Nodular Lymphocyte-Predominant Hodgkin Lymphoma in a Warthin Tumor of the Parotid Gland

Napoli, Arianna Di; Mallel, Giuseppe; Bartolazzi, Armando; Cavalieri, Elena; Becelli, Roberto; Cippitelli, Claudia; Ruco, Luigi

doi:10.1177/1066896915582263

Cited by 17 publications

(6 citation statements)

References 30 publications

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“…According to the English and Chinese literature, 28 cases of WT with lymphoma have been reported to date. We concluded that the most common subtypes of lymphoma were FLs (10 cases)[1-10], followed by Hodgkin’s lymphoma (4 cases)[11-14] and diffuse large B cell lymphoma (6 cases)[4,15-18]. The others were small lymphocytic lymphoma/chronic lymphocytic leukemia (3 cases)[19-21], mantle cell lymphoma (1 case)[22], extranodal marginal zone lymphoma of mucosa-associated lymphoid tissue (1 case)[23], Lennert lymphoma (1 case)[24], peripheral T-cell lymphoma (2 cases)[25,26], and T lymphoblastic leukemia/lymphoma (1 case)[27].…”

Section: Discussionmentioning

confidence: 99%

Diffuse large B-cell lymphoma arising from follicular lymphoma with warthin’s tumor of the parotid gland - immunophenotypic and genetic features: A case report

Wang

Chu²,

Yang

et al. 2019

WJCC

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BACKGROUNDWarthin’s tumor (WT) is composed of several cysts that are lined with tall, bilayered oncocytic columnar cells and lymphoid stroma. Within WT, the two components rarely transform into carcinoma or lymphoma, and when it does, carcinoma is the most common type. Approximately 28 cases of lymphoma with WT have been reported, most of which were non-Hodgkin lymphomas, and only a few cases were Hodgkin lymphomas. In the present report, we studied a case of diffuse large B cell lymphoma (DLBCL) arising from follicular lymphoma (FL) with WT in the parotid gland and its immunophenotypic and genetic features.CASE SUMMARYA 67-year-old man presented with a slowly enlarging right cheek mass for 12 years, and the mass began to change in size over a 2-mo time period. Over time, the patient felt mild local pain and right cheek discomfort. His medical history included a hepatitis B virus infection for 20 years and 30 years of smoking. Gross examination of the excised specimen showed a gray-red and gray-white appearance and a soft texture lobulated external surface neoplasm that measured 9 cm × 8 cm × 7 cm and was well circumscribed by relative normal parotid gland tissue. In cross section, the cut surfaces of the neoplasm were multicystic and had a homogeneous scaly appearance. A small fluid was discovered in the cyst. Bilateral oxyphilic, cuboidal or polygonal epithelium cells and lymphoid intraparenchymal components were observed. Many medium- to large-sized lymphoid cells were observed diffusely in part of the neoplasm, and a few secondary lymphoid follicles were observed at the center or edge of the neoplasm. Immunohistochemical staining showed that the columnar oncocytic cells were positive for AE1/AE3; neoplastic cells located in coarctate follicular were positive for CD20, Pax-5, bcl-2 and bcl-6; and the adjacent diffusely medium- to large-sized lymphoid cells were positive for Pax-5, bcl-6, CD20, MUM-1, bcl-2 and CD79a. The bcl-6 (3q27) break-apart rearrangement was observed, and an Epstein Barr virus test was negative in the tumor cells. The patient survived 6 months after being diagnosed without any treatment.CONCLUSIONWT-associated lymphoma is a very rare neoplasm in the parotid gland. Most cases are B cell non-Hodgkin lymphomas and involve middle-age and older males. This case highlights the extremely rare association of DLBCL arising from FL with WT and the importance of deliberate evaluation of the WT intraparenchymal stroma. Molecular detection techniques have potential advantages in the diagnosis of lymphoma with WT.

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Section: Discussionmentioning

confidence: 99%

Diffuse large B-cell lymphoma arising from follicular lymphoma with warthin’s tumor of the parotid gland - immunophenotypic and genetic features: A case report

Wang

Chu²,

Yang

et al. 2019

WJCC

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“…Multiple tumours may be considered from three perspectives: according to their histological type with identical or different histology, time of development as synchronous or metachronous and localisation as unilateral, bilateral and multiple . The rare occurrence of other primary malignant salivary gland tumours could also be a result of malignant transformation of the epithelial or lymphoid component of WT …”

Section: Association With Other Salivary Gland Tumours and Other Extrmentioning

confidence: 99%

“…Recurrence of WT is probably associated with the multifocality of WT or inadequate excision . In rare cases—about 1%‐ malignant transformation of WT may occur, ie, squamous cell carcinoma or other carcinoma may develop from the epithelial component, and lymphoma may involve the lymphoid component . Some patients with malignant transformation of WT give a history of radiation.…”

