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ORIGINAL RESEARCH

The Importance of Imaging and Fine Needle Aspiration Biopsy in Primary Benign Parapharyngeal Space Tumors
Primer Benign Parafarengeal Boşluk Tümörlerinde Görüntüleme ve İnce İğne Aspirasyon Biyopsisinin Önemi
Received Date : 09 Oct 2020
Accepted Date : 18 Nov 2020
Available Online : 11 Feb 2020
Doi: 10.24179/kbbbbc.2020-79512 - Makale Dili: EN
KBB ve BBC Dergisi. 2021;29(1):58-64
Copyright © 2020 by Turkey Association of Society of Ear Nose Throat and Head Neck Surgery. This is an open access article under the CC BY-NC-ND license (http://creativecommons.org/licenses/by-nc-nd/4.0/)
ABSTRACT
Objective: The purpose of this study is the comparison of the radiological pre-diagnosis with the cytopathological results acquired from fine needle aspiration biopsy (FNAB) and the post-operative final histopathological results in operated patients diagnosed to have primary benign parapharyngeal space (PPS) tumors. Material and Methods: In our study, 20 patients who were considered to be benign with preoperative imaging and FNAB between 2011 and 2017 were observed retrospectively. Patients suspected of malignancy with preoperative imaging or FNAB were excluded from the study. Results: From a total of 20 patients, 11 were female while 9 were male, and the mean age was 54 (21-78). In post-styloid region (n=10), the pre-operative radiological diagnosis was reported as paraganglioma (n=6), and peripheral nerve sheath tumors (n=4). In pre-styloid region (n=10), the preoperative radiological diagnosis was reported as deep lobe parotid tumor (warthin and pleomorphic adenoma) (n=6), lymphadenitis (n=1), minor salivary gland cyst (n=1), lipoma (n=1) and branchial cleft cyst (n=1). Compared to specimen results, preoperative imaging results of 20 patients were consistent with specimen in 18 patients, while specimen results were reported as malignant in 2 patients, although imaging was benign. FNAB was performed in 13 patients without vascular tumor suspicion, and results consistent with specimen results were obtained in 11 patients. Although FNAB results were reported as benign in 2 patients, the specimen result was reported as malignant. Conclusion: In our study, we found that, even if imaging and FNAB in PPS benign masses reported largely accurate results, it is rarely not able to rule out malignancy. These possibilities should be kept in mind when approaching the benign tumors of the parapharyngeal region.
ÖZET
Amaç: Çalışmamızda primer benign parafarengeal boşluk (PPS) tümörü tanısı ile opere edilen hastalarda, ince iğne aspirasyon biyopsisinden (İİAB) elde edilen sitolojik sonuçlarla, radyolojik ön tanı ve postoperatif son histopatolojik sonuçların kıyaslanması amaçlanmıştır. Gereç ve Yöntemler: Çalışmamızda, 2011-2017 yılları arasında preoperatif görüntüleme ve İİAB ile benign olduğu düşünülen 20 hasta retrospektif olarak izlendi. Preoperatif görüntülemede veya İİAB ile malignite şüphesi olan hastalar çalışma dışı bırakıldı. Bulgular: Toplam 20 hastanın 11’i kadın, 9’u erkek olup ortalama yaş 54 (21-78) idi. Poststiloid bölgede (n=10) ameliyat öncesi radyolojik tanı paraganglioma (n=6) ve periferik sinir kılıfı tümörleri (n=4) olarak rapor edildi. Prestiloid bölgede (n=10), ameliyat öncesi radyolojik tanı derin lob parotis tümörü (warthin ve pleomorfik adenom) (n=6), lenfadenit (n=1), minör tükürük bezi kisti (n=1), lipom (n=1) ve brankial yarık kisti (n=1) olarak raporlandı. Cerrahi sonrası spesmen sonuçlarıyla karşılaştırıldığında, 20 hastanın preoperatif görüntüleme sonuçları 18 hastada örnekle tutarlıyken, 2 hastada görüntüleme iyi huylu olmasına rağmen örnek sonuçları malign olarak bildirildi. Vasküler tümör şüphesi olmayan 13 hastaya, cerrahi öncesi İİAB uygulandı ve 11 hastada biyopsi sonuçlarıyla spesmen sonuçları uyumlu olarak izlendi. İki hastada, İİAB sonuçları benign olarak bildirilmesine rağmen spesmen sonucu malign olarak rapor edildi. Sonuç: Çalışmamızda, parafarengeal bölge benign tümörlerinde görüntüleme ve İİAB büyük ölçüde doğru sonuçlar bildirmiş olmasına rağmen nadiren maligniteyi ekarte edemediğini gördük. Parafarengeal bölgenin, benign lezyonlarına yaklaşımda bu yanılma payının da akılda tutulması uygun olacaktır.
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