A 46-year-old woman with a sore throat was diagnosed with anaplastic lymphoma kinase-negative anaplastic large cell lymphoma that had spread from the piriform fossa to the cervical esophagus. Tracheoesophageal fistula developed after induction chemotherapy. Because conservative repair was not applicable, intensified chemotherapy, including autologous stem cell transplantation was performed with the fistula remaining open. Laryngopharyngectomy and cervical esophagectomy were performed 6 months after transplantation. The optimal strategy for refractory lymphoma with active tracheoesophageal fistula remains undetermined. To the best of our knowledge, this is the first report describing the successful treatment of a patient with tracheoesophageal fistula who received high-dose chemotherapy supported by autologous stem cell transplantation.

This is the first report, to the best of our knowledge, of a laryngeal lesion in a patient with Crohn’s disease; the lesion led to laryngeal stenosis and dysphagia. The patient, a 66-year-old woman, who had been diagnosed as having Crohn’s disease and was in remission, visited the gastroenterology department of our hospital with the chief complaint of difficulty in swallowing. Endoscopic evaluation led to the suspicion of laryngeal stenosis, and the subject was referred to our department. Laryngeal endoscopy showed the presence of a sub-circumferential film-like adhesion extending from the epiglottis to the pharyngeal cavity. Incidentally, as per her medical record, an upper gastrointestinal tract endoscopy performed 10 years earlier had also revealed the same lesion. Since the lesion did not appear to have worsened since it was first observed 10 years ago, and laryngeal endoscopy and simple cervical computed tomography did not reveal any obvious respiratory stenosis, conservative treatment, rather than surgery, was selected, and the laryngeal stenosis has not worsened since. Although this is a rare condition, we plan to collect more data on such cases and investigate the appropriate methods of treatment.

A 56-year-old man visited our hospital with the chief complaint of facial palsy. Although a mass was detected in his right middle ear, he refused to undergo further examination and failed to return for follow-up. When he revisited the hospital 2 years later due to right otalgia, a tumor invading the skull was detected. Because the patient did not wish to undergo surgery, chemoradiotherapy was administered, which resulted in a reduction of the tumor volume. After another 2 years, the tumor regrew and the facial palsy became more severe. Chemotherapy was administered again; however, it was less effective this time, and the tumor gradually became larger and gave rise to multiple metastases in the lung, liver, and bone.

Introduction: Although the incidence of tuberculosis (TB) in Japan has been decreasing yearly, Japan remains ranked as an intermediate-burden country for TB.

Lymphadenopathy is common in young people. However, in most, it is caused by benign or inflammatory diseases, and malignant disease as the cause is rare. We report the case of a 27-year-old man who visited our hospital with the chief complaint of a left neck swelling and was diagnosed as having testicular malignancy with cervical lymphadenopathy. Computed tomography revealed multiple enlarged lymph nodes, with some showing a necrotic component. Lymph node biopsy led to the diagnosis of cervical lymph node metastasis from a carcinoma. On the basis of the age and sex of the patient, and the histopathological findings, we suspected a primary tumor of the testis. We referred the patient to the urology department, where he received prompt treatment. In a patient presenting with multiple lymphadenopathy in the supraclavicular fossa, lymph node biopsy should be considered, even if the patient is young.

Introduction Although the incidence of tuberculosis (TB) in Japan has been decreasing yearly, Japan remains ranked as an intermediate-burden country for TB.Objective This study aims to investigate the current situation of head and neck extrapulmonary TB (EPTB) diagnosed in our department.Methods We retrospectively reviewed the clinical records of 47 patients diagnosed with EPTB in the head and neck in our department between January 2005 and December 2014. The extracted data included sex and age distribution, development site, chief complaint, presence or absence of concomitant active pulmonary TB (PTB) or history of TB, tuberculin skin test (TST) results, interferon-gamma release assay (IGRA) results, and duration from the first visit to the final diagnosis of EPTB.Results The subjects consisted of 20 men and 27 women, and age ranged from 6 to 84 years. The most common site was the cervical lymph nodes (30 patients), with the supraclavicular nodes being the most commonly affected (60%). Histopathological examination was performed on 28 patients. TST was positive in 9 out of 9 patients and the IGRA was positive in 18 out of 19 patients. We observed concomitant PTB in 15 out of the 47 patients. Mean duration from the first visit to the final diagnosis of EPTB was 56 days.Conclusion The clinical symptoms of TB, especially those in the head and neck region, are varied. Otolaryngologists should be especially aware of the extrapulmonary manifestations of TB to ensure early diagnosis and treatment from the public health viewpoint.

