Malignant tumor of parotid gland
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Malignant tumor of parotid gland diagnosis
1. Fine needle aspiration cytology
It has the advantages of simple, rapid, safe, less damage, and high diagnostic coincidence rate, which can not only distinguish the benign and malignant tumors, but also determine their pathological types, and the diagnostic accuracy of malignant tumors can reach 64.7% ~ 97%. The coincidence rate with postoperative histopathological control of malignant tumors was 82.8%. The diagnosis is sometimes difficult to determine because the tissue is so small.
2. Biopsy
In general, biopsy is not suitable for parotid gland malignancies except for those who have ruptured to the skin and are inoperable at advanced stage and must be clearly diagnosed with histopathology.
3. Parotid gland angiography
For clinically undiagnosed patients, angiography can show the disordered arrangement of the catheter system caused by tumor compression, catheter distortion, displacement, interruption, and irregular filling defect of acines. When the tumor invaded the catheter, the contrast agent extravasated to form the changes of different sizes and patchy shadows. This examination indirectly reflects the presence of the lesion, but is of little help in distinguishing the nature of the tumor.
4. B-type ultrasound
It can be used as a routine examination for parotid masses. In addition to measuring the actual size of the tumor, the tumor with a diameter of less than 1cm can be found, and the benign and malignant tumors can be roughly distinguished according to the internal echo and its relationship with the perimeter. The benign manifestations were clear perimeter, homogeneous internal echo, enhanced posterior wall, and lobulated nodular manifestations in slightly larger mixed tumors. In malignant cases, the contour boundary is not clear, the internal echo is highly uneven solid dark area, and the back wall reflection is weakened or disappeared. The diagnostic coincidence rate was 78.6%, but the display of deep parotid tumors was not good due to the influence of jaw bone.
5.CT and MRI
It can determine the location, size, depth and scope of the tumor, as well as the relationship with surrounding tissues, and whether there is infiltration. In particular, the differentiation between deep lobe tumor of parotid gland and parapharyngeal space tumor and its relationship with the great blood vessels of neck were well demonstrated. The malignant ones show irregular shape, blurred boundary and uneven density.
