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Volume 33, Issue 7
Displaying 1-15 of 15 articles from this issue
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Kosuke Kashiwabara, Hiroyuki Nakamura, Yuji Fukai, Hiroshi Semba, Ryou ...1993 Volume 33 Issue 7 Pages 997-1003
Published: December 20, 1993
Released on J-STAGE: August 10, 2011
JOURNAL FREE ACCESSWe reviewed 31 cases of lung cancer detected in an emergency department. The chief complaints were dyspnea (22 cases), hemoptysis (3 cases), hemiplegia (3 cases), convulsion (1 case), shoulder pain (1 case) and numbness of the upper extremities (1case). The major causes of dyspnea were pleural effusion in adenocarcinoma cases and atelectasis in squamous cell carcinoma cases. The cause of hemoptysis was direct invasion of the main bronchus and the causes of hemiplegia and convulsion were brain metastasis. The cause of shoulder pain was invasion to the apical segment of the lung. The cause of numbness of the upper extremities was transient ischemic heart attack and adenocarcinoma was found incidentally. The clinical stage of 30 cases was III B or IV, and operation was not indicated, except in the case with transient ischemic heart attack. Eighteen of those cases (58%) had antecedent symptoms, such as cough and exertional dyspnea. However only 5 cases consulted any other doctor before consulting our emergency department. This study suggests that it is difficult to find lung cancer in the early stage.View full abstractDownload PDF (656K) -
Mitsuru Tanaka, Yasunori Taki, Eiichi Kohda, Masaru Satoh, Yasumasa Ok ...1993 Volume 33 Issue 7 Pages 1005-1010
Published: December 20, 1993
Released on J-STAGE: August 10, 2011
JOURNAL FREE ACCESSLung cancer in the peripheral pulmonary field has been diagnosed by means of diagnostic imaging and lung biopsy under bronchoscopy. Because conventional bronchoscopy does not facilitate direct observation of peripheral tumors and is less likely to provide appropriate specimens for histopathological examination, it is sometimes difficult to make a definitiv6 diagnosis of peripheral lung cancer. In the present study, peripheral areas of the affected bronchi were observed in 10 patients including 4 cases of T1N0M0 in primary lung cancer using a new type of endoscope developed by the authors, and lesions of the peripheral airway were examined. In all cases, abnormal findings were recognized endoscopically.
Endoscopic findings were classified into three types such as submucosal occlusion type, exposure type and nodular type. The accuracy of diagnoses will be increased by observing the affected bronchi in beripheral lung cancer.View full abstractDownload PDF (2498K) -
Masahiko Takenaka, Noriaki Iwahashi, Takashi Nakano, Juichiro Maeda, N ...1993 Volume 33 Issue 7 Pages 1011-1016
Published: December 20, 1993
Released on J-STAGE: August 10, 2011
JOURNAL FREE ACCESSA retrospective study on the five-year survival of 94 small cell lung cancer (SCLC) patients who had been treated with combination chemotherapy at Hyogo Medical College Hospital from 1978 to 1991 was carried out to identify factors which had prognostic significance for long-term survival. Prognosis was found to be significantly correlated with clinical stage (LD/ED), serum levels of NSE and LDH by multivariate analysis using Cox's proportional hazards model. Among these 94 cases, 5 (5.3%) survived more than 5 years. All of these had limited disease, normal serum NSE and LDH level and good performance status. Moreover, the chemotherapeutic response of these 5 patients was as follows complete remission in 3, partial remission and no change in 1 each, respectively.View full abstractDownload PDF (589K) -
Kouzo Yamada, Teruaki Yoshioka, Ikuo Nomura, Masanori Matsumura, Kazum ...1993 Volume 33 Issue 7 Pages 1017-1024
Published: December 20, 1993
Released on J-STAGE: August 10, 2011
JOURNAL FREE ACCESSTo facilitate the accurate diagnosis of small peripheral pulmonary nodules (less than 30 mm in diameter), we evaluated the use of three dimensional computed tomography (3D-CT). Conventional CT images and 3D-CT images were studied in 35 patients with peripheral pulmonary nodules (21 lung cancers, 14 benign lesions), prospectively. Conventional CT images were examined by an extended scale (window level -600, window width + 1900) using high resolution images. 3D-CT images were made using TCT-900 S, HELIX software (Toshiba, Tokyo).
