Basal Cell Adenoma Research Articles

Fine needle aspiration cytology of polymorphous adenocarcinoma of the salivary glands: A report of 11 patients and review of the literature.

Polymorphous adenocarcinoma (PAC) is a rare malignant tumor of the minor salivary glands. It has an infiltrative growth, variable architectural patterns, neurotropism and cellular monomorphism. Approximately 75% of the cases show a specific mutation in the protein kinase D1 (PRKD1) gene. Reflecting the rarity of the tumor and intraoral location, the cytologic experience is limited with few reported series. In this study we analyze our cytologic experience to determine if a preoperative diagnosis is possible. A retrospective study of 11 patients with PAC in which a cytologic study was available. A review of the literature was also performed. Our study shows that PAC has relatively constant cytological features. The analysis of the cytological literature although it shows some heterogeneity, also reveals repetitive cytological findings. Smears are cellular with irregular groups some showing pseudopapillary branching morphology. Monolayered clusters and small acinar structures are also present. Most cases have small metachromatic globules embedded within the groups determining a cylindromatous pattern. Tumoral cells are small and uniform with scarce to moderate cytoplasm. Nuclei are round and oval with occasional grooves and small nucleoli. PAC has characteristic cytological features that together with its location in minor salivary gland must make us consider it preoperatively. It may resemble basal cell adenoma and epithelial-rich pleomorphic adenoma so we should be cautious in the final diagnosis. Whenever possible, the characteristic cytomorphology of PCA should make us evaluate the mutational status of PRKD1 gene since it may permit a more accurate diagnosis.

Expression of TdT in Myoepithelial Cells: Investigation in Breasts, Sweat Glands, and Salivary Lesions Emphasizing the Never-Documented Immunohistochemical Findings.

Background. The expression of terminal deoxynucleotidyl transferase (TdT) in myoepithelial cells (MECs) within the breast was recently incidentally observed in our routine practice. This study aimed to elucidate the expression of TdT in MECs. Methods. TdT immunostaining was performed on 180 mammary, 89 cutaneous, and 94 salivary tissues or lesions. Other myoepithelial markers, including P63, calponin, and SMA as well as double staining for TdT and calponin, were also evaluated in some cases. Selected lesions with basal or myoid differentiation were also included in the investigation. Results. MECs were positive for TdT in mammary lesions that contained MECs (132/135) but negative when they did not contain MECs (45/45). MECs in sweat glands (24/30) and their neoplastic counterparts, including those in hidradenoma papilliferum (2/9), spiradenoma (6/6), and cutaneous mixed tumor (9/9), showed weak to moderate TdT positivity. MECs were variably immunolabeled for TdT in salivary or salivary gland-type tumors with myoepithelial differentiation (pleomorphic adenoma, 24/25; basal cell adenoma, 6/7; adenoid cystic carcinoma, 7/7; Warthin tumor, 0/6; mucoepidermoid carcinoma, 0/8; acinic cell carcinoma, 0/4), but MECs in normal salivary gland barely stained for TdT (30/32). Conclusions. Our findings indicate that TdT may be eligible as an additional auxiliary immunohistochemical marker as P63, but not a surrogate, to identify the MECs in the breast with limited cross-reactivity, particularly in lesions with a prominent proportion of MECs. Positivity for TdT, along with other relevant markers, in a subset of sweat gland lesions and salivary tumors may contribute to their diagnosis.

The histogram analysis of apparent diffusion coefficient in differential diagnosis of parotid tumor.

