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Volume 36, Issue 6
Displaying 1-18 of 18 articles from this issue
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Thin-section Computed Tomography Based on Radiologic-Pathologic CorrelationKouzo Yamada, Yuji Katou, Fumihiro Oshita, Ikuo Nomura, Kazumasa Noda, ...1996 Volume 36 Issue 6 Pages 721-730
Published: October 20, 1996
Released on J-STAGE: August 10, 2011
JOURNAL FREE ACCESSThe aim of this retrospective study was to evaluate the role of conventional computed tomography (CT) findings and thin-section CT findings in predicting chest wall invasion by lung cancer, and the results of surgery according to the depth of chest wall involvement. We reviewed 33 patients with lung cancer adjacent to the pleural surface who underwent conventional CT scanning and subsequent thoracotomy. All the patients were examined with a TCT-900S, HELIX scanner (Toshiba, Tokyo) following bolus intravenous contrast medium administration (conventional: 60ml; thin-section: 40ml). The conventional CT images (taken at 10mm intervals with 10mm collimation) and thinsection CT images (taken at 2mm intervals with 2mm collimation) were reconst ructed employing an extended scale (window level: 40; window width: 400) using standard images.
A comparison of the diagnoses based on the thin-section CT findings and pathological examination findings showed thin-section CT to be 82% accurate for chest wall invasion compaired to 48% for conventional CT.
We conclude that thin-section CT is useful for the accurate evaluation of chest wall invasion in lung cancer, especially for patients in whom findings by conventional CT suggest possible tumor invasion of the chest wall.View full abstractDownload PDF (3541K) -
Satoshi Yodonawa, Kiyofumi Mitsui, Eiichi Akaogi, Masataka Onizuka, Sh ...1996 Volume 36 Issue 6 Pages 731-737
Published: October 20, 1996
Released on J-STAGE: August 10, 2011
JOURNAL FREE ACCESSThirty-six cases of sternal bur hole pericardiotomy for cardiac tamponade caused by carcinomatous pericarditis associated with primary lung cancer were studied. Most patients had advanced disease, such as carcinomatous lymphangiosis, carcinomatous pleuritis, distant metastasis, and superior vena cava syndrome. Seventeen cases received treatment by only removal of pericardial effusion and the remaining 19 cases had local instillation of antineoplastic agents after drainage. In 30 cases the drainage tube was removed and the drainage period ranged from 3 to 30 days (mean 13.4). Seven cases had systemic chemotherapy or radiotherapy after drainage. In 27 out of 30 cases, there were no reaccumulation of pericardial effusion and no recurrence of cardiac tamponade more than 30 days and 13 cases could leave hospital. There was only one case of bleeding during operation. Median survival time was 78 days (3 to 904 days) and the cause of death was cancer and respiratory failure caused by carcinomatous lymphangiosis and carcinomatous pleuritis in almost all cases. We suggest that sternal bur hole pericardiotomy is one of the most effective and safe therapeutic method for cardiac tamponade caused by carcinomatous pericarditis.View full abstractDownload PDF (2832K) -
Yasuharu Nakahara, Yoshiro Mochizuki, Yukiko Nakahara, Tetsuji Kawamur ...1996 Volume 36 Issue 6 Pages 739-744
Published: October 20, 1996
Released on J-STAGE: August 10, 2011
JOURNAL FREE ACCESSThe past history and family history in patients with lung cancer and emphysema were reviewed by examining their medical records. The emphysema patients had been admitted because of complications such as respiratory failure, and their average age and cigarette indices were higher than those in the lung cancer group. According to their past history, the incidence of ischemic heart disease in the lung cancer group was higher than in the emphysema group. There was no difference between the two groups in terms of frequency of peptic ulcer history. However, age distribution at the onset of ulcers peaked in the 50's in the lung cancer group, whereas there were two peaks in the emphysema group, one in the 40's and the other in the 60-70's. As to family history, there was no difference between