Regression of a Bilateral Warthin Tumourafter Aspiration Thin Needle Biopsy

Overview

Progressive changes of Warthin’s tumour after thin needle biopsy are well known.The predominating histopathological feature is in addition to pavement metaplasia coagulationnecrosis which is rarely associated withcomplete eradication of the original structure of thetumour.An absolute rarity is the finding of a granulomatous inflammation which completely absorbs thenecrotic tumour. So far only one such case was described. We recorded a similar case of a bilateralWarthin tumour with complete regression which occurred after thin needle aspiration biopsy. Itinvolved a 61-year-old man with bilateral swelling of the parotid gland which developed asymptomaticallyfor six months. Ultrasonography and thin needle biopsy proved a Warthin tumour. Thepatient was indicated for surgery to be implemented in a month time. Eight days before the plannedoperation he developed bilaterally a necrotizing inflammation in the parotid area. Under generalanaesthesia an incision was made with evacuation of mucopurulent contents. The microscopicfinding confirmed necrosis without signs typical forWarthin’s tumour. Bacteriological examinationand histopathological evidence for the presence of molds and bacteria in the removed debris wasnegative which rules out the possibility that a bacterially infected node was involved or anotheraffection of the glandular parenchyma.

Key words:
Warthin’s tumour, regression, thin needle aspiration biopsy.