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Volume 34, Issue 1
Displaying 1-19 of 19 articles from this issue
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Motoyasu Sagawa, Yasuki Saito, Satomi Takahashi, Chiaki Endo, Katsuo U ...1994 Volume 34 Issue 1 Pages 1-5
Published: February 20, 1994
Released on J-STAGE: August 10, 2011
JOURNAL FREE ACCESSSensitivity and specificity were evaluated for lung cancer screening with chest x-ray films and sputum cytology in a high-risk group. These were evaluated for lung and laryngeal cancer screening, too. A total of 4718 screenees who were 40 years old or more, and with a Cigarette Index (no. of cigarettes/day×no. of years smoking) of 600 or more, in 12 municipalities underwent screening tests with chest x-ray films and sputum cytology during 1986-1987. All of them were followed up to the end of 1988 by means of a record linkage to the Miyagi Prefectural Cancer Registry. Using the definition that when the period from a negative screening test to diagnosis as lung cancer was within one year, the screening test was counted as false negative, the sensitivity and specificity for lung cancer were 75.0, 97.0%, respectively. The sensitivity and specificity for lung and laryngeal cancer were 76.9, 97.1%, respectively. Sensitivities and specificities using two other definitions were also calculated.View full abstractDownload PDF (549K) -
Kouzo Yamada, Teruaki Yoshioka, Ikuo Nomura, Masanori Matsumura, Kazum ...1994 Volume 34 Issue 1 Pages 7-14
Published: February 20, 1994
Released on J-STAGE: August 10, 2011
JOURNAL FREE ACCESSEight cases of resected peripheral lung cancer contiguous with pulmonary bullous disease were examined retrospectively to evaluate the clinical features and roentgenopathological correlation.
The eight patients were all males with a median age of 70 (range 53-75) years and were heavy smokers. Histological types of the carcinomas were poorly differentiated carcinoma (4 adenocarcinoma, 2 large cell carcinoma, 1 squamous cell carcinoma) except one well differentiated adenocarcinoma. Retrospective examination of chest radiographs in seven cases revealed that the radiologist had failed to detect small nodular lesions in three cases, while four cases had no lesions yet. These four cases were undetectable due to the site of the primary tumor superimposed on shadows of bullous disease on the initial chest radiographs, however these primary tumors were detected by computed tomography. Postoperative pathological evaluation showed advanced cases of lung cancer (above stage III A) in five patients.
These cases provide evidence for a strong association between bullous disease of the lung and primary lung cancer. The majority of patients with both diseases undergo surgery when the tumor is at an advanced stage, possibly because it is too late for accurate diagnosis of a concomitant cancer contiguous with pulmonary bullous disease. These eight cases suggest that lung cancer may arise in association with bullous disease, so that intensive examination is needed for early and accurate diagnosis of such lung cancers.View full abstractDownload PDF (9443K) -
Manabu Date, Katashi Satoh, Yuuichi Kobashi, Hideharu Nakano, Junpei N ...1994 Volume 34 Issue 1 Pages 15-22
Published: February 20, 1994
Released on J-STAGE: August 10, 2011
JOURNAL FREE ACCESSTo assess the usefulness of ultrasound (US) examination and US-guided fine-needle aspiration cytology in detecting cervical lymph node metastases, 27 cases of primary lung cancer were examined. Fourteen lymph nodes in 9 patients were demonstrated by US examination, and US-guided fine-needle aspiration cytology was performed on 13 lymph nodes in 8 patients. Ten of the 13 lymph nodes in 5 patients proved to be malignant. In 3 of the 5 patients with cervical lymph nodes metastases, no lymph nodes could be detected on palpation.
