• 제목/요약/키워드: Carcinoma ex pleomorphic adenoma

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주타액선 종양의 임상적 고찰 (Clinical Investigations of Major Salivary Gland Tumors)

  • 김은서;김영수
    • 대한두경부종양학회지
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    • 제17권2호
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    • pp.210-215
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    • 2001
  • 저자들은 약 4년에 걸친 주타액선 종양에 대한 치료 경험을 통하여, 성공적인 치료를 위한 필요조건으로 다음과 같은 내용들을 고려하여야 할 것으로 생각하였다. 즉 타액선 종양은 다양한 조직학적 특징과 임상 경과를 보이는 질환군이므로 수술 전 세침흡인생검 등에 의한 정확한 병리조직학적 진단의 뒷받침이 필수적이라는 점이다. 또한 악성 종양의 경우, 질병분류 및 병기설정 방식이 완전히 통일되어 있지 아니한 상황에서 특정 질환의 특정 병기에 한 가지 치료방법을 고집하기보다는 다양한 종류의 치료를 복합적으로 사용하는 데에 적극적일 필요가 있다고 생각하였다. 특히 예후에 부정적인 영향을 미치는 요소를 가지고 있을 경우에는 적극적인 외과적 절제 및 수술 후 방사선 치료 등을 통하여 생존율을 높이는데 관심을 기울여야 할 것으로 생각되었다. 더 나아가 절개선 등 수술흔이 가지는 미용적 문제점 등도 고려하여 전체적인 치료의 만족도를 향상시키는데 기여해야 할 것으로 생각하였다.

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Histopathological Diversity in Parotidectomy Materials in Turkish Population: Clinicopathologic Analysis and Demographic Features of 136 Cases in a Tertiary Care Hospital

  • Altinay, Serdar;Taskın, Umit;Sar, Mehmet;Aydin, Salih;Oktay, Mehmet Faruk
    • Asian Pacific Journal of Cancer Prevention
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    • 제15권14호
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    • pp.5701-5707
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    • 2014
  • Background: Salivary gland tumours, which account for approximately 3% of head-neck cancers, are a heterogeneous group and thus it is difficult to identify their epidemiological characteristics. The aim of this study is to determine demographic features and histopathologic distribution of parotid neoplasms in a large sample from Turkey. Materials and Methods: This study was conducted retrospectively on 136 parotidectomy materials from operations between May 2009-May 2013. Age, gender, tumor diameter, histopathological diagnosis and surgical margin status were recorded. Results: The benign cases were 112 (82.4%), while the malignancies were 24 (17.6%). The accuracy rate of FNAC was 91%. There were 46 (33.8%) male and 90 (66.2%) female patients. Female/male ratio (M/F=0.5) was two, the Warthin (WT) tumor being more apparent in males (p<0.05). Pleomorphic adenoma (PA) was detected most frequently among benign pathologies at 61.6% (69/112), while the Warthin Tumor (WT) was detected as the second most frequent tumor at 20.5% (23/112). Mucoepidermoid carcinoma (MEC) and carcinoma ex pleomorphic adenoma (Ca ex PA) were detected at equal frequency at 20.8% (5/24) among malign tumors. These were followed by acinic cell carcinoma at 16.7% (4/24). While the surgical margin was positive in ten patients with malignant tumors (41.7%), all of the benign tumors were negative (p<0.01). No significant difference was detected in the age-gender of patients, tumor size and distribution of sites among benign and malignant groups (p>0.05). Conclusions: Pleomorphic adenoma is the most frequently reported benign tumor almost in all global literature. Yet, the distribution of malignant tumors displays geographical differences. Based on these data, we believe that our findings will provide a significant contribution to future epidemiological studies. We think that it will be beneficial to generate awareness on parotid tumors and ensure a fight against smoking as with all head-neck cancers.

