Heterotopic salivary duct inclusions in Warthin tumor – A cryptic histological finding involved in its pathogenesis

IF 2.9 4区医学 Q2 PATHOLOGY

Pathology, research and practice Pub Date : 2024-08-29 DOI:10.1016/j.prp.2024.155560

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引用次数: 0

Abstract

Warthin tumor (WT) is the second most common benign parotid gland tumor after pleomorphic adenoma. WT is characterized by cystic and papillary proliferation of a two-layered oncocytic epithelium supported by lymphoid tissue. Heterotopic salivary duct inclusions (SDIs) are frequently observed in lymph nodes (LNs) of WT (SDI/LNs), and are thought to be the origin of WT. If this is true, SDIs should also persist in the lymphoid tissue of WT itself (SDI/WT), as a missing link between SDIs and WTs, but studies of this issue are limited. From 2008–2023, 138 WT cases were surgically excised at our hospital. SDI/LNs and SDI/WTs were histologically examined. Of 100 WT cases with LNs, SDI/LNs were observed in 67 cases (67 %). SDI/WTs were detected in 114 of 138 cases (82.6 %), including 107 of 127 smokers (84.3 %) and 7 of 11 never-smokers (63.6 %). SDI/WTs were located mainly in the subcapsular lymphoid tissue and often surrounded by a fibrous coat resembling salivary excretory ducts. This study revealed a high incidence of SDIs in WT itself, strongly supporting the theory that WT develops from heterotopic salivary ducts.

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Warthin 肿瘤中的异位涎腺管包涵体--与发病机制有关的隐匿组织学发现

Warthin瘤（WT）是仅次于多形性腺瘤的第二大常见腮腺良性肿瘤。WT的特征是由淋巴组织支持的两层肿瘤细胞上皮细胞的囊性和乳头状增生。在 WT 的淋巴结（SDI/LNs）中经常观察到异位唾液腺导管包涵体（SDIs），这被认为是 WT 的起源。如果情况属实，SDIs 也应存在于 WT 本身的淋巴组织中（SDI/WT），作为 SDIs 和 WTs 之间缺失的一环，但对这一问题的研究却很有限。从 2008 年到 2023 年，我院共对 138 例 WT 病例进行了手术切除。对 SDI/LNs 和 SDI/WTs 进行了组织学检查。在 100 例有 LNs 的 WT 病例中，有 67 例（67%）观察到 SDI/LNs。138 例病例中有 114 例（82.6%）发现了 SDI/WT，包括 127 例吸烟者中的 107 例（84.3%）和 11 例从不吸烟者中的 7 例（63.6%）。SDI/WTs 主要位于囊下淋巴组织中，周围通常有一层类似唾液排泄管的纤维外膜。这项研究揭示了 WT 自身 SDI 的高发病率，有力地支持了 WT 由异位唾液腺导管发展而来的理论。

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来源期刊

Pathology, research and practice 医学-病理学

CiteScore

5.00

自引率

3.60%

发文量

405

审稿时长

24 days

期刊介绍： Pathology, Research and Practice provides accessible coverage of the most recent developments across the entire field of pathology: Reviews focus on recent progress in pathology, while Comments look at interesting current problems and at hypotheses for future developments in pathology. Original Papers present novel findings on all aspects of general, anatomic and molecular pathology. Rapid Communications inform readers on preliminary findings that may be relevant for further studies and need to be communicated quickly. Teaching Cases look at new aspects or special diagnostic problems of diseases and at case reports relevant for the pathologist''s practice.