Comparison of diagnoses based on CT findings and on pathological findings showed that 3D-CT images were more accurate for detecting involved vessels and displaying in the morphology of the lesions than conventional CT images. The specific features on 3D-CT findings of lung cancers, including the appearance of the margin and the relationship between lesions and surrounding vessels, were different from those of benign lesions.
Our results may suggest that 3D-CT images could have a significant clinical role in differentiating small peripheral pulmonary nodules by demonstrating the relationship between lesions and the surrounding vessels and displaying the morphology of the lesions.View full abstractDownload PDF (9125K) -
Kenji Horino, Hajime Imada, Hiromi Terashima, Shigeru Yamashita, Hajim ...1993 Volume 33 Issue 7 Pages 1025-1030
Published: December 20, 1993
Released on J-STAGE: August 10, 2011
JOURNAL FREE ACCESSSixteen patients with thymoma were treated by combined surgery and radiotherapy at the UOEH hospital between 1981 and 1990. Postsurgical staging was done according to Masaoka's classification. Total resection was performed in 5 of 5 stage I and II cases, partial resection in 6 and biopsy in 5 of 11 stage III and N cases. Radiotherapy was performed with total doses of 20-30 Gy for preoperative irradiation, 40-50 Gy for postoperative irradiation, and 50-60 Gy for curative irradiation. The overall 5-year survival rate and 5-year recurrence-free survival rate was 70.3%, and 51.5% respectively. The 3-year recurrence-free survival rate for patients who received total resection was 100%, while it was 37.5% for those who had biopsy only and 0% for those who had partial resection (p<0.05).
Resectability was the most significant factor affecting survival, but radical radiotherapy was effective for patients who received partial resection or biopsy only.
Local or pleural recurrence occtirred in 5 patients. Three of the 5 patients who had been treated with radiotherapy combined with surgery and chemotherapy are alive at 50 months, 52 months and 70 months after recurrence.View full abstractDownload PDF (687K) -
with Special Emphasis on the Significance of a Chest CT Diagnosis of Metastasis to Mediastinal Lymph NodesMasao Ichiki, Masanori Sakurai, Izumi Hayashi, Yukitoshi Sato, Sakae O ...1993 Volume 33 Issue 7 Pages 1031-1036
Published: December 20, 1993
Released on J-STAGE: August 10, 2011
JOURNAL FREE ACCESSIn order to clarify the significance and usefulness of a chest CT scan in the diagnosis of mediastinal lymph node metastasis, we investigated the correlation between the CT findings of mediastinal lymph nodes and the prognosis in patients with pathological N2 disease. Among 80 patients, 47 cases with negative lymph node invasion in a preoperative CT scan (group A) showed significantly longer survival (p<0.05) than 33 cases with positive findings (group B). The 5-year survival rate was 35% and 8 %, respectively. Furthermore, the patients with lymph node metastasis at one level demonstrated significantly better survival (p<0.01) than those at 2 levels or more. The 5-year survival rate was 44% and 6 %, respectively. The overall sensitivity in all lymph node levels turned out to be 42 % and needs further effort for improvement. The results of the present study suggest that preoperative lymph node metastasis in 2 or more levels detected by a chest CT scan requires careful consideration in making those patients candidates for surgical treatment.View full abstractDownload PDF (718K) -
Yasuyuki Kurihara, Yasuo Nakajima, Tohru Ishikawa, Sumiho Kurisu, Yasu ...1993 Volume 33 Issue 7 Pages 1037-1044
Published: December 20, 1993
Released on J-STAGE: August 10, 2011
JOURNAL FREE ACCESSCalcification in primary lung carcinoma is supposed to be a rare manifestation. On chest radiography, the presence of calcification in a nodular lesion is usually evidence of benign disease. However, with the better density resolution by CT, there have been several case reports of calcified primary lung carcinomas. To better understand the scope of the problem, we reviewed CT records of 131 patients undergoing initial examinations for the lung. From this information we were able to estimate the prevalence of calcification and to better evaluate the morphological features of calcified carcinomas. There were 12 cases with calcification (9%). Although most of the carcinomas could be differentiated from a benign process using size criteria and the morphological features of the calcification, there are still some cases (1.5%) that are difficult to discriminate from a benign process. thus the visualization of calcium in the tumor does not always exclude the diagnosis of bronchogenic carcinoma. Small cell carcinomas had a relatively high incidence of calcification. Four of 5 squamous cell carcinomas with calcification showed solitary and punctate calcification. Small carcinomas had multiple calcifications in the center of the mass.View full abstractDownload PDF (7868K) -
