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Volume 32, Issue 6
Displaying 1-18 of 18 articles from this issue
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Akira Hayashibe, Yutaka Nishiwaki, Tetsuro Kodama, Fumihiko Hojou, Kaz ...1992 Volume 32 Issue 6 Pages 819-825
Published: October 20, 1992
Released on J-STAGE: August 10, 2011
JOURNAL FREE ACCESSThe effect of cisplatin-based systemic chemotherapy on adenocarcinoma of the Lung with malignant pleural effusion was tested on 50 patients who were randomly assigned to one of two groups. Group A (26 cases) underwent tube drainage with intracavitary administration of OK-432, while group B (24 cases) underwent additional systemic chemotherapy with CDDP and VDS, with or without MMC. The median survival time in both groups was 9 months and the two-year survival rate was 4% in both groups. There was no difference in terms of effusion control between the two groups. This may indicated that systemic chemotherapy does not provide any additional benefit in terms of survival of patients with adenocarcinoma of the lung with malignant pleural effusions and it cannot be recommended as a routine treatment.View full abstractDownload PDF (762K) -
A Phase I Trial of A Combination of Cisplatin and Carboplatin in Advanced Non-Small Cell Lung CancerAn Intensification of Platinum Dose by A Combination of Two Platinum CompoundsAkinobu Yoshimura, Akihiko Gemma, Kouzou Yoshimori, Masahiko Shibuya, ...1992 Volume 32 Issue 6 Pages 827-835
Published: October 20, 1992
Released on J-STAGE: August 10, 2011
JOURNAL FREE ACCESSWe performed a phase I trial of a combination of cisplatin (CDDP) and carboplatin (CBDCA) in advanced non-small cell lung cancer (NSCLC). The starting doses of CDDP and CBDCA were 80mg/m2 and 300mg/m2, respectively. The dose of each agent was escalated to examine three dose-levels of this combination. Among 17 patients with advanced NSCLC, 8 of them received a dose-level of 80mg/m2 CDDP and 300mg/m2 CBDCA. Six patients received 80mg/m2 CDDP and 350mg/m2 CBDCA, and 3 patients 100mg/m2 CDDP and 300mg/m2 CBDCA. Leukopenia and thrombocytopenia had the dose-limiting effects in this study. Gastrointestinal toxicity was common, but was tolerable and reversible. Liver dysfunction and nephrotoxicity were rare. No ototoxicity or neurotoxicity was observed at any dose-levels. The overall response rate was 23.5%(4/17). At the dose-level of 80mg/m2 CDDP and 300mg/m2 CBDCA, which is the recommended dose for the phase II trial, 3 out of 8 patients (37.5%) achieved partial responses. This combination can be safely given at doses of 80mg/m2 CDDP and 300mg/m2 CBDCA. A phase II trial is on-going to evaluate the efficacy of this combination.View full abstractDownload PDF (1000K) -
Takashi Eto, Harumi Suzuki, Aturo Honda, Yasuyuki Nagashima1992 Volume 32 Issue 6 Pages 837-844
Published: October 20, 1992
Released on J-STAGE: August 10, 2011
JOURNAL FREE ACCESSImage analysis on the elastic fibers (EF) in the tumor stroma extending around the central fibrotic foci (ExSt) in peripheral pulmonary adenocarcinoma, especially type 2, was studied.
The chest-roentgenographic course of the tumors revealed that the tumor size increased rapidly during approximately 6 months
Microscopically, the ExSt was composed of a thin-walled EF framework similar to the normal alveoli. In the alveoli with the ExSt, tumor cells grew vigorously and were frequently stratified into the air spaces
Using a microscopic image analyzer, it was found that in the ExSt the total or skeletonized EF was similar to that of the normal alveolar wall.
Calculating in terms of per unit wall length, the ratios were less than double those of normal counterparts.
From these findings, it was concluded that the ExSt in type 2 pulmonary adenocar-cinoma might be composed of mild-reacting pre-existing alveolar wall.View full abstractDownload PDF (8903K) -
Kouzo Yamada, Ikuo Nomura, Masanori Matsumura, Kazumasa Noda1992 Volume 32 Issue 6 Pages 845-850
Published: October 20, 1992
Released on J-STAGE: August 10, 2011
JOURNAL FREE ACCESSIn order to evaluate the relationship between peripheral pulmonary nodules (PPN) and the surrounding vessels, thin-sliced computed tomography was used to study 30 patients with PPN less than 20 mm in diameter. There were 16 patients with lung cancer (14 adenocarcinomas, 2 squamous cell carcinomas) and 14 patients with benign lesion (6 benign tumors, 2 pneumonias, 6 granulomas). Thin-sliced CT images were examined by an extended scale (window level:-600, window width: 1900). In those cases which were resected, surgical specimens were sliced transversely to correlate with the thinslice d CT images.
