Mondal Palash, Basu Nandita, Gupta Sanjay Sen, Bhattacharya Nirmal, Mallick Mamata Guha
Department of Pathology, Medical College, Kolkata, India.
J Cytol. 2009 Jul;26(3):102-4. doi: 10.4103/0970-9371.59395.
Parapharyngeal tumors are rare and often pose diagnostic difficulties due to their location and plethora of presentations.
The study was undertaken to study the occurrence in the population and to evaluate the exact nature by fine needle aspiration cytology (FNAC).
A total of five hundred and six cases of lateral neck lesions were studied over three and half years. Of these 56 suspected parapharyngeal masses were selected by clinical and radiological methods. Cytopathology evaluation was done by fine needle aspiration cytology with computed tomography and ultrasonography guidance wherever necessary. Histopathology confirmation was available in all the cases.
On FNAC diagnosis could be established in 54 cases while in two cases the material was insufficient to establish a diagnosis. The tumors encountered were, pleomorphic adenoma (33), schwannoma (3), neurofibroma (11), paraganglioma (5), angiofibroma (1) and adenoid cystic carcinoma (1). Four false positives and two false negative cases were encountered. Overall sensitivity was 96%, with specificity of 99% and accuracy being 98.8%.
With proper clinical and radiological assessment, FNAC can be extremely useful in diagnosing most of these lesions except a few which need histopathological and even immunohistochemical confirmation.
咽旁肿瘤较为罕见，因其位置及众多表现形式常给诊断带来困难。
开展此项研究以了解该肿瘤在人群中的发生率，并通过细针穿刺细胞学检查（FNAC）评估其确切性质。
在三年半的时间里共研究了506例颈部外侧病变病例。其中56例疑似咽旁肿物通过临床及影像学方法选出。必要时在计算机断层扫描及超声引导下通过细针穿刺细胞学进行细胞病理学评估。所有病例均有组织病理学确诊。
通过FNAC，54例得以确诊，2例因取材不足无法确诊。所遇到的肿瘤包括多形性腺瘤（33例）、神经鞘瘤（3例）、神经纤维瘤（11例）、副神经节瘤（5例）、血管纤维瘤（1例）及腺样囊性癌（1例）。出现4例假阳性及2例假阴性病例。总体敏感性为96%，特异性为99%，准确率为98.8%。
通过适当的临床及影像学评估，FNAC对大多数此类病变的诊断极为有用，但少数病例仍需组织病理学甚至免疫组织化学确诊。
