Papillary Cystadenoma Lymphomatosum Research Articles

Warthin’s Tumor in Submandibular Salivary Gland: An Uncommon Extra Parotid Location

Introduction: Salivary gland tumors are complex to diagnose both on histopathology and cytology. Majority of these tumours arise in the parotid glands, followed by submandibular glands, and rarely in minor salivary glands. Warthin’s tumor (WT), also known as papillary cystadenoma lymphomatosum, is characterized by a dense lymphoid stroma and a double layer of oncocytic epithelium with papillary and cystic architecture. Only 6-10% cases have been reported in the extra-parotid locations i.e. cervical lymph nodes, submandibular gland and larynx. Case Report: Our patient presented with painless bilateral submandibular swellings for 1.5 months with history of chronic smoking of two bundles of biddis per day for 32 years. Conclusion: Hereby, this case was unique in its presentation as it was located in an extra parotid region with bilateral origin, as these locations carry clinical significance in diagnosing and ruling out conditions like lymphoma.

Warthin Tumor of the Parotid Gland: The History of an Eponym.

The eponymous history of Warthin tumor (WT) is a fascinating issue in the field of salivary gland pathology. The late decades of the nineteenth century and the turn of the century saw notable German and French contributions on WT. Especially, the seminal 1910 paper of Albrecht and Arzt of Vienna is the foundation for the current knowledge of WT. It is generally believed that prior to this pioneering study, Hildebrand of Göttingen accurately described the lesion of WT in 1895. However, the historical origins of WT appear to be unsettled, and only a few German pathologists and surgeons are aware that dating back to 1885, the first recognizable reference to WT was that by the renowned German-Swiss pathologist Zahn, whose name is eponymously associated with "Zahn infarct" and "lines of Zahn". Two noted French surgeons with a major interest in pathology, Albarrán in 1885 and Lecéne in 1908, did not contribute to the topic. Since the 1950s, a mostly American group of pathologists and surgeons gradually adopted the term WT to replace the very accurate histologic descriptor "papillary cystadenoma lymphomatosum" coined by Warthin himself in 1929. It is our opinion that from a historical viewpoint, there is no particular reason why this tumor should have been named WT.

Warthin Tumor - Diagnostic Dilemma- Case Report

Warthin Tumor is also known as Papillary Cystadenoma lymphomatosum, is a fairly common tumor. Cytologically, it simulates many other lesions of salivary glands like chronic sialadenitis, low grade mucoepidermoid carcinoma, acinic cell carcinoma, squamous cell carcinoma, oncocytic carcinoma, lymphoepithelial cyst etc which poses a diagnostic dilemma.

Ultrasonographic Identification of the Parotid Cystadenolymphoma (Warthin’s Tumor) by Oral and Maxillofacial Surgeons: Supplement to the Matsuda and Colleagues’ Classification

Warthin’s tumor (WT), which is also known as papillary cystadenoma lymphomatosum, monomorphic parotid adenoma, adenolymphoma, cystadenolymphoma, and branchiogenic adenoma, is to be differentiated (in surgical practice) from other parotid masses. The purposes of our retrospective case series study are: (1) to describe ultrasound morphology (sonomorphology) of the WT in patients referred to our hospital, (2) based on the presented cases to propose a supplement to the Matsuda and colleagues’ classification (2017) of anechoic area patterns of the WT, and (3) to expand the knowledge of oral and maxillofacial surgeons for the preoperative ultrasonographic verification of the WT and for choosing the most appropriate surgical technique. Over three years, 5 patients (mean age, 65.4 years) with parotid WT had been examined with gray-scale, color, and power Doppler ultrasonography. Cystic components are visualized in all five WT cases but in different proportions. Case 1 and 4 showed the presence of septations. According to Matsuda and colleagues’ (2017) classification of anechoic area patterns, in our cases the US patterns of the WTs belong only to Group 3 (i.e., with large anechoic areas) (n = 4) and Group 4 (multiple and sponge-like anechoic areas) (n = 1). Moreover, based on the presented five cases, we offer an addition to the classification of Japanese authors. In conclusion, our supplement to Matsuda and colleagues’ classification of anechoic area patterns of the WT can help surgeons around the globe to be more accurate in preoperative verification of cystadenolymphoma. This case series illustrate the growing importance of ultrasonography in the professional life of oral and maxillofacial and head and neck surgeons. Based on the cystic structure of this benign tumor and the ultrasound appearance presented in our case series, we propose to continue using the term “cystadenolymphoma” with a purpose to emphasize the tumor`s structure.

