Yamanaka Hiroaki, Hasegawa Hisashi, Tanaka Makoto, Matsuzaki Hiroumi, Oshima Takeshi, Sugitani Masahiko
Department of Otolaryngology-Head and Neck Surgery, Nihon University School of Medicine, Tokyo, Japan.
Department of Pathology, Nihon University School of Medicine, Tokyo, Japan.
Turk Arch Otorhinolaryngol. 2019 Mar;57(1):42-45. doi: 10.5152/tao.2019.4129. Epub 2019 Mar 14.
We here report a rare salivary gland tumor, a non-sebaceous lymphadenoma (NSLA), in the parotid gland with positive technetium-99m (99mTc) pertechnetate scintigraphy and cervical masses that was difficult to distinguish from malignant lymphoma preoperatively. A 65-year-old Japanese woman presented to our institution with a painless left parotid mass that had been gradually enlarging for three months. Computed tomography and magnetic resonance imaging showed a solid mass (30 mm) in the tail of the left parotid gland with three swellings (each 10 mm) on the periphery of the parotid gland. A low grade malignant lymphoma was diagnosed by fine needle aspiration cytology. Gallium-67 scintigraphy showed mild positivity. On 99mTc pertechnetate scintigraphy, the mild accumulation remained after oral stimulation with a mixture of ascorbic acid and calcium pantothenate. The patient underwent superficial parotidectomy with removal of the cervical masses. Our findings in this patient suggest that 99mTc positivity may constitute a clue to the preoperative diagnosis of NSLA that has pathologically overlapping sites with Warthin tumor.
我们在此报告一例罕见的腮腺唾液腺肿瘤——非皮脂腺型淋巴结瘤(NSLA),其99m锝(99mTc)高锝酸盐闪烁扫描呈阳性,且伴有颈部肿块,术前难以与恶性淋巴瘤区分。一名65岁的日本女性因左侧腮腺无痛性肿块就诊于我院,该肿块已逐渐增大3个月。计算机断层扫描和磁共振成像显示左腮腺尾部有一实性肿块(30毫米),腮腺周围有三个肿大区域(每个10毫米)。细针穿刺细胞学检查诊断为低度恶性淋巴瘤。镓-67闪烁扫描显示轻度阳性。在99mTc高锝酸盐闪烁扫描中,口服抗坏血酸和泛酸钙混合物进行口腔刺激后仍有轻度积聚。患者接受了腮腺浅叶切除术及颈部肿块切除术。我们对该患者的研究结果表明,99mTc阳性可能是术前诊断NSLA的一个线索,NSLA在病理上与沃辛瘤有重叠部位。