Use apparent diffusion coefficient (ADC) histogram to investigate whether the parameters of ADC histogram can distinguish between benign and malignant tumors and further differentiate the tumor subgroups. This study retrospectively enrolls 161 patients with parotid gland tumors. Histogram parameters including mean, inhomogeneity, skewness, kurtosis and 10th, 25th, 50th, 75th, 90th percentiles are derived from ADC mono-exponential model. Mann-Whitney U test is used to compare the differences between benign and malignant groups. Kruskal-Wallis test with post-hoc Dunn-Bonferroni method is used for subgroup classification, then receiver operating characteristic curve analysis is performed in mean ADC value to obtain the appropriate cutoff values. Except for kurtosis and 90th percentile, there are significant differences in all other ADC parameters between benign and malignant groups. In subgroup classification of benign tumors, there are significant differences in all ADC parameters between pleomorphic adenoma and Warthin's tumor (area under curve 0.988; sensitivity 93.8%; specificity 94.7%; all ps < 0.05). Pleomorphic adenoma has high value in mean than basal cell adenoma (area under curve 0.819; sensitivity 76.9%; specificity 76.9%; p < 0.05). Basal cell adenoma has high values in mean (area under curve 0.897; sensitivity 92.3%; specificity 78.9%; all ps < 0.05) and 10th, 25th, 50th percentiles than Warthin's tumor. In subgroup classification of malignant tumors, low-risk parotid carcinomas have higher values than hematolymphoid tumors in mean (area under curve 0.912; sensitivity 84.6%; specificity 100%, all ps < 0.05) and 10th, 25th percentiles. ADC histogram parameters, especially mean and 10th, 25th percentiles, can potentially be an effective indicator for identifying and classifying parotid tumors.

Application of endoscopic resection of benign tumor in infratemporal fossa

Objective: To explore the application of endoscopy and clinical effect of endoscopic resection of benign tumor in infratemporal fossa. Methods: The clinical data of 11 patients with benign tumors in infratemporal fossa admitted to the Department of Otorhinolaryngology Head and Neck Surgery and Skull Base Surgery of the Affiliated Hospital of Qingdao University from January 2016 to September 2018 were retrospectively analyzed. There were 6 males and 5 females, with the age ranging from 11 to 63 years old. The main clinical manifestations were pharyngeal foreign body sensation, submaxillary pain, maxillofacial numbness and tongue numbness. Imaging examination showed that the tumor was round and had a clear boundary with the surrounding tissue. All the patients underwent endoscopic surgery. Appropriate surgical approach was selected according to the location of the tumor and its relationship with the internal carotid artery. The endoscopic surgical approaches included trans-oropharyngeal approach in 7 cases, trans-lateral pterygomandibular raphe approach in 1 case and trans-medial pterygomandibular raphe approach in 3 cases. The pathological results, prognosis, complications and relapse of patients were summarized through descriptive statistics. Results: The tumors were completely resected under endoscope in all patients, and there was no significant complication occurred after surgery. The average pain VAS score was 3.1 after surgery and average hospital stay was 5.9 d. The postoperative pathological diagnoses consisted of 6 cases of pleomorphic adenoma, 4 cases of neurilemmoma and 1 case of basal cell adenoma. All patients were followed up regularly from 6 to 39 months without recurrence of tumor. Conclusion: Endoscopic resection of benign tumors in infratemporal fossa has the advantages of minimal damage, rapid recovery, few complications, and definite curative effect, which can be used as an important alternative for surgical treatment of benign tumors.

Central pathology review of salivary gland adenoid cystic carcinoma.

To assess the role of a central pathology review in the diagnosis of salivary gland adenoid cystic carcinoma (AdCC). Surgically resected salivary gland tumors diagnosed as AdCC (n = 219) in 15 reference hospitals in Japan were subjected to a retrospective pathological re-evaluation. After the review, the AdCC diagnosis was revised in 21/219 cases (9.6%). The six benign tumors (2.7%) comprised five basal cell adenomas and one pleomorphic adenoma, and among these six patients, three received postoperative radiotherapy. The remaining 15 malignant tumors (6.8%) comprised nine basal cell adenocarcinomas and six other carcinomas. All revised basal cell adenoma/adenocarcinoma cases were of rare cribriform variants. A significant proportion of AdCC pathology reports were revised after the central pathology review. It should be emphasized that the greatest attention should be paid in differentiating AdCC from cribriform variant basal cell adenoma/adenocarcinoma, which is very rare in salivary gland tumors.

