Warthins tumor.

WARTHINS TUMOR
  • Synonym – Papillary cystadenoma lymphomatosum, adenolymphoma, cystadenolymphoma
  • It is the second most common salivary gland neoplasm
  • This tumor exclusively occurs in parotid
  • Occurs more commonly in males and in the 5th and 6th decade.
  • It is associated smoking
  • Clinical presentation: Warthins tumor present as painless, sometimes fluctuant swellings in the lower portion of the parotid gland
Morphology
  • Gross
    • Well circumscribed encapsulated tumor measuring 2 to 5cms in diametre
    • Cut section: Cystic or cleft like spaces filled with a mucinous or serous secretions. Lining of the cyst shows knob like protrusions or papillary excresences
  • Microscopy :
    • It is an encapsulated lesion with cystic spaces lined by the papillary proliferation of bilayered oncocytic epithelium whose supporting stroma is composed largely of lymphoid tissue
    • The two types of epithelium are  (a) the luminal epithelium composed of tall columnar cells having granular eosinophilic cytoplasm and nuclei in the centre or apical ends of the cells (b) Beneath the columnar cells are  smaller basaloid cells which are triangular having fusiform nuclei and are arranged perpendicular to the long axis of tall columnar cells.
    • The stroma present below the epithelium shows lymphoid tissue with germinal centres
    •  
 
By
Dr.B.Chaitanya (Consultant Pathologist, RDT Hospital, Ananthapur)( bchaitanya.med@gmail.com)
Dr.V.Shanthi (Professor of Pathology, Narayana Medical College, Nellore)