US examination of the neck combined with US-guided aspiration cytology, which is minimally invasive and safer, seems to be the modality of choice for the assessment of clinical staging in patients with primary lung cancer.View full abstractDownload PDF (12432K) -
Shoji Kudoh, Tetsuyuki Morikawa, Naotaka Nukariya, Kouichi Yamada, Kun ...1994 Volume 34 Issue 1 Pages 23-28
Published: February 20, 1994
Released on J-STAGE: August 10, 2011
JOURNAL FREE ACCESSSixteen cases of small cell lung cancer (SCLC) with poor prognosis were entered in a pilot study consisting of CDDP 30mg/m2, VCR 1mg/body×2 days, ADM 20mg/m2, ACNU 30mg/m2 and MMC 3mg/m2. All patients had extensive disease, and their performance status (PS) was 3 or 4. Among 15 eligible patients, 1 complete and 11 partial responses were obtained, resulting in an overall response rate of 75%. Although the median survival time was 3.7 months, the PS improved in 10 patients. Toxicity levels were acceptable, and no treatment-related death occurred. These results suggested that SCLC case with poor PS could improve their quality of life, using this combination chemotherapy.View full abstractDownload PDF (673K) -
Jun Araki, Hideo Mashimoto, Sadahiro Asai1994 Volume 34 Issue 1 Pages 29-36
Published: February 20, 1994
Released on J-STAGE: August 10, 2011
JOURNAL FREE ACCESSAlthough expandable metallic stents (EMS) are useful for extrinsic compression of the airway, their effectiveness is limited in cases of malignant endoluminal invasion because of tumor growth between the wires of the stent. A modified EMS with an internal surface of silicon gauze has been devised to prevent tumor invasion into the EMS. It was applied in 3 patients who complained of dyspnea due to tumor invasion in the respiratory tract. Insertion was easy under local anesthesia and rigid bronchoscopy was not required. All patients became free from dyspnea. Neither complications nor migration of the stent occurred. This new stent was useful for airway stenosis resulting from invasion of malignancy.View full abstractDownload PDF (11042K) -
Takahiko Horiguchi, Souichi Tachikawa, Seisi Tamaki, Makoto Kato, Masa ...1994 Volume 34 Issue 1 Pages 37-45
Published: February 20, 1994
Released on J-STAGE: August 10, 2011
JOURNAL FREE ACCESSTo investigate the clinical significance of BFP (basic fetoprotein) in lung cancer, serum BFP was measured in 50 patients with primary lung cancer and 40 patients with other non-malignant pulmonary diseases. For comparison, various tumor markers such as CEA, SLX, CA 19-9, CA 125, TPA, SCC, and NSE were also measured. In 58% of the patients with primary lung cancer, BFP was positive. This rate was higher than that of CEA and SLX, but lower than that of TPA. Histologically, BFP tended to occur more frequently in small cell carcinoma and large cell carcinoma.
CEA and SLX showed high specificity in adenocarcinoma, and SCC and NSE showed high specificity in squamous cell carcinoma and small cell carcinoma, respectively.
BFP levels tended to be higher in the advanced stages of disease and the change of BFP levels was related to chemotherapeutic response. However this tendency was not observed in patients who did not respond to chemotherapy; this was particularly pronounced in small cell carcinoma.
In the study of various tumor markers, a correlation was observed only between BFP and NSE, which suggests that these two tumor markers are valuable in combination assay.
In conclusion, measurement of BFP is a useful method of monitoring the effectiveness of treatment in primary lung cancer.View full abstractDownload PDF (3237K) -
Masaki Mori, Yuji Mori, Kouzo Yamada, Kenjiroh Fukuhisa, Akira Suzuki1994 Volume 34 Issue 1 Pages 47-52
Published: February 20, 1994
Released on J-STAGE: August 10, 2011
JOURNAL FREE ACCESSComputed tomography (CT) plays an important role in the evaluation of mediastinal lymph node involvement from lung cancer. However, unclear anatomic limits of nodal stations and the presence of areas which meet the criteria of several adjacent nodal stations were reported to be the reasons of poor agreement on CT designation of mediastinal nodes. This study was performed to investigate the usefulness of a newly proposed CT classification for designation of mediastinal nodal stations. Twenty physicians interpreted 202 mediastinal nodes shown on CT twice with a interval of four months. In the first reading session, they were asked to designate nodes according to the current “General Rules for Clinical and Pathological Records of Lung Cancer.” In the second session, they interpreted the nodes according to the new CT classification which adds clear anatomic limits and priorities of designations. Agreement on CT designation of nodal stations was 73.8±17.0%(mean±SD) in the first session and 82.8±16.8% in the second session; these were significantly different (p=0.0001). The new CT classification of mediastinal nodes seemed to be useful for improving agreement on designating mediastinal nodal stations.View full abstractDownload PDF (644K) -
Toshio Kasugai, Yosuke Yamakawa, Hiroshi Niwa, Masanobu Kiriyama, Ichi ...1994 Volume 34 Issue 1 Pages 53-58
Published: February 20, 1994
Released on J-STAGE: August 10, 2011
JOURNAL FREE ACCESSA total of 538 cases of primary lung cancer, excluding low grade malignant cases and double primary cases, who received operations from 1973 to 1992 were followed up. The overall 10-year survival rate was 25.9%: 26.1% in squamous cell carcinoma, 25.2% in adenocarcinoma, 32.0% in large cell carcinoma. Among cases of small cell carcinoma or adenosquamous cell carcinoma there was no 10-year survivor, the longest survivors being 9 years and 4 months in the former, and 9 years in the latter. According to stage the 10-year survival was 41.3% in stage I, 22.3% in stage II and 17.5% in stage III A. There was no 10-year survivor among cases of stage IIIB or stage IV. The longest survivors were 9 years and 2 months in stage IIIA, 2 years and 8 months in stage IV.
