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Warthin tumor (WT) is the second most common benign parotid gland tumor after pleomorphic adenoma. WT is characterized by cystic and papillary proliferation of a two-layered oncocytic epithelium supported by lymphoid tissue. Heterotopic salivary duct inclusions (SDIs) are frequently observed in lymph nodes (LNs) of WT (SDI/LNs), and are thought to be the origin of WT. If this is true, SDIs should also persist in the lymphoid tissue of WT itself (SDI/WT), as a missing link between SDIs and WTs, but studies of this issue are limited. From 2008-2023, 138 WT cases were surgically excised at our hospital. SDI/LNs and SDI/WTs were histologically examined. Of 100 WT cases with LNs, SDI/LNs were observed in 67 cases (67 %). SDI/WTs were detected in 114 of 138 cases (82.6 %), including 107 of 127 smokers (84.3 %) and 7 of 11 never-smokers (63.6 %). SDI/WTs were located mainly in the subcapsular lymphoid tissue and often surrounded by a fibrous coat resembling salivary excretory ducts. This study revealed a high incidence of SDIs in WT itself, strongly supporting the theory that WT develops from heterotopic salivary ducts., Competing Interests: Declaration of Competing Interest The authors have no competing interests to disclose., (Copyright © 2024 Elsevier GmbH. All rights reserved.)

Respiratory epithelial adenomatoid hamartoma (REAH) is a benign lesion of the nasal cavity and paranasal sinuses. Here, we report the clinicopathological characteristics of REAH identified in 2065 cases with nasal/paranasal polypoid lesions treated with endoscopic sinus surgery (ESS) at our hospital from 2008 to 2021. Cases including the olfactory area were reviewed and 50 patients of REAH were identified pathologically (50/2065, 2.4%). The average age was 58.9 years old and the male/female ratio was 45/5. Grossly, REAH showed a whitish surface and elastic firm consistency. The histopathological characteristics included proliferation of small to medium-sized glands composed of ciliated respiratory epithelium containing goblet cells; thickening of the basement membrane compared to that for inverted papilloma (9.6 ± 2.4 vs. 1.3 ± 1.6 µm, p < 0.001); and no intra-epithelial neutrophilic infiltration. Among the REAH cases, 81% were associated with sinonasal inflammatory polyps. Many olfactory cleft polyps were REAH (38/98, 39%). The rate of REAH found in ESS in the last 7 years was higher than that in the first 7 years (3.17% vs. 1.62%, p = 0.032). Our results in Japanese patients are similar to those found in other countries, including male predominance. REAH is relatively common and that 39% of polyps taken from olfactory clefts are REAH., (© 2022 Japanese Society of Pathology and John Wiley & Sons Australia, Ltd.)

The prognosis of diffuse panbronchiolitis (DPB) has been remarkably improved after the development of low-dose erythromycin therapy, possibly due to anti-inflammatory rather than anti-infective mechanisms. Interestingly, DPB associated with lung cancer is quite rare. Here, we report an autopsy case of DPB who developed lung cancer after a long successful therapy with low-dose erythromycin.

Psoriatic arthritis is an inflammatory arthritis associated with psoriasis. While an elevated incidence of lung cancer has been observed in patients with RA or psoriasis, there has been no report of psoriatic arthritis associated with lung cancer. We here report the first case of psoriatic arthritis which developed lung cancer. In this case, it was suspected that a combination of cigarette smoking, pulmonary fibrosis, and low-dose methotrexate therapy might have promoted the development of lung cancer.

There are no guidelines regarding the treatment of pulmonary sarcoidosis. Generally, oral corticosteroids are considered the first-line treatment for symptomatic patients with pulmonary sarcoidosis. We report here two Japanese cases with pulmonary sarcoidosis who demonstrated sequential evolution from radiographic stage I to III within five years. Although these two cases had no symptoms, persistent, progressive pulmonary involvements were observed on chest X-ray. Considering the effectiveness of corticosteroids on patients with radiographic type II or III sarcoidosis reported by the British Thoracic Society, corticosteroid therapy might be a choice even in asymptomatic cases, if they demonstrate developing pulmonary involvement.