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Volume 31, Issue 4
Displaying 1-21 of 21 articles from this issue
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Tomonori Hirashima, Takafumi Kimura, Naomi Hirata, Sumiko Nishimura, T ...1991 Volume 31 Issue 4 Pages 467-472
Published: August 20, 1991
Released on J-STAGE: August 10, 2011
JOURNAL FREE ACCESSThe histologic types of primary lung cancer in relation to bronchoscopic findings were discussed. This study included 143 cases of the primary lung cancer: adenocarcinoma (Ad) 66 cases, squamous cell carcinoma (Sq) 49 cases, small cell carcinoma (Sm) 28 cases. The bronchoscopic findings were based on “ Bronchoscopic Findings in Lung Cancer Classification” recognized by. the Japan Cancer Society in 1987. Furthermore we discussed 10 bronchoscopic findings: color, loss of luster, swelling, vascular engorgement, granular change, longitudinal folds, loss of cartilage rings, stenosis, necrosis, and obstruction. Ad was significantly less visible (39.4%) in comparison with the other histologic types (p<0.01). Sq had a significantly high incidence of the primarily mucosal type (82.1%) in comparison with Ad and Sm (p<0.01). Ad had a significantly high incidence of “redness”(76.9%), Sq had a significantly high incidence of “paleness” (48.7%), and Sm had a significantly high incidence of “mixed redness and paleness” (48%) in comparison with other histologic types (p<0.05). Concerning other bronchoscopic findings, Sm had a significantly high incidence of “vascular engorgement” (68%) and “loss of cartilage rings” (72%) in comparison with Sq (p<0.01). Sq had a significantly high incidence of “obstruction” (69.2%) in comparison with Ad (p<0.01). To estimate the histologic types of primary lung cancer, the important bronchoscopic findings were color, vascular engorgement, and obstruction.View full abstractDownload PDF (650K) -
Katsumi Shinozaki, Toshihiko Kohno, Hidemi Ohwada, Yutaka Hayashi1991 Volume 31 Issue 4 Pages 473-482
Published: August 20, 1991
Released on J-STAGE: August 10, 2011
JOURNAL FREE ACCESSNitrogen dioxide (NO2), one of the most common air pollutants, is known to have toxic effects on the respiratory tract, and is also considered to be a mutagen. To study the relationship between NO2 and tumor growth or pulmonary metastasis, female 7-weekold Wistar-Imamichi strain rats were made to inhale 5 or 0.5 ppm NO2 for 1, 5, 14 days before, and 1, 5 days after inoculation of 3 × 106 Walker-256 tumor cells into their tail veins (IV) or subcutaneous tissues (SC).No effect was seen on SC tumor growth, but in rats that inhaled NO2 for one day followed by IV injection of tumor cells (5 ppm BI-1 group), 13 days after IV, pulmonary metastasis was significantly increased when evaluated by Ridit analysis. These tumor cells showed higher BrdU labelling index, and the most invasive growth on histological examination. One day after IV, the 5 ppm BI-1 group showed peribronchiolar invasion Tumor growth was limited to intra- and perivascular areas in all other groups. The 5 ppm BI-1 group showed bronchiolar and peribronchiolar inflammation and perivascular edema before tumor cell inoculation, and BALF study revealed higher numbers of neutrophils and lymphocytes.
NO2 exposure enhanced pulmonary metastasis of Walker-256 tumor, and the major cause of enhancement was supposed to be due to injury of the pulmonary vasculature by NO2 exposure.View full abstractDownload PDF (7157K) -
Yoshinori Nagamatsu, Shinzo Takamori, Kenji Nasu, Michitake Yoh, Akihi ...1991 Volume 31 Issue 4 Pages 483-487
Published: August 20, 1991
Released on J-STAGE: August 10, 2011
JOURNAL FREE ACCESSWe report the effects of postoperative radiation therapy on long-term prognosis for207 patients who received either a curative or non-curative surgical operation for lungcancer, from 1973 to 1987 in our hospital. We excluded data on those patients who haddistant metastasis and those patients who died due to other causes.