Yushi Saito, Yousuke Yamakawa, Hiroshi Niwa, Masanobu Kiriyama, Ichiro ...1993 Volume 33 Issue 7 Pages 1045-1052
Published: December 20, 1993
Released on J-STAGE: August 10, 2011
JOURNAL FREE ACCESSDouble primary cancer cases involving lung cancer in surgically resected cases were studied clinically. Among all cases of surgically resected lung cancer, there were 32 cases (5.6%) of double primary cancer. The mean age of these cases at resection was older than that of non-double cancer cases. The most common sites of the other primary cancer was the stomach (9 cases), followed by urinary bladder (5 cases), large intestine (5 cases) and breast (4 cases). As background variables, a family history of cancer, heavy smoking, silicosis and human T cell lymphotropic virus type I infection were found. The interval between the first and the second cancer was less than 5 years in 26 cases (74%), and the second cancers occurred more than 10 years after the first cancer in 6 cases. Good prognosis was obtained in metachronous cases with initial lung cancer, because the prognosis of double primary cancer is decided by that of the lung cancer, and there were few stage I synchronous lung cancer cases. In 89% of initial lung cancer cases, the other primary cancer was detected from symptoms and in 62% of subsequent lung cancer cases, lung cancer was detected by examination for metastasis of the first cancer. Special attention to the possibility of double primary cancer in patients with resected lung cancer is necessary for improvement of prognosis.View full abstractDownload PDF (801K) -
Tatsuro Odaka, Haruhiko Nakamura, Satoshi Masada, Toshimitsu Hiyoshi, ...1993 Volume 33 Issue 7 Pages 1053-1064
Published: December 20, 1993
Released on J-STAGE: August 10, 2011
JOURNAL FREE ACCESSTo investigate the genetic background of lung cancer patients, HLA-A, -B, -C, -DR and-DQ antigen frequencies were tested in 130 lung cancer patients, 91 of whom were treated by surgery and 39 by chemotherapy and radiotherapy, with 111 normal healthy individuals as controls.
The antigens associated with disease susceptibility, which were significantly increased in lung cancer patients, were HLA-Aw33 and-DQw3, while the antigens associated with resistance, which were significantly decreased in those patients, were HLA-Bw67, -Bw4, -Bw6, -DR4, -DRw53 and-DQw4. However, a significant difference was seen only in Bw6 (corrected p<0.05).
The survival data were analyzed by multivariate analysis, using Cox's proportional hazards model. The results showed that the relapse-free rate of resected cases possessing B5 antigen was lower than in resected cases without the B5 antigen, and that the survival rate of unresected cases with DR2 antigen was significantly higher than in unresected cases without the DR2 antigen (p<0.05).
In conclusion, certain HLA antigens may be significantly related to disease susceptibility, relapse and survival in lung cancer patients.View full abstractDownload PDF (1209K) -
Yuka Sasaki, Fumio Yamagishi, Kiminori Suzuki, Hiroshi Miyazawa, Kazut ...1993 Volume 33 Issue 7 Pages 1065-1069
Published: December 20, 1993
Released on J-STAGE: August 10, 2011
JOURNAL FREE ACCESSWe reported an autopsy case of metastatic lung tumor of choriocarcinoma originating from the retroperitoneum. A 24-year-old man complaining bloody sputum was admitted to our hospital. Plain chest X-ray film showed multiple nodules in bilateral lung fields, and abdominal CT showed retroperitoneal mass. The tumor was thought to be a renal tumor, but the patient rejected medical examination, so it was not possible to determine the histological type. The patient died due to respiratory failure 33 days later. Postmortem examination yielded a histological diagnosis of choriocarcinoma with pulmonary metastasis. The pathology of the testis was negative, so, the retroperitoneal mass was the primary lesion.View full abstractDownload PDF (9682K) -
Masahiro Yamada, Tomei Tsukamoto1993 Volume 33 Issue 7 Pages 1071-1076
Published: December 20, 1993
Released on J-STAGE: August 10, 2011
JOURNAL FREE ACCESSA 64-year-old female patient underwent surgery following the discovery of a shadow, measuring 13×19 mm in the left S5. During thoracotomy, numerous disseminated lesions in both the visceral and parietal pleura were observed. This was classified as D2 according to the Japanese Management Code of Lung Cancer. No retention of pleural fluid was noted. The surgical stage grouping was T4N2M0, Stage IIIB. Only the tumor was resected. Histology showed the cancer to be moderately differentiated adenocarcinoma and this was also true for the disseminated lesions. After the operation, chemotherapy consisting of MMC+CPM and MMC+OK432 was administered in the thoracic cavity. Further chemotherapy such as 5-FU+MMC+Ara-C was also introduced.
