AJTR Copyright © 2009-All rights reserved. Published by e-Century Publishing Corporation, Madison, WI 53711
Am J Transl Res 2009;1(4):352-357

Original Article
Characterization of the lymphoid stroma in Warthin’s tumor of salivary
gland by immunohistochemistry, heavy chain gene and bcl-2 gene

Kunchang Song, James D. Cotelingam, Mary Lowery-Nordberg, Wei Sun

Department of Pathology, New York University School of Medicine, New York, NY, USA; Department of Pathology,
Louisiana State University Health Science Center, Shreveport, LA, USA.

Received March 22, 2009; accepted April 1, 2009; available online April 5, 2009

Abstract: Warthin’s tumor is rarely associated with malignant lymphoma. Only 18 cases were reported in the
literature so far. In most cases the latter is a low grade process, including Marginal zone/Mucosa associated
lymphoid tissue (MALT) type lymphoma, follicular lymphoma, and rarely diffuse large cell lymphoma which may
arise de novo or secondary to low grade lymphoma. This study was conducted to determine the prevalence of
occult B cell monoclones and genetic alterations in Warthin’s tumor. Fourteen cases of Warthin’s tumor were
stained with antibodies to CD3, CD20, kappa and lambda light chains. On six cases of randomly selected
Warthin’s tumor, polymerase chain reaction (PCR) of IgH gene rearrangement (IgH-GR) was performed on
genomic DNA extracted from formalin-fixed paraffin embedded tissue. One case of primary salivary gland indolent
B-cell lymphoma and 3 cases of sialadenitis were analyzed by the same methods for comparison. In all Warthin’
s tumor and sialadenitis cases most of lymphoid stroma was B cell phenotype and concentrated in germinal
centers. T cells were mostly located between germinal centers. No light chain restriction was demonstrable by
kappa and lambda immunostains. Molecular genetic studies failed to show IgH-GR by FISH and showed
polyclonal by IgH PCR. In contrast, the lymphoma case showed a diffuse proliferation of small B cells with light
chain restriction and a minor component of reactive T cells. FISH showed IgH-GR and bcl-2 gene translocation
with monoclonality by IgH PCR. Our study concludes that the lymphoid stroma of Warthin’s tumor is reactive.

Key Words: Warthin’s tumor, lymphoid stroma, immunohistochemistry, gene rearrangement

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Address all correspondence to:

Wei Sun, MD
Department of Pathology
New York University School of Medicine
550 First Avenue
New York, NY 10016, USA
Tel: (212)2635411