In thin-sliced CT images, the relationship between PPN and surrounding vessels were classified into four types, PPN with no vascular association (type 1), PPN bordered laterally by vessels (type 2), PPN with vascular involvement (type 3), PPN penetrated by vessels (type 4). Type 3 or 4 was seen in all lung cancers, whereas type 1 or 2 was seen in benign lesions. Thus involvement or penetration by PPN of surrounding pulmonary veins is strongly suggestive of malignancy.
Our results may suggest that thin-sliced CT findings may have a significant clinical role in differentiating peripheral small pulmonary lesion by demonstrating the relationship between lesions and the surrounding vessels.View full abstractDownload PDF (6325K) -
Hidemi Ohwada, Yutaka Hayashi1992 Volume 32 Issue 6 Pages 851-860
Published: October 20, 1992
Released on J-STAGE: August 10, 2011
JOURNAL FREE ACCESSTwenty-five autopsy cases exhibiting relatively diffuse pulmonary fibrotic foci, associated with (10 cases) and without (15 cases) lung cancer, were examined for the relationship between the histologic features of fibrotic foci and the frequency of epithelial hyperplastic foci.
According to the histological findings of pulmonary fibrotic foci, these 25 cases were divided into two main types, interstitial and intra-alveolar fibrosis. The two types of fibrosis were evaluated concerning to the frequency of epithelial hyperplastic foci, adenomatous hyperplasia and squamous metaplasia with or without cellular atypia, and nucleolar organizer regions of these hyperplastic cells.
The epithelial hyperplastic foci were found more frequently in the left lower lobe and in peripheral regions than hilar regions in every lobe. In the patients with adenocarcinoma, epithelial hyperplastic foci were found more frequently in the cases with interstitial fibrosis than those of intra-alveolar fibrosis. The number of nucleolar organizer regions of hyperplastic cells increased in the order of adenomatous hyperplasia, atypical adenomatous hyperplasia, adenocarcinoma, and were more plentiful in atypical squamous metaplasia than in squamous metaplasia. These findings exhibit the higher activity of hyperplastic cells in interstitial fibrosis than intra-alveolar fibrosis, and suggest that in the cases with adenocarcinoma, interstitial pulmonary fibrosis has a closer relationship to pulmonary carcinogenesis through the process of adenomatous and atyipical hyperplasia than the intra-alveolar fibrosis.View full abstractDownload PDF (3989K) -
Kiyoshi Takenaka, Akihiko Genma, Akinobu Yoshimura, Hisanobu Niitani1992 Volume 32 Issue 6 Pages 861-867
Published: October 20, 1992
Released on J-STAGE: August 10, 2011
JOURNAL FREE ACCESSIn order to determine the indications of second course chemotherapy in Non-resectable non-small cell lung cancer, 118 non-small cell lung cancer patients treated with combination chemotherapy including CDDP were analyzed to determine the percent reduction in tumor size after the first course of chemotherapy.
Thirty-two patients showed partial response (response rate=27%). Fourteen were squamous cell carcinoma (response rate=39%) and eighteen were adenocarcinoma (response rate=22%). There were no significant differences according to histology. Compared with squamous cell carcinomas, adenocarcinomas showed more various speeds of response to chemotherapy.
We concluded that chemotherapy should be continued in cases of adenocarcinomas with≥25% reduction in tumor size and in cases of squamous cell carcinomas with≥50% reduction in size after the first course of chemotherapy.View full abstractDownload PDF (781K) -
Hiroyuki Nishiyama, Motoo Kuroki, Tetsuro Kodama, Mitsuyo Nishimura, K ...1992 Volume 32 Issue 6 Pages 869-875
Published: October 20, 1992
Released on J-STAGE: August 10, 2011
JOURNAL FREE ACCESSSeventy-six patients with small peripheral type lung cancers underwent pulmonary resection in our hospital from 1972 to 1989. In all 76 patients, five-year survival rates were 77% for stage I, 71% for stage II, 36% for stage III, and 0% for stege N, respectively. Although tumors were less than 2cm in diameter, the course was poor in advanced cases (stage III, N).
In small peripheral type lung cancers less than 2cm in diameter, pleural involvement, lymphatic invasion, vascular invasion and grade scars correlated significantly with the pathological stages.
In this group, the tumor size of most advanced cases was from 1.6cm to 2cm, but in 2 patients it was less than 1.5cm in diameter.
