Pleomorphic adenoma diagnostic study of choice

Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Maneesha Nandimandalam, M.B.B.S.[2]

Overview

MRI is the study of choice for pleomorphic adenoma. On T1-weighted images they show homogeneous intensity, on T2 they show marked hyperintensity reflecting myxochondroid stroma and hypointensity corresponds to fibrous capsule of the tumor. On Gd-T1 imaging it shows heterogeneous enhancement.

Diagnostic Study of Choice

Study of choice

MRI is the preferred diagnostic study of choice for pleomorphic adenoma.^[1]

The comparison of various diagnostic studies for [disease name]

Test	Sensitivity	Specificity
MRI	43.9%	95%

[Name of test with higher sensitivity and specificity] is the preferred investigation based on the sensitivity and specificity

Diagnostic results

MRI

MRI is the imaging modality of choice for pleomorphic adenoma.^[2]^[1]
On T1-weighted images:
- Pleomorphic adenoma’s show homogeneous intensity. ^[3]
On T2-weighted images:
- Marked hyperintensity reflects abundant myxochondroid stroma.^[4]
- Hypointensity reflects the fibrous capsule of the tumor.^[4]
On Gd-T1weighted images:
- It shows heterogeneous enhancement.^[3]

Sequence of Diagnostic Studies

The various investigations must be performed in the following order:

CT is usually the first imaging modality of choice for pleomorphic adenoma.^[1]
It helps in identifying the lesion and also helps the physician in assessing the extension of the tumor.
MRI is the usually ordered investigation next after CT, for an even more detailed study.^[1]
It is a non-ionizing modality with excellent soft tissue distinction.
FNA and biopsy is the definitive method of diagnosis for pleomorphic adenoma.

Name of Diagnostic Criteria

There are no established criteria for the diagnosis of pleomorphic adenoma.

References

↑ ^1.0 ^1.1 ^1.2 ^1.3 Rai, Shalu; Rohit, Malik; Kaur, Mandeep; Mukul, Prabhat (2013). “Pleomorphic adenoma: Choice of radiographic imaging modality – Computed tomography or magnetic resonance imaging? Illustration through a case report”. Dental Hypotheses. 4 (1): 33. doi:10.4103/2155-8213.110181. ISSN 2155-8213.
↑ Ikeda K, Katoh T, Ha-Kawa SK, Iwai H, Yamashita T, Tanaka Y (March 1996). “The usefulness of MR in establishing the diagnosis of parotid pleomorphic adenoma”. AJNR Am J Neuroradiol. 17 (3): 555–9. PMID 8881252.
↑ ^3.0 ^3.1 Hisatomi, Miki; Asaumi, Jun-ichi; Yanagi, Yoshinobu; Konouchi, Hironobu; Matsuzaki, Hidenobu; Honda, Yasutoshi; Kishi, Kanji (2003). “Assessment of pleomorphic adenomas using MRI and dynamic contrast enhanced MRI”. Oral Oncology. 39 (6): 574–579. doi:10.1016/S1368-8375(03)00040-X. ISSN 1368-8375.
↑ ^4.0 ^4.1 Kato H, Kawaguchi M, Ando T, Mizuta K, Aoki M, Matsuo M (August 2018). “Pleomorphic adenoma of salivary glands: common and uncommon CT and MR imaging features”. Jpn J Radiol. 36 (8): 463–471. doi:10.1007/s11604-018-0747-y. PMID 29845358.

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[RaiRohit2013-1] 1.0 ^1.1 ^1.2 ^1.3 Rai, Shalu; Rohit, Malik; Kaur, Mandeep; Mukul, Prabhat (2013). “Pleomorphic adenoma: Choice of radiographic imaging modality – Computed tomography or magnetic resonance imaging? Illustration through a case report”. Dental Hypotheses. 4 (1): 33. doi:10.4103/2155-8213.110181. ISSN 2155-8213.

[pmid8881252-2] Ikeda K, Katoh T, Ha-Kawa SK, Iwai H, Yamashita T, Tanaka Y (March 1996). “The usefulness of MR in establishing the diagnosis of parotid pleomorphic adenoma”. AJNR Am J Neuroradiol. 17 (3): 555–9. PMID 8881252.

[HisatomiAsaumi2003-3] 3.0 ^3.1 Hisatomi, Miki; Asaumi, Jun-ichi; Yanagi, Yoshinobu; Konouchi, Hironobu; Matsuzaki, Hidenobu; Honda, Yasutoshi; Kishi, Kanji (2003). “Assessment of pleomorphic adenomas using MRI and dynamic contrast enhanced MRI”. Oral Oncology. 39 (6): 574–579. doi:10.1016/S1368-8375(03)00040-X. ISSN 1368-8375.

[pmid29845358-4] 4.0 ^4.1 Kato H, Kawaguchi M, Ando T, Mizuta K, Aoki M, Matsuo M (August 2018). “Pleomorphic adenoma of salivary glands: common and uncommon CT and MR imaging features”. Jpn J Radiol. 36 (8): 463–471. doi:10.1007/s11604-018-0747-y. PMID 29845358.

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