Warthin's tumor pathophysiology

Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]

Warthin's tumor Microchapters
Home
Patient Information
Overview
Historical Perspective
Pathophysiology
Causes
Differentiating Warthin's tumor from other Diseases
Epidemiology and Demographics
Risk Factors
Natural History, Complications and Prognosis
Diagnosis
History and Symptoms
Physical Examination
Laboratory Findings
CT
MRI
Echocardiography or Ultrasound
Other Imaging Findings
Biopsy
Treatment
Surgery
Cost-Effectiveness of Therapy
Case Studies
Case #1
Warthin's tumor pathophysiology On the Web
Most recent articles
Most cited articles
Review articles
CME Programs
Powerpoint slides
Images
American Roentgen Ray Society Images of Warthin's tumor pathophysiology All Images X-rays Echo & Ultrasound CT Images MRI
Ongoing Trials at Clinical Trials.gov
US National Guidelines Clearinghouse
NICE Guidance
FDA on Warthin's tumor pathophysiology
CDC on Warthin's tumor pathophysiology
Warthin's tumor pathophysiology in the news
Blogs on Warthin's tumor pathophysiology
Directions to Hospitals Treating Warthin's tumor
Risk calculators and risk factors for Warthin's tumor pathophysiology

Pathogenesis

• Warthin tumor is a benign tumor of the salivary gland. The first symptom is usually a painless, slow-growing bump in front of the ear, on the bottom of the mouth, or under the chin. Warthin tumors may increase in size over time, but few become cancerous.
• 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 thanpleomorphic adenoma, Warthin's tumor is the second most common benign parotid tumor.
• 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 protude into them. Additionally, the epithelium has lymphoid stroma with germinal center formation.
• 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.

Microscopic Pathology

• The appearance of this tumor under the microscope is unique.
• 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
• Additionally, the epithelium has lymphoid stroma with germinal center formation.

• 

  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.

• 

  Histopathology of Warthin tumor in the parotid gland. Image courtesy of Nephron librepathology (original file ‘’here’’). Creative Commons BY­SA­NC

• 

  Histopathology of Warthin tumor in the parotid gland. Image courtesy of Nephron librepathology (original file ‘’here’’). Creative Commons BY­SA­NC

• 

  Histopathology of Warthin tumor in the parotid gland. Image courtesy of Nephron librepathology (original file ‘’here’’). Creative Commons BY­SA­NC

• 

  Histopathology of Warthin tumor in the parotid gland. Image courtesy of Nephron librepathology (original file ‘’here’’). Creative Commons BY­SA­NC

References

Template:WikiDoc Sources