Other names:
1. Papillary Cystadenoma lymphomatosum
2. Adenolymphoma
Definition:
It is 2nd most common tumour (benign) of salivary gland.
Histogenesis:
1. Allegra:
"Warthin tumour is a delayed hypersensitivity disease, the lymphocytes being an immune reaction to salivary gland duct which undergo oncocytic change.
2. Hus and coworkers:
"Lymphoid component of tumour is an exaggerated secretory immune response".
3. currently accepted:
Tumours arises in salivary gland tissue entrapped within para-parotid or intra-parotid lymph nodes.
Predisposing factors can be:
1. Smoking
2. EBV
(Exact mechanism is not known)
Clinical features:
Age: 6th to 7th decade, Avg: 62 years
Site: Parotid gland > Submaxillary gland > accessory salivary glands
- Slow growing, painless, firm nodular mass of parotid gland
Histological features:
1. Made up of two histological components: epithelial and lymphoid tissue
2. Lesion is an adenoma exhibiting cyst formation with papillary projections within cystic spaces and a lymphoid matrix showing germinal centres
3. The cysts are lined by bilayered oncocytic epithelium
- Inner layer cells are tall columnar ( granular eosinophilic cytoplasm and hyperchromatic nuclei)
- Outer layer cells are oncocytic triangular or fusiform basaloid cells
4. Eosinophilic coagulum within cystic spaces frequently
5. Abundant lymphoid components present.
Treatment:
- Surgical excision
Recurrence: rare since well encapsulated lesions
Prognosis: Good
MCQS
1. Papillary Cystadenoma lymphomatosum is another name of
a. Pleomorphic adenoma
b. Warthin's tumour
c.Mucoepidermoid carcinoma
d. Acinic cell carcinoma
Correct answer is b.
2. Adenolymphoma is another name of
a. Pleomorphic adenoma
b. Warthin's tumour
c.Mucoepidermoid carcinoma
d. Acinic cell carcinoma
Correct answer is b.
3. 2nd most common tumour of salivary gland is
a. Warthin's tumour
b. Pleomorphic adenoma
c.Mucoepidermoid carcinoma
d. Acinic cell carcinoma
Correct answer is a.
4. Age of onset of Warthin's tumour is
a. < 10 years
b. 20 to 40 years
c. > 60 years
d. All of the above
Correct answer is c.
5. Currently accepted theory for histogenesis of Warthin's tumour is
a. "Warthin tumour is a delayed hypersensitivity disease, the lymphocytes being an immune reaction to salivary gland duct which undergo oncocytic change.
b. "Lymphoid component of tumour is an exaggerated secretory immune response".
c.Tumours arises in salivary gland tissue entrapped within para-parotid or intra-parotid lymph nodes.
d. None of the above
Correct answer is c.
6. Tumour exhibiting cyst formation with papillary projections within cystic spaces and a lymphoid matrix is
bilayered oncocytic epithelium
7. Bilayered oncocytic epithelium is a feature of
a. Warthin's tumour
b. Pleomorphic adenoma
c.Mucoepidermoid carcinoma
d. Acinic cell carcinoma
Correct answer is a.
