TITLE:
A Case of Warthin’s Tumor Together with IgG4-Related Sialadenitis
AUTHORS:
Ryogo Aoki, Risa Ito, Asuka Ohashi, Riyoko Niwa, Masashi Matsuyama, Sachiko Oka, Naomi Kawaguchi, Toshimasa Sakakima, Daichi Kodama, Naoki Watanabe, Daisuke Okamoto, Takafumi Naiki, Takuji Tanaka
KEYWORDS:
Warthin’s Tumor, Sialadenitis, IgG4-Related Disease, Immunohistochemistry
JOURNAL NAME:
Open Journal of Pathology,
Vol.14 No.3,
July
25,
2024
ABSTRACT: Warthin’s tumor is the second most frequent neoplasm next to pleomorphic adenoma in the salivary gland. The tumor contains the epithelial oncocyte cells with the presence of rich-mitochondria and their surrounding abundant lymphocytes. A relatively new disease entity of IgG4-related disease frequently occurs in the salivary gland. However, the coexistence of Warthin’s tumor and IgG4-related disease is scarcely observed. We have recently experienced a rare case of Warthin’s tumor with IgG4-related sialadenitis. A 51-year-old man presented to our hospital, complaining of a mass with right submandibular tenderness and spontaneous pain. A computed tomography scan of the cervical region revealed a suspicion of lymph node proliferative disease, including malignant lymphoma. Elevated serum levels of IL-2R: 1843 U/ml (reference value 122 - 496 U/ml), IgG: 3430 mg/dl (reference value 861 - 1747 mg/dl), and IgG4: 3140 mg/dl (reference value 11 - 121 mg/dl) were observed. Other laboratory data showed within normal ranges. The cervical tumor was diagnosed as Warthin’s tumor by the findings of fine-needle aspiration cytology and biopsy examination. Immunohistochemistry revealed numerous IgG4- and IgG-positive cells with fibrosis surrounding the epithelial component of Warthin’s tumor, suggesting IgG4-rerated sialadenitis. Finally, we diagnosed the cervical tumor as Warthin tumor with IgG4-related sialadenitis. This is the second report describing a case of Warthin’s tumor with possible involvement of IgG4-related sialadenitis.