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PubMed1999

Improving cytological diagnosis and surgical management of parotid adenolymphoma.

BACKGROUND: The role of fine-needle aspiration cytology (FNAC) in the diagnosis and management of discrete parotid swellings remains controversial. Controlled enucleation can be appropriate with accurate preoperative diagnosis. This study (1985-1995) reviewed the role of FNAC in the diagnosis and surgical management of adenolymphoma. METHODS: Review of cytological smears by two observers concentrated on the features of infarction and squamoid metaplasia. Sensitivity, interobserver and intraobserver variation were evaluated statistically in a two-run 'blinded' analysis of 80 cytological slides from a variety of lesions. RESULTS: Of 222 epithelial neoplasms of the parotid, 33 were adenolymphomas. FNAC was performed before operation in 32, producing 34 slides, and a correct cytological diagnosis was made in 21 patients. Retrospective review of the 34 slides, to examine specific features of squamoid metaplasia and infarction, improved diagnostic accuracy. The reliability and reproducibility of cytodiagnosis was confirmed by analysis of interobserver and intraobserver agreement. The sensitivity was high (0.76-0.88). Controlled enucleation was performed in 12 patients and superficial parotidectomy in 11. There were no tumour recurrences. CONCLUSION: Attention to the features of squamoid metaplasia and infarction improves cytological diagnosis and directs appropriate surgical management.

Adenolymphoma↗
PubMed1989

Infarcted ('infected') adenolymphomas. A clinicopathological study of 20 cases.

From a total of 323 adenolymphomas in the files of the British Salivary Gland Tumour Panel there were 20 cases (6.2%) which showed extensive necrosis, fibrosis and inflammation. The clinical and microscopical features of this distinctive subtype are described and it is suggested that infarction rather than infection is the more probable aetiological factor. In 40% of these infarcted adenolymphomas there was granuloma formation which mimicked tuberculosis or sarcoidosis and this possibility should be borne in mind when examining lesions in the parotid region.

Adenolymphoma↗
PubMed1984

Stereologic analysis of the lymphoid stroma in parotid adenolymphoma.

In 2 parotid adenolymphomas, the composition of lymphoid stroma was analysed, using stereologic point-counting methods at the electron microscopic level. In the 2 lesions, the stroma was almost identical with respect to organization and composition. Most areas of the stroma showed accumulation of mixed cell populations. On average, the latter were comprised of 5.1% fibroblastic/reticular cells, 2.7% macrophages, 68.9% small and 18.8% medium/large lymphocytes, 0.5% blastforming T-lymphocytes, 2.3% blastforming B-lymphocytes, and 1.6% plasma cells. Polymorphonuclear leukocytes and mast cells were extremely rare. Areas corresponding to the mantle zone of lymphoid follicles were found to contain 83.0% small and 15.8% medium/large lymphocytes. The present data seem to be in accordance with the speculation that the lymphoid stroma of adenolymphoma represents an immune reaction.

Adenolymphoma↗
PubMed1984

Adenolymphoma: an immunohistochemical study with monoclonal antibodies against lymphocyte antigens.

Twenty-two adenolymphomas (Warthin's tumours) were investigated with respect to their lymphoid stroma; 4 were analyzed by monoclonal antibodies against B-cells and T-cells. A slight predominance of B-cells was found. In the T-cell fraction, the T-helper cells outnumbered the T-suppressor cells by a factor of 4. These and other cell types were found in the stroma and in the epithelium. Mast cells were associated with those adenolymphomas having a high proportion of epithelium.

Adenolymphoma↗
PubMed1996

Membranous nephropathy complicating adenolymphoma of the parotid (Warthin's tumour).

Membranous nephropathy has been described in association with many malignancies including various lymphomas. However, it has not been previously described as a complication of benign solid adenolymphoma of the parotid, also called Warthin's tumour. We describe a patient who presented with an adenolymphoma of the parotid, and developed a severe nephrotic syndrome due to membranous nephropathy 6 months after the parotid swelling. The nephrotic syndrome resolved following parotidectomy and a short course of immunosuppression with prednisolone and cyclophosphamide. The possible pathophysiologic mechanisms are discussed.

Adenolymphoma↗
PubMed1990

Follicular non Hodgkin's lymphoma in adenolymphoma: report of a case.

A case of centroblastic centrocytic follicular lymphoma arising within a bilateral adenolymphoma of the parotid glands with involvement of the adjacent lymph nodes is reported. The patient was treated with combination chemotherapy and three years after the first cycle of therapy there was no evidence of disease. The occurrence of primary malignant lymphomas in the lymphoid stroma of an adenolymphoma has seldom been discussed in literature. All cases reported of follicular centre cell type were characterized by an indolent clinical course.

Adenolymphoma↗
PubMed1999

[Adenolymphoma (Warthin's tumor) of the larynx: coexistence with the bilateral laryngocele. Contribution to differential diagnosis with oncocytic papillary cystadenoma].

