Adenolymphoma

Adenolymphoma is a type of benign tumor that primarily affects the salivary glands. It is also known as Warthin's tumor, named after pathologist Aldred Scott Warthin who first described it in 1929.

Epidemiology

Adenolymphoma is the second most common salivary gland tumor, accounting for approximately 5-10% of all salivary gland neoplasms. It is most commonly found in older adults, with a peak incidence in the 7th decade of life. The tumor is more common in men than in women, and is strongly associated with smoking.

Pathology

Adenolymphomas are typically located in the parotid gland, although they can also occur in other salivary glands. They are characterized by a double-layered epithelial lining and a dense lymphoid stroma. The epithelial component can show a variety of patterns, including papillary, cystic, and solid. The lymphoid component often contains germinal centers.

Clinical Features

Patients with adenolymphoma typically present with a painless, slow-growing mass in the parotid region. The tumor can be bilateral in up to 10% of cases. Other symptoms can include facial nerve palsy, lymphadenopathy, and rarely, pain or discomfort.

Diagnosis

The diagnosis of adenolymphoma is usually made by fine needle aspiration cytology (FNAC). This is a minimally invasive procedure that involves the use of a thin, hollow needle to extract a sample of cells from the tumor for microscopic examination. The characteristic features of adenolymphoma, such as the double-layered epithelial lining and the dense lymphoid stroma, can usually be identified on FNAC.

Treatment

The treatment of choice for adenolymphoma is surgical excision. This usually involves a superficial or total parotidectomy, depending on the size and location of the tumor. Radiation therapy may be used in some cases, particularly for patients who are not suitable for surgery.

Prognosis

The prognosis for adenolymphoma is generally excellent, as the tumor is benign and slow-growing. However, recurrence can occur in up to 15% of cases, particularly if the tumor is not completely removed during surgery.