Difference between revisions of "Warthin tumour"

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#redirect [[Salivary_glands#Warthin_tumour]]
{{ Infobox diagnosis
| Name      = {{PAGENAME}}
| Image      =  Papillary_cystadenoma_lymphomatosum2.jpg
| Width      =
| Caption    = Warthin tumour. [[H&E stain]].
| Micro      = papillae with a two rows of pink (eosinophilic) epithelial cells (with cuboidal basal cells and columnar luminal cells), fibrous capsule, cystic space filled with debris, lymphoid stroma
| Subtypes  =
| LMDDx      = lymphoepithelial cyst.
| Stains    =
| IHC        =
| EM        =
| Molecular  =
| IF        =
| Gross      =
| Grossing  =
| Site      = [[salivary gland]] - parotid gland only
| Assdx      =
| Syndromes  =
| Clinicalhx = strong association of smoking
| Signs      =
| Symptoms  =
| Prevalence = uncommon
| Bloodwork  =
| Rads      =
| Endoscopy  =
| Prognosis  = good, benign
| Other      =
| ClinDDx    = other [[salivary gland]] tumours
}}
'''Warthin tumour''' is a relative common benign tumour of the parotid gland. It is also known as '''papillary cystadenoma lymphomatosum'''.
 
===General===
Epidemiology:
*May be multicentric ~ 15% of the time.
*May be bilateral ~10% of the time.
*Classically: male > female -- changing with more women smokers.
*Smokers.
*Old - usu. 60s, very rarely < 40 years old.
 
Notes:
*No malignant transformation.
*Not in submandibular gland.
*Not in sublingual gland.
*Not in children.
 
===Gross===
*Motor-oil like fluid.
*Cystic component larger in larger lesions.
**Small lesions may be solid.
 
Image:
*[http://www.flickr.com/photos/bc_the_path/2510239905/in/photostream/ Warthin tumour (flickr.com)].
 
===Microscopic===
Features:
* Papillae (nipple-shaped structures) with a two rows of pink (eosinophilic) epithelial cells (with cuboidal basal cells and columnar luminal cells) -- '''key feature'''.
* Fibrous capsule - pink & homogenous on [[H&E stain]].
* Cystic space filled with debris ''in situ'' (not [[necrosis]]).
* Lymphoid stroma.
 
Notes:
*+/-Squamous differentiation.
*+/-Goblet cell differentiation.
 
DDx:
*Lymphoepithelial cyst.
**Cyst within a lymph node.
 
===Images===
<gallery>
Image:Papillary_cystadenoma_lymphomatosum3.jpg | Warthin tumour - high mag. (WC/Nephron)
Image:Papillary_cystadenoma_lymphomatosum2.jpg | Warthin tumour - intermed. mag. (WC/Nephron)
</gallery>
 
==See also==
*[[Salivary glands]].
*[[Head and neck pathology]].
 
==References==
{{Reflist|2}}


[[Category:Diagnosis]]
[[Category:Diagnosis]]
[[Category:Salivary glands]]
[[Category:Head and neck pathology]]

Revision as of 23:43, 13 July 2013

Warthin tumour
Diagnosis in short

Warthin tumour. H&E stain.
LM papillae with a two rows of pink (eosinophilic) epithelial cells (with cuboidal basal cells and columnar luminal cells), fibrous capsule, cystic space filled with debris, lymphoid stroma
LM DDx lymphoepithelial cyst.
Site salivary gland - parotid gland only
Clinical history strong association of smoking
Prevalence uncommon
Prognosis good, benign
Clin. DDx other salivary gland tumours

Warthin tumour is a relative common benign tumour of the parotid gland. It is also known as papillary cystadenoma lymphomatosum.

General

Epidemiology:

  • May be multicentric ~ 15% of the time.
  • May be bilateral ~10% of the time.
  • Classically: male > female -- changing with more women smokers.
  • Smokers.
  • Old - usu. 60s, very rarely < 40 years old.

Notes:

  • No malignant transformation.
  • Not in submandibular gland.
  • Not in sublingual gland.
  • Not in children.

Gross

  • Motor-oil like fluid.
  • Cystic component larger in larger lesions.
    • Small lesions may be solid.

Image:

Microscopic

Features:

  • Papillae (nipple-shaped structures) with a two rows of pink (eosinophilic) epithelial cells (with cuboidal basal cells and columnar luminal cells) -- key feature.
  • Fibrous capsule - pink & homogenous on H&E stain.
  • Cystic space filled with debris in situ (not necrosis).
  • Lymphoid stroma.

Notes:

  • +/-Squamous differentiation.
  • +/-Goblet cell differentiation.

DDx:

  • Lymphoepithelial cyst.
    • Cyst within a lymph node.

Images

  • Warthin tumour - high mag. (WC/Nephron)

  • Warthin tumour - intermed. mag. (WC/Nephron)

See also

References

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