川井 夫規子, 中村 みちる, 横田 京子, 小野 倫子, 谷口 信行, 伊東 紘一

Fukiko KAWAI, Michiru NAKAMURA, Kyoko YOKOTA, Tomoko ONO, Nobuyuki TANIGUCHI, Koichi ITOH

自治医科大学臨床検査医学講座

Department of Clinical Laboratory Medicine, Jichi Medical School, 3311-1 Yakushiji, Minamikawachi-machi, Kawachi-gun, Tochigi 329-0498, Japan

キーワード : Fine needle aspiration cytology, Major salivary gland tumor, Tumor size, Ultrasonographic criteria, Ultrasonographic diagnosis

The potential diagnostic value of ultrasonography of salivary gland tumors rests on its ability to determine if the tumor is benign or malignant. From January 1990 to June 1999, ultrasound examinations were performed on 165 patients with salivary gland masses that were later confirmed histologically. There were 121 benign tumors (82 pleomorphic adenomas, 27 Warthin's tumors, 4 monomorphic adenomas, 4 myoepitheliomas, 2 neurinomas, 1 benign lymphoepithelial lesion, and 1 inflammatory pseudotumor), and 44 malignant tumors (9 mucoepidermoid carcinomas, 5 adenocarcinomas, 4 salivary duct carcinomas, 2 acinic cell carcinomas, 3 adenoid cystic carcinomas, 8 carcinomas in pleomorphic adenoma, 5 squamous cell carcinomas, 2 epi-myoepithelial carcinomas, 1 undifferentiated carcinoma, 1 sebaceous carcinoma, and 4 metastatic carcinomas). Ultrasonograms of all these salivary gland tumors were classified according to Suzuki's criteria into benign or malignant pattern. When the decision was difficult, however, the case was classified as intermediate pattern, (24 patients). Total diagnostic accuracy was 76.9%; sensitivity, 51.2%; and specificity, 86.2%. The accuracy of ultrasonography in determining whether a tumor was benign or malignant appeared to be affected by tumor size: smaller tumors tended to be diagnosed as benign; larger tumors, as malignant. Fine needle aspiration cytology under ultrasonographic guidance was performed on 103 lesions from 100 patients. With 21 poor specimens excluded, total accuracy of 82 aspirates was 91.6%; sensitivity, 60.0%; and specificity, 98.6%.