Adenolymphoma is a benign monomorphic lesion composed of epithelial tissue. Usually it is found in parotid gland; however, its laryngeal occurrence was rarely described. Extraparotid Warthin's tumour as scanty lymphatic tissue. In cases when there is no lymphatic tissue in subepithelial layer it is called oncocytic cystadenoma. The authors describe the case of bifocal adenolymphoma in bilateral laryngocoele and indicate classification difficulties of oncocytic lesions in the larynx.

Adenolymphoma↗
PubMed1999

[Adenolymphoma (Warthin's tumor) located bilaterally].

Adenolymphoma (Warthin's tumor) is the second in occurrence of the parotid gland's benign neoplasms. In most cases (80%) it is observed as an unilateral tumor, smoking males aged from 50 to 60 are mainly affected. The authors present an interesting case of simultaneously occurring bilateral Warthin's tumor growing in parotid gland. A 59-year-old male patient, smoker was admitted to E.N.T. Dept. with a bilateral tumor. He underwent surgical treatment: superficial parotidectomy on the left side and right side tumor exterpation at the same time. After the operation we got the confirmation of the preoperation diagnosis. The patient was discharged home and stayed on the follow-up. Smoking patients with diagnosed unilateral adenolymphoma should be followed up because of the possibility of the neoplasmatic recurrence.

Adenolymphoma↗
PubMed1991

[Salivary gland adenolymphomas as seen in current histochemical and immunomorphological research].

Samples of 32 adenolymphomas and 10 intact salivary glands were studied using histological, histochemical (Grimelius and congo red staining), microscopic and immunohistochemical methods employing polyclonal antibodies to myosin, human carboanhydrase III and monoclonal antibodies to cytokeratin polypeptides No. 8 and 17, epithelial membrane antigen and T- and B-lymphocytes as well as peroxidase--antiperoxidase reaction. Binding of monoclonal antibodies to cytokeratin No. 8 and epithelial membrane antigen was observed in glandular cells of cysts whereas proliferating cells forming "Sandersen's cushions" showed binding of polyclonal antibodies to myosin, carboanhydrase III and monoclonal antibodies to cytokeratin No. 17. Tumor stroma revealed T- and B-lymphocytes incretory granulocytes and amyloid spaced along the fiber structures. It is inferred that adenolymphoma is a tumor arising exactly in salivary glands. The epithelial component of this tumor forms following tumor transformation of epithelial and myoepithelial cells of the distal part of salivary gland ducts. T- and B-lymphocytes contribute to formation of tumor stroma. Epithelial membrane antigen is an effective marker of the epithelial component of tumor.

Adenolymphoma↗
PubMedDate not supplied

Mast cells in the aspiration cytology differential diagnosis of adenolymphoma.

Review was undertaken of 20 cases of adenolymphoma (Warthin's tumor) of the salivary glands diagnosed by fine needle aspiration (FNA). Smears of the aspirates from 16 of the 20 cases (80%) contained mast cells associated with monolayered sheets of oncocytes. Aspiration smears from control cases showed cells in significantly fewer instances: 10% of the cases of mucoepidermoid carcinoma, 5% of the cases of pleomorphic adenoma and none of the cases of acinic-cell tumor, squamous-cell carcinoma and branchial cysts. Mast cells in association with oncocytes thus should be considered supportive evidence of an FNA diagnosis of adenolymphoma.

Adenolymphoma↗
PubMedDate not supplied

A human adenolymphoma showing the chromosomal aberrations del (7)(p12p14-15) and t(11;19)(q21;p12-13).

A clearly benign parotid tumor, an adenolymphoma, was studied cytogenetically using short-term cultured material. The first preparation showed only a normal stemline. The two subsequent preparations were both characterized by a pseudodiploid stemline with the karyotype 46,XY,del(7) (p12p14-15), t(11;19) (q21;p12-13). The 11;19 translocation was identical to that characterizing the abnormal stemline of the only previously studied case. These suggestive observations give rise to several questions, in particular whether or not all adenolymphomas contain cells with this specific reciprocal translocation and, in cases with the translocation, its implications at the molecular level.

Adenolymphoma↗
PubMed1958

Adenolymphoma of the salivary gland.

Adenolymphoma of the salivary glands (here reported for the first time in two brothers whose father also might have had the disease) is typically a benign neoplasm for which excision is the treatment of choice. Incomplete excision may be followed by regrowth, which in some cases has been eliminated by roentgen therapy. Most such tumors are single and uninodular, but they may be multiple and bilateral.

Adenolymphoma↗
PubMed1988

Monoclonal antibodies to epithelial sialomucins recognize epitopes at different cellular sites in adenolymphomas of the parotid gland.

Fourteen monoclonal antibodies (MAbs) to epithelial sialomucins were studied for their immunohistochemical reactivity on serial sections of 14 formalin-fixed and paraffin-embedded adenolymphomas of the parotid gland. Two types of reactivity were observed, suggesting different cellular distribution of the corresponding epitopes. Most antibodies reacted with the luminal membrane of the columnar tumor cells (type-A reaction). The other reaction (type B) was observed with the membrane of basal epithelial cells. The antibodies could be ranked according to their tendency to show type-A and/or type-B reactions. MAb Cal was the only one with a pure type-A reaction. A strong tendency to type-A reactivity (with traces of type-B reactions) was observed for the antibodies HMFG-2, M8, E29 and NCRC-II. Several antibodies gave good type-B reactions in addition to strong type-A reactivity (MAbs 126E7, 115G2, 115D8, 140C1, F36/22, 139H2). MAb DF3 showed equally strong reactions with both cell types. A clear-cut preference of the reactions with basal cells was seen with the antibodies HMFG-1 and 115F5. This subclassification of the antibodies is in accordance with epitope mapping data, obtained by conventional blocking studies reported in the literature.