Basal Cell Adenoma: About Four Cases

Benign tumor of the salivary glands, composed of basaloid cells of architecture most often ductal and tubular or in nests (OMS 2017). We report the case of 4 patients carrying basal cell adenoma diagnosed at the department of pathological anatomy CHU MOHAMMED VI MARRAKECH. These are three women and one man. The average age was 49 years old. The clinical examination found a unilateral parotid mass gradually increasing in size. All the patients benefited from an ultrasound which was in favor of a homogeneous hypoechoic lobulated formation with posterior reinforcement evoking a pleomorphic adenoma. The patients benefited from a total parotidectomy. Macroscopic examination found a thick-walled, hemorrhagic-cystic formation in one patient. Microscopic examination showed a benign encapsulated tumor proliferation of compact architecture, in situ clusters and in channels with eosinophilic contents. . The epithelial cells have a basaloid appearance bordered at the periphery by a palisade cell base. They are of small to medium size, provided with ovoid cores with fine chromatin. The cytoplasm is abundant basophilic. The myoepithelial cells are sometimes cuboid, sometimes fusiform. The nuclei are discreetly elongated hyperchromic. The cytoplasm is scarce eosinophilic.The basal cell adenoma is a rare salivary tumor representing less than 3.7%. It occurs mainly in the elderly with a range of 57 to 70 years. Clinically, it is in most cases a mobile solitary mass of firm consistency. The tumor has a monomorphic appearance due to the predominance of basaloid cells. The differential diagnosis is primarily with basal cell adenocarcinoma and adenoid cystic carcinoma.

Basal cell adenoma of the salivary glands: MRI features and differential diagnosis

Basal cell adenoma of the salivary glands: MRI features and differential diagnosis

Gene Expression Profiling of Head and Neck Tumors Identifies FOXP1 and SOX10 Expression as Useful for Distinguishing Ameloblastoma From Basaloid Salivary Gland Tumors.

Odontogenic tumors show considerable morphologic heterogeneity and at times the diagnosis can be challenging. Ameloblastoma, the most common odontogenic tumor, can have morphologic similarity to some salivary gland tumors and therefore we sought to identify biomarkers that might aid in the diagnosis by performing transcriptome wide gene expression profiling of 80 odontogenic and salivary gland neoplasms. These data identified the FOXP1/SOX10 expression profile as characteristic of many odontogenic tumors including ameloblastoma but largely absent in salivary gland tumors. We then assessed 173 salivary gland tumors and 108 odontogenic tumors by immunohistochemistry for FOXP1 and SOX10 expression and found that 34/35 (97%) cases of ameloblastomas were diffusely positive for FOXP1 but completely negative for SOX10. None of the basaloid salivary neoplasms (basal cell adenoma, adenoid cystic carcinoma, polymorphous adenocarcinoma, and myoepitheloma) demonstrated FOXP1/SOX10 expression pattern. Taken together, the results of this study suggest that the FOXP1/SOX10 immunophenotype is common in odontogenic tumors including ameloblastoma and might be useful distinguishing these from similar appearing basaloid salivary gland tumors.

Lipomatous basal cell adenoma (Basal cell lipoadenoma) – Report of the first two cases

We present, to the best of our knowledge, the first two cases (60 year old female and 71 year old male) of basal cell adenoma with significant adipocytic components and suggest the term “lipomatous basal cell adenoma” for these lesions. Both tumors presented as slow growing nodules in the parotid gland. The two cases represent different points on a histopathological spectrum with one case being extremely well differentiated with distinct spiradenoma-like histological features; distinct bilayering, duct formation with secretory material and very low proliferative activity and the other case displaying more primitive cytological features composed of a predominant uniform, (p63-positive; CK 7-negative) basaloid, abluminal cell type, high proliferative activity and only scattered true ducts composed of (CK7-positive, p63-negative) luminal cells.

