PMID- 32223989
OWN - NLM
STAT- MEDLINE
DCOM- 20201026
LR  - 20201026
IS  - 1532-8392 (Electronic)
IS  - 0046-8177 (Linking)
VI  - 99
DP  - 2020 May
TI  - The significance of mucinous metaplasia in Warthin tumor: a frequent occurrence 
      and potential pitfall.
PG  - 13-26
LID - S0046-8177(20)30057-5 [pii]
LID - 10.1016/j.humpath.2020.03.008 [doi]
AB  - Mucinous metaplasia in Warthin tumor (WT) is a recognized phenomenon. 
      Nevertheless, its presence can create a diagnostic challenge in the distinction 
      from the newly proposed variant of mucoepidermoid carcinoma (MEC), Warthin-like 
      MEC. In this study, we evaluated the significance and diagnostic relevance of 
      mucinous metaplasia in WTs. A total of 30 WTs diagnosed based on resection 
      specimens formed the basis of this retrospective study. Mucicarmine staining was 
      performed to identify mucinous metaplasia, and fluorescence in situ hybridization 
      (FISH) analysis was used to detect MAML2 gene rearrangement. After review, one 
      MAML2 rearranged case was reclassified as Warthin-like MEC as the classic 
      bilayered epithelium in WT was not identified. The diagnosis of WT was confirmed 
      in the remaining 29 cases. Mucinous metaplasia was encountered in 24 WTs (83%), 
      with 14% (4/29) having an abundant amount. We found that mucinous metaplasia 
      correlated with tumor size (p < 0.05). Age and sex distribution were similar in 
      WT cases with or without mucinous metaplasia. In addition, neither the presence 
      of squamous metaplasia nor the time interval between fine-needle aspiration and 
      surgery was related to mucinous metaplasia (p > 0.05). The MAML2 FISH analyses 
      performed in 18 WTs with variable amounts of mucinous metaplasia were negative 
      for rearrangement. In conclusion, mucinous metaplasia is fairly common in WTs and 
      shows a significant correlation with tumor size. Therefore, caution should be 
      taken to avoid overinterpretation of WT with mucinous metaplasia as MEC in cases 
      showing the classic bilayered oncocytic lining epithelium.
CI  - Published by Elsevier Inc.
FAU - Zhang, Xiaoming
AU  - Zhang X
AD  - Department of Pathology and Laboratory Medicine, Hospital of the University of 
      Pennsylvania, Philadelphia, PA, 19104, USA.
FAU - Baloch, Zubair W
AU  - Baloch ZW
AD  - Department of Pathology and Laboratory Medicine, Hospital of the University of 
      Pennsylvania, Philadelphia, PA, 19104, USA.
FAU - Cooper, Kumarasen
AU  - Cooper K
AD  - Department of Pathology and Laboratory Medicine, Hospital of the University of 
      Pennsylvania, Philadelphia, PA, 19104, USA.
FAU - Zhang, Paul J
AU  - Zhang PJ
AD  - Department of Pathology and Laboratory Medicine, Hospital of the University of 
      Pennsylvania, Philadelphia, PA, 19104, USA.
FAU - Puthiyaveettil, Raghunath
AU  - Puthiyaveettil R
AD  - Department of Pathology and Laboratory Medicine, Hospital of the University of 
      Pennsylvania, Philadelphia, PA, 19104, USA.
FAU - LiVolsi, Virginia A
AU  - LiVolsi VA
AD  - Department of Pathology and Laboratory Medicine, Hospital of the University of 
      Pennsylvania, Philadelphia, PA, 19104, USA. Electronic address: 
      linus@pennmedicine.upenn.edu.
LA  - eng
PT  - Journal Article
DEP - 20200326
PL  - United States
TA  - Hum Pathol
JT  - Human pathology
JID - 9421547
RN  - 0 (Biomarkers, Tumor)
RN  - 0 (Coloring Agents)
RN  - 0 (MAML2 protein, human)
RN  - 0 (Trans-Activators)
RN  - 51395-97-2 (mucicarmine)
RN  - CID8Z8N95N (Carmine)
SB  - IM
MH  - Adenolymphoma/genetics/*pathology/surgery
MH  - Aged
MH  - Biomarkers, Tumor/genetics
MH  - Carmine
MH  - Coloring Agents
MH  - Databases, Factual
MH  - Diagnosis, Differential
MH  - Epithelial Cells/*pathology
MH  - Female
MH  - Gene Rearrangement
MH  - Genetic Predisposition to Disease
MH  - Humans
MH  - In Situ Hybridization, Fluorescence
MH  - Male
MH  - Metaplasia
MH  - Middle Aged
MH  - Phenotype
MH  - Predictive Value of Tests
MH  - Retrospective Studies
MH  - Staining and Labeling
MH  - Trans-Activators/genetics
MH  - Tumor Burden
OTO - NOTNLM
OT  - MAML2 rearrangement
OT  - Mucinous metaplasia
OT  - Squamous metaplasia
OT  - Warthin tumor
OT  - Warthin-like mucoepidermoid carcinoma
EDAT- 2020/04/01 06:00
MHDA- 2020/10/27 06:00
CRDT- 2020/04/01 06:00
PHST- 2020/01/14 00:00 [received]
PHST- 2020/03/14 00:00 [revised]
PHST- 2020/03/17 00:00 [accepted]
PHST- 2020/04/01 06:00 [pubmed]
PHST- 2020/10/27 06:00 [medline]
PHST- 2020/04/01 06:00 [entrez]
AID - S0046-8177(20)30057-5 [pii]
AID - 10.1016/j.humpath.2020.03.008 [doi]
PST - ppublish
SO  - Hum Pathol. 2020 May;99:13-26. doi: 10.1016/j.humpath.2020.03.008. Epub 2020 Mar 
      26.