Pleomorphic adenoma

多形性腺瘤
  • 文章类型: Case Reports
    多形性腺瘤(PA)是最常见的良性唾液腺肿瘤。它们可能发生在任何年龄,发病率在40到60岁之间。在女性中更常见(60%)。这些肿瘤可以出现在主要和次要唾液腺。这些肿瘤中约有80%被诊断为腮腺,而10%出现在小唾液腺,主要影响味觉,其次是嘴唇和脸颊。本报告通过回顾相关文献,描述了两例在我科的小唾液腺中被诊断为(PA)的异常病变。第一例涉及一名83岁的男子,他的上唇右侧出现缓慢增长的肿胀,第二例涉及一名45岁的妇女,她的上颚有缓慢生长的病变。手术切除后在组织病理学上证实了PA的存在。虽然相对罕见,PA是良性病变,对于适当的治疗管理,必须知道其诊断。
    Pleomorphic adenomas (PA) are the most prevalent benign salivary gland neoplasms. They may occur at any age, with a peak incidence between 40 and 60 years of age. They are more commonly observed in females (60%). These tumors can arise in both the major and minor salivary glands. Approximately 80% of these tumors are diagnosed in the parotid gland, whereas 10% arise in the minor salivary glands, mainly affecting the palates, followed by the lips and cheeks. This report describes two cases of unusual lesions that were diagnosed as (PA) in the minor salivary glands in our department via a review of the relevant literature. The first case involved an 83-year-old man who presented with a slow-growing swelling on the right side of the upper lip, and the second case involved a 45-year-old woman who presented with a slow-growing lesion on the palate. The presence of PA was confirmed histopathologically after surgical resection. Although relatively rare, PA is a benign lesion, the diagnosis of which must be known for appropriate therapeutic management.
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  • 文章类型: Case Reports
    皮肤混合瘤或软骨样汗管瘤是一种罕见的良性,头颈部皮肤附件肿瘤。它代表唾液腺多形性腺瘤的皮肤对应物。其临床表现通常会误导临床医生将其诊断为反应性病变。我们报告了一名94岁的男性因切除皮肤癌而入院的病例,同时伴有耳廓软骨样空洞,暂时误诊为瘢痕疙瘩。
    Cutaneous mixed tumor or chondroid syringoma is a rare benign, skin appendageal tumor prevalent in areas of the head and neck. It represents the cutaneous counterpart of the pleomorphic adenoma of salivary glands. Its clinical presentation often misguides the clinician to underdiagnose it as a reactive lesion. We report the case of a 94-year-old male admitted for excision of cutaneous carcinoma concurrently with a chondroid syringoma of the pinna provisionally misdiagnosed as a keloid.
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  • 文章类型: Case Reports
    在组织学诊断中,多形性腺瘤的扁桃体位置很少见。消除其他基本上是淋巴瘤的诊断是必不可少的。
    方法:我们介绍了一个15岁儿童的案例,该儿童因咽部不适和食用固体食物困难而咨询了6个月。临床检查和放射学(MRI)显示扁桃体区域存在肿块。活检显示多形性腺瘤。经口切除肿瘤进展良好。
    扁桃体区的多形性腺瘤是罕见的。只有组织学检查才能证实这一点。肿瘤的切除必须完成,以限制复发的风险。
    结论:扁桃体区多形性腺瘤具有非特异性临床表现。MRI有助于指导诊断。它的治疗是手术,需要完全切除。
    UNASSIGNED: The tonsillar location of pleomorphic adenomas is rare in histological diagnosis. The elimination of other essentially lymphomatous diagnoses is essential.
    METHODS: We present a case of a 15-year-old child who consults for a feeling of pharyngeal discomfort and difficulty eating solid foods for 6 months. Clinical examination and radiology (MRI) showed the presence of a mass in the tonsillar region. A biopsy revealed a pleomorphic adenoma. The tumor was removed transorally with good progress.
    UNASSIGNED: Pleomorphic adenoma of the tonsillar region is rare. Only histological examination can confirm this. Resection of the tumor must be complete in order to limit the risk of recurrence.
    CONCLUSIONS: The pleomorphic adenoma of the tonsillar region has a non-specific clinical presentation. MRI helps guide the diagnosis. Its treatment is surgical requiring complete excision.
