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Warthin Tumor
Bronwyn E. Hamilton, MD; H. Ric Harnsberger, MD
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KEY FACTS

  • Terminology

    • Imaging

      • Top Differential Diagnoses

        • Clinical Issues

          • Diagnostic Checklist

            TERMINOLOGY

            • Synonyms

              • Papillary cystadenoma lymphomatosum, adenolymphoma, lymphomatous adenoma
            • Definitions

              • Benign tumor with characteristic histopathologic appearance: Papillary structures, mature lymphocytic infiltrate, & cystic changes

            IMAGING

            • General Features

              • CT Findings

                • MR Findings

                  • Ultrasonographic Findings

                    • Nuclear Medicine Findings

                      • Imaging Recommendations

                        DIFFERENTIAL DIAGNOSIS

                          PATHOLOGY

                          • General Features

                            • Gross Pathologic & Surgical Features

                              • Microscopic Features

                                CLINICAL ISSUES

                                • Presentation

                                  • Demographics

                                    • Natural History & Prognosis

                                      • Treatment

                                        DIAGNOSTIC CHECKLIST

                                        • Consider

                                          • Image Interpretation Pearls

                                            Selected References

                                            1. Borsetto D et al: The diagnostic value of cytology in parotid Warthin's tumors: international multicenter series. Head Neck. 42(3):522-9, 2020
                                            2. Goswami A et al: Oncocytic features in salivary duct carcinoma, a potential pitfall for misdiagnosis as Warthin tumor in fine needle aspiration specimens: a cytomorphologic analysis of 14 cases. Diagn Cytopathol. 48(7):604-9, 2020
                                            3. Liu YJ et al: Imaging quality of PROPELLER diffusion-weighted MR imaging and its diagnostic performance in distinguishing pleomorphic adenomas from Warthin tumors of the parotid gland. NMR Biomed. 33(5):e4282, 2020
                                            4. Mandic R et al: Aberrant expression of glyceraldehyde-3-phosphate dehydrogenase (GAPDH) in warthin tumors. Cancers (Basel). 12(5), 2020
                                            5. Pietragalla M et al: The role of diffusion-weighted and dynamic contrast enhancement perfusion-weighted imaging in the evaluation of salivary glands neoplasms. Radiol Med. 125(9):851-63, 2020
                                            6. Psychogios G et al: Warthin's tumour seems to be the most common benign neoplasm of the parotid gland in Germany. Eur Arch Otorhinolaryngol. 277(7):2081-4, 2020
                                            7. Wu Q et al: Characterization of parotid gland tumors using T2 mapping imaging: initial findings. Acta Radiol. 61(5):629-35, 2020
                                            8. Yariv O et al: Usefulness of ultrasound and fine needle aspiration cytology of major salivary gland lesions. Am J Otolaryngol. 41(1):102293, 2020
                                            9. Mantsopoulos K et al: Watchful waiting in carefully selected metachronous cystadenolymphomas of the parotid gland: a reliable option? Br J Oral Maxillofac Surg. 57(5):425-9, 2019
                                            10. Reginelli A et al: Delayed enhancement in differential diagnosis of salivary gland neoplasm. Gland Surg. 8(Suppl 3):S130-5, 2019
                                            11. Seok J et al: The growth rate and the positive prediction of needle biopsy of clinically diagnosed Warthin's tumor. Eur Arch Otorhinolaryngol. 276(7):2091-6, 2019
                                            12. Xu Z et al: A multiparametric analysis based on DCE-MRI to improve the accuracy of parotid tumor discrimination. Eur J Nucl Med Mol Imaging. 46(11):2228-34, 2019
                                            13. Zaccarini DJ et al: Incidence of non-salivary gland neoplasms in patients with Warthin tumor: a study of 73 cases. Head Neck Pathol. 14(2):412-8, 2019
                                            14. Franzen AM et al: Increased incidence of Warthin tumours of the parotid gland: a 42-year evaluation. Eur Arch Otorhinolaryngol. 275(10):2593-8, 2018
                                            15. Ginat DT: Imaging of benign neoplastic and nonneoplastic salivary gland tumors. Neuroimaging Clin N Am. 28(2):159-69, 2018
                                            16. Matsusue E et al: Vanishing parotid tumors on MR imaging. Yonago Acta Med. 61(1):33-9, 2018
                                            17. Chen AA et al: Oncogenic DNA viruses found in salivary gland tumors. Oral Oncol. 75:106-10, 2017
