Megerian C A, Maniglia A J
Department of Otolaryngology-Head and Neck Surgery, Case Western Reserve University School of Medicine, University Hospitals of Cleveland, Ohio 44106.
Ear Nose Throat J. 1994 Jun;73(6):377-80.
During the years 1980 through 1990, 247 patients underwent parotidectomy at our institution for the removal of primary parotid lesions. Charts were reviewed in an effort to document the distribution of pathology in patients undergoing parotidectomy and the histopathology from each case was organized and tallied by virtue of the final specific diagnoses. An additional goal of this study was to evaluate the efficacy of pre-operative fine-needle aspiration biopsy (FNAB) and frozen section pathology in accurately predicting final histopathology. In our series, 86.7% of lesions were found to be benign and 13.3% were malignant in nature. When compared to final pathologic findings, FNAB yielded a diagnostic accuracy rate of 89.3% with a 2.1% false negative rate with regards to pre-operative detection of malignancy. Frozen section biopsy was found to have a diagnostic accuracy of 94.1% and also demonstrated a 2.1% false-negative rate. We believe these studies are indeed complementary to each other, as reflected in the 96.2% diagnostic accuracy achieved with a combination of FNAB and frozen section biopsy information. This report will review the patterns of misdiagnosis for each modality of diagnostic testing and present the parotid histopathology found over a 10-year period.
在1980年至1990年期间,我院有247例患者接受了腮腺切除术以切除原发性腮腺病变。查阅病历以记录接受腮腺切除术患者的病理分布情况,并根据最终的具体诊断对每个病例的组织病理学进行整理和统计。本研究的另一个目标是评估术前细针穿刺活检(FNAB)和冰冻切片病理在准确预测最终组织病理学方面的有效性。在我们的系列研究中,发现86.7%的病变为良性,13.3%为恶性。与最终病理结果相比,FNAB对恶性肿瘤术前检测的诊断准确率为89.3%,假阴性率为2.1%。冰冻切片活检的诊断准确率为94.1%,假阴性率也为2.1%。我们认为这些研究确实相互补充,这体现在结合FNAB和冰冻切片活检信息可达到96.2%的诊断准确率。本报告将回顾每种诊断测试方式的误诊模式,并呈现10年间发现的腮腺组织病理学情况。