The Differences between Benign Mixed Tumor and Papillary Cystadenoma Lymphomatosum in Proliferative, Apoptotic and Antiapoptotic Activities

The Differences between Benign Mixed Tumor and Papillary Cystadenoma Lymphomatosum in Proliferative, Apoptotic and Antiapoptotic Activities

Giant Warthin's Tumour of the Parotid Gland: A Rare Case Report.

Warthin's tumour was first adequately described in 1929 by an American pathologist, Aldred Scott Warthin. It is synonymous with papillary cystadenoma lymphomatosum (PCL), cystadenolymphoma or adenolymphoma. Giant salivary gland tumours are usually pleomorphic adenomas. The average size of Warthin's tumour is reported to be about 2-4cm. In the current fascinating case, an enormous disfiguring salivary gland tumour was reported which turned out to be Warthin's tumour on histopathology, which is probably the largest PCL reported till date.

The differences between benign mixed tumor and papillary cystadenoma lymphomatosum in proliferative, apoptotic, and antiapoptotic activity

The differences between benign mixed tumor and papillary cystadenoma lymphomatosum in proliferative, apoptotic, and antiapoptotic activity

Warthin’s tumor as “Earring” lesion of parotid gland: a case report

ABSTRACT Background: Earring lesions in the neck region comprises spectrum of different pathologies. Papillary cystadenoma lymphomatosum (PCL) is one of such entity which falls in this spectrum. The cystic lesions of the tail of parotid gland can lead to utter confusion over the diagnosis especially about the site of origin. The exact anatomy has to be delineated for the correct location and the diagnosis. The wrong location and diagnosis can lead to many iatrogenic complications. The cross-sectional imaging plays a pivot role. Computerized tomography and Magnetic Resonance imaging can diagnose the entity fairly to the exact diagnosis. Case Presentation: We present 41-year female who presented with this type of pathology with small swelling at the angle of left mandible. She reported because of cosmetic reasons and was subjected to CT and MRI. Coronal sections were able to delineate the lesion in both Contrast enhanced computerized tomography (CECT) and Magnetic resonance imaging (MRI). The lesion after histological analysis turned out to be Warthin’s tumor. Conclusion: Ear ring lesions remain undiagnosed if not evaluated by cross-sectional radiological imaging. The concern becomes greater because of the malignant potential of these neoplasms.

Perfil epidemiológico de neoplasias epiteliales de glándulas salivales

Epithelial tumors of the salivary glands, including benign tumors and aggressive malignancies with different prognoses, are uncommon. To describe the frequency and distribution of salivary gland tumors according to age, gender and anatomical location. Review of pathological reports of salivary gland tumors of a Pathology laboratory at a clinical hospital from 2006 to 2016. Five hundred ninety salivary gland biopsies were reviewed. Of these, 286 (49%) were primary epithelial tumors of the salivary glands. Two hundred thirty (80%) were benign and 56 (20%) were malignant tumors. Regarding location, 274 (96%) were in the major salivary glands, and 12 (4%) in the minor salivary glands. The most common histological types were pleomorphic adenoma for benign tumors in 172 cases, followed by papillary cystadenoma lymphomatosum in 33 cases. Mucoepidermoid carcinoma was the most common malignant tumor in 14 cases. These results are similar to reports from abroad, however more studies are necessary to be able to establish a more representative and updated analysis.