                                            18. Dell'Aversana Orabona G et al: Surgical management of benign tumors of the parotid gland: extracapsular dissection versus superficial parotidectomy--our experience in 232 cases. J Oral Maxillofac Surg. 71(2):410-3, 2013
                                            19. Ogawa T et al: Correct diagnosis of Warthin tumor in the parotid gland with dynamic MRI. Tohoku J Exp Med. 227(1):53-7, 2012
                                            20. Teymoortash A et al: Is Warthin's tumour of the parotid gland a lymph node disease? Histopathology. 59(1):143-5, 2011
                                            21. Habermann CR et al: Diffusion-weighted echo-planar MR imaging of primary parotid gland tumors: is a prediction of different histologic subtypes possible? AJNR Am J Neuroradiol. 30(3):591-6, 2009
                                            22. Ethunandan M et al: Factors influencing the occurrence of multicentric and 'recurrent' Warthin's tumour: a cross sectional study. Int J Oral Maxillofac Surg. 37(9):831-4, 2008
                                            23. Yabuuchi H et al: Parotid gland tumors: can addition of diffusion-weighted MR imaging to dynamic contrast-enhanced MR imaging improve diagnostic accuracy in characterization? Radiology. 249(3):909-16, 2008
                                            24. Yerli H et al: Dynamic multislice computed tomography findings for parotid gland tumors. J Comput Assist Tomogr. 31(2):309-16, 2007
                                            25. Hamilton BE et al: Earring lesions of the parotid tail. AJNR Am J Neuroradiol. 24(9):1757-64, 2003
                                            26. Marioni G et al: Facial nerve paralysis secondary to Warthin's tumour of the parotid gland. J Laryngol Otol. 117(6):511-3, 2003
                                            27. Parwani AV et al: Diagnostic accuracy and pitfalls in fine-needle aspiration interpretation of Warthin tumor. Cancer. 99(3):166-71, 2003
                                            28. Steinhart H et al: Contrast-enhanced color Doppler sonography of parotid gland tumors. Eur Arch Otorhinolaryngol. 260(6):344-8, 2003
                                            29. Zeebregts CJ et al: Synchronous tumours of the unilateral parotid gland: rare or undetected? J Craniomaxillofac Surg. 31(1):62-6, 2003
                                            30. Laane CJ et al: Role of Epstein-Barr virus and cytomegalovirus in the etiology of benign parotid tumors. Head Neck. 24(5):443-50, 2002
                                            31. Lewis PD et al: Mitochondrial DNA mutations in the parotid gland of cigarette smokers and non-smokers. Mutat Res. 518(1):47-54, 2002
                                            32. Maiorano E et al: Warthin's tumour: a study of 78 cases with emphasis on bilaterality, multifocality and association with other malignancies. Oral Oncol. 38(1):35-40, 2002
                                            33. Raymond MR et al: Accuracy of fine-needle aspiration biopsy for Warthin's tumours. J Otolaryngol. 31(5):263-70, 2002
                                            34. Shah GV: MR imaging of salivary glands. Magn Reson Imaging Clin N Am. 10(4):631-62, 2002
                                            35. Sungur N et al: Clinicopathological evaluation of parotid gland tumors: a retrospective study. J Craniofac Surg. 13(1):26-30, 2002
                                            36. Tsai SC et al: Parotid neoplasms: diagnosis, treatment, and intraparotid facial nerve anatomy. J Laryngol Otol. 116(5):359-62, 2002
                                            37. Webb AJ et al: Parotid Warthin's tumour Bristol Royal Infirmary (1985-1995): a study of histopathology in 33 cases. Oral Oncol. 38(2):163-71, 2002
                                            38. Nakamura Y et al: Growth factors, extracellular matrix components and cell adhesion molecules Warthin's tumor. J Oral Pathol Med. 30(5):290-5, 2001
                                            39. Lewis PD et al: Detection of damage to the mitochondrial genome in the oncocytic cells of Warthin's tumour. J Pathol. 191(3):274-81, 2000
                                            40. Mandel L et al: Differentiating HIV-1 parotid cysts from papillary cystadenoma lymphomatosum. J Am Dent Assoc. 131(6):772-6, 2000
                                            41. Joe VQ et al: Tumors of the parotid gland: MR imaging characteristics of various histologic types. AJR Am J Roentgenol. 163(2):433-8, 1994
                                            42. Yoo GH et al: Warthin's tumor: a 40-year experience at The Johns Hopkins Hospital. Laryngoscope. 104(7):799-803, 1994
                                            43. Minami M et al: Warthin tumor of the parotid gland: MR-pathologic correlation. AJNR Am J Neuroradiol. 14(1):209-14, 1993
                                            Related Anatomy
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                                            Related Differential Diagnoses
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                                            References
                                            Tables

