AJDRAJNR - American Journal of Neuroradiology

This Article
Right arrow Abstract Freely available
Right arrow Full Text
Right arrow Full Text (PDF)
Right arrow Alert me when this article is cited
Right arrow Alert me if a correction is posted
Right arrow Citation Map
Services
Right arrow Similar articles in this journal
Right arrow Similar articles in PubMed
Right arrow Alert me to new issues of the journal
Right arrow Download to citation manager
Right arrow reprints & permissions
Citing Articles
Right arrow Citing Articles via HighWire
Right arrow Citing Articles via CrossRef
Right arrow Citing Articles via Google Scholar
Google Scholar
Right arrow Articles by Ikeda, M.
Right arrow Articles by Ito, H.
Right arrow Search for Related Content
PubMed
Right arrow PubMed Citation
Right arrow Articles by Ikeda, M.
Right arrow Articles by Ito, H.

Warthin Tumor of the Parotid Gland: Diagnostic Value of MR Imaging with Histopathologic Correlation

Mitsuaki Ikedaa, Ken Motooria, Toyoyuki Hanazawab, Yuichiro Nagaic, Seiji Yamamotoa, Takuya Uedaa, Hiroyuki Funatsua and Hisao Itoa

a Department of Radiology, Chiba University Hospital, Chiba, Japan
b Department of Otolaryngology, Chiba University Hospital, Chiba, Japan
c Department of Molecular Pathology, Chiba Postgraduate School of Medicine, Chiba, Japan



View larger version (124K):

[in a new window]
  		FIG 1. Images of a Warthin tumor in the left parotid gland of a 70-year-old man.

A, STIR image (4000/30), obtained in the axial plane, shows the tumor with moderate-to-high signal intensity. The high-signal-intensity area is a cystic lesion (*); the area showed no enhancement on contrast-enhanced images (see panel C, region of interest 2).

B, T1-weighted image (400/9), obtained in the axial plane, shows a hypointense tumor.

C, Fat suppression contrast-enhanced T1-weighted image (300/20), obtained in the coronal plane, shows solid (region of interest 1) and cystic (region of interest 2) tumor in the inferior pole of the parotid gland.

D, Signal intensity graph shows that the washout ratio of the solid component was 41%. The cystic region shows no enhancement (type E). The ADC values of the solid and cystic components were 0.96 x 10–3 mm2/s and 2.74 x 10–3 mm2/s, respectively. The ADC value of the spinal cord was 1.02 x 10–3 mm2/s.

E, Axial section of the specimen shows solid and large cystic components (*). The large cyst lost its contents.

F, Solid component has slitlike or dendriform spaces (*) lined with papillary proliferation of bilayered oncocytic epithelia, with supporting stroma composed largely of lymphoid tissue (**). The small slitlike cysts are filled with proteinous secretion.



View larger version (108K):

[in a new window]
  		FIG 2. Images of a Warthin tumor in the left parotid gland of a 61-year-old man.

A, STIR image (4000/30), obtained in the axial plane, shows the tumor to be iso- to hypointense to the parotid gland. Characteristically small low-signal-intensity foci (arrows) can be detected. The margin of the tumor also has hypointense foci.

B, T1-weighted image (400/9), obtained in the axial plane, shows the tumor to have the isointensity of muscle and relatively high-signal-intensity areas, whereas the STIR image shows low-signal-intensity areas (arrows). The margin of the tumor also is hypointense on T1-weighted images.

C, Axial dynamic contrast-enhanced image shows all areas of this tumor to have type B perfusion curves.

D, Signal intensity graph shows that foci that showed hypointensity on the STIR image and relatively high signal intensity on the T1-weighted image (region of interest 1) had a low washout ratio (3%) and the other region (region of interest 2) had a high washout ratio (54%).

E, Axial section of the specimen shows cysts containing proteinous fluid with inflammatory cells (*).





Copyright © 2008 by the American Society of Neuroradiology. Print ISSN: 0195-6108 Online ISSN: 1936-959X