For all pN0 or pNl cases of pT3 that underwent curative resection, radiation therapy, with or without chemotherapy, was beneficial for prognosis when compared with those who received no radiation and chemotherapy only. We followed the long-term survival over 5 years, in 3 of 10 patients with a residual tumor at the surgical margin treated with radiation therapy combined with chemotherapy. However, all those who recieved chemotherapy died within only 3 years.View full abstractDownload PDF (528K) -
Tomofumi Igarashi, Hisashi Nakata, Hiroshi Natori, Hiroshi Tanaka, Yas ...1991 Volume 31 Issue 4 Pages 489-496
Published: August 20, 1991
Released on J-STAGE: August 10, 2011
JOURNAL FREE ACCESSFifteen patients with a superior pulmonary sulcus tumor (Pancoast tumor) were examined by ultrasonography and ultrasonically guided percutaneous needle biopsy and/ or cytology. Ultrasonograms demonstrated the location of the tumor, the relationship of tumor to the surrounding structures such as vessels, muscles, bones and the brachial plexus. It was of particular value in evaluating the chest wall invasion of the superior sulcus tumor, because it provided direct coronal and sagittal sections.
Ultrasonically guided needle biopsy was performed 14 times and malignancy was determined in 13 patients (13/14, 92.9%). Cytology specimens were obtained 15 times and the malignancy was determined in 7 patients (7/15, 46.7%) by an ultrasonically guided puncture. No complications such as hemorrhage or pneumothorax were encountered. On the other hand, diagnosis was made in 4/24 (16.7%) by sputum cytology, 0/6 (0%) by TBLB and 2/9 (22.2%) by bronchoscopic fluoroscopic guided cytology (washing or curettage). Ultrasonic examination was very useful for evaluation of the localization of the tumor and tumor extent as well as providing pathologic diagnostic results far superior to other existing methods.View full abstractDownload PDF (7816K) -
Keiko Kuriyama, Tsuyoshi Kadota, Chikazumi Kuroda, Shun-ichi Nakano, H ...1991 Volume 31 Issue 4 Pages 497-502
Published: August 20, 1991
Released on J-STAGE: August 10, 2011
JOURNAL FREE ACCESSThe detection of bone marrow involvement might have prognostic value and may influence therapeutic decisions in small cell lung cancer. In 15 patients with small cell lung cancer, bone marrow was evaluated with bone scintigraphy, magnetic resonance (MR) imaging, and aspiration biopsy of the sternum to detect bone marrow involvement. By bone marrow aspiration biopsy from the sternum, evidence of bone marrow metastases was seen in 7%(1/15) of patients with this disease. Skeletal scintigraphy showed bone marrow involvement in 7%(1/15) as well, hence, this modality is primarily sensitive to abnormalities of the bony cortex and considerably less sensitive to marrow abnormality. MR imaging was performed using a superconducting magnet operating at a field strength of 1.5 T. Sagittal images were obtained through the sternum and spine using a slice width of 5 mm, and corona' images were obtained through the lower lumbar spine, sacrum, pelvis, and proximal portion of the femur using a slice width of 8 mm. In 7 patients (47%) focal or diffuse abnormalities were detected by MR. In all patients the lesion were hypointense on Ti-weighted images (500/15), and the same lesions were demonstrated poorly on T2-weighted images (2000/90). In 4 cases with MR abnormality, low intensity lesions on T1-weighted images were enhanced by injection of gadolinium DTPA. MR imaging should be performed routinely in the staging of small cell lung cancer prior to bone marrow biopsy for the complete evaluation of bone marrow status.View full abstractDownload PDF (3366K) -
Haruhiko Nakamura, Tatsuro Odaka, Eisuke Takahashi, Toshimitsu Kobayas ...1991 Volume 31 Issue 4 Pages 503-510
Published: August 20, 1991
Released on J-STAGE: August 10, 2011
JOURNAL FREE ACCESSThe effects of long-term culture in vitro on human lung cancer cell lines established in our laboratory were examined from the points of view of cell proliferation, cell surface antigens, and tissue reconstruction in heterotransplanted tumor.