                                            Tables

                                            KEY FACTS

                                            • Terminology

                                              • Imaging

                                                • Top Differential Diagnoses

                                                  • Clinical Issues

                                                    • Diagnostic Checklist

                                                      TERMINOLOGY

                                                      • Synonyms

                                                        • Papillary cystadenoma lymphomatosum, adenolymphoma, lymphomatous adenoma
                                                      • Definitions

                                                        • Benign tumor with characteristic histopathologic appearance: Papillary structures, mature lymphocytic infiltrate, & cystic changes

                                                      IMAGING

                                                      • General Features

                                                        • CT Findings

                                                          • MR Findings

                                                            • Ultrasonographic Findings

                                                              • Nuclear Medicine Findings

                                                                • Imaging Recommendations

                                                                  DIFFERENTIAL DIAGNOSIS

                                                                    PATHOLOGY

                                                                    • General Features

                                                                      • Gross Pathologic & Surgical Features

                                                                        • Microscopic Features

                                                                          CLINICAL ISSUES

                                                                          • Presentation

                                                                            • Demographics

                                                                              • Natural History & Prognosis

                                                                                • Treatment

                                                                                  DIAGNOSTIC CHECKLIST

                                                                                  • Consider

                                                                                    • Image Interpretation Pearls

                                                                                      Selected References

                                                                                      1. Borsetto D et al: The diagnostic value of cytology in parotid Warthin's tumors: international multicenter series. Head Neck. 42(3):522-9, 2020
                                                                                      2. Goswami A et al: Oncocytic features in salivary duct carcinoma, a potential pitfall for misdiagnosis as Warthin tumor in fine needle aspiration specimens: a cytomorphologic analysis of 14 cases. Diagn Cytopathol. 48(7):604-9, 2020
                                                                                      3. Liu YJ et al: Imaging quality of PROPELLER diffusion-weighted MR imaging and its diagnostic performance in distinguishing pleomorphic adenomas from Warthin tumors of the parotid gland. NMR Biomed. 33(5):e4282, 2020
                                                                                      4. Mandic R et al: Aberrant expression of glyceraldehyde-3-phosphate dehydrogenase (GAPDH) in warthin tumors. Cancers (Basel). 12(5), 2020
                                                                                      5. Pietragalla M et al: The role of diffusion-weighted and dynamic contrast enhancement perfusion-weighted imaging in the evaluation of salivary glands neoplasms. Radiol Med. 125(9):851-63, 2020
                                                                                      6. Psychogios G et al: Warthin's tumour seems to be the most common benign neoplasm of the parotid gland in Germany. Eur Arch Otorhinolaryngol. 277(7):2081-4, 2020
                                                                                      7. Wu Q et al: Characterization of parotid gland tumors using T2 mapping imaging: initial findings. Acta Radiol. 61(5):629-35, 2020
                                                                                      8. Yariv O et al: Usefulness of ultrasound and fine needle aspiration cytology of major salivary gland lesions. Am J Otolaryngol. 41(1):102293, 2020
                                                                                      9. Mantsopoulos K et al: Watchful waiting in carefully selected metachronous cystadenolymphomas of the parotid gland: a reliable option? Br J Oral Maxillofac Surg. 57(5):425-9, 2019
                                                                                      10. Reginelli A et al: Delayed enhancement in differential diagnosis of salivary gland neoplasm. Gland Surg. 8(Suppl 3):S130-5, 2019
                                                                                      11. Seok J et al: The growth rate and the positive prediction of needle biopsy of clinically diagnosed Warthin's tumor. Eur Arch Otorhinolaryngol. 276(7):2091-6, 2019
                                                                                      12. Xu Z et al: A multiparametric analysis based on DCE-MRI to improve the accuracy of parotid tumor discrimination. Eur J Nucl Med Mol Imaging. 46(11):2228-34, 2019
                                                                                      13. Zaccarini DJ et al: Incidence of non-salivary gland neoplasms in patients with Warthin tumor: a study of 73 cases. Head Neck Pathol. 14(2):412-8, 2019
                                                                                      14. Franzen AM et al: Increased incidence of Warthin tumours of the parotid gland: a 42-year evaluation. Eur Arch Otorhinolaryngol. 275(10):2593-8, 2018
