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Volume 36, Issue 3
Displaying 1-18 of 18 articles from this issue
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Takashi Seto, Hiroshi Semba, Yuji Fukai, Ryouichi Kurano1996 Volume 36 Issue 3 Pages 213-219
Published: June 20, 1996
Released on J-STAGE: August 10, 2011
JOURNAL FREE ACCESSWe studied the biological characteristics and cytologic appearance of small cell lung cancer in cases with high CEA levels.
Fifty patients who had received at least 4 courses of systemic anticancer chemotherapy (CBDCA+VP-16).
Although treatment was not effective in cases with high CEA levels, there was a tendency towards prolongation of survival. Cytologically, the cells tended to grow in clusters and frequently had large, eosinophilic nucleoli.
There is a difference in biological characteristics and cytology between small cell lung cancer in cases with high CEA levels and those without. Therefore, there is a possibility that lesions defined as small cell lung cancer may include some other distinct cell types.View full abstractDownload PDF (3568K) -
Kouji Ohtomo, Yoshinori Kawabata, Tadashi Udagawa, Kazue Higuchi, Hiro ...1996 Volume 36 Issue 3 Pages 221-227
Published: June 20, 1996
Released on J-STAGE: August 10, 2011
JOURNAL FREE ACCESSAn immunohistochemical study was conducted to examine the histogenesis of lung tumors induced by intratracheal instillation of diesel particles into 344 female Fischer rat lungs.
Fifteen lung adenocarcinomas and 9 adenomas were studied, and diagnosis and classification of carcinoma was made according to the degree of differentiation and type of cancer nests.
In 10 adenocarcinomas, more than 40% of cancer cells showed positive staining for antisurfactant apo-protein (anti-SA) antibody. Only one carcinoma showed over 40% positive staining for anti-Clara cell antibody, and in this tumor 92% of cells stained positively for anti-SA antibody.
Among nine adenomas, 6 cases showed anti-SA positive rate of more than 40%. The percentage of positive staining with anti-Clara cell antibody was slightly higher in adenoma than that in carcinoma.
The alveolar type II cells are likely to be the main target cells for the lung cancer caused by diesel particles.View full abstractDownload PDF (11318K) -
Takahiro Mukaida, Motoi Aoe, Hiroshi Date, [in Japanese], Akio Andou, ...1996 Volume 36 Issue 3 Pages 229-235
Published: June 20, 1996
Released on J-STAGE: August 10, 2011
JOURNAL FREE ACCESSWe retrospectively studied 415 (26.8%) cases of female lung cancer treated at the Department of Surgery II, Okayama University Medical School between 1965 and 1994. Female lung cancer cases showed the following tendencies compared to male cases; increasing female: male ratio, greater number of younger patients, greater frequency of small adenocarcinomas, peripheral location, more cases detected by mass surveys.
The 5-year survival rate was significantly better in female cases than in male cases; 58.0% versus 41.5%, P<0.001. In patients with adenocarcinoma, detection by mass survey and curative operation resulted in better survival than male. Smoking was associated with increased squamous cell carcinoma incidence in females as well as in males. However, the ratio of smokers and squamous cell carcinoma in females that has decreased over the last 10 years.