타액선병변의 세침흡인 세포검사 (Fine Needle Aspiration Cytology of Salivary Gland Lesions)

  • 이승숙;박인애;함의근;이상국
    • 대한세포병리학회지
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    • 제4권2호
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    • pp.111-120
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    • 1993
  • Fine needle aspiration cytology has become a frequently used technique for the diagnosis of lesions in the head and neck. Fine needle aspiration cytology of the salivary glands were performed on 66 patients. In 59 patients with satisfactory samples, cytologic diagnoses were as follows; there were 47 benign lesions, including pleomorphic adenoma(20), Warthin's tumor(3), benign cystic lesion(4), Inflammatory lesion(4), lymphoid lesion(3), myoepithelioma(1), unspecified benign neoplasm (5), and unclassified benign lesion(7). There were 6 cases of undetermined malignancy and 6 malignant lesions including mucoepidermoid carcinoma(3), adenoid cystic carcinoma(1), carcinoma ex pleomorphic adenoma(1), and metastatic carcinoma(1) in cytologic diagnosis. In 25 patients, the cytologic diagnosis was correlated with histologic findings. The sensitivity of the benign lesion was 96% and the specificity was 82%. There was no false-positive diagnosis. The sensitivity and the specificity of pleomorphic adenoma were 75% and 95%, respectively. Some of Warthin's tumors were confused with benign cystic lesion due to frequent cystic change of the tumor. The sensitivity and specificity of the malignant lesions were 56% and 88%, respectively. There were three false negative diagnoses. Two mucoepidermoid carcinomas were correctly diagnosed by cytology. Two of three adenoid cystic carcinomas were misdiagnosed as benign tumors.

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악성 침샘종양의 세침흡인 세포검사의 정도관리 (Quality Assuarance on Fine Needle Aspiration Cytology of Malignant Salivary Gland Neoplasms)

  • 오영륜;고영혜
    • 대한세포병리학회지
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    • 제15권1호
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    • pp.40-44
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    • 2004
  • To evaluate the quality of fine needle aspiration cytology diagnosis on malignant salivary gland neoplasms, cytologic findings were correlated with histologic diagnosis of 56 surgically removed malignant salivary gland tumors. Seven cases (12.5%) were insufficient, 23 cases (41.1%) were diagnosed as malignant, 17 (30.4%) cases were accurately diagnosed by histologic subtype, and 9 cases (16%) were diagnosed as benign. Five out of 9 false negative cases were misdiagnosed as pleomorphic adenomas. Except the cases with insufficient specimen, overall sensitivity was 81.6%, and the sensitivity varied according to the histologic subtype; 91% in salivary duct carcinoma, 100% in carcinoma ex pleomorphic adenoma, 50% in mucoepidermoid carcinoma, 63% in adenoid cystic carcinoma, and 50% in acinic cell carcinoma. The diagnostic accuracy differed among cytopathologists irrespective of periods after acquisition of board of pathologists. These results confirm that salivary gland neoplasm can be easily misdiagnosed in fine needle aspiration cytology and a great caution should be given in diagnosing the benign appearing salivary aspirates to avoid under-diagnosis of malignant neoplasm with low grade cytologic atypia.

침샘에 발생하는 고등급 악성 종양과 방추세포 병변의 세침흡인 세포소견에 대한 고찰 (Fine Needle Aspiration Cytology of High Grade Neoplasm and Spindle Cell Lesion of Salivary Gland)

  • 오영륜
    • 대한세포병리학회지
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    • 제16권2호
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    • pp.75-87
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    • 2005
  • Fine needle aspiration cytology (FNAC) is a very useful tool in the preoperative diagnosis of lesions of the salivary gland. Surgical therapy of high-grade malignancies (salivary duct carcinoma, mucoepidermoid carcinoma, squamous cellcarcinoma, carcinoma ex pleomorphic adenoma, small cell carcinoma, and sebaceous carcinoma) is different from that of benign lesions or low-grade malignancies. Therefore, the recognition of high-grade malignancies is important in salivary gland FNAC. Although recognition of high-grade malignancies of the salivary gland by FNAC is not difficult, precise classification of these malignancies is often impossible. Additionally, because of its rarity, FNAC of spindle cells and mesenchymal lesions of the salivary glands is a tool that is not familiar to many cytopathologists. The characteristic cytomorphologic features of these lesions are reviewed here with a discussion of specific diagnostic problems.

한국인에서 발생한 67례의 악성타액선종양에 대한 연구 (ANALYSIS OF 67 MALIGNANT SALIVARY GLAND TUMORS IN KOREAN POPULATION)

  • 배현경;여동헌;김선아;최미라;이재일;홍삼표;홍성두
    • Journal of the Korean Association of Oral and Maxillofacial Surgeons
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    • 제33권2호
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    • pp.139-142
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    • 2007
  • Malignant salivary gland tumor is rare neoplasm. In Korean population, retrospective study of malignant salivary gland tumor has not been performed. We analyzed 67 cases of malignant salivary gland tumors from 2001 to 2005 in Seoul National University Dental Hospital in Seoul, Korea. The mean age is 51.7 and the male to female ratio is 1:1.39. The most affected site is the palate. Histologically, the tumors were classified as adenoid cystic carcinoma(34.4%), mucoepidermoid carcinoma(31.3%), adenocarcinoma, NOS(11.9%), polymorphous low grade adenocarcinoma(3.0%), salivary duct carcionoma(6.0%), carcinoma ex pleomorphic adenoma(4.5%), myoepithelial carcinoma(4.5%), epithelial-myoepithelial carcinoma(1.5%), cyatadenocarcinoma(1.5%) and adenosquamous carcinoma(1.5%).

한국인의 구강내 소타액선 종양의 발생 빈도와 조직병리학적 특성 (The Prevalence and Histopathologic Characteristics of Oral Minor Salivary Gland Tumors in Korean Patients)

  • 유미현
    • 치위생과학회지
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    • 제8권3호
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    • pp.207-214
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    • 2008
  • 본 연구는 구강내 발생하는 소타액선 종양의 발생 빈도와 조직병리학적 특성에 대한 후향적 연구로서 한국인에서 나타나는 소타액선 종양의 특성을 연구하고자 1990년부터 2006년 8월까지 연세대학교 치과대학 부속병원 구강악안면외과, 연세대학교 의과대학 부속 영동 세브란스병원, 순천향대학교 부속 부천병원에 내원한 200명의 소타액선 종양 환자를 대상으로 치과 및 의과 임상 기록지 검토와 H/E 슬라이드를 재검토하여 다음과 같은 결론을 얻었다. 1. 200명의 환자 중 양성 종양은 123예(61.5%), 악성종양은 77예(38.5%)였으며 남성에서는 87예, 여성에서는 113예였다. 2. 가장 흔하게 발생한 소타액선 종양은 다형성 선종이며 선양 낭성 암종, 점액표피암종, 와틴씨 종양, 선암종과 다형성 선종에서 발생한 악성 종양, 림프관종 등의 순이었다. 3. 호발 부위는 경구개(42.5%), 연구개(9%), 협점막(6%), 입술(3.5%) 부위였다. 4. 발생 연령은 4세부터 70세까지 다양하게 분포하였으며 50대에서 가장 많았다. 양성 종양의 발생 평균 연령은 46.2세였으며 악성 종양의 발생 평균 연령이 56.1세였다. 5. 다형성 선종은 가장 호발한 소타액선 종양으로서 모두 104예였으며 남성 38명, 여성 66명에서 발생하였다. 평균 발생 연령은 46.7세였으며 구개 부위에서 가장 많이 발생하였다. 조직학적 소견은 관 구조 형성, 별 모양, 다각형, 방추형, 형질세포양(plasmacytoid), 연골양, 점액양 구조를 보였으며 불완전한 피막과 종양 피막을 뚫고 다발성으로 발생하는 소견이 관찰되었다. 6. 선양 낭성 암종은 가장 호발한 악성 타액선 종양으로 모두 32예였으며 남성 16명, 여성 16명에서 발생하였다. 평균 발생 연령은 57.4세였으며 경구개 부위에서 가장 많이 발생하였다. 조직학적 소견은 cribriform pattern, 관상 구조, 판상 구조 형성, 종양 세포의 신경 주위 침습 등을 보였다. 7. 점액표피암종은 모두 25예였으며 남성 10명, 여성 15명에서 발생하였다. 평균 발생 연령은 50.0세였으며 경구개 부위에서 가장 많이 발생하였다. 조직학적 소견은 점액 세포, epidermoid-type 세포, intermediate cell의 분포가 대부분 저등급을 보였다. 이외에도 와틴씨 종양, 선암종과 다형성 선종에서 발생한 악성종양, 림프관종 등이 발생하였다. 8. 한국인의 소타액선 종양의 발생 빈도는 양성 종양이 높으며 특히 다형성 선종이 많았고 여성 발생, 구개 부위 발생이 많았으며 다형성 저등급 선암종 등 특정 소타액선 종양의 발생이 극히 적었다.

