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Surgery

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Salivary Gland

Question
19 out of 80
 

True statement regarding Warthin's tumor:



A Common in females

B Most malignant

C Hot spots on Tc-99 scan

D Most common tumor of minor salivary gland

Ans. C Hot spots on Tc-99 scan (Ref Bailey 25/e 1'761; Devita 9/e 1'774; Cancer of the Head and Neck by Suen and Myer 4/e 1'414)

Warthin's Tumor (Papillary Cystadenoma Lymphomatosum)

• Second MC benign tumor of the parotid gland

• Derived from salivary tissues inclusion in lymph nodes (so can arise from cervical nodes)

• Occurs exclusively in parotid gland and almost always occur in the lower portion of parotid overlying the angle of mandible.

a. Consists of both epithelial and lymphoid elements thus known as adenolymphoma (probably arises from remnants of parotid tissue trapped in lymph nodes within the parotid gland)

b. More common in males, in 5th to 7th decade,

c. Associated with smoking, bilateral in 10% cases, never involves facial nerve.

d. It is well encapsulated, cystic, extremely slow growing tumo, never turns malignant,

• Peculiar feature of Warthin's tumor: 'hot' spot in 99m Tc-pertechnate scan. (Other tumors of the parotid show 'cold' spot)

Histopathology

• Papillary cystic pattern lined with columnar oncocytes and cuboidal cells with marked lymphoid components

• Lined by a double layer of neoplastic epithelial cells resting on a dense lymphoid stroma sometimes bearing germinal centers.

The double layer of lining cells distinctive, with a surface palisade of columnar cells resting on a layer of cuboidal to polygonal cells

Diagnosis

• FNAC is best diagnostic modality

Treatment

• Superficial parotidectomy?

Salivary Gland Flashcard List

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