Adenoid Cystic Carcinoma of the Tongue
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Here is a patient who had
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a tongue adenoid cystic carcinoma.
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If you remember back to that diagram I showed of the
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concentration of minor salivary gland tissue,
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you recall that the hard palate and soft palate had the
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highest concentration or the highest number
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of minor salivary gland tissue,
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but the tongue was in the top three.
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And in this case,
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we have a patient who had an adenoid cystic carcinoma that
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was biopsied of the minor salivary gland
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tissue on the surface of the tongue.
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And I'm showing you the coronal plane just to give you a
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better perspective of the overall look
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of the head and neck region.
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In this case, it was relatively dark
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on the T1-weighted scan.
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You notice it was really bright on the T2-weighted scan
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and showed pretty avid enhancement.
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Here you can see it coming to the surface of the tongue,
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which is where the minor salivary gland tissue resided.
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Here it is on the surface of the tongue
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and on the surface of the tongue.
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Now,
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adenoid cystic carcinoma's signal intensity on
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T2-weighted imaging is quite variable.
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This is as bright as what one might think
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about with a pleomorphic adenoma,
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and this depends on whether you have the cribriform tubular
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or solid histologic growth pattern
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for adenoid cystic carcinoma.
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The cribriform pattern has the highest rate of cystic
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components within it on histology and is associated with
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the brighter signal intensity on T2-weighted scan.
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So this is one of the exceptions to the rule that
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malignancies in the salivary glands tend to be bright
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on T2-weight imaging. There are varieties of both
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mucopidermoid carcinoma low-grade and the cribriform
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pattern of adenoid cystic carcinoma where it
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may be bright on a T2-weighted scan.
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This patient was fortunate enough
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not to have perineural spread.
David M Yousem, MD, MBA
Professor of Radiology, Vice Chairman and Associate Dean
Johns Hopkins University
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