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Volume 26, Issue 4
Displaying 1-13 of 13 articles from this issue
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Shih-Yung Shen, Yutaka Hayashi, Norio Kikuchi, Toshihiko Kohno, Takayu ...1986 Volume 26 Issue 4 Pages 359-372
Published: August 25, 1986
Released on J-STAGE: August 10, 2011
JOURNAL FREE ACCESSA detailed histopathological study was done on autopsied cases of primary lung cancer to search for the histopathological characteristics in pulmonary infections, especially pneumonia seen in these invasive cases of lung cancer. The following results were obtained: 1) Among 101 cases of primary lung cancer autopsied in our institude during the 5 years period from 1978 to 1982, histopathological pictures suggesting bacterial pneumonia were found in 46 cases (45.5%), and were apt to be seen in cases with epidermoid carcinoma and small cell carcinoma. 2) Various types of histopathological pictures showing a process from acute to organizing phases of pneumonia were found in these cases, and were divided arbitrarily into mainly 6 types on the viewpoint of the progressing of pneumonic process. Various types of pictures were often present in one case, but as the common point, pictures showing the processing to the fibrosis of the exudates were found in many of the cases (27 cases, 58.7%). 3) In most of the cases (7 out of 10 cases) of organizing pneumonia that involved a large part of a lobe, the related bronchus was found morphologically to have a severe impairment in its drainage caused by the tumor. In the remaining 3 cases which showed only changes of chronic bronchitis in the related bronchus, organizing pneumonia involved a relatively smaller area. 4) Gram negative bacilli such as Pseudomonas aeruginosa, Haemophylus influenzae, and Klebsiella pneumoniae were the main microorganisms isolated from sputa obtained durning the last pneumonic episodes before the patients' death. But there was no distinct difference between the histologic reactions to various types of bacteria in these cases. 5) The complication of the pulmonary mycotic diseases, although not diagnosed before the patients' death, was found in 7 cases, accounting for 13.2% of all cases with complications of pulmonary infections (53 cases).View full abstractDownload PDF (12046K) -
Hiroko Sakamoto, Nobuyuki Katakami, Youngchol Lee, Kyosuke Ishihara, H ...1986 Volume 26 Issue 4 Pages 373-379
Published: August 25, 1986
Released on J-STAGE: August 10, 2011
JOURNAL FREE ACCESSThree hundred fifty seven lung cancer cases admitted to our hospital from May 1973 to Aug 1982, and thought to have no indication of surgical resection, were reviewed. Of the 357 non-resected cases 33cases (9.24%) survived for more than 2 years.
Lately, the rate of long-term survival of non-resected cases shown a tendency to increase. The 2 year-survival rate increased from 3.8%(-1977) to 12.4%(1978-), and its tendency to increase was more marked in squamous cell carcinoma and small cell carcinoma.
The incidence of 2 year-survival was 36% in stage I, 16.2% in stage II, 9.7% in stage III, and 2.2% in stage N, respectively.
Combination of systemic chemotherapy and radiotherapy have brought better results in the long-term survival cases except in adenocarcinoma. Particularly, many of the squamous cell carcinoma cases having survived for more than 2 years, received combination therapy of bronchial arterial infusion and radiation, and those methods seemed very effective.
