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Titre du document / Document title

Gutartige Tumoren der Glandula parotidea : Präoperative Aspirationszytologie und chirurgische Strategie = Surgery of benign tumors of the parotid gland. The value of fine needle aspiration cytology

Auteur(s) / Author(s)

GEHRKING E. (1) ; GEHRKING I. (1) ; MOUBAYED P. (2) ;

Affiliation(s) du ou des auteurs / Author(s) Affiliation(s)

(1) Klinik und Poliklinik für Hals-, Nasen-und Ohrenheilkunde, Universitätsklinikum Schleswig-Holstein, Campus Lübeck, ALLEMAGNE
(2) Institut für Pathologie, Universitätsklinikum Schleswig-Holstein, Campus Lübeck, ALLEMAGNE

Résumé / Abstract

Background. Fine needle aspiration cytology (FNAC) is a widely used diagnostic tool to evaluate neoplastic or inflammatory tumorous lesions of the salivary glands. This method influences the selection of the modality of surgical treatment. In cases of benign tumors of the parotid gland, a (partial) superficial parotidectomy is usually recommended. However, for tumors other than pleomorphic adenomas (such as cystadenolymphomas, other adenomas, or benign tumor-like lesions) this operation is considered an overtreatment because extracapsular satellites are rare and recurrences in case of a capsular lesion are not likely. In such cases, a less extended surgery (enucleation) with lower morbidity is sufficient and can be carried out provided that pleomorphic adenomas and non-pleomorphic benign lesions are reliably differentiated prior to surgery. The aim of this study was to evaluate the reliability of the FNAC in differentiating benign tumors of the parotid gland. Patients and Methods. A retrospective evaluation of 160 cases of benign parotid gland tumors was performed and the cytological diagnoses compared with the histomorphological results. A collection of 26 cases with false-negative and false-positive results was reevaluated. Results. FNAC showed a sensitivity of 74.2% and a specificity of 89.8% for differentiation between pleomorphic adenomas and non-pleomorphic benign lesions. The predictive value for pleomorphic adenomas was 82.1%, and for non-pleomorphic benign lesions 84.6%. Reevaluation showed higher sensitivity (96.2%), specificity (98.9%), and negative/ positive predictive values (97.9% and 98.1%, respectively). Discussion/conclusion. Poor quality and hypocellularity of the cytological smears seem to negatively effect the outcome of the cytological diagnosis. It is concluded that only an accurate diagnosis of non-pleomorphic adenoma or a benign tumor-like lesion, based on an adequate FNAC specimen and assessed by an experienced cytopathologist, can justify tumor enucleation because the risk of pleomorphic adenoma is only 2% under these circumstances.

Revue / Journal Title

HNO. Hals-, Nasen-, Ohrenärzte    ISSN  0017-6192 

Source / Source

2007, vol. 55, no3, pp. 195-201 [7 page(s) (article)] (38 ref.)

Langue / Language

Allemand

Editeur / Publisher

Springer, Berlin, ALLEMAGNE  (1947) (Revue)

Mots-clés anglais / English Keywords

Salivary gland disease

;

Treatment

;

Stomatology

;

ENT

;

Pleomorphic adenoma

;

Specificity

;

Sensitivity

;

Fine needle

;

Aspiration punction

;

Parotid gland

;

Cytology

;

Surgery

;

Adenolymphoma

;

Benign neoplasm

;

Mots-clés français / French Keywords

Glande salivaire pathologie

;

Traitement

;

Stomatologie

;

ORL

;

Tumeur mixte

;

Spécificité

;

Sensibilité

;

Aiguille fine

;

Ponction aspiration

;

Glande parotide

;

Cytologie

;

Chirurgie

;

Adénolymphome

;

Tumeur bénigne

;

Mots-clés espagnols / Spanish Keywords

Glándula salival patología

;

Tratamiento

;

Estomatología

;

ORL

;

Tumor mixto

;

Especificidad

;

Sensibilidad

;

Aguja fina

;

Punción aspiración

;

Glándula parótida

;

Citología

;

Cirugía

;

Adenolinfoma

;

Tumor benigno

;

Mots-clés d'auteur / Author Keywords

Fine-needle cytology

;

Sensitivity. Specificity

;

Pleomorphic adenoma Cystadenolymphoma

;

Localisation / Location

INIST-CNRS, Cote INIST : 15900, 35400014334263.0080

Nº notice refdoc (ud4) : 18585472



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