RRML - Malignant transformation of the epithelial component in Warthin’s tumor
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Dr. Adrian Man
   
 
Nr. 17(4)/2009
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Malignant transformation of the epithelial component in Warthin’s tumor

Alexandra Faur, Elena Lazar, Marioara Cornianu, Alis Dema, Codruta Lazureanu, Simona Costi, Camelia Gurban Vidita


Abstract:

In 1929, pathologist Aldred Warthin described for the first time a tumor called “papillary cystadenoma lymphomatosum”, which has been known since as “Warthin’s tumor”. Warthin’s tumor is a benign salivary neoplasm occurring mainly in the parotid gland, and has an epithelial component and a lymphoid stroma. However, rarely, either the epithelial or the lymphoid component of Warthin’s tumor can undergo malignant transformation. Malignant transformation of the lymphoid component is relatively common but the epithelial malignancy is very rare. Aim: We present a rare case with in situ carcinoma and squamous metaplasia arising in a Warthin’s tumor of a parotid gland in a 79-year-old man and the differential diagnosis to be considered for this case. Method: Formalin-fixed paraffin-embedded tissue samples were cut at 4 microns and stained using hematoxylin and eosin (HE). For the immunohistochemical evaluation we have used monoclonal antibodies against cytokeratin (CK) (MNF 116, Dako) and epithelial membrane antigen (EMA) with an EnVision (K5007, Dako) visualization system. Results: In HE stain, Warthin’s tumor was composed of papillary cystic structures lined by a bilayered oncocytic epithelium and lymphoid stroma. Areas with squamous metaplasia and in situ carcinoma were also present. Immunohistochemically, the benign oncocytic and squamous metaplastic areas and the in situ carcinoma were positive for EMA and CK. Conclusion: The epithelial malignancy was labeled with CK and EMA. The main differential diagnosis in this case must be made with an invasive squamous carcinoma and metastasis from another primary site of such carcinoma.

Keywords: Warthin’s tumor,salivary gland,immunohistochemistry

 
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How to cite
Faur A, Lazar E, Cornianu M, Dema A, Lazureanu C, Costi S, et al. Malignant transformation of the epithelial component in Warthin’s tumor. Rev Romana Med Lab. 2009;17(4):51-7