In 27 cases surviving more than 10 years that had been resected between 1973 and 1982, there was no statistically significant difference according to sex, age, histology or operation method but the rate for females was 37% while that for males was 19%. From the point of view of age, there was no relation between 10-year survival rate and age. The 50-59 age group had the highest 10-year survival. The rate for patients over 70 years old was 14%. There were significant differences of 10-year survival rate according to the pathological TN factor and curability of the procedure. There was no 10-year survivor who underwent an absolutely noncurative operation.View full abstractDownload PDF (613K) -
Shigeo Nakamura, Takashi Koshikawa, Tadashi Motoori, Kayoko Hayashi, T ...1994 Volume 34 Issue 1 Pages 59-68
Published: February 20, 1994
Released on J-STAGE: August 10, 2011
JOURNAL FREE ACCESSThe morphologic, immunologic and clinical features of 15 cases of primary pulmonary lymphomas were analyzed. There were 8 male and 7 female patients whose ages ranged from 21 to 71 years (mean, 54 years). The patients were heterogeneous in terms of the disease and were therefore histologically classified into three groups: low-grade Bcell non-Hodgkin's lymphoma (n=9); high-grade B- or T-cell non-Hodgkin's lymphoma (n=3); and lymphomatoid granulomatosis/angiocentric T-cell lymphoma (n=3). The present study also suggested that the low-grade B-cell tumors belonged to the category of malignant lymphoma arising from mucosa- or bronchus-associated lymphoid tissue (MALT or BALT).View full abstractDownload PDF (13441K) -
Shusuke Sone, Fumikazu Sakai, Toshio Kasuga, Takashi Kawai, Masayuki H ...1994 Volume 34 Issue 1 Pages 69-76
Published: February 20, 1994
Released on J-STAGE: August 10, 2011
JOURNAL FREE ACCESSIn order to improve the image quality of linear tomography performed with the Fuji Computed Radiography (FCR) system, we have examined one-dimensional unsharp mask filtering to reduce blur formed in the direction of tomographic swing. We determined a mask size and a weighting factor of the image processing suitable to obtain a quality tomogram. The mask size of “41×1 pixels for a 14×14” imaging plate, which modifies the original image data and results in demonstrating a peak frequency at 0.2 cycles/mm for spatial frequency spectrum, is superior in showing fine vessel structures and morphological features of pathology in the lung fields. An additional spatial frequency filtration in the direction perpendicular to the tomographic movement reduces the blur and clearly demonstrates object contours running parallel to the tube movement. However, the additional filtration increases the appearance of noise on the processed image and offsets the advantages of the processing.View full abstractDownload PDF (10194K) -
Osamu Mitomo1994 Volume 34 Issue 1 Pages 77-88
Published: February 20, 1994
Released on J-STAGE: August 10, 2011
JOURNAL FREE ACCESSTo assess the pulmonary function of lung cancer patients treated by radiotherapy, we tried qualitative and semiquantitative analysis of pulmonary scintigrams using 133Xe and 99m Tc-MAA.
Individual scores for ventilation, perfusion, and the ventilation-perfusion ratio of tumor-bearing lungs were calculated on the basis of healthy control cases in order to analyze whether, and to what degree, the tumor-bearing lung was functionally impaired. The score was proportional to the severity of impairment, and when the ventilation and perfusion of tumor-bearing lungs had a score of one or greater than one, the tumorbearing lung was functionally defined as an ‘impaired lung’.
Impaired lungs were demonstrated in 68% of tumor-bearing lungs. Hilar and left hilar-type cancers, clinically more advanced cancers, patients whose tumors were confirmed by bronchofiberscopy, small-cell and epidermoid cancers, etc., had higher rates of impairment and more severe impairment.
Many patients with impaired lungs had a worse prognosis, but patients in whom scintigraphy showed improvement after radiotherapy had a better prognosis.
