Warthin's tumor

Warthin's tumor
Classification and external resources
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.
ICD-10	D11.
ICD-9	210.2
ICD-O:	8561/0
DiseasesDB	31941
eMedicine	plastic/371
MeSH	[1]

Not to be confused with Wharton's duct (submandibular duct)

Warthin's tumor or Warthin tumour, also known as papillary cystadenoma lymphomatosum or adenolymphoma, is a type of benign tumor of the salivary glands.

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.^[1]

Locations

The gland most likely affected is 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 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.

Treatment

Most of these tumors are treated with surgical removal. Recurrence is rare, occurring in 6–12% of cases.

Additional images

Histopathology of Warthin tumor in the parotid gland. H&E stain.	Histopathology of Warthin tumor in the parotid gland. Another view of a file "Warthin tumor (1).jpg". H&E stain.	Histopathology of Warthin tumor in the parotid gland. Higher magnification of a file "Warthin tumor (1).jpg". H&E stain.	Intermediate magnification micrograph of a Warthin tumor.
High magnification micrograph of a Warthin tumor showing the characteristic bilayered epithelium.

References

Additional sources

• Kahn, Michael A. Basic Oral and Maxillofacial Pathology. Volume 1. 2001.

See also

• Pleomorphic adenoma

External links

• Doctor's Doctor
• Picture
• Photo
• Overview

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