The mean age of 12 cases with advanced cancer was 53 years old and reason for detection was symptomatic in 6 cases. Histologically, 11 patients had adenocarcinoma and one had small cell carcinoma.
DNA ploidy was analyzed by flow cytometry in 8 advanced cases. Four cases showed diploidy and 4 cases showed aneuploidy, but no relationship with their course was recognized.
Concerning the reason for classification as stage III or IV, 5 patients were N2, 5 patients had pulmonary metastasis and 4 patients had pleural dissemination.View full abstractDownload PDF (829K) -
Kanji Egashira, Hajime Nakata, Hideyuki Watanabe, Katsumi Nakamura, Ke ...1992 Volume 32 Issue 6 Pages 877-887
Published: October 20, 1992
Released on J-STAGE: August 10, 2011
JOURNAL FREE ACCESSThe clinical value of magnetic resonance imaging (MRI) and computed tomography (CT) for preoperative evaluation of lung cancer was studied. Subjective visual comparison of MRI with CT was done in 54 lung cancer cases, consisting of 37 surgical and 17 nonsurgical cases. Evaluation on the basis of surgical-pathological findings was performed on 37 surgical cases. Concerning the visibility of the margins of primary tumors within the peripheral lung field there was none in which MRI was superior to CT. As for the visibility of the tumors in relation to the mediastinum and abnormal mediastinal and hilar lymph node, MRI was either superior or equal to CT in the majority of cases. In the visualization of the tumors in relation to the chest wall CT was superior to MRI in 7 cases. The comparison of diagnostic accuracy on the basis of surgical-pathological findings showed that MRI was superior to CT in several cases for the T-factor. No difference of diagnostic accuracy was found between MRI and CT in the metastatic mediastinal and hilar lymph nodes. Since CT is currently more available and is easier to perform than MRI in most hospitals, CT is probably the first modality of choice in pre-operative evaluation of lung cancer. MRI is considered to be indicated in those cases in which the primary tumors are large and the relationship of the tumor to the mediastinum, heart, great vessels and chest wall must be clarified precisely or in which the diagnosis of metastasis of mediastinal and hilar lymph node is questionable on CT.View full abstractDownload PDF (10508K) -
Yuichi Takiguchi, Kouhei Chou, Keiichi Nagao, Yoshihiko Takahashi, Aki ...1992 Volume 32 Issue 6 Pages 889-896
Published: October 20, 1992
Released on J-STAGE: August 10, 2011
JOURNAL FREE ACCESSA case of rhabdomyosarcoma, its nude mouse line and cell line were presented. A 21-year-old woman who had undergone tumor resection of the labium majus pudendi and had been diagnosed as rhabdomyosarcoma 14 months previously, developed multiple pulmonary nodules and was admitted to our department because of cough and dyspnea. She died on the 34th day after the commencement of combined chemotherapy which showed little effects. Autopsy revealed multiple pulmonary metastases of alveolar type rhabdomyosarcoma with no evidence of local relapse. The nude mouse line and cell line which were successfully established from autopsy specimens showed karyotype of 47, XX, +5, +7, -13, -21, -22, -22, del (2) (q33), +der (21) t (21;?) (p11;?), +marl and +mar2. Doubling times of a pulmonary metastasis, the nude mouse line and the cell line were 17 days, 4.0 days and 1.5 days, respectively. A polar solvent differentiating agent, dimethylsulfoxide (DMSO) was found to alter the morphological features of the cultured cells from spherical shape to a myoblast-like appearance.
