Warthin-Like Secretory Carcinoma of the Parotid Gland: A Diagnostic Pitfall in Fine Needle Aspiration Cytology.
Daniel Lauffenburger, Laleh Hakima
✦ AI-curated · Sources linked
Case in brief
A 69-year-old male presented with a parotid gland neoplasm, exhibiting features of Warthin tumor on fine needle aspiration cytology, including oncocytic epithelial cells in a lymphocyte-rich background. Parotidectomy revealed a Warthin-like secretory carcinoma characterized by mixed solid, cribriform, and cystic architecture with abundant eosinophilic secretions and robust tumor-associated lymphoid proliferation. Immunohistochemical analysis confirmed the diagnosis.
What made this case unusual
The presence of robust tumor-associated lymphoid proliferation in a secretory carcinoma, which is atypical and can lead to misdiagnosis as Warthin tumor.
Diagnostic / clinical pearl
Clinicians should be aware that Warthin-like secretory carcinoma can mimic Warthin tumor cytologically, necessitating careful evaluation of histomorphologic and immunohistochemical features for accurate diagnosis.
Why it matters
This case highlights the potential for misclassification of salivary gland neoplasms, emphasizing the importance of recognizing atypical presentations in fine needle aspiration cytology.