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Head and Neck
Diagnosis
Parotid Space
Benign Tumors
Warthin Tumor
Warthin Tumor
H. Ric Harnsberger, MD; Barton F. Branstetter, IV, MD, FACR
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KEY FACTS

  • Terminology

    • Imaging

      • Top Differential Diagnoses

        • Clinical Issues

          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. 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
                                          2. 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
                                          3. Teymoortash A et al: Is Warthin's tumour of the parotid gland a lymph node disease? Histopathology. 59(1):143-5, 2011
                                          4. 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
                                          5. 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
                                          6. 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
                                          7. Yerli H et al: Dynamic multislice computed tomography findings for parotid gland tumors. J Comput Assist Tomogr. 31(2):309-16, 2007
                                          8. Hamilton BE et al: Earring lesions of the parotid tail. AJNR Am J Neuroradiol. 24(9):1757-64, 2003
                                          9. Marioni G et al: Facial nerve paralysis secondary to Warthin's tumour of the parotid gland. J Laryngol Otol. 117(6):511-3, 2003
                                          10. Parwani AV et al: Diagnostic accuracy and pitfalls in fine-needle aspiration interpretation of Warthin tumor. Cancer. 99(3):166-71, 2003
                                          11. Steinhart H et al: Contrast-enhanced color Doppler sonography of parotid gland tumors. Eur Arch Otorhinolaryngol. 260(6):344-8, 2003
                                          12. Zeebregts CJ et al: Synchronous tumours of the unilateral parotid gland: rare or undetected? J Craniomaxillofac Surg. 31(1):62-6, 2003
                                          13. 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
                                          14. Lewis PD et al: Mitochondrial DNA mutations in the parotid gland of cigarette smokers and non-smokers. Mutat Res. 518(1):47-54, 2002
                                          15. 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
                                          16. Raymond MR et al: Accuracy of fine-needle aspiration biopsy for Warthin's tumours. J Otolaryngol. 31(5):263-70, 2002
                                          17. Shah GV: MR imaging of salivary glands. Magn Reson Imaging Clin N Am. 10(4):631-62, 2002
                                          18. Sungur N et al: Clinicopathological evaluation of parotid gland tumors: a retrospective study. J Craniofac Surg. 13(1):26-30, 2002
                                          19. Tsai SC et al: Parotid neoplasms: diagnosis, treatment, and intraparotid facial nerve anatomy. J Laryngol Otol. 116(5):359-62, 2002
                                          20. 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
                                          21. Miyake H et al: Warthin's tumor of parotid gland on Tc-99m pertechnetate scintigraphy with lemon juice stimulation: Tc-99m uptake, size, and pathologic correlation. Eur Radiol. 11(12):2472-8, 2001
                                          22. 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
                                          23. 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
                                          24. Mandel L et al: Differentiating HIV-1 parotid cysts from papillary cystadenoma lymphomatosum. J Am Dent Assoc. 131(6):772-6, 2000
                                          25. 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
                                          26. Yoo GH et al: Warthin's tumor: a 40-year experience at The Johns Hopkins Hospital. Laryngoscope. 104(7):799-803, 1994
                                          27. 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

                                                  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. 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
                                                                                  2. 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
                                                                                  3. Teymoortash A et al: Is Warthin's tumour of the parotid gland a lymph node disease? Histopathology. 59(1):143-5, 2011
                                                                                  4. 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
                                                                                  5. 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
                                                                                  6. 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
                                                                                  7. Yerli H et al: Dynamic multislice computed tomography findings for parotid gland tumors. J Comput Assist Tomogr. 31(2):309-16, 2007
                                                                                  8. Hamilton BE et al: Earring lesions of the parotid tail. AJNR Am J Neuroradiol. 24(9):1757-64, 2003
                                                                                  9. Marioni G et al: Facial nerve paralysis secondary to Warthin's tumour of the parotid gland. J Laryngol Otol. 117(6):511-3, 2003
                                                                                  10. Parwani AV et al: Diagnostic accuracy and pitfalls in fine-needle aspiration interpretation of Warthin tumor. Cancer. 99(3):166-71, 2003
                                                                                  11. Steinhart H et al: Contrast-enhanced color Doppler sonography of parotid gland tumors. Eur Arch Otorhinolaryngol. 260(6):344-8, 2003
                                                                                  12. Zeebregts CJ et al: Synchronous tumours of the unilateral parotid gland: rare or undetected? J Craniomaxillofac Surg. 31(1):62-6, 2003
                                                                                  13. 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
                                                                                  14. Lewis PD et al: Mitochondrial DNA mutations in the parotid gland of cigarette smokers and non-smokers. Mutat Res. 518(1):47-54, 2002
                                                                                  15. 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
                                                                                  16. Raymond MR et al: Accuracy of fine-needle aspiration biopsy for Warthin's tumours. J Otolaryngol. 31(5):263-70, 2002
                                                                                  17. Shah GV: MR imaging of salivary glands. Magn Reson Imaging Clin N Am. 10(4):631-62, 2002
                                                                                  18. Sungur N et al: Clinicopathological evaluation of parotid gland tumors: a retrospective study. J Craniofac Surg. 13(1):26-30, 2002
                                                                                  19. Tsai SC et al: Parotid neoplasms: diagnosis, treatment, and intraparotid facial nerve anatomy. J Laryngol Otol. 116(5):359-62, 2002
                                                                                  20. 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
                                                                                  21. Miyake H et al: Warthin's tumor of parotid gland on Tc-99m pertechnetate scintigraphy with lemon juice stimulation: Tc-99m uptake, size, and pathologic correlation. Eur Radiol. 11(12):2472-8, 2001
                                                                                  22. 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
                                                                                  23. 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
                                                                                  24. Mandel L et al: Differentiating HIV-1 parotid cysts from papillary cystadenoma lymphomatosum. J Am Dent Assoc. 131(6):772-6, 2000
                                                                                  25. 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
                                                                                  26. Yoo GH et al: Warthin's tumor: a 40-year experience at The Johns Hopkins Hospital. Laryngoscope. 104(7):799-803, 1994
                                                                                  27. Minami M et al: Warthin tumor of the parotid gland: MR-pathologic correlation. AJNR Am J Neuroradiol. 14(1):209-14, 1993