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Volume 30, Issue 7
Displaying 1-13 of 13 articles from this issue
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A Radiologic-Pathologic Correlative StudyHitoshi Tokuda1990 Volume 30 Issue 7 Pages 963-973
Published: December 20, 1990
Released on J-STAGE: August 10, 2011
JOURNAL FREE ACCESSA total of 28 resected cases of peripherally originating squamous cell carcinoma of the lung 4cm or less in diameter were analyzed both radiologically and histopathologically. The prevailing pattern of tumor growth was alveolar space-filling, i.e., tumor grew along the alveolar basal lamina, beneath the pulmonary pneumocytes, and filled up the alveolar spaces successively, then formed a well defined border. In 5 cases, in some part, the tumor extended in an alveolar lining fashion, as is often seen in adenocarcinoma, which was reflected as an ill-defined margin in the radiologic image.
Regarding the desmoplastic reaction as a major determining factor in morphology, we categorized these cases into three subtypes, that is, solid growth type (13 cases), central scar type (8 cases), and diffuse desmoplastic type (7 cases). Solid growth type, with the least desmoplasia, had a well-defined margin. The tumor compressed surrounding structures, with no sign of shrinking. Central scar type, generally with peripheral solid growth and scar at the center, had a sharp border and compression as well. Pleural retraction was caused by the central scar. Diffuse desmoplastic type showed an illdefined border or spicules caused by desmoplasia at its periphery, and sometimes by alveolar-lining tumor permeation, the latter of which was restricted to this subtype. It was often difficult to distinguish the last subtype from adenocarcinoma macrospically and radiologically.
Pre-existing lesions such as emphysema, multiple bullae, as well as associated pneumonia played some role in the appearance of radiologic findings such as indistinct border or spicula.View full abstractDownload PDF (14812K) -
Yasuto Akiyama, Tetsu Shinkai, Kenji Eguchi, Yasutsuna Sasaki, Tomohid ...1990 Volume 30 Issue 7 Pages 975-985
Published: December 20, 1990
Released on J-STAGE: August 10, 2011
JOURNAL FREE ACCESSIn the sixteen years from 1973 to 1988, 18 patients with malignant mediastinal tumor were treated with chemotherapy. The histologic type was invasive thymoma in 4 cases, thymic cancer in 4 cases, malignant germ cell tumor in 4 cases (seminoma one case) and others in 6 cases. Responders consisted of 6 cases, including complete remission in one case and partial remission in 5 cases. In 5 responders 60-100mg/m2 of cisplatin was included in regimens. The mean survival time of all cases was 40.6 months and that of responders was 68 months. Their disease-free period (DFP) was 40.5 months.View full abstractDownload PDF (9930K) -
Mitsutoshi Shiba, Norikazu Urabe, Yutaka Yamaguchi, Masayuki Baba, His ...1990 Volume 30 Issue 7 Pages 987-992
Published: December 20, 1990
Released on J-STAGE: August 10, 2011
JOURNAL FREE ACCESSThe clinico-pathological features of 21 cases of resected adenosquamous carcinoma of the lung were reported. Preoperative diagnosis as lung cancer was obtained in 19 cases (90%), but only in 3 cases were lung adenosquamous carcinomas diagnosed preoperatively. Compared to the histological figures of the resected tumors, preoperative diagnoses reflected the dominant component of tumors, and usually the squamous cell carcinoma component tended to be easily diagnosed. The postsurgical outcome of adenosquamous carcinoma was poor. Especially, stage IIIA cases showed a much poorer post surgical outcome than other stage IIIA non-small cell carcinoma. The importance of preoperative diagnosis, including histologic type, was emphasized, because of their highly agressive biological behavior.View full abstractDownload PDF (641K) -
Norio Yamaoka, Yoshitaka Uchiyama, Kouji Kinimo, Shinji Akamine, Satos ...1990 Volume 30 Issue 7 Pages 993-1003
Published: December 20, 1990
Released on J-STAGE: August 10, 2011
JOURNAL FREE ACCESSAnalysis of nuclear DNA content was performed on paraffin-embedded tissue in 7 cases of multiple lung cancer and 15 cases of metastatic lung cancer using flow cytometry. The DNA index between two tumors in 14 cases of metastatic lung tumors were the same. They differed for two or three tumors in 5 cases of multiple lung cancer, but in 2 cases were the same, as also were the histological findings (adenocarcinoma). These two cases showed thus should be excluded from multiple lung cancer.
On the basis of these results, criteria for the diagnosis of multiple lung cancer based on nuclear DNA content were developed.