The doubling time of lung cancer cells decreased and reconstructed tissue showedmore undifferentiated histological findings, compared with the data immediately after the establishment of these cell lines. Nevertheless, cell surface antigens, CEA, EMA, and EGF-R, were recognized on several cells after long-term culture. These results suggest that long-term culture elevates proliferative activity, but may not affect the antigenicity of lung cancer cells.
When we use cancer cell lines in experiments, it is important to understand the characteristics of the cells at the time of use and to select appropriate cell lines.View full abstractDownload PDF (10281K) -
Shuji Miyake, Hikotaro Komatsu, Akihiko Mikami, Hideaki Nagai, Ryozo Y ...1991 Volume 31 Issue 4 Pages 511-517
Published: August 20, 1991
Released on J-STAGE: August 10, 2011
JOURNAL FREE ACCESSWe evaluated 47 fatal cases of lung cancer with brain metastases and discussed prognosis statistically using quantification Type L Hemiplegia and headache were the most frequent clinical signs and symptoms. Convulsion and confusion were prognostically bad signs. As for the evaluation of prognostic factors, the categories of age, sex, histology, and effectiveness of radiation therapy on reduction of tumor size were important prognostic factors. A formula to evaluate prognosis was proposed.View full abstractDownload PDF (759K) -
Annual Chest Radiographs with Computed Radiography (CR)Ryoichi Kamimura, Tsutomu Takashima, Takeshi Kobayashi, Hiroshi Nishij ...1991 Volume 31 Issue 4 Pages 519-526
Published: August 20, 1991
Released on J-STAGE: August 10, 2011
JOURNAL FREE ACCESSIt has been shown that chest radiography and sputum cytology are the only tests ofproved value in detecting preclinical lung cancer. In the Wajima Lung Cancer Screening Program, computed radiography (CR) was utilized in a new chest radiography trial. A total of 3965 male cigarrete smokers over 45 years of age from Wajima city volunteered for this study between June, 1984 and December, 1989. A total of 11 lung cancers had been diagnosed by March, 1990. Of these patients, 7 were detected through routine screening radiographs and 4 were detected only by sputum cytology.
The radiographs which led to the diagnosis were carefully reviewed and compared to previous studies. Previous CR films showed no evidence of cancer. Therefore, it was considered that the error rate could be decreased by chest radiographs with CR.
Single exposure dual-energy subtraction by means of CR was also utilized in some cases from June, 1989. Subtraction images markedly improve the detection of nodules hidden under the ribs and calcifications. The dual energy subtraction technique appears promissing for lung cancer screening.View full abstractDownload PDF (3270K) -
Takeshi Horai, Tatsuhito Nakae, Fumio Imamura, Takahiko Sakuma, Hitoma ...1991 Volume 31 Issue 4 Pages 527-532
Published: August 20, 1991
Released on J-STAGE: August 10, 2011
JOURNAL FREE ACCESSThe authors developed an in vitro invasion model using tumor cells of small cell lung carcinoma (OC-10 cells) and cultured layers of human pleura-derived cells. The pleuraderived cells were isolated from normal human pleura obtained by autopsy and cultured in RPMI 1640 with 10% fetal calf serum. The cultured mesothelial cells, polygonal in shape, formed a pavement. When OC-10 cells were seeded on the pleura-derived cell layers, tumor cells attached to mesothelial cells, and invaded underneath mesothelial cell layers and formed flattened tumor cell islands. By counting the number of invaded tumor cells, the in vitro invasive capacity of tumor cells was assayed.
