Pleomorphic adenoma diagnostic study of choice: Difference between revisions
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__NOTOC__ | __NOTOC__ | ||
{{Pleomorphic adenoma}} | {{Pleomorphic adenoma}} | ||
{{CMG}}; {{AE}} | {{CMG}}; {{AE}} {{M.N}} | ||
== Overview == | == Overview == | ||
[[MRI scan|MRI]] is the study of choice for pleomorphic adenoma. On T1-weighted images they show [[homogeneous]] intensity, on T2 they show marked hyperintensity reflecting myxochondroid [[stroma]] and hypointensity corresponds to [[fibrous]] [[capsule]] of the [[tumor]]. On Gd-T1 [[imaging]] it shows [[heterogeneous]] enhancement. | |||
== Diagnostic Study of Choice == | == Diagnostic Study of Choice == | ||
=== Study of choice === | === Study of choice === | ||
*MRI is the preferred diagnostic study of choice for pleomorphic adenoma.<ref name="RaiRohit2013">{{cite journal|last1=Rai|first1=Shalu|last2=Rohit|first2=Malik|last3=Kaur|first3=Mandeep|last4=Mukul|first4=Prabhat|title=Pleomorphic adenoma: Choice of radiographic imaging modality - Computed tomography or magnetic resonance imaging? Illustration through a case report|journal=Dental Hypotheses|volume=4|issue=1|year=2013|pages=33|issn=2155-8213|doi=10.4103/2155-8213.110181}}</ref> | *[[MRI]] is the preferred [[diagnostic]] study of choice for pleomorphic adenoma.<ref name="RaiRohit2013">{{cite journal|last1=Rai|first1=Shalu|last2=Rohit|first2=Malik|last3=Kaur|first3=Mandeep|last4=Mukul|first4=Prabhat|title=Pleomorphic adenoma: Choice of radiographic imaging modality - Computed tomography or magnetic resonance imaging? Illustration through a case report|journal=Dental Hypotheses|volume=4|issue=1|year=2013|pages=33|issn=2155-8213|doi=10.4103/2155-8213.110181}}</ref> | ||
==== The comparison of various diagnostic studies for [disease name] ==== | ==== The comparison of various diagnostic studies for [disease name] ==== | ||
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| style="background: #DCDCDC; padding: 5px; text-align: center;" |43.9% | | style="background: #DCDCDC; padding: 5px; text-align: center;" |43.9% | ||
| style="background: #DCDCDC; padding: 5px; text-align: center;" |95% | | style="background: #DCDCDC; padding: 5px; text-align: center;" |95% | ||
|} | |} | ||
<small> [Name of test with higher sensitivity and specificity] is the preferred investigation based on the sensitivity and specificity</small> | <small> [Name of test with higher sensitivity and specificity] is the preferred investigation based on the sensitivity and specificity</small> | ||
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===== Diagnostic results ===== | ===== Diagnostic results ===== | ||
======MRI====== | ======MRI====== | ||
*MRI is the imaging modality of choice for pleomorphic adenoma.<ref name="pmid8881252">{{cite journal |vauthors=Ikeda K, Katoh T, Ha-Kawa SK, Iwai H, Yamashita T, Tanaka Y |title=The usefulness of MR in establishing the diagnosis of parotid pleomorphic adenoma |journal=AJNR Am J Neuroradiol |volume=17 |issue=3 |pages=555–9 |date=March 1996 |pmid=8881252 |doi= |url=}}</ref><ref name="RaiRohit2013">{{cite journal|last1=Rai|first1=Shalu|last2=Rohit|first2=Malik|last3=Kaur|first3=Mandeep|last4=Mukul|first4=Prabhat|title=Pleomorphic adenoma: Choice of radiographic imaging modality - Computed tomography or magnetic resonance imaging? Illustration through a case report|journal=Dental Hypotheses|volume=4|issue=1|year=2013|pages=33|issn=2155-8213|doi=10.4103/2155-8213.110181}}</ref> | *[[MRI scan|MRI]] is the [[imaging]] modality of choice for pleomorphic adenoma.