These preliminary studies suggest that this model may be promising to provide valuable experimental system in vivo and in vitro, especially for biological investigations of cell differentiation and drug sensitivity of rhabdomyosarcoma.View full abstractDownload PDF (10570K) -
Takashi Takahashi, Naoto Miyazawa, Kohei Yokoi, Kiyoshi Mori, Yoshikun ...1992 Volume 32 Issue 6 Pages 897-903
Published: October 20, 1992
Released on J-STAGE: August 10, 2011
JOURNAL FREE ACCESSA patient with adenoid cystic carcinoma of the parotid gland underwent right total parotidectomy in 1975 when she was 31. She developed pulmonary metastases, one in the left middle field and the other in the right lower field in 1977, later another one in the right upper field in 1980, both of which were treated with radiation therapy. However, the metastatic lesions in the left middle and right upper fields of the lung continued to grow slowly by 1990, when the lesion in the left middle field of the lung suddenly started to grow rapidly. In spite of repeated radiation therapy, the tumor continued to grow and finally became a huge mass occupying the whole chest cavity, compressing and shifting the mediastinum to the opposite side, causing chest pain and dyspnea. To release these symptoms, left pneumonectomy was performed in December 1990. She died of the disease in February 1991. The resected specimen revealed a solid pattern of adenoid cystic carcinoma with many mitoses in most parts of the tumor and a tubular pattern which was consistent with the primary lesion in part. This change was thought to have reflected the rapid growth of the tumor towards the end of her life.View full abstractDownload PDF (9052K) -
Mitsuo Nakayama, Takatsugu Satoh, Chikao Torikata1992 Volume 32 Issue 6 Pages 905-911
Published: October 20, 1992
Released on J-STAGE: August 10, 2011
JOURNAL FREE ACCESSA rare case of double primary lung tumors composed of pulmonary blastoma and lung cancer is reported. A 67-year-old male was admitted to our hospital with complaints of coughing, chest pain and shortness of breath. Chest X-ray and chest CT scan revealed a large mass and pleural effusion in the right thoracic cavity, and a mass in the left lower lobe. The serum CEA and SCC levels were elevated to 9.4ng/ml and 11.3ng/ml respectively. Cytologically, adenocarcinoma cells and squamous cell carcinoma cells were obtained from the sputum, and tumor cells, which resembled adenocarcinoma cells, were found in the pleural effusion. He was therefore diagnosed as having adenosquamous carcinoma of the lung with metastasis to the contralateral lung. Radiation therapy was started, but his condition rapidly worsened, and he died. Autopsy disclosed that he had double primary lung tumors composed of pulmonary blastoma, located in the right lower lobe with extrapulmonary growth, and adenosquamous carcinoma in the left lower lobe.View full abstractDownload PDF (10760K) -
Junichi Suzuki, Tomonobu Koizumi, Kazuya Hirai, Keishi Kubo, Toshio Ko ...1992 Volume 32 Issue 6 Pages 913-918
Published: October 20, 1992
Released on J-STAGE: August 10, 2011
JOURNAL FREE ACCESSA 62 year-old man, in whom had been diagnosed lung cancer (squamous cell, stage IIIb), developed secondary leukemia after chemotherapy and irradiation. He was treated with 3 courses of chemotherapy (CDDP, VDS) and seqential irradiation (60Gy). He had no symptoms and no signs of recurrence for approximately 2 years after the therapy. He was readmitted because of pancytopenia. The diagnosis of acute myelocytic leukemia (M2) with chromosome aberration was made from the bone marrow findings. He was treated with BHAC-DMP and a low dose Ara-C, but the response was not favorable. He died of pneumonia 4 weeks after the diagnosis of acute leukemia. It is very rare secondary leukemia to develop in patients with non-small (squamous) cell lung cancer.View full abstractDownload PDF (4809K) -
Masanobu Hayakawa, Kazuya Nakaoka, Hirohisa Hirabayashi, Shoichi Katay ...1992 Volume 32 Issue 6 Pages 919-924
Published: October 20, 1992
Released on J-STAGE: August 10, 2011
JOURNAL FREE ACCESSA 62 year old male was admitted to our hospital with an abnormal shadow on chest X-ray. Adenocarcinoma was diagnosed by transbronchial brushing cytology. Right pneumonectomy with hilar and mediastinal lymph node dissection was performed.
Histological findings of the resected specimen showed pulmonary carcinosarcoma.
The tumor was composed of two sarcomatous components (fibrosarcoma and myxosarcoma).
In addition, regarding the type of metastasis, adenocarcinoma showed lymphatic and hematogenous metastasis, while the sarcomatous component showed only hematogenous metastasis, with the myxosarcoma component being predominant.View full abstractDownload PDF (8634K) -
Akira Take, Enjo Hata, Humio Murayama, Yasunori Sohara, Tsuguo Hasegaw ...1992 Volume 32 Issue 6 Pages 925-929
Published: October 20, 1992
Released on J-STAGE: August 10, 2011
JOURNAL FREE ACCESSA 63-year-old male was admitted due to an abnormal chest X-ray shadow. Chest CT showed a tumor located on the right S6 involving parietal pleura (cT3) and mediastinal lymph node (#3, 4) swelling (cN2) Transbronchial cytology revealed poorly differentiated squamous cell carcinoma. Operation was performed on January 28 1987. Median sternotomy revealed a 6×4×4cm tumor in right S6 involving the visceral pleura, but not the parietal pleura (sT2). Swollen mediastinal and right upper clavicular lymph nodes (sN3) were denoted. Right middle and lower lobectomy with R3 mediastinal lymph node dissection was performed. Pathological examinations showed that the tumor was poorly differentiated adenocarcinoma originating in the right S6 with metastasis to mediastinal and upper clavicular lymph nodes. He was discharged after postoperative chemotherapy. The patient is now well five years after the operation without any recurrence. This case suggests that the super-radical lymph node dissection through median sternotomy can be effective for N3 lung cancer.View full abstractDownload PDF (5917K) -
Two Cases of Intrapulmonary Lymph Node Indistinguishable from Small Peripheral Carcinoma of the LungFumio Nagasaki, Hidehiko Okada, Hiroyuki Imai, Young-Chi Kim, Kosho Ta ...1992 Volume 32 Issue 6 Pages 931-936
Published: October 20, 1992
Released on J-STAGE: August 10, 2011
JOURNAL FREE ACCESSIntrapulmonary lymph nodes are ordinarily identified to the level of fourth-order bronchi and are seldom recognized on a plain chest roentgenogram. We experienced two cases of an intrapulmonary lymph node which were impossible to distinguish from small peripheral carcinoma of the lung preoperatively.
