Warthin's tumor

Warthin's tumor

This Warthin's tumor presented as a parotid mass in a middle-aged male, who underwent superficial parotidectomy. The tumor, at the right of the image, is well-demarcated from the adjacent parotid tissue and tends to shell out from it.
Classification and external resources
Specialty oncology
ICD-10 D11
ICD-9-CM 210.2
ICD-O 8561/0
DiseasesDB 31941
eMedicine plastic/371
MeSH D000235
Not to be confused with Wharton's duct (submandibular duct)

Warthin's tumor or Warthin tumour, also known as papillary cystadenoma lymphomatosum, monomorphic adenoma or adenolymphoma, is a benign cystic tumor of the salivary glands containing abundant lymphocytes and germinal centers (lymph node-like stroma). It is named for pathologist Aldred Scott Warthin, who described two cases in 1929.[1]

Etiology

Its etiology is unknown, but there is a strong association with cigarette smoking. Smokers are at 8 times greater risk of developing Warthin's tumor than the general population.[2]

Locations

The gland most likely affected is the parotid gland. In fact, it is the only tumor virtually restricted to the parotid gland. Though much less likely to occur than pleomorphic adenoma, Warthin's tumor is the second most common benign parotid tumor.

Characteristic

Low magnification micrograph of a Warthin tumor arising from the parotid gland.

Warthin's tumor primarily affects older individuals (age 60–70 years). There is a slight female predilection according to recent studies, but historically it has been associated with a strong male predilection. This change is possibly due to the tumor's association with cigarette smoking and the growing use of cigarettes by women. The tumor is slow growing, painless, and usually appears in the tail of the parotid gland near the angle of the mandible. In 5–14% of cases, Warthin's tumor is bilateral, but the two masses usually are at different times. Warthin's tumor is highly unlikely to become malignant.

Histology

The appearance of this tumor under the microscope is unique. There are cystic spaces surrounded by two uniform rows of epithelial cells with centrally placed pyknotic nuclei. The cystic spaces have epithelium referred to as papillary infoldings that protrude into them. Additionally, the epithelium has lymphoid stroma with germinal center formation.

The differential diagnosis includes sebaceous lymphadenoma and oncocytoma.

Treatment

Most of these tumors are treated with surgical removal. It is non recurrent .

Additional images

See also

References

  1. ↑ Witt, Robert L. (ed.) (2005). "Chapter 9 "Benign tumors, cysts, and tumor-like conditions of the salivary glands". Salivary Gland Diseases: Surgical and Medical Management. New York: Thieme Medical Publishers. p. 123. ISBN 1-58890-414-8.
  2. ↑ Kumar V, Abbas AK, Fausto N (2005). Robbins and Cotran pathologic basis of disease, 7 Ed. St. Louis, MO: Elsevier Saunders. ISBN 0-7216-0187-1.

Additional sources

External links

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