Warthin's tumor overview: Difference between revisions

Jump to navigation Jump to search
No edit summary
No edit summary
 
(7 intermediate revisions by 4 users not shown)
Line 1: Line 1:
<div style="-webkit-user-select: none;">
{| class="infobox" style="position: fixed; top: 65%; right: 10px; margin: 0 0 0 0; border: 0; float: right;"
|-
| {{#ev:youtube|https://https://www.youtube.com/watch?v=IKG8McDLoB8 |350}}
|-
|}
__NOTOC__
__NOTOC__
{{CMG}}
 
{{CMG}};  {{AE}}  {{N.F}}
{{Warthin's tumor}}
{{Warthin's tumor}}


==Overview==
==Overview==
Warthin's tumor is a type of [[benign]] [[tumor]] of the [[salivary glands]].  It is also known as benign [[papillary]] [[cystadenoma]] lymphomatosum.  Its [[etiology]] is unknown, but there is a strong association with the cigarette [[Tobacco smoking|smoking]].  Smokers are at 8 times greater risk of developing Warthin's tumor than the general population. The most common symptoms of Evan's syndrome include swollen salivary gland, [[lump]] near the back of the lower jaw, jaw [[pain]], the sensation of pressure, facial nerve paralysis, [[tinnitus]], impaired hearing, [[earache]], etc. X-ray, computed tomography (CT) scan and magnetic resonance imaging (MRI) may help diagnosis. Surgery is the best treatment for Warthin's tumor. As a benign tumor, the prognosis of Warthin's tumor is good.
Warthin's tumor is a type of [[benign]] [[tumor]] of the [[salivary glands]].  It is also known as [[benign]] [[papillary]] [[cystadenoma]] lymphomatosum.  Its [[etiology]] is unknown, but there is a strong association with the cigarette [[Tobacco smoking|smoking]].  Smokers are at 8 times greater risk of developing Warthin's tumor than the general population. Warthin's tumor arises from [[salivary gland]] [[Epithelium|epithelium,]] which are secretory cells of the [[salivary gland]]. On [[gross pathology]], [[cystic]] and multicentric appearance are characteristic findings of Warthin's tumor. On [[microscopic]] [[Histopathological|histopathologica]]<nowiki/>l analysis, [[papillae]], [[Fibrous capsule|fibrous capsule,]] and [[cystic]] spaces are characteristic findings of Warthin's tumor. Warthin's tumor must be differentiated from [[salivary gland]] cysts, salivary gland lymphoma, and [[Salivary gland cancer|salivary gland cance]]<nowiki/>r. The [[prevalence]] of Warthin's tumor is [[Estimate|estimated]] to be 2000 to 2500 cases annually. Warthin's tumor commonly affects [[elderly]] patients greater than 60 years old. Males are more commonly affected with Warthin's tumor than females. The male to female ratio ranges from 2.6:1 to 10:1. The most potent [[risk factor]] in the [[development]] of Warthin's tumor is [[smoking]]. Other [[risk factors]] include [[irradiation]], [[Epstein-Barr virus]], and [[alcohol]]. If left untreated, few patients with Warthin's tumor may progress to develop [[facial paralysis]]. Common [[complications]] of Warthin's tumor include [[squamous cell carcinoma]] and [[facial paralysis]]. [[Prognosis]] is generally good. The most common symptoms of Warthin's tumor include [[Swelling|swollen]] [[salivary gland]], [[lump]] near the back of the lower [[jaw]], [[Jaw pain/swelling|jaw]] [[pain]], the [[sensation]] of [[pressure]], [[facial nerve paralysis]], [[tinnitus]], impaired hearing, [[earache]], etc. [[X-ray|X-ray,]] [[Computed tomography|computed tomography (CT) scan]] and [[Magnetic resonance imaging|magnetic resonance imaging (MRI)]] may help [[diagnosis]]. [[Surgery]] is the mainstay of treatment for Warthin's tumor. As a [[benign tumor]], the [[prognosis]] of Warthin's tumor is good.
==Historical Perspective==
==Historical Perspective==
Warthin's tumor was first discovered by Hildebrand, a German surgeon, in 1895.
Warthin's tumor was first discovered by Hildebrand, a German surgeon, in 1895.
==Pathophysiology==
==Pathophysiology==