                                                                                      15. Ginat DT: Imaging of benign neoplastic and nonneoplastic salivary gland tumors. Neuroimaging Clin N Am. 28(2):159-69, 2018
                                                                                      16. Matsusue E et al: Vanishing parotid tumors on MR imaging. Yonago Acta Med. 61(1):33-9, 2018
                                                                                      17. Chen AA et al: Oncogenic DNA viruses found in salivary gland tumors. Oral Oncol. 75:106-10, 2017
                                                                                      18. Dell'Aversana Orabona G et al: Surgical management of benign tumors of the parotid gland: extracapsular dissection versus superficial parotidectomy--our experience in 232 cases. J Oral Maxillofac Surg. 71(2):410-3, 2013
                                                                                      19. Ogawa T et al: Correct diagnosis of Warthin tumor in the parotid gland with dynamic MRI. Tohoku J Exp Med. 227(1):53-7, 2012
                                                                                      20. Teymoortash A et al: Is Warthin's tumour of the parotid gland a lymph node disease? Histopathology. 59(1):143-5, 2011
                                                                                      21. Habermann CR et al: Diffusion-weighted echo-planar MR imaging of primary parotid gland tumors: is a prediction of different histologic subtypes possible? AJNR Am J Neuroradiol. 30(3):591-6, 2009
                                                                                      22. Ethunandan M et al: Factors influencing the occurrence of multicentric and 'recurrent' Warthin's tumour: a cross sectional study. Int J Oral Maxillofac Surg. 37(9):831-4, 2008
                                                                                      23. Yabuuchi H et al: Parotid gland tumors: can addition of diffusion-weighted MR imaging to dynamic contrast-enhanced MR imaging improve diagnostic accuracy in characterization? Radiology. 249(3):909-16, 2008
                                                                                      24. Yerli H et al: Dynamic multislice computed tomography findings for parotid gland tumors. J Comput Assist Tomogr. 31(2):309-16, 2007
                                                                                      25. Hamilton BE et al: Earring lesions of the parotid tail. AJNR Am J Neuroradiol. 24(9):1757-64, 2003
                                                                                      26. Marioni G et al: Facial nerve paralysis secondary to Warthin's tumour of the parotid gland. J Laryngol Otol. 117(6):511-3, 2003
                                                                                      27. Parwani AV et al: Diagnostic accuracy and pitfalls in fine-needle aspiration interpretation of Warthin tumor. Cancer. 99(3):166-71, 2003
                                                                                      28. Steinhart H et al: Contrast-enhanced color Doppler sonography of parotid gland tumors. Eur Arch Otorhinolaryngol. 260(6):344-8, 2003
                                                                                      29. Zeebregts CJ et al: Synchronous tumours of the unilateral parotid gland: rare or undetected? J Craniomaxillofac Surg. 31(1):62-6, 2003
                                                                                      30. Laane CJ et al: Role of Epstein-Barr virus and cytomegalovirus in the etiology of benign parotid tumors. Head Neck. 24(5):443-50, 2002
                                                                                      31. Lewis PD et al: Mitochondrial DNA mutations in the parotid gland of cigarette smokers and non-smokers. Mutat Res. 518(1):47-54, 2002
                                                                                      32. Maiorano E et al: Warthin's tumour: a study of 78 cases with emphasis on bilaterality, multifocality and association with other malignancies. Oral Oncol. 38(1):35-40, 2002
                                                                                      33. Raymond MR et al: Accuracy of fine-needle aspiration biopsy for Warthin's tumours. J Otolaryngol. 31(5):263-70, 2002
                                                                                      34. Shah GV: MR imaging of salivary glands. Magn Reson Imaging Clin N Am. 10(4):631-62, 2002
                                                                                      35. Sungur N et al: Clinicopathological evaluation of parotid gland tumors: a retrospective study. J Craniofac Surg. 13(1):26-30, 2002
                                                                                      36. Tsai SC et al: Parotid neoplasms: diagnosis, treatment, and intraparotid facial nerve anatomy. J Laryngol Otol. 116(5):359-62, 2002
                                                                                      37. Webb AJ et al: Parotid Warthin's tumour Bristol Royal Infirmary (1985-1995): a study of histopathology in 33 cases. Oral Oncol. 38(2):163-71, 2002
                                                                                      38. Nakamura Y et al: Growth factors, extracellular matrix components and cell adhesion molecules Warthin's tumor. J Oral Pathol Med. 30(5):290-5, 2001
                                                                                      39. Lewis PD et al: Detection of damage to the mitochondrial genome in the oncocytic cells of Warthin's tumour. J Pathol. 191(3):274-81, 2000
                                                                                      40. Mandel L et al: Differentiating HIV-1 parotid cysts from papillary cystadenoma lymphomatosum. J Am Dent Assoc. 131(6):772-6, 2000
                                                                                      41. Joe VQ et al: Tumors of the parotid gland: MR imaging characteristics of various histologic types. AJR Am J Roentgenol. 163(2):433-8, 1994
                                                                                      42. Yoo GH et al: Warthin's tumor: a 40-year experience at The Johns Hopkins Hospital. Laryngoscope. 104(7):799-803, 1994
                                                                                      43. Minami M et al: Warthin tumor of the parotid gland: MR-pathologic correlation. AJNR Am J Neuroradiol. 14(1):209-14, 1993