These results suggest that detection of peripherally located early stage adenocarcinoma in a mass survey increased the chance of curative operation, and thus might be the cause of the better survival obtained in females than in males. Furthermore, smoking increased squamous cell carcinoma in female, however, it did not appear to be the main cause of the significant increase of lung cancer in women.View full abstractDownload PDF (876K) -
Kazuo Fukushima, Yoshinori Kawabata, Takashi Uchiyama, Yutzuki Nakajim ...1996 Volume 36 Issue 3 Pages 237-244
Published: June 20, 1996
Released on J-STAGE: August 10, 2011
JOURNAL FREE ACCESSA clinicopathologic study was carried out on the resected lungs of primary lung cancer patients (776 cases and 778 lesions; 561 males and 215 females) to examine the incidence of localized usual interstitial pneumonia (Lo-UIP) lesions, the clinicopathologic features of these Lo-UIP cases (N=128), and the relationship between Lo-UIP lesions and lung cancer. Pathologically confirmed Lo-UIP lesions (N=130) were found in 16.7% of all resected cancer lesions, and a gradual increase up to an average of 25.1% over the last four years was noted. Male and lower lobe predominancy were present in the Lo-UIP cases with a higher rate of squamous cell carcinoma or small cell carcinoma. In 13.3% of the Lo-UIP cases, cancer lesions were located in the midst of the Lo-UIP lesions, suggesting a pathogenetic correlation between cancer and fibrosisView full abstractDownload PDF (3777K) -
Akira Iyoda, Hideaki Miyamoto, Tetsurou Hamada, Ryuuichi Harada, Yukin ...1996 Volume 36 Issue 3 Pages 245-251
Published: June 20, 1996
Released on J-STAGE: August 10, 2011
JOURNAL FREE ACCESSWe treated six cases of diffuse malignant pleural mesothelioma (MPM) with panpleuropneumonectomy with mediastinal lymph node resection. Four patients were male and two were female, and their median age was 53.3 years. The site of malignant pleural mesothelioma was on the right in all patients. Presenting symptoms were dyspnea in three patients, and chest pain, cough in one each. One patient was asymptomatic. For preoperative diagnosis, five patients underwent pleural biopsy and the other received thoracoscopy, all of which yielded a definitive diagnosis. Microscopic findings showed invasion of mesothelioma cells in the insertion tract of the thoracoscope in the patient who had undergone thoracoscopy. Pathologic examination of the resected specimens revealed three epithelial and three biphasic MPMs. In all biphasic MPMs, metastatic mediastinal lymph nodes were recognized. This suggests the need of mediastinal lymph node resection at panpleuropneumonectomy. There was no perioperative death. Three patients remain alive with no evidence of recurrent disease, one of whom has survived for over 4 years. Local recurrence and distant metastasis were recognized in two biphasic MPMs. In these cases, patients with epithelial malignant pleural mesothelioma demonstrated better survival than patients with biphasic MPMs.View full abstractDownload PDF (2639K) -
Akira Sugiyama, Motoyuki Katayama, Mitsuharu Kokubo, Kenichirou Tateya ...1996 Volume 36 Issue 3 Pages 253-259
Published: June 20, 1996
Released on J-STAGE: August 10, 2011
JOURNAL FREE ACCESSTen patients with pleuritis carcinomatosa due to lung cancer accompanied by massive effusion were treated by tube drainage of effusion followed by instillation of MMC and OK-432 (adhesion therapy). Pleural effusion was controlled in all patients without recurrence but one showed reaccumulation 2 months later. Acute side effects of fever and chest pain were tolerable.
The average hospital stay for patients receiving adhesion therapy alone was 34 days, versus 93 days for patients receiving tube drainage therapy and radiotherapy. The average survival time for 7 patients who died of this disease was 273 days.
Serial CE-CT scans were useful to evaluate the stage of the disease and decide on therapeutic and follow-up policy. All cases had mediastinal metastasis (N2-3). On follow up CT scan, marked pleural thickening and varying degree of loss of lung volume were noticed. Individual cases with life expectancy several months are best managed by tube drainage and instillation of adhesion-inducing agents.View full abstractDownload PDF (5550K) -
Kouzo Yamada, Takeshi Isobe, Yuji Katou, Fumihiro Oshita, Ikuo Nomura, ...1996 Volume 36 Issue 3 Pages 261-270
Published: June 20, 1996
Released on J-STAGE: August 10, 2011
JOURNAL FREE ACCESSThirty cases of resected peripheral lung cancer detected only by computed tomography (CT) were examined retrospectively to evaluate their clinical features and roentgenop athological correlations.
