Pleomorphic adenoma diagnostic study of choice
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief:
Overview
Diagnostic Study of Choice
Study of choice
- The best way to arrive at a diagnosis is always do a thorough physical examination on the mass, which will guide the physician in a right direction.
- Next comes ultrasonography which has good sensitivity in detecting superficial lobe masses of the parotid gland.
- CT and MRI both are very useful diagnostic tools, and MRI being the diagnostic study of choice for pleomorphic adenoma.
- FNAB is also indicated by some clinicians.
The comparison of various diagnostic studies for [disease name]
| Test | Sensitivity | Specificity |
|---|---|---|
| Test 1 | ...% | ...% |
| Test 2 | ...% | ...% |
[Name of test with higher sensitivity and specificity] is the preferred investigation based on the sensitivity and specificity
Diagnostic results
Ultrasound
On Ultrasound, characteristic findings of pleomorphic adenomas include:
- Pleomorphic adenomas are hypoechoic, well-defined, lobulated tumors with posterior acoustic enhancement and may contain calcifications.
- Ultrasound is frequently used to guide FNA or core needle biopsy[1]
CT scan
- When the tumor is small they show homogeneous attenuation and prominent enhancement.
- When the tumor is large they can be heterogeneous with less enhancement, foci of necrosis, haemorrhage and possible delayed enhancement.[2]
- Small regions of calcification are also common.
MRI
- MRI is the imaging modality of choice for pleomorphic adenoma.[3]
- On T1-weighted images:
- Pleomorphic adenoma's show homogeneous intensity. [4]
- On T2-weighted images:
- On Gd-T1weighted images:
- It shows heterogeneous enhancement.[4]
Sequence of Diagnostic Studies
The [name of investigation] must be performed when:
- The patient presented with symptoms/signs 1, 2, and 3 as the first step of diagnosis.
- A positive [test] is detected in the patient, to confirm the diagnosis.
OR
The various investigations must be performed in the following order:
- [Initial investigation]
- [2nd investigation]
Name of Diagnostic Criteria
It is recommended that you include the criteria in a table. Make sure you always cite the source of the content and whether the table has been adapted from another source.
[Disease name] is primarily diagnosed based on clinical presentation. There are no established criteria for the diagnosis of [disease name].
OR
There is no single diagnostic study of choice for [disease name], though [disease name] may be diagnosed based on [name of criteria] established by [...].
OR
The diagnosis of [disease name] is made when at least [number] of the following [number] diagnostic criteria are met: [criterion 1], [criterion 2], [criterion 3], and [criterion 4].
OR
The diagnosis of [disease name] is based on the [criteria name] criteria, which includes [criterion 1], [criterion 2], and [criterion 3].
OR
[Disease name] may be diagnosed at any time if one or more of the following criteria are met:
- Criteria 1
- Criteria 2
- Criteria 3
OR
IF there are clear, established diagnostic criteria
The diagnosis of [disease name] is made when at least [number] of the following [number] diagnostic criteria are met: [criterion 1], [criterion 2], [criterion 3], and [criterion 4].
OR
The diagnosis of [disease name] is based on the [criteria name] criteria, which include [criterion 1], [criterion 2], and [criterion 3].
OR
The diagnosis of [disease name] is based on the [definition name] definition, which includes [criterion 1], [criterion 2], and [criterion 3].
OR
IF there are no established diagnostic criteria
There are no established criteria for the diagnosis of [disease name].
References
- ↑ Bialek, Ewa J.; Jakubowski, Wieslaw; Karpinska, Grazyna (2003). "Role of Ultrasonography in Diagnosis and Differentiation of Pleomorphic Adenomas". Archives of Otolaryngology–Head & Neck Surgery. 129 (9): 929. doi:10.1001/archotol.129.9.929. ISSN 0886-4470.
- ↑ Lev MH, Khanduja K, Morris PP, Curtin HD (1998). "Parotid pleomorphic adenomas: delayed CT enhancement". AJNR Am J Neuroradiol. 19 (10): 1835–9. PMID 9874532.
- ↑ 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.
- ↑ 4.0 4.1 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.
- ↑ 5.0 5.1 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.