A Case of a Warthin Tumor

in STEMGeeks6 months ago

These tumors are more common in males, smokers, and in the late adulthood. But this specimen came from a old woman, non-smoker in their retirement years. Arises in the parotid gland and a common benign tumor under the salivary gland neoplasm category.

At Scanner view (40x)

Warthin's Tumor Scanner.png

At Low Power View (100x)

Notice the distinct two layered oncocyte epithelium?

These tumors can appear cystic which explains those spaces and the supporting stroma has extensive lymphocytic infiltrates.

Warthin's Tumor LPF.png

At High Power View (400x)

Warthin's Tumor HPF.png

The prominent features one needs to look for under the slide is a two layer lining of oncocytic cells supported by a lymphocyte rich stroma with occasional reactive germinal centers.

Whenever the word oncocyte comes to mind, I just think of a round to polygonal cell with a large amount of pink (eosinophilic granular) cytoplasm with a central hyperchromatic nuclei and prominent nucleoli. Similar to how one can say "clear cell" find the morphologic features similar yet the disease is located on multiple parts of the body.

Anyway, this one is benign and complete resection solves it.

I remember the first time I've seen this under the microscope and said it looks exactly like how the textbooks shows it. This sort of thing can be simple consolations you got when you love your work but hate the grind.

For the visual side of things, I think Warthin Tumor looks pretty under the scope and it's recognizable which makes this my favorite guess the tumor slide for rotating interns on our department.

There's also a pleomorphic adenoma proximal to this tumor as an incidental finding but I forgot to take a shot at it.

If you made it this far reading, thank you for your time.

Posted with STEMGeeks


For some reason that looks totally 3D or is it just your microscope?

Probably the differences in focus, the low power image has a brown spot that's blurry which indicates a debris or mounting substance in another layer. Same effect with macrophotography.

I always find it incredible the number of different conditions the human body can develop. So many categories and sub categories like no two seemingly similar cases are the same.

I don't why I should be surprised , we are incredibly complex machines and I see daily, dealing with kids with various different presentations of ASD , LD and ADHD, that no two cases are alike.

Fascinating subject matter and excellently written as always.

Wishing you a great weekend fella :-)

Thank you for taking the time to look. This gets even complicated at the molecular and genetic level where diseases in the future can be possibly diagnosed right before they even manifest. We are heading that route and it's going to be interesting to see how much of the population will express the disease vs dormant when those mutations have been detecting asymptomatic.

Wow very rare in non smokers!!

Not really that rare but it's not common on non-smokers.


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