PubMed · 5765672
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G G Potdar. 1969. Warthin's tumor.. https://doi.org/10.1001/archsurg.1969.01340080098020
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A brief, schematic summary of a workshop held in Davos 2003 is presented. Sonography of the head and neck has been carried out successfully since the beginning of the sonographical era, as this region is readily accessible to the transducer head and the superficial position of the organ can be very well visualized. The prerequisites are a high-resolution transducer-head (around 7.5 MHz), operator experience and good knowledge of the relevant anatomy. The type of transducer selected--linear or mechanical wobbler--plays a subordinate role, and color Doppler technology is not mandatory. This brief presentation will not address the thyroid gland, the cervical vessels, the paranasal sinuses, the facial soft tissue or the pharynx.
Chromosome translocations in neoplasia commonly result in fusion genes that may encode either novel fusion proteins or normal, but ectopically expressed proteins. Here we report the cloning of a novel fusion gene in a common type of salivary and bronchial gland tumor, mucoepidermoid carcinomas (MEC), as well as in benign Warthin's tumors (WATs). The fusion, which results from a t(11;19)(q21-22;p13) translocation, creates a chimeric gene in which exon 1 of a novel gene of unknown function, designated WAMTP1, is linked to exons 2-5 of the recently identified Mastermind-like Notch coactivator MAML2. In the fusion protein, the N-terminal basic domain of MAML2, which is required for binding to intracellular Notch (Notch ICD), is replaced by an unrelated N-terminal sequence from WAMTP1. Mutation analysis of the N-terminus of WAMTP1-MAML2 identified two regions of importance for nuclear localization (amino acids 11-20) and for colocalization with MAML2 and Notch1 ICD in nuclear granules (amino acids 21-42). Analyses of the Notch target genes HES5 and MASH1 in MEC tumors with and without the WAMTP1-MAML2 fusion revealed upregulation of HES5 and downregulation of MASH1 in fusion positive MECs compared to normal salivary gland tissue and MECs lacking the fusion. These findings suggest that altered Notch signaling plays an important role in the genesis of benign and malignant neoplasms of salivary and bronchial gland origin.
PURPOSE: The aim of this study was to define the characteristic sonographic features of Warthin's tumors in the parotid gland, thus enhancing the ability to make a preoperative diagnosis of this disease process. METHODS: We retrospectively evaluated the sonograms of Warthin's tumors of the parotid gland that had been confirmed by histopathologic examination of surgically excised specimens from patients treated at our institution over a 2-year period. We recorded the echogenicity, shape, margin, and internal structure of the tumors and categorized them into 2 groups on the basis of size (< 5 cm versus > or =5 cm in the largest diameter). RESULTS: Eighteen patients (16 men and 2 women) with a mean age of 57 years (range, 29-82 years) were included in the analysis. One patient had 2 tumors (1 in each parotid gland); the other 17 patients each had only 1 tumor. Our review of the sonographic findings revealed that all 19 tumors were hypoechoic compared with the normal parenchyma of the affected parotid glands. Most of the tumors were ovoid, had well-defined margins, and contained multiple irregular, small, sponge-like anechoic areas. Tumors that were 5 cm or greater in diameter had a higher proportion of cystic content than smaller lesions had and in some cases were composed almost entirely of cystic material. CONCLUSIONS: Our evidence suggests that the sonographic appearance of a Warthin's tumor in the parotid gland is distinctive: a well-defined round or ovoid hypoechoic mass containing microcystic anechoic areas. These sonographic features constitute useful criteria in the preoperative diagnosis of Warthin's tumor in the parotid gland, although sonographically guided fine-needle aspiration biopsy may be needed to confirm the diagnosis.