Magnetic Resonance Imaging of the Sinus : Prevalence and Clinical Significance of Incidental Abnormal Findings in a Common Population

BACKGROUND AND OBJECTIVES: The purpose of this study is to determine the prevalence of abnormalities in the sinuses among the common population, and to correlate this with clinical data. MATERIALS AND METHODS: We retrospectively evaluated a total of five hundred patients who visited the Health Promotion Center, Asan Medical Center, to undergo MRI scan to screen for intracranial pathology from January to April, 2003. Patients who have been treated for nasal or sinus diseases and who had previous history of nasal or sinus operations were excluded. The sinus abnormalities found through the MRI were classified into 2 types as follows; sinusitis group and retention cyst group. RESULTS: Among the five hundred patients studied, ninety-six (19.2%) patients showed abnormality in one or more sinus groups; ninety patients displayed symptoms of sinusitis and nine patients exhibited signs of retention cyst. Three patients showed symptoms of both. Sinus abnormalities were most commonly observed in the maxillary sinus. Seven patients had symptoms of the sinusitis group, and one patient had symptoms of the retention cyst group. CONCLUSION: Incidental sinus abnormalities detected among the common population were relatively common. However, pathologic condition which demanded treatment among these abnormalities were rare. Therefore, it would be important not to overestimate these signs and one should evaluate their clinical correlations carefully through complete physical examinations before applying any treatment for these lesions.

Clinical Values of Fine Needle Aspiration Biopsy in Salivary Gland Diseases / 대한이비인후과학회지

BACKGROUND AND OBJECTIVES: Fine-needle aspiration biopsy (FNAB) has been used as a diagnostic instrument in patients with salivary gland lesions. This article is aimed at defining the exact role of FNAB in the diagnostic workup of patients. MATERIALS AND METHOD: A retrospective study design was used to evaluate the accuracy of FNAB for salivary gland diseases. From January 1997 to June 2004, FNABs, confirmed histologically after surgery, were carried out on 419 patients with salivary gland diseases. Cytopathologic and histologic findings were categorized as malignant, suspicious, benign neoplastic, or nonneoplastic. Sensitivity, specificity, accuracy, positive predictive value (PPV), and negative predictive value (NPV) of FNAB were calculated using histologic diagnosis of the surgical specimen as the criterion standard. RESULTS: FNAB was performed in all of 419 salivary gland lesions undergoing surgical procedures. A total of 321 lesions were in the parotid gland and 98 in the submandibular gland. There were 417 FNAB specimens (99%) that were satisfactory for evaluation. The FNAB diagnosis of malignant or suspicious lesions had positive and negative predictive values of 77% and 91%, respectively. Fine-needle aspiration biopsy diagnosis of a benign neoplasm had positive and negative predictive values of 93% and 77%, respectively. A cytopathologic diagnosis of a nonneoplastic lesion was predictive in only 59% of the cases. CONCLUSION: Although an FNAB diagnosis of malignant or neoplastic major salivary gland disease is generally predictive of the final histologic diagnosis, the predictive value of a negative FNAB finding is low. A negative FNAB finding should not supersede clinical judgment in the management of a clinically suspected malignant or neoplastic lesion of the major salivary glands.

Comparison of Clinical Characteristics of B Cell Lymphoma and NK/T cell Lymphoma of the Nose and Paranasal Sinuses

BACKGROUND AND OBJECTIVES: There are various subtypes in lymphoma of the nasal cavity and paranasal sinuses. This study aimed to compare the clinical differences between NK/T cell lymphoma and B cell lymphoma in the nose and paranasal sinuses. MATERIALS AND METHODS: From 1991 through 2003, 18 patients were diagnosed with lymphoma by histopathologic biopsy (NK/T cell 13 : B cell 5). We reviewed the medical records retrospectively regarding subjective symptoms, physical findings, and PNS CT findings. RESULTS: The most common symptom of NK/T cell lymphoma was nasal obstruction (8/13), and the main endoscopic finding was ulcerative small lesion. The PNS CT finding of NK/T cell lymphoma was homogenous, poorly enhanced, small mass. In contrast, the most common symptom of B cell lymphoma was periorbital swelling (2/5), and the main endoscopic finding was fungating mass. The PNS CT finding of B cell lymphoma was heterogenous, well-enhanced, large mass with bone destruction. The location of NK/T cell lymphoma was the inferior or middle turbinate in the nasal cavity, whereas the location of B cell lymphoma was the ethmoid or maxillary sinus. CONCLUSION: It is suggested that there may be significant clinical differences between NK/T cell lymphoma and B cell lymphoma in the sinonasal cavity.