Warthin tumour

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

• Benign.

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 - usually 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:

• 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

• 

  Warthin tumour - low mag. (WC/Nephron)

• 

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

• 

  Warthin tumour - high mag. (WC/Nephron)

See also

• Salivary glands.
• Head and neck pathology.