Only a few cases of adenocarcinoma without pleural effusion showed considerable response to non-surgical treatrrient. There was no relation between tumor effect of anticancer drugs and long-term survival in adenocarcinoma of the lung.View full abstractDownload PDF (706K) -
Prospective and Retrospective StudiesKiyoshi Mori, Kenji Eguchi, Noriyuki Moriyama, Ryosuke Tsuchiya, Tetsu ...1986 Volume 26 Issue 4 Pages 381-390
Published: August 25, 1986
Released on J-STAGE: August 10, 2011
JOURNAL FREE ACCESSIn order to compare conventional radiographic evaluation of the chest and computed tomography (CT) the preoperative staging of 125 resected lung cancer patients, was prospectively and retrospectively analyzed. CT added to the accuracy of the staging procedures (P<0.05). The accuracy of evaluation of tumor extension into the adjacent structures on CT was 81%. It was difficult to evaluate tumor extension for cases which had obstructice pneumonia in association with a neoplasm, or prior granulomatous disease. The detection rate of mediastinal lymph node metastasis (sensitivity 69%) on CT was better than that of hilar lymph node metastasis (sensitivity 38%). However there were relatively many adenocarcinoma and large cell carcinoma cases which were falsely negative for metastatic mediastinal lymph node involvement, due to the presence of micrometastasis. Furthermore, squamous cell carcinoma cases had many false positive results due to reactive hyperplasia greater than 1×1cm in diameter. In CT evaluation of regional lymph node involvement #3 (pretracheal), #3a (anterior mediastinal) and #7 (subcarinal) were detected more accurately than hilar lymph nodes with a sensitivity of almost 70%, while for #2 (paratracheal), #5 (subaortic) and #6 (paraortic) the sensitivity was less than 50%. A size criterion of 1×1cm or greater for estimation of metastasis of mediastinal lymph nodes by CT was a good prediction factor.View full abstractDownload PDF (1256K) -
Takashi Oiwa, Hiroko Saito1986 Volume 26 Issue 4 Pages 391-395
Published: August 25, 1986
Released on J-STAGE: August 10, 2011
JOURNAL FREE ACCESSA total of 20 patients with clinically suspected metastatic lung cancer underwent transbronchial aspiration cytology (TBAC) under flexible fiberoptic bronchoscopy. The primary sites of these cases were as follows: 4 cases each of breast and thyroid, 2 cases each of colorectal, kidney and lung, 1 case each of hypopharynx, esophagus, stomach, pancreas, mediastinum and lower leg.
In 17 of 20 objective cases malignant cells were obtained (85%). Fourteen of 16 cases with endoscopically invisible tumor were also positive (88%). In 9 of these cases, the lesion was 30mm or smaller, yielding diagnostic specimens in 8 cases (88%) and the case of the smallest sized tumor was 11mm diameter radiologically. In 5 cases the primary lesions were diagnosed by only TBAC materials and metastasis was suspected in 12 cases before TBAC was performed.
From this examination, it is confirmed that TBAC is a valuable cytodiagnostic procedure under fluoroscopic guidance for metastatic lung tumors.View full abstractDownload PDF (566K) -
Toshiharu Matsushima, Hiroki Hara, Michifumi Adachi, Toshio Kishimoto, ...1986 Volume 26 Issue 4 Pages 397-402
Published: August 25, 1986
Released on J-STAGE: August 10, 2011
JOURNAL FREE ACCESSThe clinical courses before diagnosis of 374 patients with lung cancer treated during the last ten years were analyzed. Out of these 374 cases, tumors were initially detected in 83 patients (22%) by mass X-ray survey (group I), 278 patients (74%) visited their doctor due to some symptoms related to lung cancer (group II), and cancer in the remaining 13 patients (4%) was detected at the time of examination for other diseases (group III).
The resection rate was 27% in group I, only 9% in group II, and 15% in group III. Among subgroups of group I, the resection rate was 55% in the asymptomatic, rapidly diagnosed group (Ia), but only 10% in the symptomatic group I (Ib), similar to group II. In 64% of cases, the patient's delay in seeing a doctor was considered as the reason for a delay in diagnosis; that is, these patients were either symptomatic or indifferent. Doctors were responsible for a delay in diagnosis in 30% of the cases; some needing more than three months to obtain a diagnosis of lung cancer in their hospital. No delay occurred in only 6% of the cases.
These results indicate that if the number of resectable, limited cases is to be increased, public education is most important, followed by improvement in diagnostic technique in primary health care facilities and improvement in mass survey techniques for detection of lung cancer.View full abstractDownload PDF (732K) -
Hiroshi Kitamura, Riichiro Mikami, Yasuhiro Sakaguchi, Takahiro Yoneda ...1986 Volume 26 Issue 4 Pages 403-409
Published: August 25, 1986
Released on J-STAGE: August 10, 2011
JOURNAL FREE ACCESSThe relationship between the immune responses and clinical manifestations in 58 patients with lung cancer was examined with a coordinated program of natural killer (NK) cell activity and delayed-type hypersensitivity reaction to dinitrochlorobenzene (DNCB).
