Difference between revisions of "Warthin tumour"
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- WARTHIN TUMOUR.
- WARTHIN TUMOUR.
Revision as of 12:41, 4 October 2019
|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|
|Gross||classically cystic, motor oil-like fluid|
|Site||salivary gland - parotid gland only|
|Clinical history||strong association with smoking|
|Prevalence||common benign salivary gland lesion|
|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.
- May be multicentric ~ 15% of the time.
- Bilateral ~6% of the time.
- Classically: male > female - changing with more women smokers.
- Smokers - almost 80% of patients is a series of 70 cases.
- Old - usually 60s, very rarely < 40 years old.
- No malignant transformation.
- Not in submandibular gland.
- Not in sublingual gland.
- Not in children.
- Motor oil-like fluid.
- Cystic component larger in larger lesions.
- Small lesions may be solid.
- 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.
- +/-Squamous differentiation.
- +/-Goblet cell differentiation.
- Lymphoepithelial cyst.
- Cyst within a lymph node.
Parotid Gland, Left, Excision: - Warthin's tumour (papillary cystadenoma lymphomatosum). - NEGATIVE for malignancy.
PAROTID GLAND, RIGHT, EXCISION: - WARTHIN TUMOUR.
The sections show a cystic tumour with lymphoid tissue associated with benign salivary gland tissue. The lymphoid tissue is composed of small cells and forms morphologically unremarkable follicules. The cyst-lining epithelium has a bilayered appearance and is composed of cells with abundant eosinophilic cytoplasm and nucleoli. The tumour focally extends to the edge of the tissue (ink present on tumour).
- Chedid, HM.; Rapoport, A.; Aikawa, KF.; Menezes, Ados S.; Curioni, OA.. "Warthin's tumor of the parotid gland: study of 70 cases.". Rev Col Bras Cir 38 (2): 90-4. PMID 21710045.
- Dăguci, L.; Simionescu, C.; Stepan, A.; Munteanu, C.; Dăguci, C.; Bătăiosu, M. (2011). "Warthin tumor--morphological study of the stromal compartment.". Rom J Morphol Embryol 52 (4): 1319-23. PMID 22203940.
- Hunt, JL. (Jan 2006). "Warthin tumors do not have microsatellite instability and express normal DNA mismatch repair proteins.". Arch Pathol Lab Med 130 (1): 52-6. doi:10.1043/1543-2165(2006)130[52:WTDNHM]2.0.CO;2. PMID 16390238.