146 - Effects of fusarochromanone on mitochondrial function in squamous cell carcinoma and salivary gland carcinoma

It is known that cancer cells undergo aerobic glycolysis and therefore have a decreased oxidative phosphorylation an increase the level of Reactive Oxygen Species (ROS) in what is called as the Warburg Effect. As both of these physiological processes occur in the mitochondria, this organelle shows potential as a target for terminating cancer cell growth. Fusarochromanone (FC-101) is a fungal metabolite that shows anti-cancer activity by inducing apoptosis and inhibiting the growth of cancer cells in-vitro by the induction of ROS in the cells. In our project, we studied the effect of FC-101 on the mitochondrial bioenergetics of the head and neck cancer cell lines SCC-40 (Squamous Cell Carcinoma) and Papillary Cystadenoma Lymphomatosum (PCL) by using western blots and the Agilent Seahorse XF Cell Mito Stress Test. We also studied the migratory capacity of PCL cells using wound-healing assays. A wound-healing assay mimics cell migration during wound healing in-vivo. The results we obtained from this project indicate an increase in the amount of oxidative phosphorylation taking place in the mitochondria of PCL and SCC-40 cancer cell lines, as well as a decrease in the rate of glycolysis. As a result, fusarochromanone is shown to cause an increase in the amount of Reactive Oxygen Species (ROS) in the mitochondria of these cancer cell lines and thus causes an increase in mitochondrial bioenergetics. The data serves to strengthen the potential of FC-101 as an anti-cancer drug.

Diagnostic value of 3.0T dynamic contrast-enhanced MRI and diffusion weighted imaging for common parotid tumors

Thirty nine patients with pathologically confirmed parotid tumors, including 18 cases of pleomorphic adenomas, 12 cases of papillary cystadenoma lymphomatosum and 9 cases of malignant tumors, were enrolled in the study. Characteristics on routine MR image, diffusion weighted imaging (DWI), time-signal intensity curve (TIC) and apparent diffusion coefficient (ADC) value in different types of tumors were evaluated. There were significant differences in imaging features between benign and malignant tumors (P<0.01). The TIC types were A, B and C for pleomorphic adenomas, papillary cystadenoma lymphomatosum and malignant tumors, respectively. The mean ADC value of pleomorphic adenomas was significantly higher than that of papillary cystadenoma lymphomatosum and malignant tumors (P<0.01). No significant difference in ADC values between papillary cystadenoma lymphomatosum and malignant tumors was detected (P=0.73). The study indicates that MR plain scan combined with dynamic contrast enhanced MRI and DWI may be helpful in pre-operative differentiation of common parotid tumors. Key words: Parotid neoplasms; Magnetic resonance imaging; Image enhancement, dynamic; Diffusion magnetic resonance imaging

Pathogenesis of Warthin's tumors.

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. The aim of this study is to analyze the pathogenesis of Warthin's tumor. 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. 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%). 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.

Fine Needle Aspiration Cytology in Warthin's Tumor: A Diagnostic tool

Warthin’s tumor, also known as papillary cystadenoma lymphomatosum or adenolymphoma, is the second most common benign tumor of the salivary glands. It is commonly seen in lower lobe of the parotid gland and affects mainly male in sixth or seventh decades of life. Studies have shown that there is a close association between Warthin’s tumor and cigarette smoking. Preoperative fine needle aspiration cytology (FNAC) of a parotid mass plays a pivotal role in differentiating neoplastic from inflammatory lesion as well as management of patients. We report a case of a 70 year old male chronic smoker who presented with painless swelling in the parotid region bilaterally.

