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
Sevim ASLANa, Zeynep KIZILKAYA KAPTANb, Burak Numan UĞURLUa, Hasan YİĞİTc, Hatice ÜNVERDİd, Münir DEMİRCİe
aDepartment of Otolaryngology, Hitit University Erol Olçok Training and Research Hospital, Çorum, TURKEY
bDepartment of Otolaryngology, University of Health Sciences Ankara Training and Research Hospital, Ankara, TURKEY
cDepartment of Radiology, University of Health Sciences Ankara Training and Research Hospital, Ankara, TURKEY
dDepartment of Pathology, University of Health Sciences Ankara Training and Research Hospital, Ankara, TURKEY
eClinic of Otolaryngology, Medical Park Hospital, Ankara, TURKEY
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.
Keywords: Parapharyngeal space; biopsy; fine-needle
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.
Anahtar Kelimeler: Parafarengeal boşluk; biyopsi; ince iğne
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