Section: Prognosis Of Wtmentioning

confidence: 99%

“…In such cases of malignant transformation of the epithelial component of WT, the differential diagnosis includes squamous or mucous metaplasia, and metastases of extra‐salivary malignancies to a pre‐existing WT. Lymphomas arising from the lymphoid component of WT include MALT lymphoma, small lymphocytic lymphoma and nodal types such as follicular cell lymphoma and rarely Hodgkin's lymphoma …”

Section: Prognosis Of Wtmentioning

confidence: 99%

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Cytopathology and diagnostics of Warthin's tumour

Sučić

Ljubić²,

Perković³

et al. 2020

Cytopathology

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Warthin's tumour (WT) is a benign epithelial salivary tumour, one type of salivary adenoma. Histologically, WT is structured of two components, epithelial tissue that often lines cystic formations and lymphoid tissue in the tumour stroma. FNA is a reliable diagnostic approach in the diagnosis of salivary gland lesions allowing a highly accurate categorization of benign tumour‐like lesions, benign tumours and malignant tumours. In the proposed Milan reporting system of salivary gland lesions, WT is categorized in the IVA group of benign neoplasms. Accurate cytological diagnosis is straightforward when three characteristic components are present: oncocytes, either isolated or associated in clusters, lymphocytes and lymphoid cells and often an inflammatory/necrotic‐like substance. Also, specific features of scintigraphy and radiological imaging contribute to the diagnosis of WT. WT is categorized according to Seifert G. et al in 4 types, depending on the proportions of the epithelial component and lymphoid stroma. Differential cytopathological and pathohistological diagnosis include other salivary gland lesions with lymphoid, oncocytic epithelial and cystic components. In some cases, such as the metaplastic WT variant, there are additional cytopathological and histological diagnostic difficulties. Moreover, bilateral, multicentric or multiple and infrequently seen extra‐salivary localizations of WT are associated with further cytopathological diagnostic difficulties. Also, a rare possibility of malignant transformation of the epithelial or lymphoid component of WT as well as possible association with other primary tumours remains a challenge in accurate cytopathological and histological diagnosis of WT.

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“…[ 14 ] Similar to our case of simultaneous association of Warthin tumor and cervical lymph nodes, Di Napoli et al reported 1 case, like the other 2 of 3 reported cases in the literature, whereas only 1 case of association was reported as an intraparotid lymph node. [ 17 ]…”

Section: Discussionmentioning

confidence: 99%

Risk interrelationship among multiple primary tumors

Safi

Sun²,

Wang³

et al. 2018

Medicine

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Rationale:Along with advanced management in oncology, great progress has been recently achieved in the studies of multiple primary tumors. Several reports have studied the coexistence between lymphoma and either renal cell carcinoma (RCC) or Warthin tumor. However, the level of coexistence between these cases remains unclear due to the absence of a distinct link between them.Patient concerns:We present a unique case of multiple primary tumors (lymphoma, RCC, and Warthin tumor) in an 80-year-old man and a review of the literature on the coexistence of RCC with lymphoma and lymphoma with Warthin tumor.Diagnosis:With a history of RCC, the patient had a freely movable lump under his left ear, and the pathological report indicated Hodgkin lymphoma and Warthin tumor.Intervention:RCC and Warthin tumor of the patient were surgically treated, followed by 2 cycles (14 days per cycle) of Epirubicin 40 mg day 1, Bleomycin 8 mg day 1, Vincristine 2 mg day 1, and Dacarbazine 500 mg day 1. The chemotherapy protocol was then changed to Epirubicin 40 mg day 1, Vincristine 2 mg day 1, and Dacarbazine 500 mg day 1 for 7 cycles.Outcomes:After the last day of chemotherapy, the patient showed a complete response.Lessons:To the best of our knowledge, this paper is the first to report a case of multiple primary tumors with a complete response. For their early detection, favorable prognosis, and correlation identification, we suggest a transitive relation between these coexisting tumors. Therefore, similar studies should be conducted.

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Nodular Lymphocyte-Predominant Hodgkin Lymphoma in a Warthin Tumor of the Parotid Gland

Cited by 17 publications

References 30 publications

Diffuse large B-cell lymphoma arising from follicular lymphoma with warthin’s tumor of the parotid gland - immunophenotypic and genetic features: A case report

Diffuse large B-cell lymphoma arising from follicular lymphoma with warthin’s tumor of the parotid gland - immunophenotypic and genetic features: A case report

Cytopathology and diagnostics of Warthin's tumour

Risk interrelationship among multiple primary tumors

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