Tamiolakis Dimitrios, Mygdakos Nikolaos, Tsamis Ioannis, Nikolaidou Sylva, Thomaidis Vasilios, Georghiou Georgios, Costopoulou Akrivi
Department of cytopathology, Regional Hospital of Chania, Crete, Greece.
Stomatologija. 2015;17(2):67-72.
Lesions of the tongue have a broad differential diagnosis ranging from benign idiopathic processes to infections, cancers, and infiltrative disorders. An important thing to remember is that most tongue lesions will resolve spontaneously or with simple therapy within a week, if not, they should be biopsied or evaluated further for a definitive diagnosis of a potentially serious disorder. Some tongue lesions may be clues to other underlying illnesses which require further evaluation Tongue lesions are traditionally evaluated by surgical biopsy. Most of them, however, are easily accessible by fine-needle aspiration (FNA) or brushing.
Fifteen males and twelve females aged from 15 to 72 were examined in our institution over a period of 15 years and 27 lesions, were evaluated by fine-needle aspiration cytology (FNAC) or brushing cytology.
The lesions were located at the mobile aspect of the tongue.10 malignant tumors were diagnosed: 9 cases of squamous cell carcinoma (SCC), and 1 non-Hodgkin lymphoma (NHL). In addition, 13 benign tumors (7 cases of papillomas / fibromas, 3 cases of hemangiomas, 2 cases lymphangiomas, and 1 case of lipoma), and 4 nonneoplastic benign conditions (3 traumatic ulcers and 1 hematoma) were found. There were no false-positive diagnoses. There were no clinical complications resulting from FNA or brushing.
Cytologic examination is rapid, safe, accurate, inexpensive, and patient-friendly for establishing preoperative diagnosis in tumors and tumor-like conditions of the tongue, and we recommend this method as the first diagnostic step in the evaluation of these lesions.
舌部病变的鉴别诊断范围广泛,从良性特发性病变到感染、癌症及浸润性疾病。需要记住的重要一点是,大多数舌部病变会在一周内自行消退或通过简单治疗痊愈,否则应进行活检或进一步评估以明确诊断潜在的严重疾病。一些舌部病变可能是其他潜在疾病的线索,需要进一步评估。传统上,舌部病变通过手术活检进行评估。然而,其中大多数通过细针穿刺抽吸(FNA)或刷检很容易获取样本。
在15年的时间里,我们机构对15名年龄在15至72岁之间的男性和12名女性进行了检查,并通过细针穿刺抽吸细胞学检查(FNAC)或刷检细胞学检查对27个病变进行了评估。
病变位于舌的活动部。诊断出10例恶性肿瘤:9例鳞状细胞癌(SCC)和1例非霍奇金淋巴瘤(NHL)。此外,还发现了13例良性肿瘤(7例乳头状瘤/纤维瘤、3例血管瘤、2例淋巴管瘤和1例脂肪瘤)以及4例非肿瘤性良性病变(3例创伤性溃疡和1例血肿)。没有假阳性诊断。FNA或刷检未导致临床并发症。
细胞学检查对于舌部肿瘤及肿瘤样病变的术前诊断快速、安全、准确、廉价且对患者友好,我们建议将此方法作为评估这些病变的首要诊断步骤。