It can be concluded that pulmonary scintigraphy scoring is capable of semiquantitatively indicating the degree of pulmonary impairment and is useful in deciding on a radiotherapeutic plan and predicting the outcome in pre-and post-radiotherapy lung cancer patients.View full abstractDownload PDF (10346K) -
Shozo Fujino, Toru Enokibori, Atsushi Katsura, Jun Hanaoka, Takaaki Ko ...1994 Volume 34 Issue 1 Pages 89-94
Published: February 20, 1994
Released on J-STAGE: August 10, 2011
JOURNAL FREE ACCESSThe relationship between epidermal growth factor receptor (EGFr) expression and various prognostic factors was investigated in 50 samples of human non-small cell lung cancer tissues. EGFr was measured by competitive binding assay using 125I-EGF. The mean EGFr level was 31.83±44.07 (mean±sd) fmol/mg · p for all lung cancers, 21.25±18.99 in stage I, 13.20±12.85 in stage II, 41.28±69.27 in stage IIIA, 30.08±34.28 in stage III B, 57.67±63.50 in stage IV, 26.12±33.21 for cancers without lymph node metastasis, 14.88±12.75 for cancers with hilar lymph node metastasis and 54.55±65.14 for cancers with mediastinal lymph node metastasis. The mean EGFr concentration was significantly higher in stage IV than in stage I, and the same significant difference was found between advanced stages (III and N) (45.31±58.53) and early stages (I and II) (19.39±17.86) too (p≤0.05). A tendency toward a possible relationship between receptor concentrations and lymph node status was found; the mean EGFr concentration was significantly higher in cases with advanced lymph node status (2 and 3) than in cases with early lymph node status (0 and 1) (23.00±29.25), while no relationship was observed between receptor concentrations and tumor size. No relationships were found between receptor concentrations and histological tumor type, gender and patient age. These data suggest that EGFr status may be important in the prediction of biologically high malignant potential.View full abstractDownload PDF (641K) -
Kousuke Kashiwabara, Hiroyuki Nakamura, Yuuji Fukai, Hirosi Semba, Ryo ...1994 Volume 34 Issue 1 Pages 95-102
Published: February 20, 1994
Released on J-STAGE: August 10, 2011
JOURNAL FREE ACCESSTwo cases of primary lung cancer presenting as nephrotic syndrome were reported. Case 1 was a 65-year-old male who had squamous cell carcinoma coincident with membranous glomerulonephritis. The nephrotic syndrome was relieved by the resection of the left upper lobe and chemotherapy. It did not relapse until he died of pneumonia, which suggested that squamous cell carcinoma had a close relationship with the nephrotic syndrome. Case 2 was a 56-year-old male who had small cell carcinoma metachronous with the membranous glomerulonephritis in the course of SLE. Small cell carcinoma had been in complete remission when the nephrotic syndrome occurred and appeared to have no relationship with the nephrotic syndrome. It could be considered that lupus nephritis was not associated with the nephrotic syndrome because of no recurrence of SLE (anti-Sm antibody: negative). From that point of view, it was suggested that there was no relationship between small cell carcinoma and the nephrotic syndrome.View full abstractDownload PDF (11907K) -
Yukitoshi Satoh, Shigehiro Tsuchiya, Sakae Okumura, Ken Nakagawa, Beni ...1994 Volume 34 Issue 1 Pages 103-108
Published: February 20, 1994
Released on J-STAGE: August 10, 2011
JOURNAL FREE ACCESSA 50-year-old male, who had undergone right nephrectomy for renal cell carcinoma two months previously, was admitted to the Cancer Institute Hospital because of cough, bloody sputum, chest pain and dyspnea. Chest X-ray film showed atelectasis in the left upper lung field. Bronchoscopic examination revealed a gray and irregular tumor completely occluding the left upper lobe bronchus. Polypectomy confirmed that it was metastatic renal cell carcinoma. Left upper the lobectomy was subsequently performed. The resected specimen demonstrated a polypoid tumor about 12mm in diameter showing a cylindrical growth in the left B1+2c. Histologically the tumor protruded into the bronchial lumen with a thin stalk. The tumor was compatible with the metastasis of clear cell carcinoma of the kidney and its surface was covered with squamous epithelium. Beneath the polypoid tumor, another metastatic focus circumscribed within the bronchial wall was discovered. It was believed that, in this case, the bronchial arteries served as pathways for the development of the metastases.View full abstractDownload PDF (9321K) -
Noritaka Isowa, Akira Yamanaka, Yohsuke Ohtake, Tatsuyoshi Ikeue, Shin ...1994 Volume 34 Issue 1 Pages 109-114
Published: February 20, 1994
Released on J-STAGE: August 10, 2011