Conclusion: B-cell non-Hodgkin's lymphoma (B-NHL) in the head and neck most commonly affected the oropharynx and the cervical lymph node in sexagenarian patients, with more than 70% of these cases being diffuse large B-cell lymphoma (DLBCL). Accordingly, B-NHL should be considered one of the most important differential diagnoses of head and neck malignancies. Objectives: It has previously been reported that the majority of head and neck malignant lymphomas are B-NHLs. This analysis aimed to assess the site-specific profiles of B-NHL of the head and neck. Methods: The medical records of patients with B-NHL of the head and neck diagnosed between January 2004 and December 2013 were retrospectively reviewed. The clinical parameters of these patients, including age, sex, site distribution, and histopathologic sub-type, were analyzed. Results: A total of 153 cases (95 males; 58 females) were included in this analysis (male-to-female ratio = 1.64:1). The patient age at the time of diagnosis ranged from 30-92 years (median = 68 years). The oropharynx was the most commonly affected site (40.5%), followed by the cervical lymph nodes (33.3%). The most common histopathologic sub-type was DLBCL (71.9%), followed by follicular lymphoma (11.1%), and extranodal marginal zone lymphoma of mucosa-associated lymphoid tissue (9.2%).

Some of the tumors in the buccal region arise from Stensen’s duct or the accessory parotid gland. Both of them, especially Stensen’s duct, are rare. However, it is often difficult to distinguish the origin ; we think that there is a histopathologic tendency in each origin. According to previous reports, the most frequent types of the tumor arising from Stensen’s duct and the accessory parotid gland are squamous cell carcinoma and mucoepidermoid carcinoma, respectively. We report another case of primary squamous cell carcinoma arising from Stensen’s duct. A 71-year-old man suffering from swelling in his right cheek was referred to our hospital. We located the tumor arising from the accessory parotid gland and performed local resection penetrating the buccal region from the skin of the cheek to the buccal mucosa and total neck dissection. Following histopathological examination, we generally diagnosed the tumor as primary squamous cell carcinoma originating from Stensen’s duct.

Accessory parotid gland tumors are relatively rare; hence, adequately detailed clinical analyses of these tumors are difficult to perform at a single institution. In this report, we describe the findings for 65 patients [29 men, 36 women; median age, 51 (9-81) years] with accessory parotid gland tumors, consisting of 4 cases documented by us and 61 cases previously reported by other Japanese authors. Approximately 50% of the patients were treated in an otolaryngology department, while the remaining patients were treated in plastic surgery, oral surgery, or dermatology departments. In 4 patients, the results of preoperative fine-needle aspiration cytology indicated that the tumor was benign; however, the postoperative histopathology results revealed malignant tumors. The frequencies of malignant and benign tumors were 44.6% (n = 29) and 55.4% (n = 36), respectively. Mucoepidermoid carcinoma and pleomorphic adenoma were the most frequent types of malignant and benign accessory parotid gland tumors, respectively. Among the various surgical methods that were used, such as direct cheek and intraoral incisions, a standard parotidectomy incision was the most preferred treatment approach for these tumors. Recently, an endoscopic approach has also been found to yield satisfactory results. An optimal approach should be selected after evaluating the advantages and disadvantages of these methods. No definite guidelines are available regarding the choice of elective neck dissection and postoperative radiation therapy for malignant accessory parotid gland tumors. Although tumor resection (plus elective neck dissection) and postoperative radiation therapy have been frequently performed for various kinds of malignant accessory parotid gland tumors to date, additional studies are needed regarding the criteria for selecting elective neck dissection and postoperative radiation therapy. Since the malignancy rate for accessory parotid gland tumors is higher than that for parotid gland tumors, the possibility of malignancy (especially mucoepidermoid carcinoma and carcinoma ex pleomorphic adenoma) should be considered when resecting accessory parotid gland tumors, even if the results of preoperative fine-needle aspiration cytology indicate that the tumor is benign.