Warthin tumour

What is a Warthin tumour?

A Warthin tumour is a common non-cancerous growth in the salivary glands. It is not capable of transforming into cancer over time. Most Warthin tumours develop in the parotid gland, but they can be found in any of the salivary glands. Most individuals who develop a Warthin tumour are older adults with a history of smoking.

Most Warthin tumours are slowly growing and usually painless. It is not unusual for a patient to have more than one Warthin tumour. However, regrowth is rare if the tumour is removed completely.

The salivary glands

When we chew food our body releases fluid called salvia into our mouths. Saliva is important because it contains chemicals that aid in digestion. Saliva is produced by organs called salivary glands, which are located throughout the head and neck.

Most people have three major salivary glands and numerous minor salivary glands. The major salivary glands are the parotid gland, submandibular gland, and sublingual gland. The minor salivary glands are very small and there are so many of them that they are not given their own names. Most of the minor salivary glands are found inside the mouth.

The parotid gland is the largest salivary gland, and it is located on the inside of the face, just in front of the ear. The submandibular gland is located just below the lower jaw and near the top of the neck. The sublingual gland is the smallest of the major glands and it can be found below the tongue.

Salivary glands are made up of small groups of cells called glands, which are connected to the inside of the mouth by long, thin channels called ducts. The glands make the chemicals in the saliva, which travels down the ducts and into the mouth.

How do pathologists make a diagnosis of a Warthin tumour?

The diagnosis is usually made after a small sample of tissue is removed in a procedure called a biopsy or a fine needle aspiration. The diagnosis can also be made after the entire tumour is removed in a procedure called a resection. The tissue is then sent to a pathologist who examines it under a microscope.

Under the microscope, Warthin tumours have a distinct look. At least some of the tumour will be made up of large pink epithelial cells. Pathologists describe these cells as oncocytic. The cells connect to form two rows, which pathologists describe as bilayered. The tissue below these cells is filled with small round immune cells called lymphocytes. Because of the large number of lymphocytes, a Warthin tumour can sometimes be confused for a type of immune organ called a lymph node.

Warthin tumour

Some Warthin tumours will have large spaces on the inside of the tumour. Pathologists describe these spaces as cysts. The cysts may be filled with fluid or tumour cells.

Most patients with a Warthin tumour will be offered surgery to remove it. The tumour will then be sent to a pathologist who will prepare another pathology report which may include the size of the tumour removed.

by Kristina-Ana Klaric MD and Jason Wasserman MD PhD FRCPC (updated August 23, 2021)
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