Warthin tumor (see comment). Comment: The small core biopsy shows columnar-lined oxyphilic epithelium with underlying lymphoid tissue composed predominantly of small lymphocytes with rare small reactive appearing germinal centers. Immunohistochemical stains show that the underlying lymphocytic infiltrate is composed of aggregates of CD20+, CD5- B cells with intervening CD3+ CD5+ T cell rich regions. BCL2 stains most lymphocytes with a rare small germinal centers negative for BCL2. Flow cytometry is negative for a B cell lymphoproliferative disorder (see below).
The findings support a diagnosis of Warthin tumor.
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Clinical history
48 yo male
Diagnosis
A. INTRAPAROTID LYMPH NODE BX RIGHT: Warthin tumor (see comment). Comment: The small core biopsy shows columnar-lined oxyphilic epithelium with underlying lymphoid tissue composed predominantly of small lymphocytes with rare small reactive appearing germinal centers. Immunohistochemical stains show that the underlying lymphocytic infiltrate is composed of aggregates of CD20+, CD5- B cells with intervening CD3+ CD5+ T cell rich regions. BCL2 stains most lymphocytes with a rare small germinal centers negative for BCL2. Flow cytometry is negative for a B cell lymphoproliferative disorder (see below). The findings support a diagnosis of Warthin tumor.
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| Sequence | Case | Clinical history | Diagnosis |
|---|---|---|---|
| 1 | WSI21-128-Case-1 WSI21-128-Case-1 | 53M | Mucoepidermoid carcinoma, low-grade Mucoepidermoid carcinoma, low-grade |
| 2 | WSI21-128-Case-2 WSI21-128-Case-2 | 40-year-old female. Left parotid mass. 40-year-old female. Left parotid mass. | Bland-appearing spindle cells, consistent with nodular fasciitis.
Molecular testing confirmed USP6-rearrangement. Bland-appearing spindle cells, consistent with nodular fasciitis.
Molecular testing confirmed USP6-rearrangement. |
| 3 | WSI21-128-Case-3 WSI21-128-Case-3 | 22yo M with 3.1cm left submandibular mass x 3 years 22yo M with 3.1cm left submandibular mass x 3 years | Cellular, myoepithelial-predominant pleomorphic adenoma Cellular, myoepithelial-predominant pleomorphic adenoma |
| 5 | WSI21-128-Case-5 WSI21-128-Case-5 | 72yo F with right parotid mass 72yo F with right parotid mass | Pleomorphic adenoma Pleomorphic adenoma |
| 6 | WSI21-128-Case-6 WSI21-128-Case-6 | 73-year-old female. 73-year-old female. | Merkel cell carcinoma Merkel cell carcinoma |
| 7 | WSI21-128-Case-7 WSI21-128-Case-7 | 38-year-old female. Left temporal/supra-auricular mass. 38-year-old female. Left temporal/supra-auricular mass. | Adenoid cystic carcinoma. Adenoid cystic carcinoma. |
| 8 | WSI21-128-Case-8 WSI21-128-Case-8 | 49-year-old male. Parotid mass. 49-year-old male. Parotid mass. | Pleomorphic adenoma, myoepithelial-rich Pleomorphic adenoma, myoepithelial-rich |
| 9 | WSI21-128-Case-9 WSI21-128-Case-9 | 59F. Left neck/mandible. History of ductal carcinoma of breast. 59F. Left neck/mandible. History of ductal carcinoma of breast. | Salivary duct carcinoma Salivary duct carcinoma |
| 10 | WSI21-128-Case-10 WSI21-128-Case-10 | 60F. Parotid mass. 60F. Parotid mass. | Atypical basaloid cells. Resection consistent with basal cell adenoma. Atypical basaloid cells. Resection consistent with basal cell adenoma. |
| 11 | WSI21-128-Case-11 WSI21-128-Case-11 | 69M. Parotid mass. 69M. Parotid mass. | Bland-appearing ductal cells with abundant chronic inflammation. Resection - low-grade mucoepidermoid carcinoma with CRTC1-MAML2 Bland-appearing ductal cells with abundant chronic inflammation. Resection - low-grade mucoepidermoid carcinoma with CRTC1-MAML2 |