The 30 cases comprised 16 males and 14 females with a median age of 66 (range 39-79) years. Abnormal shadows were detected in five due to some complaints, eight under observation and the remainder by CT screening. The CT images were classified into groups the air density type with obscure margins and the solid density type with clear margins. The reasons why the primary tumors were overlooked on plain chest X-ray images were that the former had vague lesions and the latter were located in the paramediastinal area or behind the ribs. Pathological evaluation showed stage I in 25 cases (83%), notably in 21 cases of the air density type.
We conclude that CT is more useful than a plain chest X-ray for early detection of lung cancer. Chest CT examinations can therefore be expected to be useful in screening for lung cancer.View full abstractDownload PDF (14674K) -
Ritsuko Kunitake, Kazuyoshi Kuwano, Masayuki Kawasaki, Naoki Hagimoto, ...1996 Volume 36 Issue 3 Pages 271-276
Published: June 20, 1996
Released on J-STAGE: August 10, 2011
JOURNAL FREE ACCESSWe investigated the association between DNA damage or apoptosis and the expression of p53 protein in untreated adenocarcinoma and squamous cell carcinoma of the lung, using the method of terminal deoxynucleotidyl transferase mediated biotin-dUTP nick end labeling (TUNEL) and immunohistochemistry (IHC) for p53 protein, respectively. We performed IHC and TUNEL on formalin-fixed, paraffin-embedded tissues from 23 cases of lung cancer (11 of adenocarcinoma and 12 of squamous cell carcinoma) obtained by lobectomy. The results showed that TUNEL-positive cells were detected in 6 of 23 cases (26%), and p53 proteins were detected in 12 of 23 cases (52%). There was no significant difference in the number of p53 positive cases in TUNEL-positive cases (4/6cases) or in TUNEL-negative cases (8/17 cases). There was no direct association between apoptosis and the expression of p53 in this study. We speculate it may be due to the presence of other factors and pathways in the process of apoptosis.View full abstractDownload PDF (5498K) -
Takuya Kobayashi, Katashi Satoh, Yoshirou Kawase, Hitoshi Takasima, Ma ...1996 Volume 36 Issue 3 Pages 277-283
Published: June 20, 1996
Released on J-STAGE: August 10, 2011
JOURNAL FREE ACCESSCT findings of seven cases (3 organizing pneumonia, 4 old tubeculosis) of localized inflammatory lesions confirmed by thoracotomy were evaluated. The preoperative chest CT findings of all cases showed findings characteristic of peripheral lung cancer. It was difficult to exclude the possibility of peripheral lung cancer from these 7 cases based only on analysis of the relationship between existing lung structures and lesions. For differential diagnosis, it was important to analyze the findings suggestive of inflammatory lesion; such as accompanying shadows, pleural thickening, bronchiectasis, bronchial wall thickening surrounding the lesion, and concave margin of the lesion due to fibrotic construction.View full abstractDownload PDF (7182K) -
Masanori Nishikawa, Yutaka Matsumoto, Hirotada Ikeda, Takao Okubo, Yuk ...1996 Volume 36 Issue 3 Pages 285-289
Published: June 20, 1996
Released on J-STAGE: August 10, 2011
JOURNAL FREE ACCESSA 49-year-old male was admitted with dyspnea and cough, eight months after the onset of symptoms. The chest radiograph showed a diffuse pleural tumor in the right hemithorax. It was diagnosed as mixed-cell type mesothelioma by percutaneous biopsy. Five courses of cisplatin-based combination chemotherapy and thermoradiotherapy remarkably reduced the size of tumor. He is alive 29 months after the onset of symptoms, 20 months after the beginning of the therapy. Although diffuse malignant pleural mesothelioma has a poor prognosis, combination chemotherapy and thermoradiotherapy may offer better treatment for patients with malignant mesothelioma.View full abstractDownload PDF (7642K) -
Shunsuke Yamada, Akio Kosaka1996 Volume 36 Issue 3 Pages 291-295
Published: June 20, 1996
Released on J-STAGE: August 10, 2011