Warthin's tumor arises from salivary gland epithelium, which are secretory cells of the salivary gland. On gross pathology, cystic and multicentric appearance are characteristic findings of Warthin's tumor. On microscopic histopathological analysis, papillae, fibrous capsule, and cystic spaces are characteristic findings of Warthin's tumor.
Warthin's tumor arises from [[salivary gland]] [[epithelium]], which are secretory cells of the [[salivary gland]]. On gross pathology, [[cystic]] and multicentric appearance are characteristic findings of Warthin's tumor. On [[microscopic]] [[histopathological]] [[analysis]], [[papillae]], [[fibrous capsule]], and [[Cystic|cystic spaces]] are characteristic findings of Warthin's tumor.
==Causes==
==Causes==
There are no known direct causes for Warthin's tumor.  
There are no known direct causes for Warthin's tumor.  
==Differential Diagnosis==
==Differential Diagnosis==
Warthin's tumor must be differentiated from salivary gland cysts, salivary gland lymphoma, and salivary gland cancer.
Warthin's tumor must be [[Differentiating (disease name) from other diseases page|differentiated]] from [[salivary gland]] [[Cyst|cysts]], [[salivary gland]] [[Lymphomas|lymphoma]], and [[salivary gland cancer]].
==Epidemiology and Demographics==
==Epidemiology and Demographics==
The prevalence of Warthin's tumor is estimated to be 2000 to 2500 cases annually. Warthin's tumor commonly affects elderly patients greater than 60 years old. The male is more commonly affected with Warthin's tumor than female. The male to female ratio ranges from 2.6:1 to 10:1.
The [[prevalence]] of Warthin's tumor is estimated to be 2000 to 2500 cases annually. Warthin's tumor commonly affects elderly patients greater than 60 years old. The male is more commonly affected with Warthin's tumor than female. The male to female ratio ranges from 2.6:1 to 10:1.
==Risk Factors==
==Risk Factors==
The most potent risk factor in the development of Warthin's tumor is smoking. Other risk factors include irradiation, Epstein-Barr virus, and alcohol.
The most potent [[risk factor]] in the development of Warthin's tumor is [[smoking]]. Other risk factors include [[irradiation]], [[Epstein-Barr virus]], and [[alcohol]].
==Natural history, Complications and Prognosis==
==Natural history, Complications and Prognosis==
If left untreated, few patients with Warthin's tumor may progress to develop facial paralysis. Common complications of Warthin's tumor include squamous cell carcinoma and facial paralysis. Prognosis is generally good.
If left untreated, few patients with Warthin's tumor may progress to develop [[Facial nerve paralysis|facial paralysis]]. Common [[complications]] of Warthin's tumor include [[squamous cell carcinoma]] and [[Facial nerve paralysis|facial paralysis]]. [[Prognosis]] is generally good.
==History and Symptoms==
==History and Symptoms==
The hallmark of Warthin's tumor is swelling of jaw, cheek, mouth, or neck. A positive history of swollen salivary gland and jaw [[pain]] is suggestive of Warthin's tumor. The most common
The hallmark of Warthin's tumor is [[swelling]] of [[jaw]], [[cheek]], [[mouth]], or [[neck]]. A positive history of [[Swelling|swollen]] [[salivary gland]] and jaw [[pain]] is suggestive of Warthin's tumor. The most common
symptoms of Warthin's tumor include [[tinnitus]], [[an earache]], and blood in saliva.
[[symptoms]] of Warthin's tumor include [[tinnitus]], [[Earache|an earache]], and blood in [[saliva]].
==Physical Examination==
==Physical Examination==
Patients with Warthin's tumor usually appear well. Physical examination of patients with Warthin's tumor is usually  remarkable for mobile nontender mass which is firm and solitary, normal in color and appearance.
Patients with Warthin's tumor usually appear well. Physical examination of patients with Warthin's tumor is usually  remarkable for mobile nontender mass which is firm, [[solitary]], and normal in color and [[appearance]].
 