CT examinations in the 6th and 7th years after operation revealed multiple nodules with a diameter of 0.3 to 0.5 cm in the periphery of the left lung. These hardly changed in size, and the patient had no evidence of distant metastases. It has been nine years since the operation was performed and she is now in Performance Status 0.
Survival for a long period is usually rare with cases of D2 lung cancer. In this case, either chemotherapy has worked very well or this is a case of adenocarcinoma with a long natural course of development. At the moment, we are trying to decide which therapy to choose in the future, taking quality of life into account.View full abstractDownload PDF (5235K) -
Cytological Detection of Cilia and Brush Border-like StructuresHiroyuki Shiono, Osamu Kuwahara, [in Japanese], Yasuhiko Tani, Mitsuno ...1993 Volume 33 Issue 7 Pages 1077-1081
Published: December 20, 1993
Released on J-STAGE: August 10, 2011
JOURNAL FREE ACCESSA 57-year-old man had a round lesion on his chest X-ray film for 4 years and 8 months. No evidence of malignancy was revealed by two bronchoscopic examinations before admission to our hospital. Our own bronchoscopic examination also revealed no evidence of malignancy. Right lower lobectomy was performed, with a preoperative diagnosis of lung cancer on the basis of the X-ray findings.
The aspiration biopsy cytology specimen obtained at operation showed columnar epithelium with slight atypia and brush border-like structures. Histological examination showed tall and enlarged columnar epithelium, leading to a diagnosis of well differentiated papillary adenocarcinoma of the bronchial surface cell type. The specimens demonstrated cilia and brush border-like structures. When cytology specimens reveal cilia and brush border-like structures, it is difficult to determine whether a lesion is malignant or not.View full abstractDownload PDF (8594K) -
Toshinori Hashizume, Keiichi Kikuchi, Toyohiko Tsurumi, Yotaro Izumi, ...1993 Volume 33 Issue 7 Pages 1083-1089
Published: December 20, 1993
Released on J-STAGE: August 10, 2011
JOURNAL FREE ACCESSTwo cases of primary pulmonary non-Hodgkin's lymphoma were resected. The first case was a 48-year-old female. An abnormal infiltrative shadow with air bronchogram was pointed out in the right middle lobe. The right middle lobe and mediastinal lymph nodes were resected. The pathological diagnosis was non-Hodgkin's lymphoma, B-cell, diffuse, small cell type and lymph nodes were normal. She has had no evidence of recurrence for 1 year and 9 months after operation.
The second case was a 38-year-old male. An abnormal mass shadow with no air bronchogram was pointed out in the left upper lobe. The left upper lobe and mediastinal lymph nodes were resected. The pathological diagnosis was the same as in the first case. However, since metastasis was recognized in intralobal lymph nodes, postoperative chemotherapy (CHOP) was performed. He has had no evidence of recurrence for 1 year and 3 months after operation.View full abstractDownload PDF (9002K) -
Due to Large Cell Lung Cancer Treated with a Combination of Carboplatin, Etoposide, and RadiationSadanori Takeo, Masato Furuyama, Toru Muranaka, Yoshihiko Oshiumi1993 Volume 33 Issue 7 Pages 1091-1094
Published: December 20, 1993
Released on J-STAGE: August 10, 2011
JOURNAL FREE ACCESSA 62-year-old man with SVC Syndrome and tracheal stenosis due to large cell lung cancer was treated with combination therapy including carboplatin, etoposide and radiation. Complete disappearance of tracheal invasion by tumor was observed, and there was no subsequent recurrence in the trachea during the 4-month period preceding death due to malignant pleuritis.
Treatment was associated with no side effects other than mild myelosuppression, nausea, and loss of appetite, and the patient's quality of life was well maintained during therapy. We thus confirmed that this combination therapy was an effective form of emergency local palliation.View full abstractDownload PDF (3277K) -
1993 Volume 33 Issue 7 Pages 1095-1116
Published: December 20, 1993
Released on J-STAGE: August 10, 2011
JOURNAL FREE ACCESSDownload PDF (3368K)
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