Suzuki Kensuke, Iwai Hiroshi, Kaneko Toshihiko, Sakaguchi Mariko, Hoshino Shoichi, Inaba Muneo
Department of Otolaryngology, Takii Hospital, Kansai Medical University, Osaka 570-8507, Japan.
Otolaryngol Head Neck Surg. 2009 Aug;141(2):282-4. doi: 10.1016/j.otohns.2009.05.023.
To estimate parotitis caused by fine-needle aspiration (FNA) in parotid Warthin tumor.
Case series with chart review.
Hospital records were reviewed for 104 parotid tumors (103 patients) including 35 Warthin tumors, which underwent FNA within our department.
Three patients with four Warthin tumors among them noticed parotid pain, swelling, and abscess formation as a consequence of acute parotitis after FNA. Examinations of the materials obtained from tumor puncture or drainage before the start of antibiotic therapy showed no bacterial association in any patient. Two of the patients with Warthin tumor underwent parotidectomy, and the surgical specimens indicated histopathological changes with necrosis, abscess, granuloma, and the infiltration of inflammatory cells including Langhans-type multinucleated giant cells.
It is conceivable that Warthin tumor bears the characteristics of inflammation induced by the FNA procedure without any relation to infection. Therefore, it may be better to avoid routine FNA and give priority to diagnostic imagings over FNA in the diagnosis of tumors strongly suspected as Warthin tumor.
评估腮腺沃辛瘤细针穿刺抽吸（FNA）所致的腮腺炎。
病例系列研究并回顾病历。
回顾了我院104例腮腺肿瘤（103例患者）的病历，其中35例为沃辛瘤，均在我科接受了FNA。
其中3例患者的4个沃辛瘤在FNA后出现急性腮腺炎，表现为腮腺疼痛、肿胀及脓肿形成。在开始抗生素治疗前，对肿瘤穿刺或引流所获材料进行检查，未发现任何患者有细菌感染。2例沃辛瘤患者接受了腮腺切除术，手术标本显示有坏死、脓肿、肉芽肿以及包括朗汉斯型多核巨细胞在内的炎性细胞浸润等组织病理学改变。
可以想象，沃辛瘤具有FNA操作诱发炎症的特征，与感染无关。因此，对于高度怀疑为沃辛瘤的肿瘤诊断，最好避免常规FNA，优先选择诊断性影像学检查而非FNA。