Multifocal Occurrence of Warthin’s Tumor in Both Parotid Glands and in the Larynx

The Warthin’s tumor or papillary cystadenoma lymphomatosum is a benign neoplasm which affects commonly the salivary glands und especially the parotid gland. We present a case of an 80-year-old Caucasian woman, who presented in our ENT department because of a progressive swelling in the left parotid gland. The clinical as well as the radiological findings suggested a multifocal lobular neoplasia in both parotid glands as well as a tumor in the left morgagni sinus of the larynx, most probably of benign nature. We proceeded in performing a lateral parotidectomy of the left side, a fine needle aspiration of the right parotid tumor and a CO 2 laser assisted transoral excision of the larynx tumor. The histopathological examination showed a multifocal cystadenolymphoma of both parotid glands as well as the left supraglottic region (left laryngeal ventricle) with no signs of malignancy. To our knowledge, this is the first case described in the literature of a multifocal cystadenolymphoma of both parotid glands and the larynx.

Papillary cyst adenoma lymphomatosum: A case report and review

Papillarycyst adenoma lymphomatosum is the next common tumor to the pleomorphic adenoma affecting exclusively parotid gland, was first described in 1895 by Hilderbrad. Due to its unique presentation both clinically as well as histopathologically and its unknown origin, this tumor entity is still riveting oral surgeons and pathologist. Here we report a case of parotid swelling clinically diagnosed as benign salivary gland tumor and its review.

A large painless swelling of the lateral neck

Lateral neck swellings are common findings in our daily practice. The etiology of a mass arising in the neck can be congenital, inflammatory, or neoplastic. Warthin's tumor was first described by Aldred Warthin, the pathologist who named this tumor papillary cystadenoma lymphomatosum, but since then it was also known as adenolymphoma, cystadenolymphoma, and Warthin's tumor. Although a few cases of Warthin's tumor have been reported in the literature, the occurrence of extraparotid Warthin's tumor is rare. This article presents a case report on painless lateral neck swelling that was finally diagnosed as extraparotid Warthin's tumor after histopathological analysis that was suspected to be sialadenitis on fine-needle aspiration cytology and metastatic lymph node on ultrasound.

PP183: Management of Warthin’s tumor: Our 10 year clinical experience and a review of the literature

Purpose Warthin’s tumor, also known as adenolymphoma or papillary cystadenoma lymphomatosum, is a benign, controversial lesion which is almost exclusively restricted to the parotid gland. The purpose of this study is to evaluate the treatment outcome of a group of 34 patients who were treated in our clinic. Materials and methods Between 2000 and 2010 a group of 34 patients with Warthin’s tumor were treated in the Oral and Maxillofacial Surgery Department of “G. Papanikolaou” Hospital in Thessaloniki. The age range was from 39 to 75 years. Thirty-one patients were male and three patients were female. Ten patients underwent partial superficial parotidectomy and two patients were treated with extracapsular dissection. Results The follow-up period ranged from 2 to 10 years. Two patients had multiple tumors involving the same parotid gland. Two patients developed a second tumor in the same parotid gland 6 and 5 years after surgery respectively. One patient was diagnosed with a new tumor affecting the other parotid gland 2 years postoperatively. Today all 34 patients are free of the disease. Conclusion Partial superficial parotidectomy and extracapsular dissection seem to be adequate methods of treatment for the majority of Warthin’s tumors.

Warthin tumor in an unusual site: a case report

Warthin tumor (papillary cystadenoma lymphomatosum, adenolymphoma) is a benign neoplasm from salivary glands and is almost restricted to the parotid gland and the periparotid lymph nodes. Its etiopathogenesis has been associated with tobacco smoke. Several authors believe that the tumor develops from heterotopic salivary gland tissues or through the attraction of a heavy lymphoid reaction. Most cases involve the lower pole or the tail of the parotid. Since its description, a few cases have been reported in other sites, like the submandibular salivary gland. This study aimed to describe a rare presentation of a Warthin tumor and discuss its etiology and differential diagnosis. A 72-year-old male patient presented an asymptomatic, nodular mass adjacent to the submandibular salivary gland. Based on clinical diagnosis of cervical lymphadenopathy, the patient underwent a surgical excision of the lesion. Histopathological exam revealed a benign neoplasm from salivary glands composed of two components: epithelial and lymphoid. The findings were consistent with Warthin tumor. Warthin tumor from submandibular salivary gland is a rare lesion. Professionals should not misinterpret their site of origin, as if they were from the lower pole or the tail of the parotid.