1) Each tumor must be distinct (in a different segment, lobe or lung)
2) Different histology, but:
if histology within a part of each tumor is the same, and DNA content is the same, tumors may not be considered multiple lung cancers
3) Same histology, but:
a. if DNA content of each tumor is the same, tumors are not considered multiple lung cancer
b. if DNA content of each tumor is different, tumors are strongly suspected to be multiple lung cancer, and:
b1. Origin from carcinoma in situ
b2. No carcinoma in lymphatics common to both
These criteria should be helpful, if two tumors in the lung show the same histological findings and DNA indices. Tumors that are metastatic lung cancers can be excluded from multiple lung cancer. These criteria should provide information essential for the diagnosis of multiple lung cancer.View full abstractDownload PDF (6883K) -
Kouzou Yamada, Akira Kojima, Yuichirou Ohe, Tomohide Tamura, Yasutsuna ...1990 Volume 30 Issue 7 Pages 1005-1011
Published: December 20, 1990
Released on J-STAGE: August 10, 2011
JOURNAL FREE ACCESSFrom 1984 to 1989, 142 patients were entered into protocol studies of chemotherapy for small cell carcinoma in the National Cancer Center Hospital. Diagnosis of brain metastases was established in 58 patients by brain CT scan. The incidence of brain metastases was 41%.
Of 58 patients with brain metastases, 44 presented with one or more signs or symptoms, on the other hand 14 had no neurological complaints. The most common symptoms or signs were gait disturbance (26%), nausea and vomiting (10%). In 58 patients who were diagnosed by CT scan, 15 (26%) had solitary metastases and 42 (72%) had multiple metastases. Forty-seven patients were treated by whole brain irradiation with doses of more than 30 Gray, followed by an improvement of neurological complaints, and response rate was obtained in 85% of patients who were evaluated by CT scan. The median survival time from the detection of metastases of the irradiated or resected patients was 7 months.View full abstractDownload PDF (820K) -
Tomohiro Horiguchi, Hiroshi Nogimura, Hisao Sugimura, Takahisa Tomono, ...1990 Volume 30 Issue 7 Pages 1013-1019
Published: December 20, 1990
Released on J-STAGE: August 10, 2011
JOURNAL FREE ACCESSForty six cases of lung cancer with brain metastasis were studied retrospectively. They included 6 cases of squamous cell cancer, 23 cases of adenocarcinoma, 6 cases of large cell cancer, 9 cases of small cell cancer and 2 cases of unclassified lung cancer.
Among these types, the prognosis of patients with adenocarcinoma was the best. The 1- and 2-year survival rates were 33.8% and 28.9%. In the other histological types, no patient survived a full year.
The 1- and 2-year survival rates of the cases who had an operation on the metastatic lesion were 27.8% and 23.2%. No patient without an operation on the metastatic lesion survived a full year. Both 1- and 2-year survival rates of the cases with irradiation to the metastatic lesion were 15.8%. In cases without irradiation, the 1- and 2-year survival rates were 8.7% and 4.3%. The combined therapy of operation and irradiation to the metastatic lesion of the brain was significantly effective.
The cases which had radical operations performed on the primary lesion resulted in a favorable prognosis compared with other cases.
After analyzing the five longest survivors, the most favorable outcome was for cases of adenocarcinoma with those who received both operation and irradiation, and had their primary lesions controlled.View full abstractDownload PDF (659K) -
Bumpei Kimura, Tatsuo Kidokolo, Mitsuru Hashizume, Kiyonori Komagata, ...1990 Volume 30 Issue 7 Pages 1021-1027
Published: December 20, 1990
Released on J-STAGE: August 10, 2011
JOURNAL FREE ACCESSFor the early detection of lung cancer, we have tried to organize 7 hospitals and 16 clinics in the local community into one medical network system. All chest roentgenograms were sent to our group which specializes lung cancer, and examined by us. When lung cancer was detected, internists and surgeons decided the course of therapy of the case jointly. From April 1977 to December 1989 we studied 211 patients with resected primary lung cancer. Of these, 90 cases (42.6%) were over 70 years old, while of 195 primary lung carcinomas, 112 patients (59%) revealed postoperativestage I. The histologic type was adenocarcinoma in 104 patients (49%) of the total. Asymptomatic patients consisted of 62%. The 5-year survival rate of absolutely and relatively curative resections were 65% and 21% respectively, and that of all cases was 46%. The medical network system of the hospitals and clinics in the local community is considered to yield better results concerning the early detection and treatment of lung cancer.View full abstractDownload PDF (870K) -
Keisuke Tomii, Yoshio Taguchi, Kazukiyo Oida, Takekuni Iwata, Akira Sa ...1990 Volume 30 Issue 7 Pages 1029-1033
Published: December 20, 1990
Released on J-STAGE: August 10, 2011
JOURNAL FREE ACCESSTwo cases of lung cancer complicated with sudden, fatal hemorrhage from adrenal metastasis were reported. In spite of remission of the primary lesion, sudden and increasing epigastralgia and/or backache developed in both cases. Contrast enhanced CT showed a large adrenal mass with nonhomogeneous density extending to the peri-and anterior pararenal space. Angiography was useful for evaluating the hemorrhage together with an embolization procedure in one case. Another required open laparotomy, which allowed hemostasis but not removal. Both patients died approximately a month after the onset of bleeding. Autopsy revealed hemorrhagic adrenal tumors metastatic from lung cancer (large cell type). Such metastasis should be kept in mind as a possible and significant complication of lung cancer.View full abstractDownload PDF (5762K) -
Ichiro Kubota, Nobuyuki Hara, Yukito Ichinose, Akira Motohiro, Tomohar ...1990 Volume 30 Issue 7 Pages 1035-1041
Published: December 20, 1990
Released on J-STAGE: August 10, 2011
JOURNAL FREE ACCESSA 44-year-old female complained of cough and sputum. The chest X-ray film showed a mass shadow in right S6. She underwent right middle and lower lobectomy on the suspicion of malignant tumor. Histologically the resected specimen revealed a typical storiform pattern consisted of fibroblastic cells and histiocytic cells with pleomorphism and abnormal mitosis. No abnormal lesion was detected in the abdomen or extremities, and the tumor was diagnosed as malignant fibrous histiocytoma (MFH) of the lung.
