背景:Warthin肿瘤(WT)是唾液腺中第二常见的良性肿瘤。它的生长速度缓慢,最常见于腮腺。大多数患者出现耳下/耳前无痛性肿块的偶然发现。除了肿瘤的上皮成分,WT在特征上与被认为是良性的淋巴间质相关。虽然有一些关于WT中淋巴成分恶性转化的报道,WT合并套细胞淋巴瘤(MCL)的病例极为罕见。据我们所知,英语文献中描述了两种情况。在这里,我们报告了一例WT合并MCL的70岁女性患者,并强调仔细检查WT中淋巴间质的重要性,以免错过并发淋巴瘤。
方法:一名70岁的中国女性,有40年的吸烟史,有1年的右颌下肿块史,近期肿大。
方法:颈部超声(US)和计算机断层扫描(CT)扫描显示右腮腺中有一个界限明确的肿块,最大直径为3.1cm。对肿块进行手术切除。组织病理学检查显示肿瘤上皮的特征性双层,具有突出的淋巴间质,建议WT。此外,形态学和免疫组织化学研究证实了MCL的共存。此后,该病例的最终诊断为WT合并MCL.
方法:患者在临床评估后分期为I期。由于腮腺病变生长缓慢,密切观察是通过定期临床和放射学监测决定的。
结果:目前,通过临床评估,患者显示病情稳定。
结论:据我们所知,报告的WT合并MCL的病例非常罕见。该病例强调了对WT的淋巴间质进行全面评估的重要性,以避免在碰撞肿瘤中漏诊淋巴瘤成分。
BACKGROUND: Warthin tumor (WT) is the second most common benign tumor in salivary gland. It has a slow growth rate and most frequently occurs in the parotid gland. Most patients present with an incidental finding of a painless mass inferior/anterior to the ear. Besides the epithelial component of the tumor, WT is characteristically associated with lymphoid stroma that is considered benign. While there have been a few reports of malignant transformation of the lymphoid components in WT, cases of WT concomitant with mantle cell lymphoma (MCL) are extremely rare. To the best of our knowledge, two cases have been described in the English literature. Herein, we report a case of WT concomitant with MCL in a 70-year-old female patient, and emphasize the importance of careful examination of lymphoid stroma in WT so that concurrent lymphoma is not missed.
METHODS: A 70-year-old Chinese woman with a 40-year history of cigarette smoking presented with a one year history of a right submaxillary mass with recent enlargement.
METHODS: Cervical ultrasound (US) and computed tomography (CT) scans of the neck revealed a well-circumscribed mass in the right parotid with a maximum diameter of 3.1 cm. Surgical resection of the mass was performed. Histopathological examination revealed a characteristic double-layer of neoplastic epithelium with prominent lymphoid stroma, suggesting WT. In addition, morphology and immunohistochemistry studies confirmed the coexistence of MCL. Thereafter, the final diagnosis of this case was WT concomitant with MCL.
METHODS: The patient was staged as stage I after clinical assessment. Due to the slow growth of parotid lesions, close observation was decided with periodic clinical and radiological monitoring.
RESULTS: Currently, the patient demonstrates a stable disease by clinical evaluation.
CONCLUSIONS: To the best of our knowledge, reported cases of WT concomitant with MCL are very rare. This case highlights the importance of a comprehensive assessment of the lymphoid stroma of WT to avoid missed diagnosis of a lymphoma component in a collision tumor.