Abstract
Warthin-like tumor of the thyroid is a recently described rare variant of thyroid papillary carcinoma. The distinguishing histological feature of this variant is papillary foldings lined by oncocytic neoplastic cells with clear nuclei and nuclear pseudoinclusions, accompanied by prominent lymphocytic infiltrate in the papillary stalks. Its prognosis has been reported to be almost similar to conventional papillary carcinoma. In this case series, we report four cases with Warthin-like papillary carcinoma of the thyroid, diagnosed at Dokuz Eylul University Faculty of Medicine Department of Pathology in 2008 and 2009. Three patients were female. The mean patient age was 39 years (range, 20-56) and the mean tumor size was 1.7 cm (range, 0.9-2.0 cm). All of the cases had lymphocytic thyroiditis in the background. None of the tumors showed lymphovascular invasion. The patients are free of any recurrence and/or distant metastasis with a mean follow-up of 25 months. This rare variant of thyroid papillary carcinoma with distinct histopathological features should be indicated in pathology reports. Further studies and long-term follow-up of patients are needed to highlight the biological behavior of this variant.
Highlights
Papillary carcinoma is the most common primary malignant neoplasm of the thyroid gland
Warthin-like papillary carcinoma is an uncommon variant of thyroid papillary carcinoma
When Apel et al first described the features of these tumors in 1995, they named it as “papillary Hurthle cell carcinoma of the thyroid with lymphocytic stroma - Warthin-like tumor of the thyroid” [2]
Summary
Papillary carcinoma is the most common primary malignant neoplasm of the thyroid gland. Warthin-like variant of papillary carcinoma is an uncommon variant that was first described by Apel et al in 1995 [2]. This morphologic variant has distinct features of papillary architecture with prominent lymphocytic stroma in fibrovascular cores, resembling Warthin tumor of the salivary gland. There is only one case of Warthin-like tumor of papillary carcinoma reported in the literature, who underwent anaplastic changes [14]. We report four cases of Warthin-like tumor of papillary carcinoma, diagnosed at our institution in 2008 and 2009. The mean follow-up period of the patients was 25 months (range, 22-26 months), and there was no sign of either local recurrence and/or distant metastases in any of the patients. All of the cases had lymphocytic thyroiditis in non-neoplastic areas (Figure 4)
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