These results indicate that the system described in the study might provide a useful model to study tumor cell invasion.View full abstractDownload PDF (5871K) -
Yasuhiro Shibuya, Jun Kobayashi, Yukihiko Sugiyama, Satoshi Kitamura, ...1991 Volume 31 Issue 4 Pages 533-538
Published: August 20, 1991
Released on J-STAGE: August 10, 2011
JOURNAL FREE ACCESSA 53-year-old male case of synchronous triple lung cancer associated with idiopathicinterstitial pneumonia (IIP) is reported. He was admitted because of dyspnea on exertion.Chest computed tomography study showed double lung cancers located in S6 and S3in the right lung associated with honeycomb changes in the bilateral lower lung fields.He died of respiratory failure one month after the initial diagnosis. At autopsy findingsanother cancer was detected at S6 in the left lung. Those three cancers were welldifferentiatedsquamous cell carcinoma. The cancer in right S6 was central type lungcancer and the others were considered to be peripheral type, related to IIP.View full abstractDownload PDF (10665K) -
Hiroyuki Nakamura, Yasufumi Yamaji, Jiro Fujita, Yuuki Hata, Taiichi S ...1991 Volume 31 Issue 4 Pages 539-545
Published: August 20, 1991
Released on J-STAGE: August 10, 2011
JOURNAL FREE ACCESSA 28-year-old male was admitted to Kagawa Medical School Hospital because of diplopia and left orbital mass. Orbital CT scan demonstrated an intraorbital mass and destruction of the orbit. Chest X-ray disclosed a nodular shadow in the right S6 and swollen lymph nodes in the right hilum and paratracheal area. Biopsy of the intrabronchial tumor yielded a diagnosis of small cell lung carcinoma (intermediate cell type). Systemic chemotherapy including ADM, CDDP and VP-16 was started on February 20, 1986. The masses in the orbit and right lung responded well to the chemotherapy. Therefore, the orbital mass was speculated to be a metastasis of small cell carcinoma. After 4 courses of induction therapy, he received maintenance chemotherapy as an outpatient for 18 months. He died 32 months after initial treatment because of systemic metastasis, but no orbital relapse was recognized.
Metastasis of lung carcinoma to the orbit has been considered to be uncommon in Japan. Only 6 cases have been reported in the literature; 3 were adenocarcinoma and the other 3 were squamous cell carcinoma. The present case is the first case in which small cell carcinoma of the lung had already spread to the orbit at the time of diagnosis. It should also be noted that systemic chemotherapy yielded a much longer remission period than expected.View full abstractDownload PDF (8842K) -
Tomoharu Kuda, Nobuyuki Hara, Hiroshi Asoh, Tokujirou Yano, Yukito Ich ...1991 Volume 31 Issue 4 Pages 547-550
Published: August 20, 1991
Released on J-STAGE: August 10, 2011
JOURNAL FREE ACCESSTwo cases of pulmonary embolism after lung cancer resection were reported. The first case was a pT1NOMO adenocarcinoma. Six days after operation, dyspnea on exertion and hypoxia developed, and pulmonary embolism was diagnosed because of abnormal lung scintigram findings. She recovered following heparin administration. The second case was a pT3N2M0 squamous cell carcinoma. Ten days after operation, circulatory collapse developed and the patient died. Diagnosis was confirmed by autopsy. Close attention must be paid to pulmonary embolism associated with lung cancer, because it is not rare, and the diagnosis and management of this situation are complicated.View full abstractDownload PDF (2804K) -
Hiroaki Nomori, Ryuichiro Kobayashi, Yoshiaki Ono, Shojiroh Morinaga1991 Volume 31 Issue 4 Pages 551-554
Published: August 20, 1991
Released on J-STAGE: August 10, 2011
JOURNAL FREE ACCESSThe patient was a 45-year-old male whose chief complaints were fever, weight loss, and left upper back pain. Deterioration of diabetes was pointed out by a local doctor, and the patient was admitted to our hospital. On chest X-ray film, a mass shadow was found at the left lung apex. This was diagnosed as giant cell carcinoma by needle aspiration biopsy. Fever, leukocytosis, anemia, elevation of serum Al-P and LDH, which are characteristic findings of giant cell carcinoma of the lung, were present before surgery. In addition, blood sugar was so high that 30 units of intermittent insulin and 40 units of rapid insulin per day were required. After resection of the tumor, these conditions improved, and blood sugar was well controlled by 20 units of intermittent insulin. In this case, it seemed that an inflammatory condition due to lung giant cell carcinoma caused deterioration of diabetes.View full abstractDownload PDF (5581K) -
Koichi Tanaka, Hideki Chikama, Osamu Sigemitsu, Tetsuo Hadama, Yuzo Uc ...1991 Volume 31 Issue 4 Pages 555-559
Published: August 20, 1991
Released on J-STAGE: August 10, 2011
JOURNAL FREE ACCESSA rare case of myocardial metastasis of lung cancer inducing stenosis of the right ventricular outflow tract, detected by echocardiography, is presented.
