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• W3177184436 abstract "Introduction Warthin tumors often demonstrate striking and easily recognizable histologic features. We present 2 cases containing prominent granulomatous inflammation and a review of the literature. Case 1 A 55-year-old male patient presented with painless mandibular swelling over 12 weeks. He was a smoker, otherwise fit and well. Magnetic resonance imaging and fine-needle aspiration (FNA) were suggestive of Warthin tumor. Histologic examination confirmed Warthin tumor, with the lymphoid stroma demonstrating reactive hyperplasia along with well-defined, partially confluent, nonnecrotizing granulomas. Special stains for microorganisms were negative, and the background salivary gland showed mild fatty metaplasia. Case 2 A 73-year-old female patient presented with a rapidly expanding parotid mass over 4 weeks, with no history of trauma. She was cachetic and a smoker but otherwise fit and well. FNA was suggestive of Warthin tumor but magnetic resonance imaging was suggestive of malignancy. Histologic examination revealed Warthin tumor with multiple foci of ulceration to the bilayered epithelium, with the associated stroma containing prominent nonnecrotizing granulomatous inflammation with multinucleate giant cells. Again, special stains for microorganisms were negative. The background parotid showed acinar atrophy, mild intralobular fibrosis, and fatty metaplasia. Literature Review Granulomatous inflammation within the stroma and tissues surrounding Warthin tumors is uncommon but well documented in the literature. Many cases are attributed to infection, including tuberculosis, toxoplasmosis, and histoplasmosis. Another reported etiology is rupture of the cystic spaces following FNA or infarction. More rarely, inflammatory systemic conditions such as sarcoidosis and Langerhans cell histiocytosis have been implicated. We will present the literature to date, including recommended histologic investigations. Warthin tumors often demonstrate striking and easily recognizable histologic features. We present 2 cases containing prominent granulomatous inflammation and a review of the literature. A 55-year-old male patient presented with painless mandibular swelling over 12 weeks. He was a smoker, otherwise fit and well. Magnetic resonance imaging and fine-needle aspiration (FNA) were suggestive of Warthin tumor. Histologic examination confirmed Warthin tumor, with the lymphoid stroma demonstrating reactive hyperplasia along with well-defined, partially confluent, nonnecrotizing granulomas. Special stains for microorganisms were negative, and the background salivary gland showed mild fatty metaplasia. A 73-year-old female patient presented with a rapidly expanding parotid mass over 4 weeks, with no history of trauma. She was cachetic and a smoker but otherwise fit and well. FNA was suggestive of Warthin tumor but magnetic resonance imaging was suggestive of malignancy. Histologic examination revealed Warthin tumor with multiple foci of ulceration to the bilayered epithelium, with the associated stroma containing prominent nonnecrotizing granulomatous inflammation with multinucleate giant cells. Again, special stains for microorganisms were negative. The background parotid showed acinar atrophy, mild intralobular fibrosis, and fatty metaplasia. Granulomatous inflammation within the stroma and tissues surrounding Warthin tumors is uncommon but well documented in the literature. Many cases are attributed to infection, including tuberculosis, toxoplasmosis, and histoplasmosis. Another reported etiology is rupture of the cystic spaces following FNA or infarction. More rarely, inflammatory systemic conditions such as sarcoidosis and Langerhans cell histiocytosis have been implicated. We will present the literature to date, including recommended histologic investigations." @default.
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• W3177184436 date "2021-07-01" @default.
• W3177184436 modified "2023-09-27" @default.
• W3177184436 title "GRANULOMAS IN WARTHIN TUMORS OF THE PAROTID: REPORT OF TWO NOVEL CASES AND REVIEW OF THE LITERATURE" @default.
• W3177184436 doi "https://doi.org/10.1016/j.oooo.2021.03.058" @default.
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