Warthin tumors - Tumor of salivary gland

Warthin tumors
(Also known as Adenolymphoma )

👉 Second most common tumors of salivary gland.

👉This tumor 1st recognized by Albrecht in 1910

and later described by warthin in 1929

👉It occurs mainly in parotid gland. And sometimes also seen in submaxillary gland(rare).

☀️ Pathogenesis :-

👉 Current accepted theory -

The tumor arise in salivary gland tissue trapped within paraparotid or intraparotid lymph nodes during embryogenesis.

👉 Hus and Coworkers studies the tumor immunohistochemically and suggested that the lymphoid component of the tumor is an exaggerated secretory immune response.

☀️(Immune reaction in salivary duct that causes oncocytic change)

👉 There is a strong association with cigarette smoking.

👉 Epstein Barr virus also cause the warthin tumors

☀️ Clinical findings: -

1) Commonly present in the 6th and 7th decades ( Average 62)

2) The tumor is generally superficial, lying just beneath the parotid capsule or protruding through it.

Painless

4) Firm to palpation

5) Male predominantly

Histological features:--

 Macroscopic features -

1) Location in parotid gland - Smooth, soft parotid mass, and well encapsulated

2) Tumor contain a variable number of cyst that contains a clear fluid.

3) Area of ​​focal hemorrhage may also be seen.

Histological features -

This tumor made up by two histological components:-

Epithelial

2) Lymphoid tissue

👉The cyst are lined by papillary formation of bilayerd oncocytic epithelium.

The inner cells are tall columnar with finely granular and eosinophillic cytoplasm due to presence of mitochondrial and slightly hyperchromatic nuclei.

Outer layer cells are oncocytic triangular and occasionally fusiform basaloid cells.

Focal areas of squamous metaplasia and mucous cell prosplasia may be seen.

Often an eosinophillic coagulum is present within cystic spaces, which appears as chocolate colored fluid.

(Histological diagram of warthin tumor) 

Treatment :-

surgical excision