A 64-year-old man was admitted to our hospital with complaints of cough and emaciation in August 1990. Chest X-ray film and CT revealed a large mass in the left upper lung field. We performed left upper lobectomy with lymph node dissection, and the pathological diagnosis was poorly differentiated adenocarcinoma without lymph node metastasis. The postoperative course was uneventful until two weeks after operation, when exertional dyspnea developed progressively, and eventually a cardiac murmur became audible. Echocardiography disclosed a mass shadow protruding from the interventricular myocardium to the right ventricular outflow tract, almost occluding the orifice of the pulmonary artery. He died of heart failure on day 46 postoperatively, and postmortem examination disclosed myocardial metastasis of the lung cancer.View full abstractDownload PDF (6383K) -
Tomoko Nakayama, Akira Yokoyama, Koichi Kinameri, Yuzo Kurita, Masanor ...1991 Volume 31 Issue 4 Pages 561-566
Published: August 20, 1991
Released on J-STAGE: August 10, 2011
JOURNAL FREE ACCESSAn 18-year-old male was admitted with a complaint of right chest pain. Chest X-ray revealed an anterior mediastinal tumor and multiple pulmonary tumors. The serum alpha-fetoprotein and human-chorionic gonadtropin were markedly elevated (AFP: 674.94ng/ml, HCG: 4364mIU/ml). No abnormality was found in the testis. He was diagnosed as having a primary mediastinal germ cell tumor with multiple pulmonary metastasis.
After three courses of chemotherapy, which consisted of high-dose cisplatin, etoposide and bleomycin, the serum tumor markers became normalized. Following chemotherapy, the residual tumors were resected. The resected tumors consisted of immature teratoma and necrotic tissue. The patient is free of the disease at present.View full abstractDownload PDF (8362K) -
Motoko Machishi, Osamu Taguchi, Esteban C. Gabazza, Kiyoyuki Tsutsui1991 Volume 31 Issue 4 Pages 567-572
Published: August 20, 1991
Released on J-STAGE: August 10, 2011
JOURNAL FREE ACCESSA 62-year-old man was admitted to our hospital with cough and sputum. Based on radiographic and bronchoscopic findings, multiple bilateral primary carcinoma of the lung was suspected clinically. The upper gastrointestinal endoscopic examination showed a Borrmann- II type metastatic lesion in the gastric corpus. The histologic diagnosis of these lesions was moderately differentiated squamous cell carcinoma. These lesions were resistant to radiation and chemotherapy. The patient's clinical condition worsened progressively with controllable anemia. Nine months after admission the patient died and the autopsy findings were as follows; multiple primary lung carcinoma (squamous cell carcinoma), metastatic tumors found in stomach, liver, adrenal glands, colon, brain and lymph nodes. Multiple primary lung cancer as well as lung cancer with metastatic gastric tumors, are two very rare pathological entities with a frequency of 1-4% and 2-4% among lung cancer cases, respectively.View full abstractDownload PDF (6926K) -
Takuro Saito, Akio Ohishi, Ryuzo Kanno, Tomoyuki Kanno, Hitoshi Inoue, ...1991 Volume 31 Issue 4 Pages 573-578
Published: August 20, 1991
Released on J-STAGE: August 10, 2011
JOURNAL FREE ACCESSA case of human chorionic gonadotropin (HCG)-producing squamous cell carcinoma of the lung is reported.A 47-year-old woman was admitted to our hospital with an abnormal shadow on chest X-ray without any symptom.Because of the high titer of HCG (urine HCG;1000IU/L, serum, β-HCG;l5ng/ml) and the past history of hydatidiform mole, it was suspected that the tumor in the left lung was a metastatic lesion from uterus choriocarcinoma.Chemotherapy, simple hysterectomy, and wedge resection of the left lung were performed.However, the resected specimen revealed no abnormalities in the uterine by pathological examination, and a definitive diagnosis of HCGproducing squamous cell carcinoma of the lung was made.
