3. Etiology
ts etiology is unknown,
but there is a strong association with cigarettemoking. Smokers are at 8 times greater riskf developing Warthin's tumor than the generalopulation.[2]
4. clinically
Warthin's tumor primarily affects older individuals
(age 60–70 years).
There is a slight female predilection according to
recent studies, but historically it has been
associated with a strong male predilection. This
change is possibly due to the tumor's association
with cigarette smoking and the growing use of
cigarettes by women
5. The tumor is slow growing, painless
In 5–14% of cases, Warthin's tumor is bilateral, but the two
masses usually are at different times. Warthin's tumor is
highly unlikely to become malignant.
6. Warthin’s Tumor
• Epithelial Component
– Consists of papillary fronds which
demonstrate 2 layers of oncocytic epitheilal
cells
– Cytoplasm stains deep pink and shows
granularity b/c of an abundance of
mitochondria
- The tumour is well encapsulated.
7. Warthin’s Tumor
• Lymphoid Component
– An abundance of this is present
– Occasional germinal centres will be seen
– Lymphoid tissue forms the core or papillary
structures
• Both lymphoid and oncocytic
epithelial elements must be present to
diagnose Warthin’s
10. Histogenesis
there is debat
1/that this tumor is an
adenoma with concomitant
lymphocytic infilteratoin this
means that this tumor not true
neoplasm as it consist of 2
component
(epithelium+lymphoid
11. 2/ectopia salivary gland
remnants entrapped in the
parotideal lymph nodes
3/ immunological (epithelial
cells stimulate alymphocytic
response
13. However, because of the
arguments against a true
neoplastic origin of this tumor,
the author favour a hypothesis
combining immunological
interactions between tumor
cells and lymphocytic
infiltrations
14. Sialosis / Sialadenosis
• ‘Sialadenosis’ is a non-specific term
used to describe an
uncommon, , non-inflammatory, non-
neoplastic
enlargement of a salivary gland, usually
the parotid gland
but occasionally affects the
submandibular glands and
rarely, the minor salivary glands.
15. • This enlargement is bilateral,
symmetrical and painless (it
is often painless but not invariably so).
In general, the enlargement is
asymptomatic and the cause
is idiopathic.
21. • Alcohol abuse ± liver cirrhosis + hepatic
steatosis and alcoholic hepatitis.
(Previous reports have indicated that
between 30% and 80% of patients with
alcoholic cirrhosis have sialosis but, if
that were universally true, one would
expect sialosis to be seen more often
than it is)
Sympathomimetics such as
isoprenaline
32. Sjogren syndrome
• Sjögren’s Syndrome is a systemic auto-immune
disease characterised by dry mouth and dry eyes and
various auto-immune changes, confirmed by a blood
test or salivary gland biopsy.
Second most common disease after systemic lupus erythromatosis
-etiology
1-auto immunne
2-reteo viral but not proven
The reasons for this remains unknown, but research suggests that it's
triggered by a combination of genetic, environmental and, possibly,
hormonal factors.
33. Types
• Primary the disease present alone
secondary /associated with other auto
immne disease e.g (rheumatoid arthritis
or lupus erythematosis
34. Pathogenesis
• Lymphoid infliltration of exocrine
glands
• (infiltrating lymphocytes are mostly
CD4+ αβ T cells); with
• concomitant inflammation and slow
destruction.
Warthins: WHALE = Warthins Has Abundant Lymphoid and Epithelial components
Batsakis-Pg 8
Figure 16-18 Warthin tumor. A, Low-power view showing epithelial and lymphoid elements. Note the follicular germinal center beneath the epithelium. B, Cystic spaces separate lobules of neoplastic epithelium consisting of a double layer of eosinophilic epithelial cells based on a reactive lymphoid stroma.