Diversity and diagnostic challenges in salivary neoplasms

Diversity and diagnostic challenges in salivary neoplasms - IJPO- Print ISSN No: - 2394-6784 Online ISSN No:- 2394-6792 Article DOI No:- 10.18231/j.ijpo.2019.116, Indian Journal of Pathology and Oncology-Indian J Pathol Oncol

MYB-NFIB gene fusion in prostatic basal cell carcinoma: clinicopathologic correlates and comparison with basal cell adenoma and florid basal cell hyperplasia

Prostatic basal cell carcinoma is a malignant neoplasm composed of basaloid cells forming infiltrative nests and tubules, which may potentially be misdiagnosed as benign basal cell proliferations (i.e., florid basal cell hyperplasia or basal cell adenoma) and also closely resembles adenoid cystic carcinoma of the salivary gland. MYB-NFIB gene rearrangement occurs in 30–86% of salivary gland adenoid cystic carcinomas. We sought to further characterize MYB gene rearrangement in prostatic basal cell carcinoma and correlate MYB-NFIB fusion status with other clinicopathologic characteristics. To this end, FISH analysis for MYB-NFIB gene fusion using fusion probes was performed on formalin-fixed, paraffin-embedded tissue sections from prostatic basal cell carcinoma (n = 30), florid basal cell hyperplasia (n = 18), and basal cell adenoma (n = 4). Fourteen of 30 (47%) cases of basal cell carcinoma were positive for MYB-NFIB gene fusion FISH, and no cases of benign basal cell proliferations were positive (p < 0.05). FISH-positive patients (mean age = 63 years, range: 35–81) tended to be younger than FISH-negative patients (mean age = 70 years, range: 55–93). Most FISH-positive cases demonstrated adenoid cystic carcinoma-like morphology (57%), and most FISH-negative cases demonstrated nonadenoid cystic carcinoma-like morphology (93%); one case (FISH-positive) demonstrated areas with both adenoid cystic carcinoma-like and nonadenoid cystic carcinoma-like morphology. FISH-positive cases more frequently demonstrated perineural invasion (50% vs. 14%, p < 0.05) compared to FISH-negative cases. Conversely, tall basal cells (i.e., neoplastic cells at least two times taller than wide) were more frequent in FISH-negative cases than FISH-positive cases (93% vs. 36%, p < 0.05). Approximately, 50% of prostatic basal cell carcinoma harbor MYB-NFIB gene fusion. The majority of these cases were characterized by adenoid cystic carcinoma-like morphology, perineural invasion, and lack tall basal cells. Florid basal cell hyperplasia and basal cell adenoma are negative for MYB-NFIB gene fusion.

Basal cell adenoma of the lung identified with obstructive pneumonia.

The seromucinous glands of the bronchi can give rise to tumors resembling those of the salivary glands. Basal cell adenoma (BCA) has not been reported in salivary gland-type tumors of the lung. Here, we report a case of an 86-year-old Asian man who suffered from pneumonia in the left upper lung field that may be associated with an endobronchial tumor occluding B1 + 2a + b. The bronchoscopic biopsy of the tumor revealed that the basaloid cells, which constituted a major component of the tumor and were positive for p40/p63 immunohistochemistry, exhibited a cord-like structure. The Ki-67 (MKI67) staining was less than 1% positive. These findings suggest that the endobronchial tumor was BCA of the lung, which caused obstructive pneumonia in the patient.