A 39-year-old male complained of cough and substernal oppression. The chest Xray film and chest CT scan film showed a huge left mediastinal mass. The tumor and involved left lung were resected completely. The same microscopic findings as in the first case yielded a diagnosis of MFH of the mediastinum.View full abstractDownload PDF (7013K) -
Masazumi Watanabe, Koichi Kobayashi, Tsuneo Ishihara, Akira Kawai, Tak ...1990 Volume 30 Issue 7 Pages 1043-1047
Published: December 20, 1990
Released on J-STAGE: August 10, 2011
JOURNAL FREE ACCESSOn follow-up chest X-ray film a nodular shadow was detected in the right lower lung field in a65-year-old man, who had been treated for interstitial pneumonia. Because serum CEA level was elevated (10.6ng/ml) and the abdominal examinations revealed no abnormal findings, primary lung cancer was strongly suspected. Right middle and lower lobectomy was performed.
A nodule in the lower lobe was adenocarcinoma and another small nodule was detected in the middle lobe. Pathologically the nodule in the middle lobe was also carcinoma composed of squamous cell carcinoma and small cell carcinoma. Metastases for squamous cell carcinoma was detected in the mediastinal lymph nodes.
This case was synchronous multiple primary lung cancer, one primary adenocarcinoma in the lower lobe and another primary carcinoma in the middle lobe consisting of two differrent histological types.View full abstractDownload PDF (7229K) -
Juichiro Maeda, Kazuhiko Tokita, Shinsuke Tamura, Hisakazu Hada, Kazuy ...1990 Volume 30 Issue 7 Pages 1049-1053
Published: December 20, 1990
Released on J-STAGE: August 10, 2011
JOURNAL FREE ACCESSA 52-year-old man was admitted to the Department of Chest Surgery on suspicion of mediastinal malignant teratoma. Although he underwent the resection after radiation therapy with the dose of 26Gy, it was an absolutely non-curative operation. The histology of the resected specimen showed pure seminoma. Afterwards, he received chemotherapy, consisting of cisplatinum, vinblastine and bleomycin, and radiation. Four months later he was admitted to our ward because of recurrence of left pleuritis carcinomatosa. In spite of chemotherapy consisting of cyclophosphamide, actinomycin-D and vincristine, he died of pneumonia.View full abstractDownload PDF (5304K) -
Hiroshi Ueoka, Taisuke Ohnoshi, Takeyuki Numata, Katsuyuki Kiura, Haru ...1990 Volume 30 Issue 7 Pages 1055-1060
Published: December 20, 1990
Released on J-STAGE: August 10, 2011
JOURNAL FREE ACCESSMetastases to skeletal muscle are extremely rare. A 42-year-old male with squamous cell carcinoma of the lung who selectively developed metastases to skeletal muscle is reported. The patient was hospitalized in August 1988. Chest X-ray examination revealed a mass in the right middle lobe associated with unilateral hilar lymphadenopathy and malignant pleural effusion. Staging procedures, including CT of the brain, CT of the abdomen, and radionuclide bone scan disclosed negative extrathoracic metastases. A partial regression of the mass and the complete disappearance of the pleural effusion for 7 weeks duration were achieved with chemotherapy regimen of cisplatin and vindesine. Following the relapse of the primary lesion, multiple severely painful nodules developed on his back, right forearm, and left thigh in February 1989 despite continuing chemotherapy. These nodules were shown to be intramuscular masses by MRI and proved to be metastases by percutaneous needle aspiration cytology. Restaging procedures again disclosed no extrathoracic metastases except those in skeletal muscle. The patient died of progressive primary lesion and intractable hypercalcemia in July 1989. Postmortem examination was not done. Accordingly, it was uncertain whether the metastatic disease was confined to the skeletal muscle, however, the patient was of interest because of the fact that the skeletal metastases were clearly detectable by MRI and by clinical means, and those were the only extrathoracic manifestations until his death.View full abstractDownload PDF (7483K) -
1990 Volume 30 Issue 7 Pages 1061-1088
Published: December 20, 1990
Released on J-STAGE: August 10, 2011
JOURNAL FREE ACCESSDownload PDF (4204K)
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