these two groups in the incidence of benign diseases, but the incidence of cancer among relatives in the lung cancer group was twice as high as in the emphysema group. Concerning the organs in which the cancers arose among the families of the lung cancer group, the frequency of incidence seemed to parallel that in the general population in Japan. This tendency was seen not only in blood relatives but in spouses. Smoking is widely thought to be one of the risk factors of lung cancer. Conversely, heavy smokers who do not have lung cancer may have suppressive factors against lung cancer, and the patients with emphysema we studied are good examples. So, our comparative study may give a suggestion to the surveillance of risk factors for lung cancer.View full abstractDownload PDF (638K) -
Shoko Kawanami, Hajime Imada, Hiromi Terashima, Hajime Nakata1996 Volume 36 Issue 6 Pages 745-752
Published: October 20, 1996
Released on J-STAGE: August 10, 2011
JOURNAL FREE ACCESSThe records of 38 patients with superior vena cava syndrome (SVC syndrome) due to malignancy and who received radiation therapy were retrospectively reviewed. The majority were lung cancers, constituting 28 of the 38 cases (73.7%). All patients were treated with conventional radiation doses ranging from 20 to 70Gy and good symptomatic response was observed in 31 cases (81.6%). The response appeared within 1.7±0.9 weeks on average (3 days-4 weeks), and performance status also improved in 50% of the patients. The median survival was 6.6 months. Long term survivors were seen mostly in patients with thymoma, and only one patient ever showed a recurrence of SVC syndrome. We conclude that radiotherapy can be an effective therapeutic modality for SVC syndrome and that it improves the quality of life in most patients.View full abstractDownload PDF (938K) -
Tetsuji Kawamura, Yoshirou Mochizuki, Yasuharu Nakahara, Yukiko Nakaha ...1996 Volume 36 Issue 6 Pages 753-757
Published: October 20, 1996
Released on J-STAGE: August 10, 2011
JOURNAL FREE ACCESSBetween January 1990 and December 1992, 240 patients visited or were referred to our hospital because of bloody sputum. Chest X-ray studies and cytologic examination of sputum were carried out on all patients and bronchoscopy in 185 patients of all. These examinations showed lung cancer in 54 patients, laryngeal cancer in 1 patient, old pulmonary tuberculosis in 16 patients, bronchiectasis in 11 patients, acute bronchitis in 11 patients, upper respiratory tract inflammation in 6 patients, middle lobe syndrome in 6 patients, bronchial asthma in 4 patients, atypical mycobacteriosis in 4 patients, diffuse panbronchiolitis in 3 patients, pneumonia in 2 patients, chronic bronchitis in 2 patients, active pulmonary tuberculosis in 2 patients, 4 other cases and an unknown cause in 114 patients. Our results revealed that approximately 23% of all the patients with bloody sputum suffering from lung cancer and that careful check-up and bronchoscopic examination is required for early diagnosis of lung cancerView full abstractDownload PDF (490K) -
Teruaki Koike, Masanori Terashima, Tsuneyo Takizawa, Tadashi Aoki, Yuz ...1996 Volume 36 Issue 6 Pages 759-764
Published: October 20, 1996
Released on J-STAGE: August 10, 2011
JOURNAL FREE ACCESSThe history of the lung cancer mass screening system in the Niigata Prefecture can be divided into four distinct periods. In the first period (1963-1977) there was no systematic mass screening, next there was experimental mass screening in designated districts (1978-1983). The third period (1984-1987) had standardized mass screening and the fourth is the period after the introduction of lung cancer mass screening under the Health and Medical Services Law (1988-1994). Cases resected at our institute (1592) were divided into four groups according to each period and the surgical results were analyzed.
The five-year survival rate improved steadily 34.0%, 50.4%, 54.4% and 57.8% respectively. The major reason for this improvement was the increase in p-Stage I cases, especially peripheral tumors 2cm or smaller in diameter. Judging from the reason for detection, the increase of small lung cancers is a result of increased mass screening.
