Research On Ultrasound And Clinical Features Of Parotid Basal Cell Tumor And Its Identification With Common Benign Tumors

Objective:Investigate the clinical manifestations,conventional ultrasound and contrast-enhanced ultrasound features of parotid basal cell tumor,seek diagnostic value,and obtain the differential diagnosis of pleomorphic adenoma and adenolymphoma.Method:Clinical manifestation,conventional ultrasound and contrast-enhanced ultrasound data on patients with parotid basal cell tumor and pleomorphic adenoma and adenolymphoma were collected between January 2011 and December2014.These features of parotid basal cell tumor were analyzed in these three areas and the significance of difference study were performed between parotid basal cell tumor and the other two tumors.The clinical data include age(?50years old/<50 years old),sex(male/female),smoking history(yes/no),palpation(soft/hard),growth history(yes/no)etc.The conventional ultrasound features described the tumor location(single / bilateral,left / right),reaching deep leaf(yes/no),tumor maximal axial length(<3.0cm/?3.0cm),boundary appearance(clear/blurred),inner echogenicity(low/mixed),lobulated change(yes/no),grid echo(yes/no),enhancement of behind echo(yes/no),liquidity(yes/no),liquefaction range(large/small),calcification(yes/no),peripheral lymph node(yes/no),inner vascularity(Alder classification,level 0 to level I/level II to level III)etc.The performance of contrast-enhanced ultrasound on tumor enhanced phase(early enhancement/synchronous or late enhancement),Initialenhancement site(peripheral/center or diffuse),peak enhancement(high/low),enhanced uniformity(uniformity /inhomogeneity),peripheral ring enhancement(yes/no),peripheral nodular enhancement(yes/no),no enhancement area(yes/no),enhanced boundary(clear/unclear),enhanced range(change/no change),fade(faster /slower)etc.Results: Between January2011 and December 2014,108 patients with 112 lesions,of which 14 cases of basal cell tumor in patients with 14 lesions,pleomorphic adenoma in 59 patients with lesions in 61 cases,lymphoma in 35 patients with 37 lesions.After the three tumor clinical data analysis found that basal cell tumor age of onset is generally greater than or equal to 50 years old,soft touch,which were statistically significant difference with the pleomorphic adenoma(P < 0.05),no significant difference with adenolymphomas;in addition,basal cell tumor often occurred in female patients,no smoking the history and the change history,there was statistically significant difference with adenolymphomas(P < 0.05),no significant difference with pleomorphic adenoma.Conventional ultrasound,basal cell tumor occurred in all unilateral,of which 71.4%(10/14)occurred on the left,85.7%(12/14)had maximum diameter of less than 3.0cm,35.7%(5/14)showed mixed echo,none had grid echo,42.8%(6/14)had liquefaction,and liquefaction range accounted for 28.6%(range 4/14),57.1%(8/14)showed level II to III blood flow signal.The pleomorphic adenoma occurred in all unilateral,of which 37.7% occurred on the left(23/61),26.2%(16/61)had maximum diameter of less than 3.0cm,3.3%(2/61)showed mixed echo,1.6%(1/61)showed grid echo,18%(11/61)tumor had liquefaction and liquefaction range accounted for 3.3%(2/ 61),16.4%(10/61)showed level II to III blood flow signal.Adenolymphoma,59.5%(22/37)occurred in the left side,67.6%(25/37)had maximum diameter of less than 3.0cm,24.3%(9/37)showed mixed echo,29.7%(11/37)had grid echo,40.5%(15/37)had liquefaction,liquefaction range accounted for 16.2%(6/37),35.1%(12/37)showed level II to III blood flow signal.Basal cell tumor in tumor location,tumor size,innnal echo,liquefaction,liquefaction range with those of pleomorphic adenoma compared with significant statistical difference(P < 0.05),and there was significant statistical difference between basal cell tumor and adenolymphoma in grid echo(P < 0.05).On contrast enhanced ultrasonography,in the basal cell tumor group,78.6%(11/14)showed early enhancement and high enhancement,42.9%(6/14)showed “no enhancement area”,14.3%(2/14)had the nodular enhancement,21.4%(3/14)faded more quickly.In the pleomorphic adenoma group,18%(11/61)showed early enhancement,27.9%(17/61)showed high enhancement,18.0%(11/61)showed “no enhancement area”,none had peripheral nodular enhancement,3.3%(2/61)faded faster.In the adenolymphoma,54.1%(20/37)showed early enhancement,86.5%(32/37)showed high enhancement,54.1%(20/37)showed “no enhancement area”,none had peripheral nodular enhancement,no case faded faster.In enhanced phase,peak enhancement,“no enhancement area”,peripheral nodular enhancement,regression,the basal cell tumor had the statistically significantdifference with the pleomorphic adenoma(P< 0.05),but there was no significant difference compared with adenolymphoma,excepting the speed of fade(P<0.05).Conclusion:Research shows that there are some characteristics of the clinical manifestation,conventional ultrasound and contrast-enhanced ultrasound in the basal cell tumor.For example,age more than 50 year old woman with soft touch,unilateral,mostly located on the left side,maximum diameter less than 3.0cm,internal mixed echo,liquefaction an relatively large liquefaction,relatively abundant blood flow signal,mostly early enhancement,high enhancement and “no enhancement area”,peripheral nodular enhancement,the possibility of fast fading.Mastering these points can improve the accuracy of the diagnosis of basal cell tumor,but also provide more accurate information for the surgeon.In addition,these characteristics of the basal cell tumor are significantly different from those of pleomorphic adenoma,which is useful in Improving the specificity of diagnosis of the basal cell tumor.However,compared with adenolymphoma,except sex,smoking history,growth history,grid echo,fade,the rest has no significant difference.It is difficult to identify them.