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  • 文章类型: Letter
    暂无摘要。
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  • 文章类型: Journal Article
    评估基于MRI的影像组学模型在区分Warthin肿瘤(WT)和误诊或模糊的多形性腺瘤(PA)方面的有效性。
    收集来自两个中心的PA和WT患者的数据。MR图像用于提取放射学特征。通过在特征缩减和选择后运行9种机器学习算法,找到了最佳的影像组学模型。为了创建临床模型,采用单因素logistic回归(LR)分析和多因素LR.将独立的临床预测因子和影像组学组合以创建列线图。分别基于临床模型和最佳影像组学模型,通过集成和堆叠算法构建了两个集成模型。使用曲线下面积(AUC)评估模型性能。
    总共有149名患者。性别,年龄,患者吸烟是独立的临床预测因素。验证组的平均AUC(0.896)和准确性(0.839)最大,LR模型是最佳的影像组学模型.在平均验证组中,基于LR的影像组学模型的AUC(0.795)不高于临床模型(AUC=0.909).列线图(AUC=0.953)在辨别性能方面优于影像组学模型。平均验证组中的列线图具有比堆叠模型(0.914)或集合模型(0.798)最高的AUC。
    使用基于MRI的影像组学模型可以对误诊或不明确的PA和WT进行非侵入性区分。列线图显示出优异且稳定的诊断性能。在日常工作中,有必要结合临床参数来区分PA和WT。
    UNASSIGNED: To evaluate the effectiveness of MRI-based radiomics models in distinguishing between Warthin tumors (WT) and misdiagnosed or ambiguous pleomorphic adenoma (PA).
    UNASSIGNED: Data of patients with PA and WT from two centers were collected. MR images were used to extract radiomic features. The optimal radiomics model was found by running nine machine learning algorithms after feature reduction and selection. To create a clinical model, univariate logistic regression (LR) analysis and multivariate LR were used. The independent clinical predictors and radiomics were combined to create a nomogram. Two integrated models were constructed by the ensemble and stacking algorithms respectively based on the clinical model and the optimal radiomics model. The models\' performance was evaluated using the area under the curve (AUC).
    UNASSIGNED: There were 149 patients included in all. Gender, age, and smoking of patients were independent clinical predictors. With the greatest average AUC (0.896) and accuracy (0.839) in validation groups, the LR model was the optimal radiomics model. In the average validation group, the radiomics model based on LR did not have a higher AUC (0.795) than the clinical model (AUC = 0.909). The nomogram (AUC = 0.953) outperformed the radiomics model in terms of discrimination performance. The nomogram in the average validation group had a highest AUC than the stacking model (0.914) or ensemble model (0.798).
    UNASSIGNED: Misdiagnosed or ambiguous PA and WT can be non-invasively distinguished using MRI-based radiomics models. The nomogram exhibited excellent and stable diagnostic performance. In daily work, it is necessary to combine with clinical parameters for distinguishing between PA and WT.
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  • 文章类型: Journal Article
    背景与目的:粘蛋白通过多种机制参与肿瘤细胞的发育和生长。然而,唾液腺肿瘤中粘蛋白表达的研究是有限的,尤其是小唾液腺的样本。这项研究旨在调查和比较粘蛋白在次要和主要唾液腺起源的良性和恶性唾液腺肿瘤中的表达。材料和方法:使用特殊染色剂对中性粘蛋白(高碘酸希夫)进行染色,来自六个正常唾液腺和73个唾液腺肿瘤的组织内的唾液酸粘蛋白(AlcianBlue)和磺粘蛋白(AldehideFuschin),包括31个多形性腺瘤,27例粘液表皮样癌,和15例腺样囊性癌.半定量方法用于评估导管腔内的粘蛋白表达。唾液酸粘蛋白是所有唾液腺肿瘤中表达最多的粘蛋白,不管起源。结果:良性和恶性唾液腺肿瘤之间的粘蛋白表达存在显着差异,与粘液表皮样癌和腺样囊性癌相比,多形性腺瘤显示唾液粘蛋白的表达明显高出三倍(p=0.028)。与次要腺体相比,主要腺体的多形性腺瘤显示出42倍的唾液酸粘表达(p=0.000)。结论:与小腺体相比,大腺体多形性腺瘤中的唾液酸蛋白含量大大增加。唾液粘蛋白在良性和恶性唾液腺肿瘤中的差异表达表明在诊断交界性唾液腺肿瘤中的作用。
    Background and Objectives: Mucin has been implicated via various mechanisms in the development and growth of tumour cells. However, mucin expression studies in salivary gland tumours are limited, especially with samples from minor salivary glands. This study aims to investigate and compare mucin expression in benign and malignant salivary gland tumours of minor and major salivary gland origins. Materials and Methods: Special stains were used to stain neutral mucin (Periodic acid Schiff), sialomucin (Alcian Blue) and sulfomucin (Aldehyde Fuschin) within tissues from six normal salivary glands and 73 salivary gland tumours including 31 pleomorphic adenomas, 27 mucoepidermoid carcinomas, and 15 adenoid cystic carcinomas. A semi-quantitative approach was used to evaluate mucin expression within ductal lumens. Sialomucin was the most expressed mucin in all salivary gland tumours, regardless of origin. Results: A significant difference was observed in the mucin expression between benign and malignant salivary gland tumours, as pleomorphic adenoma showed three times significantly higher expression of sialomucin compared to mucoepidermoid carcinoma and adenoid cystic carcinoma (p = 0.028). Pleomorphic adenomas of major glands showed 42 times significantly higher expression of sialomucin compared to those of minor glands (p = 0.000). Conclusions: Sialomucin content in pleomorphic adenomas of major glands was vastly increased compared to that in minor glands. Differential sialomucin expression in benign and malignant salivary gland tumours suggests a role in diagnosing of borderline salivary gland tumours.