JOURNAL FREE ACCESSA 36-year-old man presented with a painful chest mass, 3cm in diameter, adjacent to the left sternal border. A chest CT scan showed a probable soft tissue tumor. T1-weighted magnetic resonance imaging (MRI) revealed a hypo-intense mass that was homogeneously enhanced with Gd-DTPA in the sternal marrow cavity, but CT and bone scan did not comfirm the sternal bone involvement of the tumor. Preoperative biopsy did not yield a definitive diagnosis, therefore it was widely excised first for definitive diagnosis and treatment. Macroscopically, the mass appeared to originate in the 2nd intercostal space and was attached to the sternum, and the 2nd and 3rd rib cartilage. The histological appearance of the tumor was consistent with leiomyosarcoma, and frequent mitotic activity (5 mitoses/ high power field) was noted. The bone marrow space of the resected sternum was almost completely replaced by tumor tissues, and the surgical margin was positive. Extensive sternectomy was performed. MRI findings closely reflected the extent of tumor within the sternal marrow cavity. Despite curative resection and postoperative chemotherapy, local recurrence appeared 12 months after the second operation. The recurrence tumor was totally removed and the patient was treated postoperatively with chemotherapy. There has been no sign of local recurrence and metastasis up to now.View full abstractDownload PDF (6911K) -
Hideki Kikuma, Hideo Kobayashi, Naokazu Nagata, Teruhiro Aoki, Shinsuk ...1996 Volume 36 Issue 3 Pages 297-301
Published: June 20, 1996
Released on J-STAGE: August 10, 2011
JOURNAL FREE ACCESSA 65-year-old male admitted to our hospital for evaluation of an abnormal shadow on chest roentgenogram. Chest X-ray and CT scans revealed a 2.8×2.2cm sharply circumscribed tumor in the right middle lobe. The diagnosis of papillary adenocarcinoma was obtained by transbronchial biopsy and right middle lobectomy was performed. The resected tumor showed a cystic appearance and consisted of copious extracellular mucus and small clusters of cancer cells suspended in the mucus. Therefore it was finally diagnosed as muconodular adenocarcinoma. It was suggested that the tumor showed differentiation to bronchial gland because ultrastructurally most cancer cells had features of oncocytes characterized by numerous swollen mitochondria. Although the preoperative diagnosis of muconodular adenocarcinoma was difficult due to scanty cellular component, small foci of papillary adenocarcinoma found in the central site of tumor were recognized in the biopsy specimen of the present case.View full abstractDownload PDF (7096K) -
Takeo Ojika, Norio Mukouyama, Noriko Hattori, Masayuki Suzuki, Toyonor ...1996 Volume 36 Issue 3 Pages 303-306
Published: June 20, 1996
Released on J-STAGE: August 10, 2011
JOURNAL FREE ACCESSA 46 year-old female was hospitalized as an emergency case because she had severe dyspnea due to suppression of the left main bronchus by a large anterior mediastinal mass. The anterior mediastinal mass was diagnosed as small cell carcinoma by percutaneous biopsy. We performed chemotherapy (CBDCA 300mg/m2, day 1, VP16, 100mg/m2, days 1, 2, 3, two cycles) which reduced the size of the tumor. In addition, she had a 2 cm in diameter right breast cancer diagnosed as invasive ductal carcinoma. The anterior mediastinal tumor was removed by total thymectomy and the breast cancer by simultaneous modified radical mastectomy. The anterior mediastinal mass was separated from other organs except for the thymus and no other primary tumor was found. Although she had a few axillary lymphnode metastases of breast cancer in the Ia region, there were no lymphnode metastases in the mediastinum. There has been no other reported case of synchronous thymic small cell carcinoma and breast cancer.View full abstractDownload PDF (6800K) -
Masaru Nishitsuji, Takuma Bandou, Masahide Yasui, Masaki Fujimura, You ...1996 Volume 36 Issue 3 Pages 307-312
Published: June 20, 1996
Released on J-STAGE: August 10, 2011
