Utilization of Telecytopathology for Rapid On-Site Evaluation of Ultrasound-Guided Fine Needle Aspirates of Neoplastic and Non-Neoplastic Salivary Gland Lesions

Radioactive iodine (131I) targets the thyroid gland and has proven to play an effective role in the treatment of differentiated papillary and follicular thyroid carcinomas. Simultaneously this isotope hones in on the salivary glands where it is concentrated and secreted. Dose-related damage to the salivary ducts and secreting parenchyma results from the 131I tissue irradiation, usually in direct proportion to the dosage of the radioiodine. Salivary gland symptoms, most frequently obstructive in nature, may develop immediately after a therapeutic dose of 131I and/or months later. In conjunction with this radiation sialadenitis, secondary complications that have been reported include hyposalivation, dysgeusia, neoplasia, and facial nerve involvement. These adverse reactions have initiated a reassessment of the benefits and dosages of 131I, and have resulted in a limitation of its use and the administration of a lowered 131I regimen. A variety of promoted measures to prevent sialadenitis have not been generally accepted. Sialendoscopy and supportive care have succeeded in ameliorating the symptomatology of sialadenitis.