With the increase in the detection of early stage lung cancer, the resection rate for lung cancer cases admitted to our institute reached 57.1% and the 5-year survival of admitted cases, including all stages, improved to over 30%, compared to less than 10% before the mass screening system was introduced.View full abstractDownload PDF (662K) -
Toshiaki Fujikane, Yuka Fujita, Tadakatsu Tsuji, Hiroyuki Matsumoto, N ...1996 Volume 36 Issue 6 Pages 765-774
Published: October 20, 1996
Released on J-STAGE: August 10, 2011
JOURNAL FREE ACCESSA retrospective study of 104 women and 375 men with primary lung cancer was conducted to clarify sex-associated difference in clinical features, with special reference to smoking habits. The ratio of smokers and the smoking index in women were significantly lower than those in men, respectively. Adenocarcinoma was the most common histologic type in women. Women showed significantly fewer symptoms than men. The ratios of women who were diagnosed as clinical stage I or IV and performance status (PS) 0 or 4 were significantly higher than those of men, respectively. However, these sex-associated differences of clinical features were closely related to differences in smoking habits between both sexes. In this study, smoking women showed significantly more symptoms than non-smoking women. The ratios of smoking women who were diagnosed as clinical stage N and PS 4 were significantly higher than those of nonsmoking women, respectively. Smoking habits had more important effects on clinical features of lung cancer in women than in men. There were no sex-associated differences in the survival of all cases or in the survivals by histologic type, clinical stage, PS, treatment or smoking habits. However, the survival of women with stage N adenocarcinoma was significantly better than that of men in the same group. There were no differences in clinical features, apart from smoking habits, between men and women with stage N adenocarcinoma.View full abstractDownload PDF (1147K) -
Hiroaki Nakamura1996 Volume 36 Issue 6 Pages 775-783
Published: October 20, 1996
Released on J-STAGE: August 10, 2011
JOURNAL FREE ACCESSThe recent increase in the incidence of “CT-detected lung cancer” demands further development in diagnostic methodology. CT-fluoroscopy is a new device to make visible even a small lesion, for which it has been adopted in performing lung biopsy while observing the lesion in real time.
As this CT-fluoroscopic lung biopsy method could be very useful for diagnosis of “CTdetected lung cancer”, we attempted to determine the merits and limitation of this new technique. In this study percutaneous lung biopsy was performed using a 21G needle while observing the lesion in real time. We estimated the extent of radiological exposure of the operators using a thermoluminescence docimeter (TLD). It was possible to exermine lesions as small as 4mm in diameter. The diagnosis was confirmed by histopathology, in 5 out of 7 cases. Pneumothorax occurred in 4 cases, but none of them required any treatment. We estimated the extent of radiological exposure of the operator's middle finger, back of the hand and forearm. The middle finger was found to be the most exposed part with a maximum exposure value of 34mSV in one case.
It can be concluded that in spite of the small numbers of cases this technique was found to be exceedingly useful for the diagnosis of very small “CT-detected lung cancer”. Another point to be added is that none of the complications required any treatment. The most significant problem with the method was the greater radiological exposure of part of the operator's body, which should be considered carefully in future.View full abstractDownload PDF (9285K) -
Yan Chen, Yasuki Saito, Masami Sato, Motoyasu Sagawa, Hiroto Takahashi ...1996 Volume 36 Issue 6 Pages 785-790
Published: October 20, 1996
Released on J-STAGE: August 10, 2011
JOURNAL FREE ACCESSWe investigated the expression ofBcl-2 protein, apoptosis and p53 protein immunohistochemically in resected non-small cell lung cancer.Bcl-2 protein was expressed in 24% of squamous cell carcinoma (SQ), 17% of adenocarcinoma (AD), and 17% of large cell carcinoma (LA). The staining with Apop Tag was positive in 35% of SQ, 27% of AD, and 25% of LA. p53 protein was detected in 42% of SQ, 20% of AD, and 42% of LA. In squamous cell carcinoma, the expressions ofBcl-2 protein, Apop Tag and p53 protein were higher than in other histologic types. The survival rate of patients with resectedBcl-2-positive carcinoma was higher than those with resectedBcl -2-negative carcinoma (95.5% vs. 81.4%). The expression ofBcl-2 protein was higher in stage I lung carcinoma than in others. The expression of p53 protein was higher inBcl-2 protein positive tumors than inBcl-2 protein negative tumors (p=0.06). The expression of Apop Tag was significantly higher inBcl-2 protein and p53 protein-positive tumors than in Bcl-2 protein-negative and/or p53 protein-negative tumors (p=0.018).View full abstractDownload PDF (2945K) -
Masaki Nagasawa, Tomei Tsukamoto, Keiko Yamada, Tohru Satoh, Yoshiki N ...1996 Volume 36 Issue 6 Pages 791-796
Published: October 20, 1996
Released on J-STAGE: August 10, 2011
JOURNAL FREE ACCESSWe encountered three cases of endobronchial growth of tumors. Case 1 was a 56-yearold man in whom chest roentgenogram revealed a tumor mass in left S3. Bronchoscopy showed a tumor obstructing the left upper division bronchus, and the results of a tumor biopsy demonstrated bronchial adenoma. Left upper lobectomy was performed. The tumor had an intrabronchial growth along the bronchial wall of left B3 bronchus, and the final pathologic diagnosis was typical bronchial carcinoid. Case 2 was a 51-year-old man whose chest roentgenogram revealed infiltration in right S2. Bronchoscopy revealed an endobronchial mass obstructing distal right B2b. Biopsy yielded a diagnosis of epithelial tumor. After right upper lobectomy, microscopic examination of the resected specimen showed that the tumor was composed mainly of clear cells. The final diagnosis was pulmonary metastasis of right renal cell carcinoma. Case 3 was a 62-year-old man. A chest roentgenogram revealed finger-like shadows in the left upper lung field and bronchoscopic examination showed a mass which almost totally occluded the left upper division bronchus. Left upper lobectomy was done. The tumor had an intrabronchial growth in the left upper division bronchus and carcinosarcoma was diagnosed.