==Laboratory Findings==
==Laboratory Findings==
There are no diagnostic lab findings associated with Warthin's tumor.
There are no [[diagnostic]] [[Lab finding|lab findings]] associated with Warthin's tumor.
==CT==
==CT==
Neck CT scan may be helpful in the diagnosis of Warthin's tumor. Findings on CT scan suggestive of Warthin's tumor include cystic lesion posteriorly within the parotid with a focal tumor nodule and absence of calcifications.
Neck CT scan may be helpful in the diagnosis of Warthin's tumor. Findings on CT scan suggestive of Warthin's tumor include [[cystic]] lesion posteriorly within the [[parotid]] with a focal tumor nodule and absence of [[Calcification|calcifications]].
==MRI==
==MRI==
On MRI, Warthin's tumor is characterized by well-defined bilateral lesions which are heterogeneous and variable in signal intensity.
On MRI, Warthin's tumor is characterized by well-defined [[bilateral]] [[lesions]] which are [[heterogeneous]] and [[variable]] in signal intensity.
==Echocardiography or Ultrasound==
==Echocardiography or Ultrasound==
Neck ultrasound may be helpful in the diagnosis of Warthin's tumor. Findings on neck ultrasound suggestive of Warthin's tumor include  well defined, ovoid, hyperechoic mass, internal cystic areas, and hypervascularity.
Neck [[ultrasound]] may be helpful in the [[diagnosis]] of Warthin's tumor. Findings on neck ultrasound suggestive of Warthin's tumor include  well defined, [[ovoid]], hyperechoic mass with internal [[cystic]] areas and hypervascularity.
 
==Other Imaging Findings==
==Other Imaging Findings==
Other diagnostic studies for Warthin's tumor include scintigraphy, which demonstrates uptake of with Tc99-pertechnetate, thallium, and FDG-PET.
Other diagnostic studies for Warthin's tumor include [[scintigraphy]], which demonstrates uptake of with Tc99-pertechnetate, [[thallium]], and [[FDG-PET]].
==Biopsy==
==Biopsy==
On biopsy, Warthin's tumor is characterized by cystic spaces surrounded by two uniform rows of [[cell (biology)|cells]] with centrally placed pyknotic [[cell nucleus|nuclei]], papillae with a two rows of pink epithelial cells, and lymphoid stroma.
On [[biopsy]], Warthin's tumor is characterized by cystic spaces surrounded by two uniform rows of [[cell (biology)|cells]] with centrally placed pyknotic [[cell nucleus|nuclei]], [[papillae]] with a two rows of pink [[epithelial cells]], and [[Lymphoid|lymphoid stroma]].
==Surgery==
==Surgery==
Surgery is the mainstay of treatment for Warthin's tumor.
Surgery is the mainstay of treatment for Warthin's tumor.
Line 43: Line 52:
{{WH}}
{{WH}}
{{WS}}
{{WS}}
[[Category:Oral pathology]]
[[Category:Oral pathology]]
[[Category:Types of cancer]]
[[Category:Types of cancer]]
Line 49: Line 57:
[[Category:Disease]]
[[Category:Disease]]
[[Category:Hereditary cancers]]
[[Category:Hereditary cancers]]
[[Category:Up-To-Date]]
[[Category:Oncology]]
[[Category:Medicine]]
[[Category:Otolaryngology]]
[[Category:Gastroenterology]]

Latest revision as of 19:43, 29 November 2018

https://https://www.youtube.com/watch?v=IKG8McDLoB8 |350}}


Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Nazia Fuad M.D.

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 overview 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 overview