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주타액선 종양의 임상적 고찰 (A Clinical Analysis of Major Salivary Gland Tumors)

  • 유영삼;우훈영;윤자복;최정환;조경래;정상원;한동훈
    • 대한두경부종양학회지
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    • 제18권1호
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    • pp.56-59
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    • 2002
  • Background and Objective: Even though major salivary gland tumor is a rare disease, the diversity of histopathologic characteristics makes treatment decisions difficult. The aim of this study is to analysis the clinical experience of our major salivary gland tumor and to suggest a guideline of treatment. Materials and Method: Sixty-eight major salivary gland tumors and tumor-like glandular enlargements treated at Sanggye Paik Hospital during the past seven years between June, 1995 and January, 2002 are analyzed for histopathologic diagnosis, treatment modality, clinical manifestation, local control, and treatment-related morbidity, recurrence rate, retrospectively. Results: In twenty-eight patients the swellings were diagnosed as non-tumorous condition. The clinical features, diagnostic and surgical management of fourty salivary neoplasms involving the parotid and submandibular glands are correlated with their histological features. Conclusion: We have concluded that salivary gland neoplasms are needed multimodal treatment, because of their highly variable biologic behavior in each tumor type. Thirty-four cases were benign and six cases were malignant. Most of benign cases were pleomorphic adenoma and they showed wide age-distribution. In six malignant cases, there were acinic cell carcinoma, adenocarcinoma, carcinoma ex-plemorphic adenoma, myoepithelioma, and adenoid cystic carcinoma.

두경부 영역에 발생한 선양낭성암종에서 CK7, CK19, CK20, SMA 및 Ki-67의 발현에 관한 면역조직화학적 연구 (Immunohistochemistry of CK7, CK19, CK20, SMA and Ki-67 Expression in Adenoid Cystic Carcinoma of the Head and Neck)

  • 문영은;정우진;이동욱;송형근
    • 대한두경부종양학회지
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    • 제25권2호
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    • pp.123-127
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    • 2009
  • Objectives : The aim of this study was to investigate immunohistochemical expression of CK7, CK19, CK20, SMA and Ki-67 in Adenoid cystic carcinoma(ACC) of the Head and Neck. Material and Methods : Sixteen patients who were treated in Chungbuk National University Hospital from 1992 to 2004, were included in this study. Ten ACCs, 3 MECs, 1 Salivary duct carcinoma, 1 Adenocarcinoma(NOS), and 1 cacinoma ex pleomorphic adenoma were analyzed immunohistochemically for CK7, CK19, CK20, SMA, and Ki-67. Results : CK7 was expressed in 100% of the adenoid cystic carcinoma and 75% of the other tumors. CK19 was expressed in 75% of the adenoid cystic carcinoma and 100% of the other tumors. CK20 was not expressed in all tumors. SMA was expressed in 88.9% of the adenoid cystic carcinoma and not expressed in the other tumors. Ki-67 was expressed in low level in the adenoid cystic carcinoma. Conclusion : The Ki-67 index could explain the natural course of tumor. Immunohistochemistry of CK7, CK19, CK20, SMA and Ki-67 expression in Adenoid cystic carcinoma may provide useful information to diagnosis.