JOURNAL FREE ACCESSA 54-year-old man was admitted complaining of bloody sputum. A chest-roentgenogram showed atelectasis of the right middle and lower lobes. The level of urinary 5-HIAA was elevated but carcinoid syndrome was not observed. Bronchoscopy revealed a dark reddish polypoid tumor occluding the truncus intermedius. Right middle and lower sleeve bilobectomy was performed. No metastasis to the lymph nodes was observed. The level of urinary 5-HIAA had normalized after the surgery. Light microscopic findings revealed large cells with abundant granular eosinophilic cytoplasm. Grimelius stain revealed numerous argyrophilic granules in the cytoplasm. However, Fontana-Masson stain for argentaffin granules and immunohistochemical stain for serotonin were negative. Ultrastructural analysis revealed numerous mitochondria and dense neurosecretory granules in the cytoplasm. 25 months after surgery the patient has not shown recurrence or metastasis.View full abstractDownload PDF (6942K) -
Shuji Ohishi, Koichi Katsura, Keisaku Sugiyama, Hideo Kobayashi, Takes ...1994 Volume 34 Issue 1 Pages 115-120
Published: February 20, 1994
Released on J-STAGE: August 10, 2011
JOURNAL FREE ACCESSA 51-year-old woman, complaining of cough and back pain, visited our hospital in May, 1989. The chest X-ray film showed a tumor shadow in the right middle lobe. As a result of further examinations, her illness was diagnosed as small cell lung cancer (T2, N2, Ml Stage IV). She received chemotherapy (CDDP+VP-16, ADR+ACNU+VCR), but did not respond. She had felt general fatigue, easy fatigability, and had pigmentation on the face and hands since May, 1990. She was admitted to our hospital again because of serious hypokalemia in July, 1990. Subsequently, she developed moon face, muscle weakness, skin pigmentation, hypertension, and metabolic alkalosis with hypokalemia which suggested Cushing's syndrome. Serum ACTH and cortisol levels were elevated. She died due to complications of pulmonary aspergillosis. The concentrations of ACTH in the tumor and in the metastatic lesion (liver) were high.View full abstractDownload PDF (8240K) -
Yoshihiko Arano, Junzo Shimizu, Katsuya Morita, Yoh Watanabe, Ryouichi ...1994 Volume 34 Issue 1 Pages 121-126
Published: February 20, 1994
Released on J-STAGE: August 10, 2011
JOURNAL FREE ACCESSA case of adenocarcinoma of the lung combined with pulmonary metastasis from osteosarcoma in a 13-year-old girl was presented. She had been treated for osteosarcoma of the right fibula and bilateral multiple pulmonary metastases.
The CT scan of the chest on admission revealed five mass shadows in both lung fields. She underwent a marginal resection of the right fibula and was treated by five courses of chemotherapy using high dose methotrexate and six courses of cisplatin + caffeine. After the chemotherapy, four of the mass shadows disappeared, and only the one in the left lower lobe remained. Partial resection of the left lower lobe was performed under the diagnosis of metastatic pulmonary osteosarcoma which was resistant to the induction chemotherapy. Histopathologically, the tumor was diagnosed as a primary adenocarcinoma of the lung.
A CT scan 4 months after the operation detected five mass shadows in both lung fields. On the second operation, five nodules in the bilateral lung were resected. Histopathologically, all of the nodules were diagnosed as pulmonary metastasis of osteosarcoma.View full abstractDownload PDF (8682K) -
Hiroyuki Taguchi, Hirotoshi Akita, Hironori Takekawa, Shousaku Abe, Ta ...1994 Volume 34 Issue 1 Pages 127-131
Published: February 20, 1994
Released on J-STAGE: August 10, 2011
JOURNAL FREE ACCESSA 66-year old man was admitted with hemoptysis. His chest x-ray film revealed a left hilar mass shadow. The cytology of sputum and brushing samples demonstrated the following mixed pattern: 1) some tumor cells had a high nuclear-cytoplasmic ratio and hyperchromatic nuclei; 2) the other cancer cells had a relatively low nuclear-cytoplasmic ratio and varied in size and shape. Mitotic figures were frequently observed. Since it was very difficult to determine the cell type of his tumor on the basis of the cytological findings, a left cervical metastatic lymph node was biopsied. The histopathological, immunohistochemical and electron microscopic findings of this specimen showed LCNEC. To our knowledge, this is the first reported case of LCNEC with various cytological findings.View full abstractDownload PDF (6980K) -
1994 Volume 34 Issue 1 Pages 133-139
Published: February 20, 1994
Released on J-STAGE: August 10, 2011
JOURNAL FREE ACCESSDownload PDF (994K)
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