Epithelial membrane antigen and DOG1 expression in minor salivary gland tumours

Epithelial membrane antigen (EMA) and DOG1 are used as marker of epithelial cells, particularly the luminal cells, of salivary gland tumours. The aim of this study was to compare the EMA and DOG1 expression in tumours of minor salivary glands. Cases of pleomorphic adenoma (PA), basal cell adenoma (BCA), canalicular adenoma (CA), adenoid cystic carcinoma (ACC), polymorphous adenocarcinoma (PAC), mucoepidermoid carcinoma (MEC) and epithelial-myoepithelial carcinoma (EMC) were submitted to immunohistochemistry for EMA and DOG1. In PA and BCA, EMA and DOG1 were observed in luminal cells, while in CA the tumour cells were negative for both proteins. The EMA and DOG1 pattern expression detected in EMC was similar to that one observed in benign tumours. In ACC, both myoepithelial e epithelial expressed EMA and DOG-1. PAC tumour cells were only positive for DOG1, whereas MEC were only positive for EMA. In conclusion, EMA and DOG1 expression in benign salivary gland tumours was similar to normal salivary gland tissue and can be used as good marker of tumoral cells derived from intercalated ducts or its progenitor cells, while in malignant salivary gland tumours EMA expression is, however, better used as an indicator of aggressive behavior than a marker of luminal cells.

Analysis of the Clinical Relevance of Histological Classification of Benign Epithelial Salivary Gland Tumours.

IntroductionA vast increase in knowledge of numerous aspects of malignant salivary gland tumours has emerged during the last decade and, for several reasons, this has not been the case in benign epithelial salivary gland tumours. We have performed a literature review to investigate whether an accurate histological diagnosis of the 11 different types of benign epithelial salivary gland tumours is correlated to any differences in their clinical behaviour.MethodsA search was performed for histological classifications, recurrence rates and risks for malignant transformation, treatment modalities, and prognosis of these tumours. The search was performed primarily through PubMed, Google Scholar, and all versions of WHO classifications since 1972, as well as numerous textbooks on salivary gland tumours/head and neck/pathology/oncology. A large number of archival salivary tumours were also reviewed histologically.ResultsPleomorphic adenomas carry a considerable risk (5–15%) for malignant transformation but, albeit to a much lesser degree, so do basal cell adenomas and Warthin tumours, while the other eight types virtually never develop into malignancy. Pleomorphic adenoma has a rather high risk for recurrence while recurrence occurs only occasionally in sialadenoma papilliferum, oncocytoma, canalicular adenoma, myoepithelioma and the membranous type of basal cell adenoma. Papillomas, lymphadenoma, sebaceous adenoma, cystadenoma, basal cell adenoma (solid, trabecular and tubular subtypes) very rarely, if ever, recur.ConclusionsA correct histopathological diagnosis of these tumours is necessary due to (1) preventing confusion with malignant salivary gland tumours; (2) only one (pleomorphic adenoma) has a considerable risk for malignant transformation, but all four histological types of basal cell adenoma can occasionally develop into malignancy, as does Warthin tumour; (3) sialadenoma papilliferum, oncocytoma, canalicular adenoma, myoepithelioma and Warthin tumour only occasionally recur; while (4) intraductal and inverted papilloma, lymphadenoma, sebaceous adenoma, cystadenoma, basal cell adenoma (apart from the membranous type) virtually never recur. No biomarker was found to be relevant for predicting recurrence or potential malignant development. Guidelines for appropriate treatment strategies are given.Electronic Supplementary materialThe online version of this article (10.1007/s12325-019-01007-3) contains supplementary material, which is available to authorized users.

