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Vol. 57, No. 3, 2013
Issue release date: May – June
Section title: Novel Insights from Clinical Practice
Acta Cytologica 2013;57:309-312

Warthin Tumor with Signet-Ring Cell Features as a Pitfall in Salivary Gland Cytopathology

Bellevicine C. · Iaccarino A. · Malapelle U. · Troncone G.
Department of Biomorphological and Functional Sciences, University Federico II, Naples, Italy
email Corresponding Author

Correspondence to: Dr. Giancarlo Troncone

Dipartimento di Scienze Biomorfologiche e Funzionali

Università degli Studi di Napoli Federico II

via Sergio Pansini 5, IT-80131 Napoli (Italia)


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Background: Warthin tumor (WT) is a common parotid lesion reliably diagnosed by fine-needle aspiration (FNA). Worrisome metaplastic changes may occur in WT. Their interpretation as mucoepidermoid carcinoma represents a diagnostic pitfall. Moreover, WT and mucoepidermoid carcinoma may coexist, making this distinction difficult. So it is worthwhile to report unusual WT features. We describe a WT with signet-ring cells (SRCs). Case: A 61-year-old male presenting with a 3.6-cm right parotid gland mass underwent FNA with rapid on-site evaluation. DiffQuik-stained smears showed groups of oncocytic cells with abundant granular cytoplasm in a background rich with debris, foamy macrophages and lymphoid cells. SRCs were observed on Papanicolaou-stained smears prepared from a second pass. A WT with SRC features was diagnosed. Histology revealed a WT with post-FNA infarctual changes. Conclusion: To avoid false-positive diagnoses, the cytopathologist should be aware that SRC features may occur in WT. The concomitant presence of oncocytes and SRCs is useful to correctly diagnose this unusual WT variant.

© 2013 S. Karger AG, Basel

Article / Publication Details

Received: 8/6/2012
Accepted: 1/16/2013
Published online: 4/25/2013

Number of Print Pages: 4
Number of Figures: 2
Number of Tables: 0

ISSN: 0001-5547 (Print)
eISSN: 1938-2650 (Online)

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