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European Annals of Otorhinolaryngology,... Dec 2020
Topics: Adenolymphoma; Humans; Parotid Neoplasms
PubMed: 32768320
DOI: 10.1016/j.anorl.2020.05.003 -
Interventional Medicine & Applied... Jun 2016Warthin's tumor, also known as papillary cystadenoma lymphomatosum, monomorphic adenoma, or adenolymphoma, is a benign cystic tumor of the salivary glands containing... (Review)
Review
INTRODUCTION
Warthin's tumor, also known as papillary cystadenoma lymphomatosum, monomorphic adenoma, or adenolymphoma, is a benign cystic tumor of the salivary glands containing abundant lymphocytes and lymph node-like stroma. It is named after the pathologist Aldred Scott Warthin, who described two cases in 1929.
OBJECTIVE
The aim of this study is to analyze the pathogenesis of Warthin's tumor.
METHODS
A total of 15 patients with Warthin's tumor were studied. Hematoxylin and eosin stains, which have been used for at least a century and are still essential for recognizing various tissue types and the morphologic changes for cancer diagnosis, were used. Warthin's tumor was evaluated for the expression of MGMT, CD3, HSP90AA1, MMP-1, Bcl-2, CD79A, IgG, Ki-67, p53, IgM, OPN, S100, myeloperoxidase, and VEGF by immunohistochemistry.
RESULTS
Immunohistochemical staining confirmed that the immune cells within the follicles of Warthin's tumor were positive for MGMT (10.0 ± 0.34%), Ki-67 (13.3 ± 0.45%), Bcl-2 (42.6 ± 8.33), and p53 (11.6 ± 2.3). The immune cells associated with CD3 were present at the stroma of residual cells (47.3 ± 3.89); however, they were not present in the epithelium cell layers. B cells (CD79A) consistent with germinal centers were present within the immune cells and formed follicles (43.2 ± 13.5%).
CONCLUSIONS
Histopathological analysis of the stroma and parenchyma revealed balanced distribution of epithelial and stromal component. Epithelial component of the Warthin's tumor is the trigger for the tumor process. This study indicates that the Warthin tumor is a consequence of inflammatory etiology.
PubMed: 28386459
DOI: 10.1556/1646.8.2016.2.2 -
BMJ (Clinical Research Ed.) Dec 2004
Topics: Adenolymphoma; Adenoma, Pleomorphic; Dissection; Humans; Parotid Neoplasms
PubMed: 15576716
DOI: 10.1136/bmj.329.7478.1299 -
Head and Neck Pathology Mar 2023Oncocytes are a component of many metaplastic and neoplastic lesions throughout the head and neck area, primarily originating in salivary/seromucinous glands and the... (Review)
Review
BACKGROUND
Oncocytes are a component of many metaplastic and neoplastic lesions throughout the head and neck area, primarily originating in salivary/seromucinous glands and the thyroid gland. In addition, other lesions can contain cells that mimic oncocytes (pseudo-oncocytes); these can be of epithelial or non-epithelial origin.
METHODS
Review article.
RESULTS
Oncocytic metaplasia is common in seromucinous glands throughout the upper aerodigestive tract, most notable in the oral cavity, nasopharynx and larynx. The main oncocytic salivary gland neoplasms are Warthin tumor and oncocytoma. Infarction of Warthin tumor may lead to recognition difficulties. Oncocytic subtypes of mucoepidermoid carcinoma and intraductal carcinoma have morphologic and immunohistochemical features that allow distinction from major oncocytic entities. Oncocytic thyroid tumors include adenoma, carcinoma (follicular, papillary and medullary), along with poorly differentiated tumors. Oncocytic papillary sinonasal and middle ear tumors must be distinguished from low grade adenocarcinomas. Pseudo-oncocytic entities include paraganglioma, Langerhans cell histiocytosis, giant cell tumor, rhabdomyoma, and metastatic tumors.