<ref name="pmid8881252">{{cite journal |vauthors=Ikeda K, Katoh T, Ha-Kawa SK, Iwai H, Yamashita T, Tanaka Y |title=The usefulness of MR in establishing the diagnosis of parotid pleomorphic adenoma |journal=AJNR Am J Neuroradiol |volume=17 |issue=3 |pages=555–9 |date=March 1996 |pmid=8881252 |doi= |url=}}</ref><ref name="RaiRohit2013">{{cite journal|last1=Rai|first1=Shalu|last2=Rohit|first2=Malik|last3=Kaur|first3=Mandeep|last4=Mukul|first4=Prabhat|title=Pleomorphic adenoma: Choice of radiographic imaging modality - Computed tomography or magnetic resonance imaging? Illustration through a case report|journal=Dental Hypotheses|volume=4|issue=1|year=2013|pages=33|issn=2155-8213|doi=10.4103/2155-8213.110181}}</ref> | ||
*On T1-weighted images: | *On T1-weighted images: | ||
** Pleomorphic adenoma's show homogeneous intensity. <ref name="HisatomiAsaumi2003">{{cite journal|last1=Hisatomi|first1=Miki|last2=Asaumi|first2=Jun-ichi|last3=Yanagi|first3=Yoshinobu|last4=Konouchi|first4=Hironobu|last5=Matsuzaki|first5=Hidenobu|last6=Honda|first6=Yasutoshi|last7=Kishi|first7=Kanji|title=Assessment of pleomorphic adenomas using MRI and dynamic contrast enhanced MRI|journal=Oral Oncology|volume=39|issue=6|year=2003|pages=574–579|issn=13688375|doi=10.1016/S1368-8375(03)00040-X}}</ref> | ** Pleomorphic adenoma's show [[homogeneous]] intensity. <ref name="HisatomiAsaumi2003">{{cite journal|last1=Hisatomi|first1=Miki|last2=Asaumi|first2=Jun-ichi|last3=Yanagi|first3=Yoshinobu|last4=Konouchi|first4=Hironobu|last5=Matsuzaki|first5=Hidenobu|last6=Honda|first6=Yasutoshi|last7=Kishi|first7=Kanji|title=Assessment of pleomorphic adenomas using MRI and dynamic contrast enhanced MRI|journal=Oral Oncology|volume=39|issue=6|year=2003|pages=574–579|issn=13688375|doi=10.1016/S1368-8375(03)00040-X}}</ref> | ||
*On T2-weighted images: | *On T2-weighted images: | ||
**Marked hyperintensity reflects abundant myxochondroid stroma.<ref name="pmid29845358">{{cite journal |vauthors=Kato H, Kawaguchi M, Ando T, Mizuta K, Aoki M, Matsuo M |title=Pleomorphic adenoma of salivary glands: common and uncommon CT and MR imaging features |journal=Jpn J Radiol |volume=36 |issue=8 |pages=463–471 |date=August 2018 |pmid=29845358 |doi=10.1007/s11604-018-0747-y |url=}}</ref> | **Marked hyperintensity reflects abundant myxochondroid [[stroma]].<ref name="pmid29845358">{{cite journal |vauthors=Kato H, Kawaguchi M, Ando T, Mizuta K, Aoki M, Matsuo M |title=Pleomorphic adenoma of salivary glands: common and uncommon CT and MR imaging features |journal=Jpn J Radiol |volume=36 |issue=8 |pages=463–471 |date=August 2018 |pmid=29845358 |doi=10.1007/s11604-018-0747-y |url=}}</ref> | ||
**Hypointensity reflects the fibrous capsule of the tumor.<ref name="pmid29845358">{{cite journal |vauthors=Kato H, Kawaguchi M, Ando T, Mizuta K, Aoki M, Matsuo M |title=Pleomorphic adenoma of salivary glands: common and uncommon CT and MR imaging features |journal=Jpn J Radiol |volume=36 |issue=8 |pages=463–471 |date=August 2018 |pmid=29845358 |doi=10.1007/s11604-018-0747-y |url=}}</ref> | **Hypointensity reflects the [[fibrous]] [[capsule]] of the [[tumor]].<ref name="pmid29845358">{{cite journal |vauthors=Kato H, Kawaguchi M, Ando T, Mizuta K, Aoki M, Matsuo M |title=Pleomorphic adenoma of salivary glands: common and uncommon CT and MR imaging features |journal=Jpn J Radiol |volume=36 |issue=8 |pages=463–471 |date=August 2018 |pmid=29845358 |doi=10.1007/s11604-018-0747-y |url=}}</ref> | ||
*On Gd-T1weighted images: | *On Gd-T1weighted images: | ||
