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Our aim was to assess the specific ultrasonic characteristics of pleomorphic adenoma and Warthin's tumor in major salivary glands.We retrospectively reviewed and analyzed the ultrasonographic (US) features of 19 pleomorphic adenomas in 16 patients and 29 Warthin's tumors in 20 patients. The features included tumor size, echotexture, boundary, and shape on gray-scale US imaging and grading and distribution of tumor vascularity on color Doppler ultrasound (CDU).All lesions were hypoechoic, and only 22.9% had a homogeneous echotexture. Most of the tumors (87.5%) wereor=10 mm, and 93.8% were well defined. On CDU, 91.7% had intermediate (+ and ++) grades of vascularity. Only two of 29 Warthin's tumors had the highest grade of vascularity (+++). Predominantly central blood flow was present in 58.6% of Warthin's tumors and 42.1% of pleomorphic adenomas. Lobulated margin (shape) was noted in 84.2% of pleomorphic adenomas and 51.7% of Warthin's tumors (P.05). Anechoic cystic components were present in 13 (44.8%) of 29 Warthin's tumors and in only one pleomorphic adenoma (1/19, 5.3%) (P.01).Most pleomorphic adenomas were lobulated. Internal anechoic cystic components were absent from pleomorphic adenomas but present in some Warthin's tumors. The grading and distribution of blood flow signals on CDU provided only limited additional diagnostic information for distinguishing pleomorphic adenomas from Warthin's tumors. Gray-scale ultrasonography is a useful method for evaluating and distinguishing pleomorphic adenomas from Warthin's tumors.

The purpose of this study is to assess the specific ultrasonic characteristics of papillary thyroid carcinoma and to determine the relative frequency of various patterns of papillary carcinoma on gray-scale ultrasonography (US) and color Doppler ultrasonography (CDU).We retrospectively reviewed US features in 51 patients with confirmed papillary thyroid carcinoma. The features were analyzed based on tumor size, echogenicity, echotexture, boundary, margin, shape, and calcification pattern on gray-scale US imaging, and on patterns of vascularity on CDU. We obtained the relative frequency of features and classified these features into three categories: common (or =50% of lesions), less common (10% but50%), and uncommon (or =10%). Individual differences and combinations of features were also analyzed.In total, 67 nodules were enrolled in our study. The sizes of 76% of nodular lesions were20.0 mm. Common US features of papillary carcinoma included: a homogeneous hypoechoic solid picture; a poorly defined boundary; an irregular margin; the absence of halo; the absence of calcifications or microcalcifications; and mixed perinodular and intranodular blood flow patterns. Less common features included: a heterogeneous hypoechoic or very hypoechoic picture; microcalcifications; a well-defined boundary; a regular margin; a halo with uneven thickness or an incomplete halo; and a taller-than-wide shape. Uncommon features included: an isoechoic picture; solid with cystic components; coarse calcifications; mixed coarse calcifications and microcalcifications; "inferno"-type blood flow; and absence of blood flow. On average, each nodule had 4.9 US features considered common, 1.8 US features considered less common, and 0.4 US feature considered uncommon. Features such as predominantly cystic composition, hyperechoic texture, and hypoechoic halo with even thickness were never found in our study. The top two common manifestations of papillary carcinoma were solid architecture and mixed perinodular and intranodular blood flow signals.All lesions in our series had a predominantly solid characteristic on gray-scale US.