Type of Preparation:
Direct Smear
Magnification:
High Power Magnification
Clinical History:
65-year old female with left parotid mass
Interpretation:
Fig. 5.9b Neoplasm: Benign: Warthin Tumor
Cytomorphologic Criteria:
Tripartite appearance with dirty proteinaceous background, lymphocytes, and
sheets of oncocytes
• Oncocytes: Abundant homogeneous granular cytoplasm (orange on Papanicolaou
stain) with well-defined borders
• Epithelial cell nuclei: Centrally placed and round, with prominent nucleolus
• Lymphocytes: Mixed population dominated by small mature-appearing cells
Explanatory Notes:
FNA of Warthin tumor (WT) showing classic cytomorphologic features consisting of background lymphocytes and groups of oncocytic epithelial cells. WT occurs almost exclusively in the parotid gland and the tripartite appearance is essentially diagnostic. Aspirates with classic features should be diagnosed as “Neoplasm: Benign.” Distinction should be made from intraparotid lymph nodes, lymphoepithelial sialadenitis (LESA), oncocytoma, and lymphoepithelial cyst. Intraparotid lymph nodes and LESA lack the oncocytic epithelium and dirty cyst debris characteristic of a WT. Oncocytomas consist of epithelial cells only and lack
the dirty cystic background and lymphocytes of WT.