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  • 文章类型: Journal Article
    目的:探讨多形性腺瘤(PA)和不典型腮腺腺癌(PCA)术前CT增强后的细胞外体积分数(ECV)和动脉强化分数(AEF)对常规图像和临床特征的增加价值。
    方法:2010年1月至2023年10月,共收集187例腮腺肿瘤患者,分为训练队列(102个PA和51个PCAs)和测试队列(24个PA和10个非典型PCAs)。评估肿瘤的临床和CT图像特征。计算了增强CT衍生的ECV和AEF。单变量分析确定的变量在训练队列中的两个亚组之间具有统计学上的显着差异。采用正向变量选择方法进行多因素logistic回归分析,建立4个模型(临床模型,临床模型+ECV,临床模型+AEF,和组合模型)。使用受试者工作特征(ROC)曲线分析评估诊断性能。德隆检验比较了模型的差异,和校准曲线和决策曲线分析(DCA)评估校准和临床应用。
    结果:选择年龄和边界建立临床模型,并构建其ROC曲线。合并临床模型,ECV,和AEF建立组合模型在训练和测试队列中与临床模型相比显示出优异的诊断有效性(AUC=0.888,0.867)。在训练队列中组合模型和临床模型之间存在显著的统计学差异(p=0.0145)。
    结论:ECV和AEF有助于区分PA和非典型PCA,整合临床和CT图像特征可以进一步提高诊断性能。
    OBJECTIVE: To investigate the added value of extracellular volume fraction (ECV) and arterial enhancement fraction (AEF) derived from enhanced CT to conventional image and clinical features for differentiating between pleomorphic adenoma (PA) and atypical parotid adenocarcinoma (PCA) pre-operation.
    METHODS: From January 2010 to October 2023, a total of 187 cases of parotid tumors were recruited, and divided into training cohort (102 PAs and 51 PCAs) and testing cohort (24 PAs and 10 atypical PCAs). Clinical and CT image features of tumor were assessed. Both enhanced CT-derived ECV and AEF were calculated. Univariate analysis identified variables with statistically significant differences between the two subgroups in the training cohort. Multivariate logistic regression analysis with the forward variable selection method was used to build four models (clinical model, clinical model+ECV, clinical model+AEF, and combined model). Diagnostic performances were evaluated using receiver operating characteristic (ROC) curve analyses. Delong\'s test compared model differences, and calibration curve and decision curve analysis (DCA) assessed calibration and clinical application.
    RESULTS: Age and boundary were chosen to build clinical model, and to construct its ROC curve. Amalgamating the clinical model, ECV, and AEF to establish a combined model demonstrated superior diagnostic effectiveness compared to the clinical model in both the training and test cohorts (AUC = 0.888, 0.867). There was a significant statistical difference between the combined model and the clinical model in the training cohort (p = 0.0145).
    CONCLUSIONS: ECV and AEF are helpful in differentiating PA and atypical PCA, and integrating clinical and CT image features can further improve the diagnostic performance.