CONCLUSIONS
Correct diagnosis of oncocytic head and neck lesions requires a knowledge of the spectrum of possible entities, their characteristic sites of occurrence, architecture, histomorphology, and immunohistochemistry. Oncocytic subtypes of several newly described entities are now recognized. Both epithelial and non-epithelial mimics of oncocytes exist. The molecular features of oncocytic tumors can be helpful in their diagnosis and understanding their pathogenesis.
Topics: Humans; Oxyphil Cells; Adenolymphoma; Salivary Gland Neoplasms; Salivary Glands; Adenoma, Oxyphilic
PubMed: 36928735
DOI: 10.1007/s12105-022-01520-y -
Diagnostic and Interventional Imaging Mar 2021The purpose of this systematic review was to provide an overview of the contribution of multiparametric magnetic resonance imaging (MRI) in the diagnosis of parotid... (Review)
Review
PURPOSE
The purpose of this systematic review was to provide an overview of the contribution of multiparametric magnetic resonance imaging (MRI) in the diagnosis of parotid tumors (PT) and recommendations based on current evidences.
MATERIAL AND METHODS
We performed a retrospective systematic search of PubMed, EMBASE, and Cochrane Library databases from inception to January 2020, using the keywords "magnetic resonance imaging" and "salivary gland neoplasms".
RESULTS
The initial search returned 2345 references and 90 were deemed relevant for this study. A total of 54 studies (60%) reported the use of diffusion-weighted imaging (DWI) and 28 studies (31%) the use of dynamic contrast-enhanced (DCE) imaging. Specific morphologic signs of frequent benign PT and suggestive signs of malignancy on conventional sequences were reported in 37 studies (41%). DWI showed significant differences in apparent diffusion coefficient (ADC) values between benign and malignant PT, and especially between pleomorphic adenomas and malignant PT, with cut-off ADC values between 1.267×10mm/s and 1.60×10mm/s. Perfusion curves obtained with DCE imaging allowed differentiating among pleomorphic adenomas, Warthin's tumors, malignant PT and cystic lesions. The combination of morphological MRI sequences, DCE imaging and DWI helped increase the diagnostic accuracy of MRI.
CONCLUSION
Multiparametric MRI, including morphological MRI sequences, DWI and DCE imaging, is the imaging modality of choice for the characterization of focal PT and provides features that are highly suggestive of a specific diagnosis.
Topics: Adenolymphoma; Contrast Media; Diagnosis, Differential; Diffusion Magnetic Resonance Imaging; Humans; Magnetic Resonance Imaging; Multiparametric Magnetic Resonance Imaging; Parotid Neoplasms; Retrospective Studies; Sensitivity and Specificity
PubMed: 32943368
DOI: 10.1016/j.diii.2020.08.002 -
Canadian Medical Association Journal Nov 1952
Topics: Adenolymphoma; Salivary Gland Neoplasms
PubMed: 13009589
DOI: No ID Found -
Diagnostics (Basel, Switzerland) Aug 2021To review the current options in the management of Warthin tumors (WTs) and to propose a working management protocol. (Review)
Review
PURPOSE
To review the current options in the management of Warthin tumors (WTs) and to propose a working management protocol.
METHODS
A systematic literature search was conducted using PubMed and ScienceDirect database. A total of 141 publications were selected and have been included in this review. Publications were selected based on relevance, scientific evidence, and actuality.
RESULTS
The importance of parotid WTs is increasing due to its rising incidence in many countries, becoming the most frequently encountered benign parotid tumor in certain parts of the world. In the past, all WTs were treated with surgery, but because of their slow growth rate, often minimal clinical symptoms, and the advanced age of many patients, active observation has gradually become more widely used. In order to decide on active surveillance, the diagnosis of WT must be reliable, and clinical, imaging, and cytological data should be concordant. There are four clear indications for upfront surgery: uncertain diagnosis; cosmetic problems; clinical complaints, such as pain, ulceration, or recurrent infection; and the patient's wish to have the tumor removed. In the remaining cases, surgery can be elective. Active surveillance is often suggested as the first approach, with surgery being considered if the tumor progresses and/or causes clinical complaints. The extent of surgery is another controversial topic, and the current trend is to minimize the resection using partial parotidectomies and extracapsular dissections when possible. Recently, non-surgical options such as microwave ablation, radiofrequency ablation, and ultrasound-guided ethanol sclerotherapy have been proposed for selected cases.