Papillary cystadenoma of the lower lip exhibiting ciliated pseudostratified columnar epithelium: report of a bizarre case and review of the literature

Salivary gland tumors are uncommon and constitute 2-6.5 % of all head and neck neoplasms. Tumors of minor salivary gland origin account for less than 25 % of all salivary gland neoplasms. Papillary cystadenoma of salivary glands is a rare benign epithelial neoplasm characterized by multicystic growth in which the epithelium exhibits adenomatous proliferation. Papillary cystadenoma of minor salivary glands most frequently involves the lip, buccal mucosa, and palate. This tumor typically presents as a slow-growing, painless mass, usually with diameter of less than 1 cm and clinical resemblance to a mucocele. Although most papillary cystadenomas are predominantly of one cell type, a regional variability may be present. We present a case of papillary cystadenoma of the minor salivary glands in a 58-year-old patient exhibiting an upper respiratory tract epithelium, a profoundly atypical benign tumor. This type of minor salivary gland tumor epithelium in the lower lip may be the result of a metaplastic process or simply another neoplastic manifestation of papillary cystadenoma. As far as the differential diagnosis of this entity is concerned, it is important to distinguish it from papillary cystadenoma lymphomatosum (Warthin's tumor), low-grade mucoepidermoid carcinoma, the papillary-cystic variant of acinic cell carcinoma, and cystadenocarcinoma Recognition of this lesion is important for the clinician since the differential diagnosis includes lesions with similar clinical appearance and infiltrative behavior.

Application value of 99Tco4- salivary gland scintigraphy on the diagnosis of papillary cystadeuoma lymphomatosum

Objective To stuty the imaging characteristics of papillary cystadenoma lymphomatosum on technetium-99m ( Tc-99m )pertechnetate scintigraphy and to explore the value of 99mTco4-salivary gland scintigraphy on the diagnosis of papillary cystadenoma lymphomatosum.Methods 44 patients with clinically diagnosed papillary cystadenoma lymphomatosum received dynamic/static salivary gland scintigraphy and Doppler ultrasonography.The detection results were compared with the pathological findings.And the diagnostic value of salivary gland scintigraphy for papillary cystadenoma lymphomatosum was evaluated.The obtained data were analyzed by the statistical software SPSS 16.0 and tested by x2 test.Results Papillary cystadenoma lymphomatosum in 32 patients,pleomorphic adenoma in 10,villous adenoma in one,and branchial cleft cyst in one were confirmed by postoperative pathological examinations.The radionuclide imaging revealed positive findings ( ‘hot nodules' at the secretory phase ) were in 32 patients,lesions in 46,single lesion in 22 and multiple lesions in 10,and negative findings in 12 ( including one case of cold nodule and 11 cases of warm nodules ),with a sensibility of 96.88％ ( 31/32 ),a specificity of 91.67％ ( 11/12 ),a positive predictive value of 96.88％ ( 31/32 ),a negative predictive value of 91.67％ ( 11/12 ),and a accuracy of 95.45％ ( 42/44 ); Doppler ultrasonography showed 20 patients had positive findings and 24 had negative findings; as compared with pathological examination,the sensitivity,specificity,positive predictive value,negative predictive value and accuracy were 46.88％ ( 15/32 ),54.55％ ( 6/11 ),75.00％ ( 15/20 ),25.00％ ( 6/24 ),and 47.72％ ( 21/44 ),respectively.Statistical significance was found between the two methods.Conclusions The sensitivity and specificity of salivary gland scintigraphy in the diagnosis of papillary cystadenoma lymphomatosum are remarkably higher than those of Doppler ultrasonography.Scintigraphy has a higher coincident rate of diagnosis and has a better diagnostic value for preoperative localization and differential diagnosis. Key words: Papillary cystadenoma lymphomatosum; Salivary gland; 99mTco4-; Radionuclide imaging