Ahn Soomin, Kim Yuil, Oh Young Lyun
Department of Pathology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea.
Acta Cytol. 2013;57(6):567-74. doi: 10.1159/000354958. Epub 2013 Oct 1.
The aim of this study was to evaluate the diagnostic accuracy of fine needle aspiration (FNA) cytology of benign salivary gland tumors with myoepithelial cell participation, namely, pleomorphic adenoma, basal cell adenoma and myoepithelioma, at a single institution over a period of 10 years.
This study was based on 575 cytologic and matching histological samples (534 pleomorphic adenomas, 26 basal cell adenomas and 15 myoepitheliomas).
In most cases (393/534) of pleomorphic adenoma, a precise diagnosis was given. However, only 2 cases of basal cell adenoma and 1 case of myoepithelioma were diagnosed definitively. Descriptive diagnosis, instead of a definite diagnosis, was rendered in 16.9% of pleomorphic adenomas, 53.8% of basal cell adenomas and 40.0% of myoepitheliomas. Among all cases, the possibility of malignancy was raised in 5.2% of pleomorphic adenomas, 15.4% of basal cell adenomas and 20.0% of myoepitheliomas with a variable degree of suspicion.
In some cases, the distinction between these three neoplasms remains difficult in that all exhibit some degree of myoepithelial participation. However, FNA showed a high diagnostic accuracy in diagnosing benign salivary tumors with myoepithelial differentiation, and triage into this category provides sufficient information for clinicians to make treatment decisions.
本研究旨在评估在一家机构10年期间,细针穿刺(FNA)细胞学检查对伴有肌上皮细胞参与的良性涎腺肿瘤(即多形性腺瘤、基底细胞腺瘤和肌上皮瘤)的诊断准确性。
本研究基于575份细胞学和匹配的组织学样本(534例多形性腺瘤、26例基底细胞腺瘤和15例肌上皮瘤)。
在大多数多形性腺瘤病例(393/534)中,给出了准确诊断。然而,仅明确诊断出2例基底细胞腺瘤和1例肌上皮瘤。16.9%的多形性腺瘤、53.8%的基底细胞腺瘤和40.0%的肌上皮瘤给出的是描述性诊断而非明确诊断。在所有病例中,5.2%的多形性腺瘤、15.4%的基底细胞腺瘤和20.0%的肌上皮瘤被不同程度怀疑有恶性可能。
在某些情况下,这三种肿瘤之间的区分仍然困难,因为它们都表现出一定程度的肌上皮参与。然而,FNA在诊断具有肌上皮分化的良性涎腺肿瘤方面显示出较高的诊断准确性,分类到这一类别可为临床医生做出治疗决策提供足够信息。