华西口腔医学杂志

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涎腺Warthin瘤超声特征与病理对照分析

苟加梅1,2  陈琴1  周青1  刘颖娴2   

  1. 1.四川省人民医院超声科,成都 610072;2.遵义医学院研究生学院,遵义 563003
  • 出版日期:2013-08-01 发布日期:2013-08-01
  • 通讯作者: 陈琴,Tel:18981838665
  • 作者简介:苟加梅(1974—),女,四川人,主治医师,硕士

Comparative analysis of ultrasonographic feature and histopathology in salivary Warthin’s tumor

Gou Jiamei1,2, Chen Qin1, Zhou Qing1, Liu Yingxian2.   

  1. 1. Dept. of Ultrasound, Sichuan Provincial People’s Hospital, Chengdu 610072, China; 2. Graduate School, Zunyi Medical College, Zunyi 563003, China
  • Online:2013-08-01 Published:2013-08-01

摘要:

目的  总结涎腺Warthin瘤的超声图像表现,旨在提高超声诊断的准确性。方法  回顾性分析58例(69个病灶)涎腺Warthin瘤的超声图像表现,并与病理检查结果进行对照分析。结果  涎腺Warthin瘤的超声表现分为3种类型。Ⅰ型:实性肿块型(34个,49.3%),超声表现为实性弱回声团块,内部见部分网格状回声;病理显示为多种组织成分(如腺上皮细胞、淋巴组织、纤维组织)排列致密而均匀,上皮形成乳头状结构突入少量黏液构成的小囊腔。Ⅱ型:囊实性肿块型(30个,43.5%),团块内可见片状无回声,囊实性分界清楚;病理显示腺上皮细胞构成不规则的腺管和囊腔样结构,囊腔内含有较多淡黄色黏液或棕色胶冻样物。Ⅲ型:囊性肿块型(5个,7.2%),超声显示肿块呈分隔状囊性团块;病理显示Warthin伴梗死及感染。超声与病理诊断的符合率为79.7%。结论  Warthin瘤的超声图像表现基于病理组织结构,掌握Warthin瘤的不同超声图像特征以及病理改变有助于作出较为准确的超声诊断。

关键词: Warthin瘤, 超声特征, 病理组织学

Abstract:

Objective  To promote the diagnostic accuracy of salivary Warthin’s tumor by summarizing the ultrasonographic features of salivary Warthin’s tumor. Methods  Sixty-nine lesions(58 patients with salivary Warthin’s tumor)were retrospectively studied by ultrasonography and confirmed by histopathology. Results The ultrasonographic manifestations of salivary Warthin’s tumor demonstrated in three patterns. TypeⅠ: Solid mass(34 lesions, 49.3%), the mass was solid, grid-shaped echo inside. The mass was pathologically composed of such various tissues as epithelial cells, lymphatic organization, fibrous tissue which were compactly and evenly arranged, and little mucous formed the cyst cavity in which there projected epithelial papilla. Type Ⅱ: Cystic-solid mixed mass(30 lesions, 43.5%), there was no flake-like echo, cystic-solid boundary was clear. Histopathological study revealed glandular epithelium made up irregular catheter and cyst cavity with yellowish mucous, glue-frozen-like stuff or brown colloidal  substances. Type Ⅲ: Cystic mass(5 lesions, 7.2%), the mass manifested separated cystic echo crumbs. The histopathological study showed salivary Warthin’s tumor with infarctions and infections. The coincidence of ultrasound and histopathology diagnose was 79.7%. Conclusion  The ultrasonographic features of salivary Warthin’s tumor are mainly based on the organization of histopathological study. The grasp of various ultrasonographic imagings and pathological changes is beneficial for increasing the accuracy rate of diagnosis higher.

Key words: Warthin’s tumor, ultrasonographic feature, histopathology