CLINICO-PATHOLOGICAL SIGNIfiCANCE OF B-CATENIN AND E-CADHERIN EXPRESSION IN SALIVARY GLAND TUMOR AT UCH IBADAN

Objectives β-catenin (B-Cat) is a cell adhesion molecule associated with the invasion and metastasis of carcinomas of the head and neck, esophagus while reduced expression of E-cadherin (E-cad), a transmembrane glycoprotein, is associated with loss of differentiation, acquisition of an invasive phenotype, and an unfavorable prognosis in carcinomas from several sites. B-Cat & E-Cad complex are involved in cell adhesion, signal transduction & motility. Aim is to identify the clinical / pathological significance of B-Cat & E-Cad expressions in salivary gland tumors (SGTs) presenting at the University College Hospital, Ibadan. Findings The expressions of β-cat & E-Cad were analyzed in 46 SGTs (10 pleomorphic adenomas PSA, 3 basal cell adenoma, 12 adenoid cystic carcinoma ADCC, 10 mucoepidermoid carcinoma MEC, 5 acinic cell carcinoma ACC, 4 polymorphous low grade adenocarcinoma PLGA & 2 papillary cystadenocarcinoma PCADCA) by immunohistochemistry in formalin-fixed, paraffin embedded specimens (Rabbit monoclonal; Satacruz biotechnology). Result shows immunostaining of B-cat & E-Cad were membranous & cytoplasmic without nuclear involvement, staining was more severe in the ductal areas especially in PSA, there was significant loss of membranous stain in ACC on multivariate analysis. E-Cad staining loss was significantly associated with tumour stage in ACC & MEC. Conclusion loss of β-catenin adhesion molecule may be involved in the development of ACC. E-cad expression is an independent indicator of clinical aggressiveness in patients with ACC.& MEC.

Cytological features of basal cell adenocarcinoma of the salivary glands.

The cytological features of basal cell adenocarcinoma (BAC) of the salivary gland, a rare carcinoma, have not been well described. This study included patients who were histopathologically diagnosed with BAC and who underwent preoperative fine-needle aspiration cytological examination. Cytological characteristics, including background, arrangement and shape of the neoplastic cells, nuclear and cytoplasmic features, and presence of stromal spindle cells, were reviewed. Seven patients were enrolled in the study. The cytological specimens were cellular and composed of large or small clusters with occasional discohesive neoplastic cells at the periphery. The predominant cellular morphology was spindle-shaped in four cases, and small round-shaped in three cases. These neoplastic cells were tightly packed, showed high cellularity and overlapping nuclei, and had mildly to moderately enlarged round to oval nuclei with occasional small nucleoli and scant cytoplasm. Stromal spindle cells were observed around the basaloid cells in three cases (42.9%). All histology-proven stromal spindle cell-positive cases had stromal spindle cells in the cytological specimens. The study findings clearly demonstrate the relatively high frequency of stromal spindle cells in cytological specimens of BAC. This finding is characteristic of BAC, although basal cell adenoma of salivary gland frequently has stromal spindle cells in the cytological specimens. The characteristic that differentiates BAC from basal cell adenoma is the presence of tightly packed and high cellular clusters with discohesive neoplastic cells. An understanding of these cytological features can aid the cytodiagnosis of BAC.

Basal Cell Adenoma of the Salivary Gland and Possible Recurrence as Basal Cell Adenocarcinoma in a Black-tailed Prairie Dog (Cynomys ludovicianus)

We describe a black-tailed prairie dog (Cynomys ludovicianus) with a benign biphasic nodular tumour that recurred as a malignant biphasic tumour at the same site 2 years after resection. Both tumours were biphasic with regard to the glandular epithelium and basal cellsand contained little of the mucus, cartilage or fibrous tissue that characterize pleomorphic adenoma and carcinoma ex-pleomorphic adenoma. Both the first and second tumours exhibited histopathological features similar to those exhibited by human basal cell adenoma and adenocarcinoma, respectively. Both were resectedand the animal was alive with no recurrence or metastasis at the time of writing, 9 months after the second surgery.

Cytological features of basal cell adenoma of salivary glands: Analysis of 19 cases emphasizing stromal spindle cells.

