Dreyer T, Battmann A, Silberzahn J, Glanz H, Schulz A
Institute of Pathology, University of Giessen, FRG.
Pathol Res Pract. 1993 Jun;189(5):577-81; discussion 581-5. doi: 10.1016/S0344-0338(11)80369-9.
A 67-year-old female patient developed a slowly growing swelling in the region of the left mandibular angle. This swelling was tender on pressure. Clinical examinations revealed an immobile, circumscribed, palpable node. Sonography showed an inhomogeneous space-occupying mass with a predominantly poor echo in the cranial and dorsal parts of the parotid gland. Intraoperatively the lesion presented as a smooth-bordered, round, capsulated tumor, which was excised "in toto". The postoperative course was uneventful. Histologic examination revealed a salivary gland tumor consisting of two components. Glandular structures corresponding to a Warthin tumor were seen in the center, whereas differentiation in the periphery of the tumor was that of a sebaceous lymphadenoma. Metaplastic sebaceous glands within salivary glands have been occasionally described, but true sebaceous lymphadenomas of the salivary glands are a rarity. A rare variant of Warthin's tumor is its metaplastic type, in which extensive metaplasia of the squamous epithelium is observed. The morphologic parallels as well as the differences seen in our case are described. We believe that it does not meet the criteria of a metaplastic Warthin tumor and have therefore diagnosed a combination tumor of the parotid gland, which is composed of a Warthin tumor component and a sebaceous lymphadenoma component.
一名67岁女性患者左侧下颌角区域出现一个生长缓慢的肿物。该肿物压痛明显。临床检查发现一个固定、边界清晰、可触及的结节。超声检查显示腮腺颅部和背侧有一个不均匀的占位性肿块，主要为低回声。术中病变表现为边界光滑、圆形、有包膜的肿瘤，完整切除。术后过程顺利。组织学检查显示唾液腺肿瘤由两种成分组成。肿瘤中心可见符合沃辛瘤的腺管结构，而肿瘤周边则为皮脂腺腺瘤分化。唾液腺内的化生皮脂腺偶尔有报道，但真正的唾液腺皮脂腺腺瘤实属罕见。沃辛瘤的一种罕见变异型是化生型，其中可见鳞状上皮广泛化生。描述了我们病例中观察到的形态学相似之处和差异。我们认为它不符合化生型沃辛瘤的标准，因此诊断为腮腺混合瘤，由沃辛瘤成分和皮脂腺腺瘤成分组成。
