Classical Hodgkin lymphoma arising from heterotopic Warthin's tumor in the cervical lymph node: A case report

Abstract

Abstract. Heterotopic Warthin's tumor (WT) arising from the cervical lymph nodes is uncommon and WT presenting concomitantly with classical Hodgkin's lymphoma has only been previously reported three times in English literature. The current study presents an unusual case of classical Hodgkin lymphoma (CHL) involving the heterotopic WT in a 59-year-old male. Histopathologic examination revealied a WT with extensive expansion of mixed-cellularity CHL in a lymph node in the right of the neck. Clinical staging was determined as stage IA disease. The patient received four courses of chemotherapy and local consolidative radiotherapy, no evidence of disseminated lymphoma was observed over the 6-month follow-up. To the best of our knowledge, this is the first well documented collision tumor between CHL and heterotopic WT of the cervical lymph nodes. The present case also expands the anatomical site of malignant lymphomas associated with WT.

Warthin’s Tumor of the Parotid Gland With Degeneration to Diffuse Large B-cell Lymphoma: A Case Report and Review of Literature

“…Primary parotid gland lymphomas are rare and, as described in the literature, predominate in elderly patients with a mean age of 65 years [6,7], in the male sex [5][6][7], and mainly affect the parotid gland [6,7], very similar to the case of our patient.…”

“…However, transformation to lymphomas, as in our case, is very rare [ 7 , 9 ], with no more than 30 cases reported in the literature [ 6 , 7 ]. The risk factors for malignancy are not entirely clear; exposure to radiotherapy has been proposed [ 10 ] in our case, there was no such history; however, in the cases reported by Ozkök G et al, Li Jun et al, Wang CS et al and some other authors, they report a history of heavy smoking [ 6 , 7 , 9 ] which could be a predisposing factor for transformation to lymphoma as in our case. Some diseases, such as Sjogren's syndrome or Mikulicz's disease, are also risk factors for malignant transformation [ 1 , 3 , 10 ].…”

“…Primary lymphomas of the parotid gland account for 1%-4% of parotid tumors [ 1 , 4 , 5 ]. Degeneration of WT to lymphoma has been documented only as an isolated case report, and there are no more than 30 cases in the literature [ 6 , 7 ]. Clinically, it can be indistinguishable from other gland tumors, which delays diagnosis and worsens the prognosis [ 3 ], but with proper management, it has a good prognosis [ 5 ].…”

Follicular Lymphoma Diagnosed in Warthin Tumor: A Case Report and Review of the Literature

“…Giardini et al reported bilateral parotid gland Warthin tumor involvement with follicular lymphoma [12]. Reiner et al reported a case of large cell lymphoma in association with Warthin tumor, in a patient having preexisting Sjogren syndrome [19]. Generally, a bone marrow biopsy for these patients may show involvement by small clonal B cell population.…”