Left pneumonectomy and mediastinal lymphnode dissection were carried out.At 1 year 8 months after the operation, her clinical course is good and she is alive.View full abstractDownload PDF (10027K) -
Yuka Sasaki, Kiminori Suzuki, Junichi Yasuda, Fumio Yamagishi, Shouich ...1991 Volume 31 Issue 4 Pages 579-584
Published: August 20, 1991
Released on J-STAGE: August 10, 2011
JOURNAL FREE ACCESSA patient with pulmonary and intrabronchial metastasis of malignant melanoma, one of which showed a cavitary lesion on the chest X-ray film is reported. He had a history of extensive resection of the left heel because of primary malignant melanoma. Two years and three months after the surgery, he developed lung metastasis. He had been treated several times for the metastatic lung lesions for nine months at another hospital, when he developed a new lesion with a cavity on his chest X-ray film. He was referred to our hospital on the suspicion of lung tuberculosis. The cavitary lesions, as well as the cavity itself, had become consistently larger, and finally developed into giant cystic lesions on his chest X-ray. He died of respiratory failure four years after the initial surgery. Postmortem examination revealed that all the mass lesions, including the giant cavitary lesion, which had been found on his chest X-rays were consistent with metastatic malignant melanomas.
It is rare that a metastatic malignant melanoma of the lung presents as a large cavitating tumor shadow on chest X-ray.View full abstractDownload PDF (10262K) -
Yuji Morita, Hideaki Watanabe, Seiya Katoh, Hisao Mishina, Mitsuo Asak ...1991 Volume 31 Issue 4 Pages 585-590
Published: August 20, 1991
Released on J-STAGE: August 10, 2011
JOURNAL FREE ACCESSA 61-year-old man was admitted for evaluation of an abnormal shadow on a chest X-ray film which was incidentally found at the time of a health check-up. CT demonstrated a tumor located between the SVC and the trachea, suggesting a swollen lymph node due to metastasis. No lesions were detected outside the mediastinum by bronchofiberscopy, whole-body CT, Gallium scintigram etc. Resection was performed under a diagnosis of mediastinal tumor.
Histologic studies, including various immunohistochemical stains, proved that the tumor was an atypical carcinoid. Carcinoid cells occupied the greater part of the tumor and lymphatic tissues were scattered in the tumor, however benign epithelial elements such as thymic tissue or bronchial epithelium were not present. The above findings suggest that the tumor arose from a mediastinal lymph node. Such a case has never been reported previously.
It is presumed that the tumor cells originated from an ectopic microepithelial tissue which had existed in a lymph node and that they proliferated and replaced the original lymph node. Needle aspiration cytology was shown to be useful for the diagnosis of systemic lymph node metastasis.View full abstractDownload PDF (10605K) -
Masato Minami, Kazuya Nakahara, Shinichiro Miyoshi, Akinori Akashi, Ta ...1991 Volume 31 Issue 4 Pages 591-597
Published: August 20, 1991
Released on J-STAGE: August 10, 2011
JOURNAL FREE ACCESSTwo cases of lung cancer and hypercalcemia (Case 1: 66-year-old male; adenocarcinoma, Case 2: 63-year-old male; squamous cell carcinoma) were diagnosed as humoral hypercalcemia of malignancy (HHM) based on the results of bone scintigram and the laboratory findings concerning Ca metabolism. In both patients hypercalcemia and disturbed consciousness improved transiently after administration of mithramycin and preoperative evaluation could be accomplished. A right upper sleeve lobectomy was performed in Case 1 (p-T3NOMO) and hypercalcemia temporarily disappeared postoperatively, but he died of metastases on the 73rd postoperative day. Thoracotomy in Case 2 revealed the tumor to be unresectable because of pleural dissemination (p-T4N2M1) and he died of hypercalcemia on the 18th postoperative day. In summary, in two lung cancer patients diagnosed as HHM operation was indicated but their prognoses were extremely poor.View full abstractDownload PDF (4634K) -
1991 Volume 31 Issue 4 Pages 599-608
Published: August 20, 1991
Released on J-STAGE: August 10, 2011
JOURNAL FREE ACCESSDownload PDF (1375K)
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