J Korean Soc Radiol.  2011 Sep;65(3):213-216.

Tuberculosis Infection within a Warthin's Tumor of the Parotid Gland: A Case Report

• Lee H
• Suh SI

Abstract

Warthin's tumor (WT) is a common benign tumor of the parotid gland. Because WT has a lymphoid stroma, lymph node pathology can be superimposed on a WT, and its appearance can differ from that of a typical WT on imaging studies. We report on a rare case of a WT and tuberculosis within another WT in the same parotid gland, with a good correlation between histological sections and computed tomography scans. The patient underwent a superficial parotidectomy and received anti-tuberculous treatment. The patient recovered without complication. In summary, clinicians and radiologists should be concerned about lymph node pathology superimposed on a WT, particularly when an unusual imaging finding of a WT is suspected.

MeSH Terms

Humans
Lymph Nodes
Parotid Gland
Tuberculosis

Figure

• 

  Fig. 1 A 51-year-old female with multifocal Warthin's tumors. A. Axial neck sonogram shows a mixed hypoechoic and anechoic, well defined mass measuring 3.0 × 2.4 cm in the left inferior aspect of the parotid tail. B. Non-contrast enhanced axial CT scan reveals a low density mass without internal calcification. C. Contrast enhanced study shows a well-defined lesion with central low density, including necrosis and thick irregular rim-enhancement (arrows).

• 

  Fig. 2 A. Contrast-enhanced coronal salivary gland CT shows two lesions that differed in appearance: the upper lesion is a small homogenous enhancing solid nodule (arrowheads) and the lower lesion, detected by sonogram, is an irregular, thick-rim enhanced complex mass (arrows) in the superficial lobe of the left parotid gland. B. Corresponding gross specimen of parotid lesions (arrowheads; upper solid nodule, arrows; lower necrotic complex mass).

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  Fig. 3 A. The homogeneously enhancing nodule in Fig. 2 is composed of proliferative oncocytic columnar epithelium and lymphocytic infiltration within the stroma, which was consistent with a solid WT (H&E stain, original magnification × 12). B. Mass with central low density in Fig. 2 shows TB granuloma (asterisk) in the lymphoid stroma, intermingled with WT (W) (H&E, original magnification × 100). C. AFB were found within TB granuloma (Ziehl-Neelsen stain, original magnification × 1,000). Note.-AFB = acid-fast bacilli, TB = tuberculosis, WT = Warthin's tumor

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