Patients were divided into four groups:(A) normal NK cell activity (≥25%) and positive reaction to DNCB, (B) normal NK cell activity but negative reaction to DNCB, (C) subnormal NK cell activity (<25%) but positive reaction to DNCB, (D) subnormal NK cell activity and negative reaction to DNCB.
Group A patients were characterized by good performance status, low tumor burden and high response rate (82%) to therapy, but group D patients were characterized by poor performance status, high tumor burden and no response to therapy. Group B and C patients showed intermediate patterns.
The immune spectrum presented here was shown to be related to the clinical manifestations. The simple method of immune spectrum evaluation might be a useful tool in the management of lung cancer patients.View full abstractDownload PDF (807K) -
Analysis of 156 Autopsy CasesMasafumi Yoshizawa1986 Volume 26 Issue 4 Pages 411-420
Published: August 25, 1986
Released on J-STAGE: August 10, 2011
JOURNAL FREE ACCESSOne hundred fifty-six autopsy cases of small cell carcinoma of the lung treated at the National Cancer Center Hospital were subclassified into oat cell type (OAT) (64 cases), intermediate cell type (INT) (60 cases), combined oat cell carcinoma (COM) (2 cases) and undifferentiated carcinoma, small cell type (UD) (22 cases). Eight cases could not be subclassified because of therapeutic effects or postmortem changes. The characteristics in subtypes of OAT, INT and UD were analyzed.
The results of immunohistochemical staining for neuron-specific enolase, gastrin-releasing peptide, keratin and secretory component revealed that OAT and INT had more neuroendocrine features and UD had more epithelial ones.
Biopsy and cytology materials in OAT and INT gave reliable diagnoses of small cell carcinoma, whereas some thirty percent of cytology materials in UD were diagnosed as non-small cell carcinoma.
Response rates to initial combined chemotherapy were 46% for OAT, 46% for INT and 20% for UD, respectively.
These findings indicate that OAT and INT should be classified as one single subtype, while UD should be distinguished from OAT and INT. Immunohistochemical examinations, besides morphological analysis, of biopsy and cytology materials will be useful to distinguish UD from OAT and INT.View full abstractDownload PDF (6735K) -
Tomoko Kutsuzawa, Yuji Takasaki, Sumie Shioya, Yasuyo Ohta, Hajime Yam ...1986 Volume 26 Issue 4 Pages 421-426
Published: August 25, 1986
Released on J-STAGE: August 10, 2011
JOURNAL FREE ACCESSA 64 year-old man was admitted to Tokai University Hospital because of chest pain and lumbago. Chest rentogenogram showed a mass on the right 3rd rib and pleural effusion. Cytologically, numerous atypical plasma cells were found in pleural effusion. Therefore myeloma was diagnosed. Immunoelectrophoresis revealed monoclonal IgD (k) in serum and pleural effusion. Quantitative immunogloblin determination indicated marked increases in IgD (1850mg/d1) in serum, and in pleural effusion (350mg/dl). Biopsy of the bone marrow showed numerous atypical plasma cells. Skeletal radiographic survey revealed punched-out lesions in the skull and pelvic bone. He Was treated with melphalan and prednisolone, but died 6 months after the onset. We estimated that accumulation of pleural effusion was caused by direct invasion of the 3rd rib tumor to the pleura.
The incidence of myeloma associated with pleural effusion is so rare that we could find only 15 cases reported in Japan.View full abstractDownload PDF (5677K) -
Akihiko Okano, Khaled Reshad, Kenji Inui, Toru Shindo, Hiromi Wada1986 Volume 26 Issue 4 Pages 427-432
Published: August 25, 1986
Released on J-STAGE: August 10, 2011
JOURNAL FREE ACCESSA 29 year-old female was admitted with a 2-year history of cough and sputum. Chest X-ray film revealed atelectasis of the right lower lobe and bronchography showed cystic ectasis and no ventilation of the right basal bronchus. Because of recurrent episodes of infection, right lower lobectomy was performed. Only one degenerated vessel which was presumably formed by fusion of a pulmonary artery and vein into a cord-like structure was demonstrated in the right lower lobe.