Endobronchial growth of neoplastic processes is a well-recognized pattern of tumors originating within the lung and, less frequently, endobronchial metastases of extrathoracic tumors.View full abstractDownload PDF (8893K) -
Koichiro Kobayashi, Haruo Kimoto, Shouji Maeda, Masanobu Kitagawa1996 Volume 36 Issue 6 Pages 797-801
Published: October 20, 1996
Released on J-STAGE: August 10, 2011
JOURNAL FREE ACCESSBronchoscopy performed in a 34-year-old male who had been followed up for pneumonia and atelectasis, revealed a tumor occluding the right upper bronchus 15 months after onset of the disease, and the histological diagnosis was typical carcinoid tumor. Right upper lobectomy and lymph node dissection were performed. No lymph node metastasis was recognized and no recurrence has been observed for 13 months. The second patient was a 24-year-old female who had an abnormal shadow on a survey chest X-ray. Chest CT revealed a mass in left S1+2, and the histological diagnosis ofadenocarcinoma was obtained a open lung biopsy. Left upper lobectomy and lymph node dissection were performed. No lymph node metastasis was recognized and no recurrence has been observed for 12 months.View full abstractDownload PDF (8593K) -
Hiroshi Hirano, Terumasa Sashikata, Noriaki Tubota, Yoshiki Takada, Ka ...1996 Volume 36 Issue 6 Pages 803-807
Published: October 20, 1996
Released on J-STAGE: August 10, 2011
JOURNAL FREE ACCESSA case of a 66-year-old man with primary leiomyosarcoma arising in the lung from right main bronchus was reported. The patient consulted with complaints of cough and hemoptysis and an abnormal shadow was found on chest radiograph and cytological examination showed malignant findings. He was admitted to our medical center. Right middle and lower lobectomy was carried out on the suspicious diagnosis of lung cancer. Histologically, the resected specimen disclosed the tumor composed of spindle cells with blunt-ended nuclei and polygonal cells with pleomorphic nuclei. Immunohistological study disclosed that α-smooth-muscle actin was positive and that Vimentin was weakly positive. Ultrastructural findings revealed myofilaments with dense-patch in the cytoplasm of the tumor cells. The patient is alive 19 months postoperatively without any evidence of recurrence or metastasis. Primary pulmonary leiomyosarcoma wasdiagnosed.View full abstractDownload PDF (4318K) -
Shinichiro Watanabe, Yasutaka Nakamura, Kazuo Takeuchi, Jyunzou Simizu ...1996 Volume 36 Issue 6 Pages 809-814
Published: October 20, 1996
Released on J-STAGE: August 10, 2011
JOURNAL FREE ACCESSA 63-year-old man was referred to our hospital because of persistent cough. Chest Xray and CT scan revealed a nodular shadow in the middle lobe of the right lung and swollen lymph nodes in the mediastinum. Laboratory findings showed marked elevated serum levels of CEA (194.6ng/mL) and CA19-9 (4448U/mL). The patient underwent right middle lobectomy and mediastinal lymph node dissection. Histopathological examination showed papillary adenocarcinoma of the lung. Immunohistochemical study of the lung specimen showed positive staining for CEA and CA19-9 on the tumor cells. This demonstrated that this tumor was a CEA- and CA19-9-producing lung cancer. The patient was treated with 60Gy radiotherapy and 2 courses of hyperthermia one month after the operation. Chemotherapy using 4 UFT capusules a day was also started 2 months after operation. The values of serum CEA and CA19-9 levels were within the normal ranges 4 months after surgery.View full abstractDownload PDF (4504K) -
Ryo Masuda, Isao Tanaka, Masaharu Inoue, Yoshiaki Furuhata, Tamiko Tak ...1996 Volume 36 Issue 6 Pages 815-819
Published: October 20, 1996
Released on J-STAGE: August 10, 2011
JOURNAL FREE ACCESSDifferential diagnosis between an inflammatory pseudotumor infiltrating the chest wall and neoplasm was difficult. A 67-year-old man was admitted due to a mass with cavitation in the right upper lung field in the chest roentogenogram. The lesion gradually increased in size. Right upper lobectomy with chest wall resection was performed. The 48-54mm tumor was fixed to the chest wall suggesting invasion by malignant tumor. Histologically, the tumor was formed by spindle cells. Lymphocytes, histiocytes, plasma cells infiltrated bundles of spindle cells.