Adenolymphoma↗
PubMed1985

Lymphoma arising in an adenolymphoma.

A malignant lymphoma that originated in association with an adenolymphoma (Warthin's tumor) of the parotid salivary gland is reported. The occurrence of lymphomas in salivary glands is discussed briefly.

Adenolymphoma↗
PubMed1999

Adenolymphoma (Warthin's tumor) with multiple sarcoid-like granulomas.

Five cases of adenolymphoma (Warthin's tumor) (AL) with numerous sarcoid-like granulomas within the lymphoid stroma are described. All patients were males, aged from 44 to 71 years (mean 57.3 years); all tumors were localized in the parotid gland. Fine needle aspiration cytology was performed in two cases 7.5 and 2 weeks before operation, respectively. Microscopic examination demonstrated the typical structure of AL. In addition, dispersed throughout the lymphoid stroma there were numerous granulomas formed by both epithelioid and multinucleated giant cells of Langhans type, strongly resembling sarcoidosis. The pathogenesis of the granulomatous change remains speculative. It could be caused by a toxic effect of the cysts' contents but probably not by its direct action; the spread of the fluid via sinuses into the lymphatic tissue seems to be more probable. We presume that the previous FNA may have some triggering effect. Granulomatous transformation of the lymphoid stroma resembling sarcoidosis is rare, but should be included in the spectrum of secondary changes in AL. It is not limited to metaplastic AL; it can be seen in an otherwise typical AL without any additional histologic changes. Knowledge of a previous FNA and awareness of the possibility of this peculiar histologic change are necessary to avoid incorrect diagnosis.

Adenolymphoma↗
PubMed1985

Characteristics of the epithelial component of parotid adenolymphoma.

Parotid adenolymphoma is composed of two histologic components, epithelial and lymphoid. Although some theories regarding the histogenesis of this tumor have long been disputed, there have been no definite conclusions. The purpose of this study was to clarify the origin of the epithelial components of this tumor using histochemical and immunopathological techniques, electron microscopy and a survey of HE-stained tumor sections. The results obtained indicated that the functions of the epithelial components were similar to those of the striated duct of the normal parotid gland, and morphological studies showed that the origin of the epithelial components may arise from parotid ductal inclusion in the lymphnodes in or around the parotid gland.

5'-Nucleotidase↗
PubMed1997

Radiological findings of adenolymphoma (Warthin's tumor).

The radiological findings of adenolymphomas (Warthin's tumor) treated in six hospitals between 1985 and 1994 were compared with the operative and histological findings and the usefulness of the radiological examinations was evaluated. The total number of patients was 72. The mean age was 61.8 years; 61 were males and 11 were females. All tumors developed in the parotid gland. Tc-99m-pertechnetate salivary gland scanning was performed in 13 patients and an increased uptake of the isotope was observed in only six patients. Even if Tc-99m-pertechnetate salivary gland scanning does not reveal intense accumulation, this tumor should not be ruled out. By computed tomography (CT), ultrasonography (US), and magnetic resonance imaging (MRI), the margin of all tumors was evident; however, the contents of the tumor varied. The contents and multiplicity of the tumors were well demonstrated by MRI, which was found to be the most accurate imaging modality.

Adenolymphoma↗
PubMed2000

Pleomorphic adenoma and adenolymphoma in ultrasonography.

OBJECTIVE: The aim of the study was to define ultrasonographic morphologic features characteristic of pleomorphic adenoma and adenolymphoma (Warthin's tumor). METHODS: Documentation of 31 ultrasonographic examinations of 20 pleomorphic adenomas and 10 Warthin's tumors in 28 patients was analysed. All cases were confirmed by fine needle aspiration biopsy or/and histopathological examination. Estimated ultrasound criteria were: borders (well-defined, predominantly well-defined, ill-defined), shape (lobulated, oval, irregular), echogenicity (increased, decreased), structure (homogeneous, slightly inhomogeneous, inhomogeneous) and presence of irregular anechoic areas within a tumor. RESULTS: 100% of the lesions were hypoechoic. 80.6% of all tumors were well-defined. The remaining 19.4% had predominantly well-defined borders. 55% of pleomorphic adenomas had a lobulated shape. Almost equal percentages of Warthin's tumors were lobulated, had an oval and irregular shape. Irregular echolucent areas were present in six of 11 examinations of Warthin's tumors and in one pleomorphic adenoma. CONCLUSIONS: Ultrasonography is a useful method for the evaluation of pleomorphic adenomas and Warthin's tumors and sometimes it might allow to suggest the nature of a tumor if a certain sonographic pattern is present.

Adenolymphoma↗