We have examined 32 cases of primary bronchogenic carcinoma which had been complicated with unilateral ventilatory impairment due to non-neoplastic pleuropul monary diseases.
The age-sex distributions revealed a much higher incidence among the aged males as compared with the incidence of the lung cancer in general population. The time intervals between the past non-neoplastic lung disease and the detection of the lung carcinoma were over 10 years in 75 % of cases in this series. In 27 cases (84.4%), carcinoma developed in the healthy side of the lung.
Analyses as to the histological types of the tumors disclosed:
1) the frequency of the squamous cell carcinoma was high (17 cases, 53.1%), 2) all of 17 squamous cell carcinomas and 2 undifferentiated small cell carcinomas developed in the healthy side of the lung, and 4 of 9 adenocarcinomas in the lung with ventilatory impairment.
From the results obtained, it is considered that the bronchial epithelium of the healthy side of the lung was exposed more to the exogeneous carcinogens than that of the diseased side because of the increased ventilatory volume in that side, resulting in the higher risk of the development of squamous cell carcinoma.

View full abstract

Lung cancer is the most commonly lethal type of cancer in the U. S. A. 75, 000 patients are expected to die this year of lung cancer in the U. S. A. This amounts to one of every five cancer deaths for both sexes or one of every three cancer deaths for males.
The five year survival remains between 8 and 10% of all patients. 50% of the patients have recognized, extrapulmonary metastases at the time of diagnosis, an additional 30% have regional disease and only 20 % are surgically resectable (1). Hence, chemotherapy is poten tially indicated in 50% of the patients at the time of diagnosis and in almost 90% of all patients at some time of their disease. What, then. is the current status of chemotherapy in the treatment of lung cancer, which are the limitations and where are the major gaps of knowledge?
There are published data on approximately 18, 000 patients included into chemotherapeu tic trials (including untreated controls) (2). For purposes of this review, we will focus on controlled and uncontrolled trials for mono chemotherapy, the use of single drugs as basis for polychemotherapy and for multidisciplinary chemotherapy. For polychemotherapy and multidisciplinary treatment, we will limit the discussion to prospective, controlled clinical trials.
Where possible, data are presented by cell type, using the classification of the World Health Organization (3), because of the marked differences of natural history, spread of disease and response by cell type for different types of lung cancer (1-2).
It will be assumed, that the reader is familiar with basic aspects of chemotherapy. Details on drug dose, schedule and toxicity are, therefore, omitted, except for instances where drugs were used in an unusual way.

View full abstract

A study of the vascularization of lung cancer was made by 68 cases of selective bronchial arteriography and 67 cases of microangiography.
The degree and extent of vascularization of lung cancer is unpredictable and variable. It depends on site of origin, histologic type, stage of tumor growth, the way of invasion to the surrounding tissues and other factors such as radiation and anticancer chemotherapy effects.
In the present paper, the correlation between the structure of bronchial arteries and the site of origin was discussed. The cases of this study were classified into three groups clinically and pathologically according to the site of origin: They are central origin, intermediate and peripheral origin.
Tumors of central origin showed three types of selective bronchial arteriography. Two and three types were observed in tumors of intermediate and peripheral origin respectively.
1. Tumors of central origin. (22 cases)
Type 1. Bronchial stem artery was markedly dilatated and obstructed abruptly at the proximal margin of the tumor. An increased number of small abnormal vessels is distributed within the tumor as “tumor blush”. (8 cases)
Type 2. In atelectatic process, localized hypervascularity of the bronchial arteries made it possible to distinguish the tumor mass itself in the a telectatic lung parenchyma. (3 cases)
Type 3. Inflamatory vascular pattern -stands out exclusively, such as dilatation of the bronchial arteries and bronchopulmonary anastomosis. Bronchial a ngiogram gives no clue to the presence of underlying lung cancer. (6 cases)
2. Tumors of peripheral origin. (25 cases)
Type 1. Avascular pattern.
These tumors shows almost completely avascular. Few bronchial arteries coming into tumors were found angiographically. (2 cases)
Type 2. Hypovascular pattern.
Only a few broncial arteries were demonstrated aldng the bronchi and at the paroximal margin of the tumors. (14 cases)
Type 3. Hypervascular pattern
Hypervascularization of bronchial arteries was observed partially in the tumor, and these abnormal vessels radiated from this area. (6 cases)
3. Tumors of intermediate origin. (22 cases)
Type 1. Bronchial arteries are regularly distributed within the tumor. (13 cases)
Type 2. Bronchial angiographic pattern is same as peripheral type 3. (6 cases)
It seems that growing feature of tumors, especially characteristic differences due to the site of origin are well reflected in the selective bronchial arte riography.

View full abstract

A 47 years old female was admitted with complain of dyspnea April 4, 1974. One month prior to the admission, she had a abdominal pain and was told that she might have ovarial tumor.
On admission the patient had right pleural fluid, ascites and abdominal tumor. Amylase activities (Somogyi unit) were 1650u. in serum, 8000u. in ascites, 5000u. in pleural fluid, and 5700u. in urine. Al-P activities (K-A unit) were 27. u. in serum, 238u. in ascites and 160u. in pleural fluid.
Ovarial carcinoma was suspected and removed on May 30, '74. Amylase was 95000u. and Al-P was 287u. in 10% homogenates of tumor tissues. Zymograms proved the existence of a peculiar amylase isoenzymes different from those originated from the pancreas and salivary glands and also the existence of Regan type heatstable Al-P isoenzymes. After the operation, these isoenzymes disappeared rapidly.

View full abstract