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  • 文章类型: Case Reports
    背景:涎腺肿瘤相对罕见。大多数小唾液腺肿瘤是恶性的,良性肿瘤占肿瘤的18%。多形性腺瘤(PA)是最常见的涎腺肿瘤。嘴唇PA并不常见,其中9.8%发生在上唇。我们正在增加罕见的上唇PA(良性混合肿瘤)的知识。
    方法:我们报告了一名28岁男性的上唇PA(良性混合瘤)。他的抱怨是上唇无痛肿胀。一个无痛的,非招标,界限分明,轻微移动,无柄,结节状,并且在他的上唇左侧注意到5.0cmx2.0cm的橡胶状(一致性)肿瘤。上面的皮肤没有固定,颜色正常。没有溃疡,触诊未引起疼痛或出血。没有外伤史。钝性解剖用于完全切除结节,发白,和包膜肿瘤。显微镜检查显示界限清楚且部分包裹的双相病变,具有粘液软骨样基质的大小叶和基底细胞的中间细胞结节,形成良好的小管,含有曙红分泌,和肌上皮细胞的巢穴.诊断为PA(良性混合瘤)。
    结论:钝性解剖表明可以保留上唇的外观和功能。
    BACKGROUND: Salivary gland tumors are relatively rare. Most minor salivary gland tumors are malignant with benign tumors accounting for 18% of the tumors. Pleomorphic adenoma (PA) is the most common salivary gland tumor. Lip PA is uncommon with 9.8% occurring in the upper lip. We are adding on the knowledge of the rare upper lip PA (benign mixed tumor).
    METHODS: We report an upper lip PA (benign mixed tumor) in a 28-year-old man. His complaint was a painless swelling on the upper lip. A painless, non-tender, well-circumscribed, slightly mobile, sessile, nodular, and rubbery (in consistency) tumor measuring 5.0 cm x 2.0 cm was noted on the left side of his upper lip. The overlying skin was not fixed and of normal color. There was no ulceration, and palpation did not elicit pain or bleeding. There was no history of trauma. Blunt dissection was used to completely excise the nodular, whitish, and encapsulated tumor. Microscopy showed a well-circumscribed and partly encapsulated biphasic lesion, with large lobules of myxo-chondroid stroma and intervening cellular nodules of basaloid cells, well-formed tubules containing eosinic secretion, and nests of myoepithelial cells. A diagnosis of PA (benign mixed tumor) was confirmed.
    CONCLUSIONS: Blunt dissection is indicated to preserve the cosmesis and function of the upper lip.
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  • 文章类型: Journal Article
    咽旁间隙腮腺深叶多形性腺瘤1例,表现为口内肿胀。FNAC表现为多形性腺瘤。通过经宫颈途径进行手术。切除肿块的HPE证实多形性腺瘤。
    A case of pleomorphic adenoma of deep lobe of parotid in parapharyngeal space presented as intra oral swelling. FNAC showed features of pleomorphic adenoma. Surgery done through transcervical route. HPE of excised mass confirmed pleomorphic adenoma.
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  • 文章类型: Journal Article
    多形性腺瘤(PA)是主要和次要唾液腺中最常见的良性肿瘤。然而,在极少数情况下,鼻PA是一种上皮源性交界性肿瘤,通常起源于鼻中隔。诊断通常依赖于组织病理学分析。在全身麻醉下,这些罕见的鼻腔肿瘤可以通过内窥镜手术完全切除。本文报道一例49岁的鼻塞患者的PA源自鼻中隔,以及对当前文献的简要回顾。诊断性鼻内窥镜检查显示左侧鼻腔有粉红色肿瘤。随后的放射学检查显示鼻中隔前部有软组织肿块。在鼻内镜下完全切除后,组织病理学检查证实为PA。幸运的是,围手术期及术后无相关并发症发生。手术后,使用鼻内镜进行彻底检查并安排定期随访是预防局部复发的关键步骤.
    Pleomorphic adenoma (PA) represents the most frequently occurring benign tumor within both major and minor salivary glands. However, in rare instances, nasal PA is an epithelial-derived borderline tumor, often originating from the nasal septum. Diagnosis usually relies on histopathological analysis. Under general anesthesia, these rare nasal tumors can be completely resected via endoscopic surgery. This article reports a case of PA originating from the nasal septum in a 49-year-old patient presenting with nasal congestion, along with a brief review of the current literature. The diagnostic nasal endoscopic examination showed a pink neoplastic mass in the left nasal cavity. Subsequent radiologic examination demonstrated a soft tissue mass in the anterior part of the nasal septum. After complete resection under nasal endoscopy, histopathological examination confirmed it as PA. Fortunately, no related complications occurred perioperatively and postoperatively. After surgery, performing a thorough examination with nasal endoscopy and scheduling regular follow-ups are crucial steps to prevent local recurrence.
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