CONCLUSIONS
The management of WT is gradually shifting from superficial or total parotidectomy to more conservative approaches, with more limited resections, and to active surveillance in an increasing number of patients. Additionally, non-surgical treatments are emerging, but their role needs to be defined in future studies.
PubMed: 34441400
DOI: 10.3390/diagnostics11081467 -
Head & Face Medicine Mar 2021The purpose of this study is to determine the histopathological spectrum and risk of primary malignancy of asymptomatic parotid lesions incidentally discovered on...
BACKGROUND
The purpose of this study is to determine the histopathological spectrum and risk of primary malignancy of asymptomatic parotid lesions incidentally discovered on cross-sectional imaging.
METHODS
Over a 10-year period, 154 patients underwent 163 ultrasound-guided parotid lesion biopsies at our institution. This retrospective chart review included 89 lesions in 87 patients with asymptomatic parotid lesions discovered on cross-sectional imaging studies performed for unrelated clinical indications. The histopathologic findings of all sampled lesions were reviewed. We evaluated the patient demographics and pathological diagnoses of sampled parotid lesions to determine the histopathological spectrum and risk of malignancy.
RESULTS
The average age was 67.5 years and 92 % were males. 25 % of patients had bilateral lesions. The average size of the parotid lesions was 1.5 cm and 91 % were located in the superficial lobe. 92.1 % of lesions were benign with Warthin tumor being the most common diagnosis followed by pleomorphic adenoma. 2.3 % of lesions were primary parotid malignant neoplasms, while 5.6 % were metastatic lesions in patients with known malignancy.
CONCLUSIONS
The incidence of primary parotid malignant neoplasm in asymptomatic incidentally discovered parotid lesions is low. Imaging or clinical follow-up may be considered in patients with incidental parotid lesions who prefer to avoid biopsy.
Topics: Adenolymphoma; Aged; Biopsy; Female; Humans; Male; Parotid Gland; Parotid Neoplasms; Retrospective Studies
PubMed: 33757536
DOI: 10.1186/s13005-021-00262-6 -
Head & Neck Oct 2022It is important to define the accuracy of fine-needle aspiration cytology (FNAC) in the diagnosis of Warthin tumor (WT). This systematic review and meta-analysis... (Meta-Analysis)
Meta-Analysis Review
It is important to define the accuracy of fine-needle aspiration cytology (FNAC) in the diagnosis of Warthin tumor (WT). This systematic review and meta-analysis evaluated the accuracy of FNAC in the diagnosis of WT in the parotid gland and WT growth rate. For determination of FNAC accuracy, 17 studies, encompassing 1710 cases, were included. Pulled random model estimates of sensitivity, specificity, PPV, and NPV were 93.7% (95%CI: 92.1, 95.3), 97.9% (95%CI: 97, 98.9), 93.3% (95%CI: 91.5, 95.1), and 97.4% (95%CI: 96.4, 98.4), respectively. FNAC is highly reliable for the diagnosis of WT of the parotid. The high PPV value suggests that patients with a cytological diagnosis of WT of the parotid may be assigned to active surveillance.
Topics: Adenolymphoma; Biopsy, Fine-Needle; Humans; Parotid Gland; Parotid Neoplasms; Retrospective Studies; Sensitivity and Specificity
PubMed: 35586869
DOI: 10.1002/hed.27099 -
Indian Journal of Dermatology,... 2012
Topics: Adenolymphoma; Adult; Facial Neoplasms; Humans; Male; Skin Neoplasms; Young Adult
PubMed: 22960832
DOI: 10.4103/0378-6323.100575