Immunohistochemical staining of the tumor cells revealed strongly positive findings for PCNA in both tumor and site of infiltration. However, the tumor cells had no immunoactivity for P53. Flow cytometric determination of the tumor cell DNA content conducted on paraffin-embedded tissues revealed a diploid pattern. The patients have remained well for three years without recurrence.View full abstractDownload PDF (3857K) -
Tomoko Katoh, Shoji Ohno, Satoshi Kitamura, Tsutomu Yamaguchi, Yasunor ...1996 Volume 36 Issue 6 Pages 821-825
Published: October 20, 1996
Released on J-STAGE: August 10, 2011
JOURNAL FREE ACCESSA 70-year-old male in whom rheumatoid pneumonitis had been diagnosed six years previously, was admitted because of a coin lesion seen on his annual chest X-ray examination. The lesion was located in left S9 and was cytologically diagnosed as malignant by percutaneous needle biopsy. A left lower lobectomy was performed and the tumor was determined to be a large cell neuroendocrine carcinoma by an immunohistochemical study. Because of vascular invasion, adjuvant chemotherapy was administered. We report this rare case because there have been no reports in the literature on this complication of rheumatoid pneumonitis and large cell neuroendocrine carcinoma.View full abstractDownload PDF (5607K) -
Koichi Tanaka, Takashi Miura, Shingo Takeno, Yozo Kawano, Yuzo Uchida, ...1996 Volume 36 Issue 6 Pages 827-831
Published: October 20, 1996
Released on J-STAGE: August 10, 2011
JOURNAL FREE ACCESSThe authers treated a 52-year-old female patient who had long-term survival for more than 6 years following resection of lung cancer. She was admitted to our hospital due to an abnormal shadow in the left upper lobe on chest X-ray film. A supraclavicular hard lymph node was already palpable, and serum CEA titers were elevated to 27.4ng/ml. Under a diagnosis of clinical N3 lung cancer, we performed a midsternotomy with anterolateral thoracotomy and cervical incision. The primary tumor was adjacent to the mediastinal pleura, and several hilar and mediastinal lymph node metastases were recognized macroscopically. Left upper lobectomy, and dissection of bilateral cervical and mediastinal lymph nodes were carried out with combined resection of the main pulmonary artery. The pathological diagnosis was adenocarcinoma (T3N3M0). Chemotherapy was performed postoperatively. She is doing well without recurrence. We considered that lung cancer with palpable supraclavicular lymph node metastasis should not simply be eliminated from the indications of curative operation.View full abstractDownload PDF (5646K) -
Shigeru Koyama, Takeo Ichiyoshi, Takayuki Kanbayashi, Yoichi Okazaki1996 Volume 36 Issue 6 Pages 833-838
Published: October 20, 1996
Released on J-STAGE: August 10, 2011
JOURNAL FREE ACCESSWe report two cases of fatal bilateral radiation-related pneumonitis following limited thoracic irradiation for lung cancer. Diffuse bilateral infiltrates, which had appeared at first within the projected field of irradiation in both patients at doses of 54 Gy and 56 Gy, respectively, grew even worse and respiratory failure developed rapidly. Progressive hypoxemia did not respond to steroids. Other potential causes of lung injury, such as infections, lymphangitic tumor, and exacerbation of antecedent interstitial lung disease, were excluded by postmortem examination. Pathological findings in unirradiated volumes of lungs were consistent with hyaline membrane changes.View full abstractDownload PDF (9590K) -
1996 Volume 36 Issue 6 Pages 839-860
Published: October 20, 1996
Released on J-STAGE: August 10, 2011
JOURNAL FREE ACCESSDownload PDF (3344K)
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