Image Based Question – 69981

A 50 year old male patient presented with a parotid swelling.Histopathological examination of the swelling shows the following features.What can be the most probable diagnosis?

A. Pleomorphic Adenoma

B. Warthin’s Tumor

C. Adenoid Cystic Carcinoma

D. Mucoepidermoid Carcinoma

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Correct Answer » B Explanation

Ans:B. Warthin’s Tumor.

WARTHIN’S TUMOUR (PAPILLARY CYSTADENOMA LYMPHOMATOSUM, ADENOLYMPHOMA).

• It is a benign tumour of the parotid gland comprising about 8% of all parotid neoplasms, seen more commonly in men from 4th to 7th decades of life. Rarely, it may arise in the submandibular gland or in minor salivary glands. Most accepted theory is that the tumour develops from parotid ductal epithelium present in lymph nodes adjacent to or within parotid gland.

MORPHOLOGIC FEATURES.

• Grossly, the tumour is encapsulated, round or oval with smooth surface.

• The cut surface shows characteristic slit-like or cystic spaces, containing milky fluid and having papillary projections.

• Microscopically, the tumour shows 2 components: epithelial parenchyma and lymphoid stroma :

• Epithelial parenchyma is composed of glandular and cystic structures having papillary arrangement and is lined by characteristic eosinophilic epithelium.

• Lymphoid stroma is present under the epithelium in the form of prominent lymphoid tissue, often with germinal centres.