Warthin's tumor pathophysiology: Difference between revisions
Aditya Ganti (talk | contribs) |
Aditya Ganti (talk | contribs) |
||
| Line 20: | Line 20: | ||
==Microscopic Pathology== | ==Microscopic Pathology== | ||
The appearance of this [[tumor]] under the [[microscope]] is unique. Following features can be observed on microscopic picture | The appearance of this [[tumor]] under the [[microscope]] is unique. Following features can be observed on microscopic picture | ||
* There are cystic spaces surrounded by two uniform rows of [[cell (biology)|cells]] with centrally placed pyknotic [[cell nucleus|nuclei]].<ref name="EllisAuclair2009">{{cite journal|last1=Ellis|first1=Gary L.|last2=Auclair|first2=Paul L.|title=Salivary Glands|year=2009|pages=246–294|doi=10.1016/B978-1-4160-3966-2.00011-4}}</ref> | * There are cystic spaces surrounded by two uniform rows of [[cell (biology)|cells]] with centrally placed pyknotic [[cell nucleus|nuclei]].<ref name="EllisAuclair2009">{{cite journal|last1=Ellis|first1=Gary L.|last2=Auclair|first2=Paul L.|title=Salivary Glands|year=2009|pages=246–294|doi=10.1016/B978-1-4160-3966-2.00011-4}}</ref> | ||
Revision as of 21:48, 10 January 2019
|
Warthin's tumor Microchapters |
|
Diagnosis |
|---|
|
Treatment |
|
Case Studies |
|
Warthin's tumor pathophysiology On the Web |
|
American Roentgen Ray Society Images of Warthin's tumor pathophysiology |
|
Risk calculators and risk factors for Warthin's tumor pathophysiology |
Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Ammu Susheela, M.D. [2] Nazia Fuad M.D.
Overview
Warthin's tumor arises from salivary gland epithelium, which are secretory cells of the salivary gland. On gross pathology, cystic and multicentric appearance are characteristic findings of Warthin's tumor. On microscopic histopathological analysis, papillae, fibrous capsule, and cystic spaces are characteristic findings of Warthin's tumor.
Pathogenesis
- Warthin tumor (or papillary cystadenoma lymphomatous) is a benign, sharply demarcated tumor of the salivary gland. It is bilateral in 10-15% of cases.
- The gland most likely affected is the parotid gland. In fact, it is the only tumor virtually restricted to the parotid gland.
- Though much less likely to occur than pleomorphic adenoma, Warthin's tumor is the second most common benign parotid tumor.
- The first symptom is usually a painless, slow-growing bump in front of the ear, on the bottom of the mouth, or under the chin.
- The tumor is slow growing, painless, and usually appears in the tail of the parotid gland near the angle of the mandible.
- In 5–14% of cases, Warthin's tumor is bilateral, but the two masses usually are at different times.
- Warthin's tumor is highly unlikely to become malignant.[1][2]
Genetics
- Expression of CRTC1 - MAML2 chimeric genes through t(11;19)(q21;p13) translocation is involved in the pathogenesis of Warthin's tumor.
Gross Pathology
Warthin's tumor is often multicentric (20%) and is usually small (1-4 cm). It has typically heterogeneous appearance on all modalities, often with cystic components (30%). Other features include:[3][4]
- Encapsulated
- Lobulated with inter spread heamorrhagic and pale gray surface areas
Microscopic Pathology
The appearance of this tumor under the microscope is unique. Following features can be observed on microscopic picture
- There are cystic spaces surrounded by two uniform rows of cells with centrally placed pyknotic nuclei.[5]
- The cystic spaces have epithelium referred to as papillary infoldings that protude into them. Additionally, the epithelium has lymphoid stroma with germinal center formation.
- Papillae (nipple-shaped structures) with a two rows of pink (eosinophilic) epithelial cells (with cuboidal basal cells and columnar luminal cells) - key feature
- Fibrous capsule - pink & homogenous on H&E stain
- Cystic space filled with debris in situ (not necrosis)
- Lymphoid stroma
- Additionally, the epithelium has lymphoid stroma with germinal center formation.
.jpg)
.jpg)
References
- ↑ "Rare diseases Warthin tumor".
- ↑ NIH Warthin tumor. Rarediseases (2015). https://rarediseases.info.nih.gov/gard/8569/warthin-tumor/resources/1 Accessed on December 02, 2015
- ↑ Blake, Michael (2009). Adrenal imaging. Totowa, NJ: Humana Press. ISBN 193411586X.
- ↑ "Radiopedia 2015 Warthin tumor [Dr Henry Knipe and A.Prof Frank Gaillard]".
- ↑ Ellis, Gary L.; Auclair, Paul L. (2009). "Salivary Glands": 246–294. doi:10.1016/B978-1-4160-3966-2.00011-4.