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 overview

CDC on Warthin's tumor overview

Warthin's tumor overview in the news

Blogs on Warthin's tumor overview

Directions to Hospitals Treating Warthin's tumor

Risk calculators and risk factors for Warthin's tumor overview

Overview

Warthin's tumor is a type of benign tumor of the salivary glands. It is also known as benign papillary cystadenoma lymphomatosum. Its etiology is unknown, but there is a strong association with the cigarette smoking. Smokers are at 8 times greater risk of developing Warthin's tumor than the general population. Warthin's tumor arises from salivary gland epithelium, which are secretory cells of the salivary gland. On gross pathology, cystic and multicentric appearance are characteristic findings of Warthin's tumor. On microscopic histopathological analysis, papillae, fibrous capsule, and cystic spaces are characteristic findings of Warthin's tumor. Warthin's tumor must be differentiated from salivary gland cysts, salivary gland lymphoma, and salivary gland cancer. The prevalence of Warthin's tumor is estimated to be 2000 to 2500 cases annually. Warthin's tumor commonly affects elderly patients greater than 60 years old. Males are more commonly affected with Warthin's tumor than females. The male to female ratio ranges from 2.6:1 to 10:1. The most potent risk factor in the development of Warthin's tumor is smoking. Other risk factors include irradiation, Epstein-Barr virus, and alcohol. If left untreated, few patients with Warthin's tumor may progress to develop facial paralysis. Common complications of Warthin's tumor include squamous cell carcinoma and facial paralysis. Prognosis is generally good. The most common symptoms of Warthin's tumor include swollen salivary gland, lump near the back of the lower jaw, jaw pain, the sensation of pressure, facial nerve paralysis, tinnitus, impaired hearing, earache, etc. X-ray, computed tomography (CT) scan and magnetic resonance imaging (MRI) may help diagnosis. Surgery is the mainstay of treatment for Warthin's tumor. As a benign tumor, the prognosis of Warthin's tumor is good.

Historical Perspective

Warthin's tumor was first discovered by Hildebrand, a German surgeon, in 1895.

Pathophysiology

Warthin's tumor arises from salivary gland epithelium, which are secretory cells of the salivary gland. On gross pathology, cystic and multicentric appearance are characteristic findings of Warthin's tumor. On microscopic histopathological analysis, papillae, fibrous capsule, and cystic spaces are characteristic findings of Warthin's tumor.

Causes

There are no known direct causes for Warthin's tumor.

Differential Diagnosis

Warthin's tumor must be differentiated from salivary gland cysts, salivary gland lymphoma, and salivary gland cancer.

Epidemiology and Demographics

The prevalence of Warthin's tumor is estimated to be 2000 to 2500 cases annually. Warthin's tumor commonly affects elderly patients greater than 60 years old. The male is more commonly affected with Warthin's tumor than female. The male to female ratio ranges from 2.6:1 to 10:1.

Risk Factors

The most potent risk factor in the development of Warthin's tumor is smoking. Other risk factors include irradiation, Epstein-Barr virus, and alcohol.

Natural history, Complications and Prognosis

If left untreated, few patients with Warthin's tumor may progress to develop facial paralysis. Common complications of Warthin's tumor include squamous cell carcinoma and facial paralysis. Prognosis is generally good.

History and Symptoms

The hallmark of Warthin's tumor is swelling of jaw, cheek, mouth, or neck. A positive history of swollen salivary gland and jaw pain is suggestive of Warthin's tumor. The most common symptoms of Warthin's tumor include tinnitus, an earache, and blood in saliva.

Physical Examination

Patients with Warthin's tumor usually appear well. Physical examination of patients with Warthin's tumor is usually remarkable for mobile nontender mass which is firm, solitary, and normal in color and appearance.

Laboratory Findings

There are no diagnostic lab findings associated with Warthin's tumor.

CT

Neck CT scan may be helpful in the diagnosis of Warthin's tumor. Findings on CT scan suggestive of Warthin's tumor include cystic lesion posteriorly within the parotid with a focal tumor nodule and absence of calcifications.

MRI

On MRI, Warthin's tumor is characterized by well-defined bilateral lesions which are heterogeneous and variable in signal intensity.

Echocardiography or Ultrasound

Neck ultrasound may be helpful in the diagnosis of Warthin's tumor. Findings on neck ultrasound suggestive of Warthin's tumor include well defined, ovoid, hyperechoic mass with internal cystic areas and hypervascularity.

Other Imaging Findings

Other diagnostic studies for Warthin's tumor include scintigraphy, which demonstrates uptake of with Tc99-pertechnetate, thallium, and FDG-PET.

Biopsy

On biopsy, Warthin's tumor is characterized by cystic spaces surrounded by two uniform rows of cells with centrally placed pyknotic nuclei, papillae with a two rows of pink epithelial cells, and lymphoid stroma.

Surgery

Surgery is the mainstay of treatment for Warthin's tumor.

Reference

Template:WH Template:WS