Pleomorphic adenoma diagnostic study of choice: Difference between revisions

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{{CMG}}; {{AE}}
{{CMG}}; {{AE}}
== Overview ==
== 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.
[[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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===== 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 =====

Revision as of 16:08, 28 January 2019

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief:

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

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
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. 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.
  2. 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. 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. 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.

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