Warthin’s Tumor and Sialolithiasis: Causes, Clinical Features, Diagnosis, and Treatment

Warthin Tumor

Question 1. Write short note on Sialolithiasis.

Answer. Sialolithiasis is the formation of hardened intraluminal deposits in ductal system of salivary gland which obstructs the normal flow of saliva.

“Risk Factors For Developing Sialolithiasis”

Sialolith Composition

Sialolith is made up of:

• Inorganic materials: Calcium phosphate, calcium carbonate,combined with other salts such as Mg, Zn, etc.
• Organic materials, i.e. glycoproteins, mucopolysaccharides and cellular debris.
• Aggregations of bacteria, clumps of epithelial cells, mucus,blood clots following trauma, are all suggested to form foci.

“Causes Of Warthin’S Tumor In Salivary Glands”

Question 2. Write short note on Warthin’s tumor.

Answer.

• Warthin’s tumor is also called adenolymphoma.
• It is a benign parotid tumor, it constitute about 10% of parotid tumors.
• Origin of adenolymphoma during development some parotid tissue gets included within lymph nodes which are present within the parotid sheath.
• It involves only superfial lobe of parotid gland.

Warthin’s tumor Etiology

Smoking and radiation exposure can be the cause.

Warthin’s tumor Clinical Features

• Middle-aged or elderly males are commonly affcted usually they are smokers.
• Can be bilateral, in some cases.
• It has smooth surface, round border with soft, cystic flctuant swelling in lower pole often bilateral and is non-tender.
• Classically, situated at the lower pole of parotid elevating the ear lobule.
• May be multicentric.
• This tumor affects only parotid gland.

“Symptoms Of Warthin’S Tumor Vs Sialolithiasis”

Warthin’s tumor Investigations

• Adenolymphoma produces “hot spot” in 99 Technetium pertechnetate scan which is diagnostic.
• FNAC can be done
• Biopsy is done and histology reveals:

• Cyst is lined by a bilayered oncocytic epithelium, the inner cells of which are tall columnar with fine granular and eosinophilic cytoplasm and slightly hyperchromatic nuclei.
  The outer layer consists of basaloid cells.
• An eosinophilic coagulum is present within the cystic spaces.
• The numerous lymphocytic components may represent normal lymphoid tissue within which tumor is developed.

“Best Ways To Manage Sialolithiasis”

Warthin’s Tumor Treatment

It is best treated by superficial parotidectomy which spares the facial nerve