[A Warthin's tumor showing extensive necrosis]

Warthin's tumors are one of the most easily recognizable tumors using light microscopy. However, histopathological diagnosis is difficult in a few cases when characteristic cystic cavities with papillary walling and underlying lymphoid stroma are obscured by reactive changes. We describe a case of an extirpated Warthin's tumor of the right parotid gland which demonstrated extensive necrosis, squamous metaplasia and xanthomatous inflammation. No characteristic structure for this tumor was noticed in a section of an initially sampled specimen. As a result, a destroyed fistula was suspected. An additional sampling was performed to confirm the diagnosis and the sampled specimen fortunately demonstrated the diagnostic structure of a Warthin's tumor excluding malignancy. An awareness of the morphological variation seen in this tumor should lead to additional sampling of specimens, thereby preventing erroneous interpretation.