The first case was a 62-year-old female who was found to have a small peripheral pulmonary nodule in a preoperative chest film prior to cataract surgery. Subsequent chest CT scan six months later revealed pleural indentation suggestive of malignancy which prompted an exploratory thoracotomy.
The second case was a 60-year-old male with a smoking history of 30 cigarrettes per day for forty years who was discovered to have a coin lesion in a mass screening chest roentgenogram. Chest CT scan showed a small subpleural nodule with adjacent vascular convergences and pleural indentation. Malignancy could not be ruled out and an exploratory thoracotomy was performed.
Both lesions were about 1cm in size and located subpleurally in the lower lobes. Histological examinations revealed anthracotic lymph nodes without silica on polarized light.
We anticipate more frequent detection of small peripheral pulmonary nodules due to increasing availability of chest CT scans. Though reports of intrapulmonary lymph nodes are rare, it is to be considered as one of differential diagnoses for benign or malignant pulmonary nodules.View full abstractDownload PDF (8192K) -
Naofumi Suyama, Hideo Mashimoto, Jun Araki, Sadahiro Asai, Hiroyuki Mi ...1992 Volume 32 Issue 6 Pages 937-942
Published: October 20, 1992
Released on J-STAGE: August 10, 2011
JOURNAL FREE ACCESSIn recent years, reported cases of synchronous or metachronous primary lung cancers have been increasing as a result of the development of new diagnostic and therapeutic procedures for lung cancer. However, synchronous primary lung cancers in the same lobe are still rare.
We reported a case of synchronous primary lung cancers associated with hamartoma in the same lobe. A 72-year-old man with nonproductive cough showed two growing nodules in the left lower lobe of the lung on chest x-ray. Bronchoscopic biopsy revealed adenocarcinoma in B10 and carcinoma cells of undetermined histologic type in B6. Thereafter a small third nodule was noticed in S10 which retrospectively had been present on the initial chest x-ray, too.
Left lower lobectomy was performed and the pathological diagnosis was synchronous multiple lung cancers (adenocarcinoma and squamous cell carcinoma) associated with hamartoma in the same lobe. There was no metastasis to regional lymph nodes or to other organs and the postoperative course has been uneventful.
It is important to make a cytologic or pathological diagnosis for each nodule when multiple nodules have been found on chest x-ray. Although some authors have argued the increased risk of associated lung cancers in cases of pulmonary hamartoma, further collection of similar cases is needed to prove this contention.View full abstractDownload PDF (6574K) -
Hidenori Kondo, Fumiyuki Inoue, Kenji Nishii, Yoshiaki Moritani1992 Volume 32 Issue 6 Pages 943-948
Published: October 20, 1992
Released on J-STAGE: August 10, 2011
JOURNAL FREE ACCESSA 61-year-old man in whom sputum cytology revealed category D cells underwent selective brushing of all bronchial branches twice for determination of occult lung cancer. Squamous cell carcinoma in the left B1+2c was detected, therefore left upper lobectomy was performed. Although the cancerous lesion could not be detected macroscopically, a histopathological study showed a 2mm in situ squamous cell carcinoma in the left B1+2c (4th order bronchi).
This case indicated that deciding the site of lesion by selective brushing of all bronchial branches is very important in occult lung cancer.View full abstractDownload PDF (10083K) -
1992 Volume 32 Issue 6 Pages 949-975
Published: October 20, 1992
Released on J-STAGE: August 10, 2011
JOURNAL FREE ACCESSDownload PDF (3919K)
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