Diagnosis of salivary gland tumors: Does the triple diagnosis method have value?

BACKGROUND: Appropriate clinical management of salivary gland lesions requires a determination as to whether a salivary gland nodule is benign or malignant. Approximately three-quarters of all salivary gland nodules represent benign neoplasms. Separation of salivary gland carcinomas from benign lesions can be diagnostically challenging. The Milan System for Reporting Salivary Gland Cytopathology recommends the correlation of cytologic diagnoses with imaging and clinical findings creating a diagnostic triplet. How often the "Triple Diagnosis" method is used and its accuracy in separating salivary gland nodules into benign and malignant groups are unknown. METHODS: An electronic records search of cytology files at the University of Missouri was performed for fine needle aspirates of the salivary gland obtained between September 2018 and August 2022. Chart review was performed for preoperative clinical and imaging diagnoses. Diagnostic "Triplets" constructed from cytologic, clinical, and imaging diagnoses were correlated with final surgical pathology diagnosis. RESULTS: One hundred and thirty-six FNAs were identified. Eighty-seven cases had preoperative imaging with 52 of these cases having clinical diagnoses. Due to the lack of a definitive clinical or imaging diagnosis for a nodule as benign or malignant, only 12 (23%) cases had definitive "Triplets." Nine (17%) "Triplets" were benign and three (6%) were malignant. Accuracy of concordant triplets was 100% for the prediction of malignancy and 89% for the prediction of a benign result as determined by final histologic diagnoses. CONCLUSION: While highly accurate in predicting the benign or malignant nature of a salivary gland nodule, concordant triplets made up only 23% of cases limiting their clinical utility.

Complete Genome Sequences of Cluster S Mycobacteriophages Beelzebub, Raela, and RedRaider77.

We isolated three mycobacteriophages that belong to cluster S, namely, Beelzebub, Raela, and RedRaider77. Annotation revealed a genome structure typical of cluster S phages, including an atypical location of two minor tail protein genes in the right arm of these viral genomes.

The orbitalauricular chord of Alligator: The unusual functional linkage between the earflap and eyelid of Crocodylians.

One of the distinctive features of the Crocodylia is the presence of a superficial meatal chamber the aperture of which is regulated by two earflaps. The movements of the upper earflap have been detailed by multiple workers, however, the mechanics of the lower earflap remain unresolved. The present study was undertaken to document the mechanics of the lower earflap in the American alligator, Alligator mississippiensis, and to explore the functional bases of coordinated movements between the lower earflap and lower eyelid in this species. This anatomical system was examined using a combination of fresh dissection, histology, and micro-CT analyses applied to post-embryonic specimens. The rostral margin of the lower earflap is tightly bound to a block of dense connective tissue herein termed the orbitalauricular chord. The orbitalauricular chord is anatomically distinct from both a ligament and a tendon. The dorsal surface of the orbitalauricular chord is attached to a slip of the levator palpebra, while the ventral surface is attached to a slip of the depressor palpebra. These attachments produce a simple mechanism for the elevation and depression of the lower earflap, and thus the opening and closing of the meatal aperture. The caudal surface of the orbitalauricular chord has connective tissue links to the rostral margin of the lower earflap. The morphology of the orbitalauricular chord appears to explain both the mechanics of the lower earflap and the functional coupling between the lower eyelid and lower earflap.