**It shows heterogeneous enhancement.<ref name="HisatomiAsaumi2003">{{cite journal|last1=Hisatomi|first1=Miki|last2=Asaumi|first2=Jun-ichi|last3=Yanagi|first3=Yoshinobu|last4=Konouchi|first4=Hironobu|last5=Matsuzaki|first5=Hidenobu|last6=Honda|first6=Yasutoshi|last7=Kishi|first7=Kanji|title=Assessment of pleomorphic adenomas using MRI and dynamic contrast enhanced MRI|journal=Oral Oncology|volume=39|issue=6|year=2003|pages=574–579|issn=13688375|doi=10.1016/S1368-8375(03)00040-X}}</ref> | **It shows [[heterogeneous]] enhancement.<ref name="HisatomiAsaumi2003">{{cite journal|last1=Hisatomi|first1=Miki|last2=Asaumi|first2=Jun-ichi|last3=Yanagi|first3=Yoshinobu|last4=Konouchi|first4=Hironobu|last5=Matsuzaki|first5=Hidenobu|last6=Honda|first6=Yasutoshi|last7=Kishi|first7=Kanji|title=Assessment of pleomorphic adenomas using MRI and dynamic contrast enhanced MRI|journal=Oral Oncology|volume=39|issue=6|year=2003|pages=574–579|issn=13688375|doi=10.1016/S1368-8375(03)00040-X}}</ref> | ||
===== Sequence of Diagnostic Studies ===== | ===== Sequence of Diagnostic Studies ===== | ||
The various investigations must be performed in the following order: | The various investigations must be performed in the following order: | ||
*CT is usually the first imaging modality of choice for pleomorphic adenoma.<ref name="RaiRohit2013">{{cite journal|last1=Rai|first1=Shalu|last2=Rohit|first2=Malik|last3=Kaur|first3=Mandeep|last4=Mukul|first4=Prabhat|title=Pleomorphic adenoma: Choice of radiographic imaging modality - Computed tomography or magnetic resonance imaging? Illustration through a case report|journal=Dental Hypotheses|volume=4|issue=1|year=2013|pages=33|issn=2155-8213|doi=10.4103/2155-8213.110181}}</ref> | *[[CT]] is usually the first [[imaging]] modality of choice for pleomorphic adenoma.<ref name="RaiRohit2013">{{cite journal|last1=Rai|first1=Shalu|last2=Rohit|first2=Malik|last3=Kaur|first3=Mandeep|last4=Mukul|first4=Prabhat|title=Pleomorphic adenoma: Choice of radiographic imaging modality - Computed tomography or magnetic resonance imaging? Illustration through a case report|journal=Dental Hypotheses|volume=4|issue=1|year=2013|pages=33|issn=2155-8213|doi=10.4103/2155-8213.110181}}</ref> | ||
*It helps in identifying the lesion and also | *It helps in identifying the [[lesion]] and also helps the [[physician]] in assessing the [[extension]] of the [[tumor]]. | ||
*MRI is the usually ordered investigation next after CT, for | *[[MRI]] is the usually ordered investigation next after [[CT]], for an even more detailed study.<ref name="RaiRohit2013">{{cite journal|last1=Rai|first1=Shalu|last2=Rohit|first2=Malik|last3=Kaur|first3=Mandeep|last4=Mukul|first4=Prabhat|title=Pleomorphic adenoma: Choice of radiographic imaging modality - Computed tomography or magnetic resonance imaging? Illustration through a case report|journal=Dental Hypotheses|volume=4|issue=1|year=2013|pages=33|issn=2155-8213|doi=10.4103/2155-8213.110181}}</ref> | ||
*It is a non-ionizing modality with excellent soft tissue distinction. | *It is a [[Non-ionizing radiation|non-ionizing]] modality with excellent [[soft tissue]] distinction. | ||