JOURNAL FREE ACCESSA 49-year-old woman was admitted with dry cough, and consolidation in the right middle lobe was predominant on a chest X-ray film in May 1994. Transbronchial biopsy was performed, and pathologically the diagnosis was bronchiolo-alveolar cell carcinoma. Five months after the surgery, cavitary shadows appeared in the left lung. The number of cavitary shadows increased, and the patient died due to respiratory failure. Intrapulmonary metastasis of lung cancer rarely presents with multiple cavitary shadows. In this case, a check-valve mechanism caused by the infiltration of cancer cells into the bronchiole may be responsible for the formation of multiple cavities.View full abstractDownload PDF (9579K) -
Kenji Doi, Ryuichiro Namba, Ritsuo Matsui, Tadafumi Shimizu, Kozo Suey ...1996 Volume 36 Issue 3 Pages 313-317
Published: June 20, 1996
Released on J-STAGE: August 10, 2011
JOURNAL FREE ACCESSA 58-year-old female was admitted because of an abnormal shadow about 10 mm in diameter in the right middle lung field on chest X-ray. No malignant findings were recognized on chest CT, chest MRI or bronchofiberscopy. Bronchial arteriograms repeatedly displayed several tumor vessels and tumor stain. Lung Tl-201 SPECT showed a hot spot in this tumor in the early images and wash out in the delayed images. A diagnosis of sclerosing hemangioma was suspected before the operation. We performed the enucleation of the tumor and obtained a histological diagnosis of sclerosing hemangioma of the lung.View full abstractDownload PDF (6250K) -
Katsuhiro Nakagawa, Tsutomu Yasumitsu, Yahiro Kotake, Kenjirou Fukuhar ...1996 Volume 36 Issue 3 Pages 319-324
Published: June 20, 1996
Released on J-STAGE: August 10, 2011
JOURNAL FREE ACCESSSeven operated cases of small intestinal cancer metastatic from primary lung cancer were reported. All were men and their mean age was 61 years old. Five were large cell carcinoma and two were adenocarcinoma. Five patients with intra-abdominal lymph node metastasis died within 5 months after the abdominal operation. Two patients who had no intra-abdominal lymph node metastasis are alive more than 3 years after the abdominal operation. A total of 126 cases of metastasis to the small intestine have been reported in the literature in Japan, the prognosis of patients with small intestine metastasis from primary lung cancer was extremely poor. If, however, the primary lung cancer had been resected and the intra-abdominal lymph node metastasis had not been present, the outcome may be improved by abdominal surgery.View full abstractDownload PDF (5535K) -
Rieko Kawanami, Tetsuji Kawamura, Terumi Kimoto, Yasuharu Nakahara, Yo ...1996 Volume 36 Issue 3 Pages 325-330
Published: June 20, 1996
Released on J-STAGE: August 10, 2011
JOURNAL FREE ACCESSLung adenocarcinoma (c-T1N2M1) was diagnosed in a 57-year-old male who was treated with a regimen of carboplatin, mitomycin C and vindesin. On the 17th course of chemotherapy, chest pain developed 5 minutes after azasetron injection ECG showed STsegment elevation in II, III and aVF leads. After treatment of isosorbide dinitrate, the ECG was nornalized and chest pain disappeared. He experienced chest pain only when he received intravenous injections of Azasetron. A treadmill exercise test showed no evidence of ischemic change. It was therefor considered that azasetron induced vasospastic angina of the inferior wall. He died 4 months later due to respiratory falure caused by lung metastasis. Autopsy revealed that coronary arteries showed no evidence of atherosclerosis.
Although no other study has reported the cardiovasculaer side effect of 5-HT3 antagonists in Japan, we should be aware of the possibility of coronary vasospasm induced by one-shot intravenous injection of azasetron.View full abstractDownload PDF (2697K) -
1996 Volume 36 Issue 3 Pages 331-335
Published: June 20, 1996
Released on J-STAGE: August 10, 2011
JOURNAL FREE ACCESSDownload PDF (702K)
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