True statement regarding Warthin's tumor:
|A||Common in females|
|C||Hot spots on Tc-99 scan|
|D||Most common tumor of minor salivary gland|
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)
• 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
• FNAC is best diagnostic modality
• Superficial parotidectomy?