Pathological findings showed the entire resected lobe to be filled with growths of fibrous tissue. There were no mitoses and cleft-like spaces were lined by cuboidal or ciliated columnar epithelium. These pathologic findings were compatible with fibroleiomyomatous hamartoma.
Usually pulmonary fibroleiomyomatous hamartoma consists of solitary or multiple nodular lesions in pulmonary parenchyma associated with myoma uteri. However, in this case, the entire right lower lobe was involved diffusely by fibroleiomyomatous lesions. This case might be helpful in understanding the classification of pulmonary fibroleiomyomatous diseases.View full abstractDownload PDF (6353K) -
Akihide Matsumura, Yasumasa Monden, Kazuya Nakahara, Kiyoshi Ohno, Yos ...1986 Volume 26 Issue 4 Pages 433-438
Published: August 25, 1986
Released on J-STAGE: August 10, 2011
JOURNAL FREE ACCESSEndobronchial lipoma is a rare pulmonary benign tumor. Only 11 cases have been reported in Japan. Recently we experienced a case of endobronchialipoma. The patient was a 58-year-old man with a history of left upper lobectomy and thoracoplasty due to pulmonary tuberculosis, suffering from productive cough and fever for about three months. The chest X-ray film showed atelectasis of the right middle and lower lobes. At bronchoscopy, a smooth yellowish tumor was seen in the right intermediate bronchus. It was diagnosed as a lipoma by biopsy. The tumor was resected under fiberoptic bronchoscopy and the stump of the stalk was coagulated with an Nd-YAG laser. The tumor consisted of predominantly mature fat cells and b ronchial epithelium showing squamous metaplasia. The postoperative course was uneventful.View full abstractDownload PDF (6349K) -
Akira Yokota, Naoyoshi Kohjiro, Masami Ito, Tadashi Kaneko, Kenichi Ya ...1986 Volume 26 Issue 4 Pages 439-443
Published: August 25, 1986
Released on J-STAGE: August 10, 2011
JOURNAL FREE ACCESSA case of large cell carcinoma of the lung diagnosed by transcutaneous needle lung biopsy, Stage III-3N0M0, was presented. Chest X-ray film showed a mass density (diameter 6cm) associated with invasion of the chest wall in the left upper lung field. The patient received single-agent chemotherapy of Cisplatin (100 mg/m2) four times at 4-week intervals and remarkable shrinkage of the density (partial response) was achieved. Following chemotherapy, surgical resection of the tumor resulted in finding no malignant cells histologically in all the surgically resected specimens of lung tissues, pleura, ribs, chest wall, and draining lymph nodes.
These findings suggest that this patient is a relatively rare case of large cell carcinoma of the lung in which complete regression was obtained by Cisplatin alone, and that radiographic examination including computed tomography are, in some instances, not helpful to definitively evaluate the effectiveness of cancer chemotherapy.View full abstractDownload PDF (5805K) -
Norio Kasamatsu, Ikko Hashizume, Katsumi Shinozaki, Yuichi Takiguchi, ...1986 Volume 26 Issue 4 Pages 445-451
Published: August 25, 1986
Released on J-STAGE: August 10, 2011
JOURNAL FREE ACCESSA rare case of solitary papilloma of the bronchus with an area of carcinoma in situ is presented.
The tumor was located at the left upper lobe bronchus in a 75year-old man who had had recurrent pneumonia. By transbronchial biopsy, it was diagnosed as solitary papilloma of the bronchus. Unfortunately he died of perforation of a duodenal ulcer and autopsy was performed.
Microscopically the tumor consisted of a well-developed connective tissue stroma covered by multilayered epithelium, the cells of which had various grades of atypia. In the basal part of the tumor, marked atypia was recognized, but no invasion was present. So it was diagnosed as solitary papilloma of the bronchus with an area of carcinoma in situ.
From the histological feature of the tumor, it was considered that solitary papilloma of the bronchus in adults should be surgically resected whenever as possible.View full abstractDownload PDF (8922K) -
1986 Volume 26 Issue 4 Pages 453-474
Published: August 25, 1986
Released on J-STAGE: August 10, 2011
JOURNAL FREE ACCESSDownload PDF (3345K)
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