International Journal of Hematology

DOI: 10.1007/s12185-009-0271-z Pages: 359-364

T cell lymphoblastic lymphoma in parotidectomy for Warthin’s tumor: case report and review of the literature

1. John Radcliffe Hospital, Department of Cellular Pathology

2. John Radcliffe Hospital, Nuffield Department of Clinical Laboratory Sciences

3. National and Kapodistrian University of Athens, First Department of Pathology, School of Medicine

4. National and Kapodistrian University of Athens, First Department of Internal Medicine

5. National and Kapodistrian University of Athens, Department of Hematology

Correspondence to:
Dimitrios N. Kanakis
Tel: +30-210-7462229
Fax: +30-210-7462157
Email: aristoteles_stageira@yahoo.com

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Abstract

Lymphomas associated with Warthin’s tumor (WT) are extremely uncommon and the majorities are of B cell type. We report the simultaneous occurrence of T-cell lymphoblastic lymphoma (T-LBL) and WT in an 81-year-old patient, who presented with fever, night sweats and enlargement of the right parotid gland. The parotidectomy specimen showed a WT with extensive replacement of the lymphoid stroma by T-LBL, but preservation of the oncocytic epithelium. Staging investigations revealed mediastinal and abdominal lymphadenopathy, bilateral pleural effusions and bone marrow infiltration, in keeping with stage IVB disease. The patient received combination chemotherapy treatment but responded poorly, and died three months after diagnosis. To our knowledge, this is the first case report of T-LBL involving WT. The present study indicates that the lymphoid stroma in WT belongs to the systemic lymphoid tissue and can be involved in disseminated lymphoma. It highlights the importance of careful examination of WT’s lymphoid stroma for the possible presence of any coexistent malignancy.

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