*[[FNA]] and [[biopsy]] is the definitive method of [[diagnosis]] for pleomorphic adenoma. | |||
=== Name of Diagnostic Criteria === | === Name of Diagnostic Criteria === | ||
There are no established [[criteria]] for the [[diagnosis]] of pleomorphic adenoma. | |||
==References== | ==References== | ||
{{Reflist|2}} | {{Reflist|2}} | ||
{{WH}} | {{WH}} | ||
{{WS}} | {{WS}} | ||
[[Category: Otolaryngology]] | |||
[[Category: Medicine]] | |||
[[Category: Oncology]] | |||
[[Category: Surgery]] | |||
[[Category: Up-To-Date]] | |||
Latest revision as of 18:48, 28 January 2019
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Maneesha Nandimandalam, M.B.B.S.[2]
Overview
MRI is the study of choice for pleomorphic adenoma. On T1-weighted images they show homogeneous intensity, on T2 they show marked hyperintensity reflecting myxochondroid stroma and hypointensity corresponds to fibrous capsule of the tumor. On Gd-T1 imaging it shows heterogeneous enhancement.
Diagnostic Study of Choice
Study of choice
- MRI is the preferred diagnostic study of choice for pleomorphic adenoma.[1]
The comparison of various diagnostic studies for [disease name]
| Test | Sensitivity | Specificity |
|---|---|---|
| MRI | 43.9% | 95% |
[Name of test with higher sensitivity and specificity] is the preferred investigation based on the sensitivity and specificity
Diagnostic results
MRI
- MRI is the imaging modality of choice for pleomorphic adenoma.[2][1]
- On T1-weighted images:
- Pleomorphic adenoma's show homogeneous intensity. [3]
- On T2-weighted images:
- On Gd-T1weighted images:
- It shows heterogeneous enhancement.[3]
Sequence of Diagnostic Studies
The various investigations must be performed in the following order:
- CT is usually the first imaging modality of choice for pleomorphic adenoma.[1]
- It helps in identifying the lesion and also helps the physician in assessing the extension of the tumor.
- MRI is the usually ordered investigation next after CT, for an even more detailed study.[1]
- It is a non-ionizing modality with excellent soft tissue distinction.
- FNA and biopsy is the definitive method of diagnosis for pleomorphic adenoma.
Name of Diagnostic Criteria
There are no established criteria for the diagnosis of pleomorphic adenoma.
References
- ↑ 1.0 1.1 1.2 1.3 Rai, Shalu; Rohit, Malik; Kaur, Mandeep; Mukul, Prabhat (2013). "Pleomorphic adenoma: Choice of radiographic imaging modality - Computed tomography or magnetic resonance imaging? Illustration through a case report". Dental Hypotheses. 4 (1): 33. doi:10.4103/2155-8213.110181. ISSN 2155-8213.
- ↑ Ikeda K, Katoh T, Ha-Kawa SK, Iwai H, Yamashita T, Tanaka Y (March 1996). "The usefulness of MR in establishing the diagnosis of parotid pleomorphic adenoma". AJNR Am J Neuroradiol. 17 (3): 555–9. PMID 8881252.
- ↑ 3.0 3.1 Hisatomi, Miki; Asaumi, Jun-ichi; Yanagi, Yoshinobu; Konouchi, Hironobu; Matsuzaki, Hidenobu; Honda, Yasutoshi; Kishi, Kanji (2003). "Assessment of pleomorphic adenomas using MRI and dynamic contrast enhanced MRI". Oral Oncology. 39 (6): 574–579. doi:10.1016/S1368-8375(03)00040-X. ISSN 1368-8375.
- ↑ 4.0 4.1 Kato H, Kawaguchi M, Ando T, Mizuta K, Aoki M, Matsuo M (August 2018). "Pleomorphic adenoma of salivary glands: common and uncommon CT and MR imaging features". Jpn J Radiol. 36 (8): 463–471. doi:10.1007/s11604-018-0747-y. PMID 29845358.