Basal cell adenoma (BCA) of the salivary gland is a relatively rare benign tumor. Although the presence of stromal spindle cells is a characteristic histopathological feature, this finding has not been the focus of much attention in the cytodiagnosis of BCA. Thus, we analyzed the cytological features of BCA, especially the presence of stromal spindle cells. Patients who were histopathologically diagnosed with BCA and underwent preoperative fine-needle aspiration cytological examination were enrolled in this study. The cytological characteristics including arrangement and shape of the neoplastic cells, nuclear and cytoplasmic features, and the presence of stromal spindle cells were reviewed. Nineteen patients were enrolled in the study. The cytological specimens were cellular and composed of small or large clusters or both. The neoplastic cells had scant cytoplasm and small round to oval nuclei. Basement membrane-like material was observed in 57.9%, and peripheral palisading was noted in 84.2%. Loose aggregates of stromal spindle cells were present in 63.2%, and the stromal spindle cells shown in the histological examination of 85.7% of cases were expressed in the cytological specimens. This study clearly demonstrated the relatively high frequency of stromal spindle cells in cytological specimens of BCA. This finding is characteristic of BCA, and therefore, the combination of cytological features, including packed clusters of neoplastic cells with scant cytoplasm and small nuclei, peripheral palisading, and basement membrane-like material, and the presence of stromal spindle cells could increase the diagnostic success of BCA.

Case Report: Basal cell adenoma of esophagus, a rare tumor at an atypical site

Basal cell adenomas are rare, salivary gland tumors. These are a class of non-malignant tumors that have glandular epithelial tissue origin. Often described to have a disputed recurrence rate after excision, the prognosis of basal cell adenomas is generally good. However, their rarity makes their continuous monitoring vital. Basal cell adenomas normally cause problems exerting a pressure effect on the surrounding organs or to the originating area. Often due to its location and effect, differentiation between other tumors, e.g. basal cell carcinoma, adenocarcinoma and cystic carcinoma, must be done. We were able to treat a patient with complaints of sensation of regurgitation that was diagnosed as an esophageal mass on esophagogastroduodenoscopy and later as basal cell adenoma on histopathological examination. The patient was treated with endoscopic submucosal dissection successfully and has had no fresh complaints since. Here, we present a case of basal cell adenoma in the esophagus, a rare entity in itself.

The clinical utility of ARFI imaging for the differential diagnosis of salivary gland tumors

Objective Elastography is expected to be useful as an additional diagnostic aid for differentiating between benign and malignant tumors, but the diagnostic accuracy of conventional elastography is low in the salivary gland. Acoustic radiation force impulse (ARFI) imaging is a kind of elastography with a new mechanism. The purpose of this study is to clarify the clinical usefulness of ARFI imaging in distinguishing salivary gland tumors. Patients and Methods This study included patients who underwent ultrasonography and cytological or histological evaluation of salivary gland tumors at our department between July 2014 and February 2019. ARFI imaging was performed using Virtual Touch imaging (VTI), which was presented in grayscale, with dark color indicating hard. VTI images were divided into the following scores: score 1, mostly white color or white honeycomb; score 2, gray color with light parts; score 3, gray color; score 4, dark gray or black color with light parts; and score 5, dark gray or black color. The VTI images of different tumors were compared. Results Overall, 151 cases were benign tumors (87 Warthin tumors, 59 pleomorphic adenomas, 3 oncocytomas, 1 basal cell adenoma, 1 myoepithelioma) and 21 cases were malignant tumors. In the benign tumor group, 10, 56, 32, 34, and 19 VTI images were classified as score 1, 2, 3, 4, and 5, respectively, while the corresponding numbers were 0, 1, 5, 5, and 10 in the malignant group. If scores 4 and 5 were defined as malignant tumors, the sensitivity, specificity, and diagnostic accuracy for differentiating benign and malignant tumors were 76.5%, 67.6%, and 68.8%, respectively. In benign tumors, among Warthin tumors, 88.5% were included in scores 1–3, while among pleomorphic adenomas, 72.9% were included in scores 4 and 5. Among the malignant tumors, 71.4% were included in scores 4 and 5. Malignant tumors of scores 2 and 3 were located deeper site than those of scores 4 and 5. Conclusion Regarding salivary gland tumors at shallow site, AFRI imaging was considered useful technique because scores 1–3 of VTI system can be predicted benign tumors, especially Warthin tumors.