查仍是此类肿瘤最准确的诊断工具。对于难以通过常规活检获取样本的头颈部肿瘤,可考虑采用FNAC。

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