Seifert G
Institut für Pathologie, Universität Hamburg.
Mund Kiefer Gesichtschir. 1998 Mar;2(2):62-9. doi: 10.1007/s100060050032.
Diagnostic pitfalls exist when benign salivary gland diseases are mistakenly classified as malignant, with consequences for treatment and prognosis. Examples are necrotizing sialometaplasia, metaplastic Warthin tumour and sclerosing polycystic sialadenopathy. The proper diagnosis is of eminent importance to distinguish cases of primary tumours that have developed in salivary glands or their lymph nodes from cases of extraglandular tumours with metastases in these glands or their nodes. In these cases clinical data and additional immunocytochemical methods are necessary to clarify the exact diagnosis, especially when the primary salivary gland tumours have a structure largely identical to the metastases (e.g. squamous cell carcinoma). Nasopharyngeal or cervical chordomas can be mistaken for pleomorphic adenoma or mucinous adenocarcinoma. The initial stage of malignant MALT lymphomas in association with Sjögren's syndrome demands identification of clonal rearrangement for therapeutic implication. The diagnostic criteria for proper classification are analysed in detail.
当良性唾液腺疾病被误诊为恶性时，就会出现诊断陷阱，这会对治疗和预后产生影响。例如坏死性涎腺化生、化生型沃辛瘤和硬化性多囊性腺病。正确诊断对于区分唾液腺或其淋巴结中发生的原发性肿瘤与这些腺体或其淋巴结中有转移的腺外肿瘤病例至关重要。在这些情况下，临床数据和额外的免疫细胞化学方法对于明确准确诊断是必要的，尤其是当原发性唾液腺肿瘤的结构与转移瘤基本相同时（如鳞状细胞癌）。鼻咽或颈部脊索瘤可能会被误诊为多形性腺瘤或黏液腺癌。与干燥综合征相关的恶性黏膜相关淋巴组织淋巴瘤的初始阶段需要识别克隆重排以指导治疗。详细分析了正确分类的诊断标准。
