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Background: In the present study, we focused on the periostin expression in Warthin’s tumor and malignant lymphomas, which require differentiation from these tumors. Objectives: we investigated the expression and the roles of periostin in the formation of parotid gland mass. Methods: Twenty-eight samples of parotid gland mass were investigate histopathologically and immunohistochemically. Result: Pathologically, tumors were diagnosed as Warthin’s tumors in 15 specimens and malignant lymphomas in 13 specimens. Increased periostin expression was observed in the stroma of Warthin's tumor and malignant lymphoma in 24 of 28 samples (12 Warthin's tumor, 12 malignant lymphoma) (85.7%). Periostin expression was observed in three different patterns: negative, superficial, and infiltrative. Statistically significant differences were found between the histological classification of the tumors and periostin expression patterns. When periostin expression was examined in the same 28 specimens, increased periostin expression was observed in the tumor capsule in 13 specimens (46.4%). A statistically significant association was found between the presence or absence of periostin expression within the tumor capsule and the histology of parotid tumors. Conclusion and significance: Periostin may be involved in the development of Warthin's tumor and malignant lymphoma. Periostin may serve as a new biomarker for these diseases.

Access full-text academic articles: J-STAGE is an online platform for Japanese academic journals.

Introduction: Among patients undergoing thyroid or head and neck surgery, the incidence of postoperative hemorrhage is reported to range between 0.36 % and 4.2 %. Postoperative bleeding in the neck can lead to severe complications if not promptly addressed. Presentation of case: The patient in this case was a man in his 50s, who was being treated for T3-dominant Basedow's disease with medication at the endocrinology department of our hospital. However, owing to the ineffectiveness of drug therapy in controlling the condition, the patient was referred to our department for surgery. Approximately 18 h after undergoing a thyroidectomy, the patient suddenly complained of dyspnea. Laryngeal fiberoptic examination showed no signs of laryngeal edema or recurrent nerve palsy. However, a neck CT scan revealed a hematoma at the surgical site, necessitating emergency surgery. During the operation, hematomas were found in both the superficial and deep layers of the surgical area. Arterial bleeding from the left side of the thyroid cartilage was confirmed, and the branches of the superior laryngeal artery were ligated to stop the bleeding. Discussion: Hematoma formation in a narrow space, particularly in the neck, can obstruct large vessels such as the internal jugular veins, compromising venous return. This may result in laryngeal edema, asphyxia, and, in the worst-case scenario, death. Conclusion: An early neck CT scan revealed a subcutaneous neck hematoma caused by postoperative bleeding, leading to emergency hematoma removal, hemostasis, and tracheotomy, which successfully prevented airway obstruction. Highlights: