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Volume 37, Issue 1
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[in Japanese], [in Japanese]1997 Volume 37 Issue 1 Pages 1-4
Published: February 20, 1997
Released on J-STAGE: August 10, 2011
JOURNAL FREE ACCESSDownload PDF (353K) -
Kimitaka Kakizawa, Yutaka Yamaguchi, Mitsutoshi Shiba, Hiroshi Shirosa ...1997 Volume 37 Issue 1 Pages 5-11
Published: February 20, 1997
Released on J-STAGE: August 10, 2011
JOURNAL FREE ACCESSMutations of the p53 gene are one of the most frequent genetic abnormalities in lung cancer. However, the relationship with metastatic spread in lymph nodes is still unclear. We investigated 47 specimens of primary non-small cell lung cancer and 8 specimens of metastatic lymph nodes, using polymerase chain reaction single-strand conformation polymorphism (PCR-SSCP) analysis and sequencing on exon5 to exon9 of the p53 gene. In the primary tumors, 12 mutations (25.5%) were identified. Three samples presented G to T transversion, reflecting the influence of benzopyrene contained in tobacco smoke, whereas no significant correlations were found between p53 mutations and smoking indices. In lymph node metastases, 2 mutations were found, which were identical with those in the primary tumors. In these cases, both aberrant and normal SSCP bands were observed. Quantitative analysis of aberrant and normal bands revealed that there was no significant difference in aberrant-normal p53 ratio between the primary tissue and metastatic lymphnodes. Our results suggest that there is no correlation between p53 mutation and lymph node metastasis in non-small cell lung cancer.View full abstractDownload PDF (4898K) -
Bumpei Kimura, Tatsuo Kidokoro, Mitsuru Hashizume, Shouji Tokimitsu, K ...1997 Volume 37 Issue 1 Pages 13-21
Published: February 20, 1997
Released on J-STAGE: August 10, 2011
JOURNAL FREE ACCESSTo evaluate the treatment of lung cancer in local community hospitals, we analyzed the result of 403 patients with lung cancer admitted to 7 hospitals in Tokyo between 1991 and 1993. The mean age was 70 and the clinical stage distribution was: stage I 28%, stage II 3%, stage IIIA 16%, stage IIIB 22%, and stage IV 28%. The advanced disease was in majority. Treatment of symptoms only was performed in 43% of the patients, and resection was performed in 34%. Excluding 2% of unknown cases, the reasons for detection of lung cancer were classified into 3 groups: symptoms (56%), mass survey (15%), cases on examinations for other diseases (27%). The percentages of clinical stage I+II cases in each group were 13%, 57%, and 56% respectively, with the group detected due to symptoms being significantly lower than others. The resection rates were 20%, 68%, 43% respectively, and with significant differences among the 3 groups. Forty percent of the patients detected by symptom had had regular medical consultation for chronic diseases. In local community hospitals, the diagnostic system should be organized by chest physicians, and when lung cancer is detected before symptoms develop, we can expect the better results of lung cancer treatment.View full abstractDownload PDF (1010K) -
Shoichi Katayama, Kikuo Nakano, Takehiko Hiramoto, Masanobu Hayakawa, ...1997 Volume 37 Issue 1 Pages 23-32
Published: February 20, 1997
Released on J-STAGE: August 10, 2011
JOURNAL FREE ACCESSTwenty one cases of malignant mesothelioma were encountered from April, 1975 through March, 1995 in Kure National Hospital. All except one died of their disease. More than 70% of cases had a history of asbestos-exposure related occupations, such as shipyard worker, or steel worker, and the male: female ratio was 17: 4. The ratio of autopsied cases of mesothelioma compared to all autopsied cases in our institution is constantly higher than that for the entire country, and especially statistically significant during 5 years, 1985 through 1989.
Crocidolite is the most common asbestos fiber in thelungs of mesothelioma patients, followed by amosite, and these two asbestos fibers are accounted for 80% of all asbestos fibers detected in this study. The numbers of asbestos fibers detected in the autopsied lungs were 10 times more in 6 cases autopsied before 1988 than in 7 cases autopsied after 1989, indicating heavy exposure of asbestos fibers in Kure, one of the biggest naval shipyards in Japan until the end of World War II. It is important to warn of the development of mesothelioma and all persons with a high rate of asbestos exposure should be followed up carefully.View full abstractDownload PDF (3037K) -
Mayumi Seto, Keiko Kuriyama, Shoji Kido, Chikazumi Kuroda, Ken Kodama, ...1997 Volume 37 Issue 1 Pages 33-40
Published: February 20, 1997
Released on J-STAGE: August 10, 2011
JOURNAL FREE ACCESSTo evaluate radiotherapeutic and/or chemotherapeutic effects on lung cancers, westudied changes in size, changes in shape, and contrast enhancement of tumors on CT and MR images. Twenty one patients with primary lung cancers (8 squamous cell carcinoma, 12 adenocarcinoma, 1 large cell carcinoma) reviewed neoadjuvant therapy followed by surgical resection. CT and MR images were comformed with histologic specimens to evaluate therapeutic effects according to the criteria of General Rule for Clinical and Pathological Record of Lung Cancer. In 11 patients with partial response (PR), 5 histologically showed complete response (Ef. c), and in 10 patients with no response (NC), 5 were histologically classified as partial response (Ef. 2). Hence, size criteria tend to underestimate histological therapeutic effects. All 5 patients with Ef. c were PR in terms of size criteria, and residual tumors morphologically changed into a irregular shape and also remarkably diminished contrast enhancement.
According to our results, we proposed the following three criteria for Ef. c: 1) more than 50 percent size reduction; 2) morphological changes in primary lung cancer (round or oval shape before neoadjuvant therapy to starlike or triangular shape aftertherapy; 3) Contrast enhancement disappeared in residual tumors.View full abstractDownload PDF (6693K) -
Takashi Seto, Hiroshi Semba, Yuji Fukai, Atsushi Inayoshi, Ryouichi Ku ...1997 Volume 37 Issue 1 Pages 41-45
Published: February 20, 1997
Released on J-STAGE: August 10, 2011
JOURNAL FREE ACCESSWe performed thoracoscopy on lung cancer cases with cytology-negative pleural effusion (examinations for pleural effusion were done more than 2times). Thoracoscopy was performed by flexible bronchoscopes under local anesthesia. Nineteen lung cancer patients with pleural effusion but without metastatic pleural tumor in chest CT were studied. Whose pleural effusion was exudative, lymphocyte dominant, had a low level of ADA, and a negative study of malignant cells in cytological pleural effusion smears. Seventeen patients were untreated lung cancer patients and 2 had been received resection. Histological diagnosis ofmetastasis to pleural cavity were made in 11 of untreated lung cancer patients and in one of the resected patients. Of the 6 cases of non-spesific inflammation no accumulation of pleural effusion was observed after only drainage. Although there is the exception of non-hemorrhagic and non-exudative effusion, pleural effusion of lung cancer are treated as malignant effusion, even in the cases whose effusion are negative for malignant cells. Thoracoscopy by the flexible bronchoscope is a simple procedure without major side effects, using equipment which pulmonary physicians are most accustomed to. The examination enables us to make correct staging for lung cancer.View full abstractDownload PDF (2778K) -
Seiji Shiotani, Kouzo Yamada, Fumihiro Oshita, Ikuo Nomura, Kazumasa N ...1997 Volume 37 Issue 1 Pages 47-54
Published: February 20, 1997
Released on J-STAGE: August 10, 2011
JOURNAL FREE ACCESSTo establish diagnostic criteria for small solitary pulmonary nodules, the findings of thin-section computed tomography (CT) were compared with pathological findings. We evaluated thin-section CT images and compared them with pathological findings in 23 specimens of resected benign lesions less than 20mm in diameter located in the peripheral region. The thin-section CT images were reconstructed using 2mm thick sections taken by TCT-900S, HELIX (Toshiba, Tokyo) and were examined with two different windows and level settings. In every case, the surgical specimens were sliced transversely to correlate with the CT findings. The thin-section CT images were classified into two types; solid and air-containing types. The former consisted of benign pulmonary tumors, granulomas and some focal fibrosis, while the latter all consisted of focal fibrosis. Both types were difficult to distinguish from peripheral lung cancer based only on margin analysis of the lesion, but analysis of how pulmonary vessels relate to the lesion can allow benign pulmonary lesions to be distinguished from peripheral lung cancer.View full abstractDownload PDF (9903K) -
Yu Shomura, Akira Shimamoto, Iwao Hioki, Katsutoshi Adachi, Toshiya To ...1997 Volume 37 Issue 1 Pages 55-59
Published: February 20, 1997
Released on J-STAGE: August 10, 2011
JOURNAL FREE ACCESSAmong 153 patients with mediastinal tumors seen in our department during the past 17 years. There were five with mediastinal tumor associated with lung tumor.
The patients consisted of two men and three women (aged 35 to 76years). Two patients had thymoma and lung cancer, two had mediastinal cystic tumors and lung cancer, and one had thymoma and pulmonary hamartoma. All patients underwent surgery. Both tumors were resected in three patients, while only the malignant lung tumor was resected in the other two. The latter two patients were more than 70 years of age and had benign mediastinal tumors, which did not change after resection of the malignant lung tumor. Tumors of the mediastinum and the lung were resected by median sternotomy, anterolateral thoracotomy, or posterolateral thoracotomy.
The results of this study suggest that the background of the patient, the location of the tumor, and the preoperative diagnosis help to determine the operative method.View full abstractDownload PDF (568K) -
Ikuma Kasuga, Yuichi Ichinose, Makoto Yonemaru, Harubumi Katoh, Keisuk ...1997 Volume 37 Issue 1 Pages 61-66
Published: February 20, 1997
Released on J-STAGE: August 10, 2011
JOURNAL FREE ACCESSIn a study of 147 lung cancer patients during a 5-year period, 77 had leukocytosis (WBC>9, 000/mm3). In 33 of 77 patients, no obvious infection or bone marrow metastasis was recognized. In 11 (7.5%) of 147 patients, marked leukocytosis (WBC>20, 000/mm3) was recognized. In 6 (4.1%) of 147 patients, the leukocyte count showed more than 30, 000/mm3. In order to determine the constructive expression of granulocyte-colony stimulating factor (G-CSF), we analyzed serum G-CSF activity in these patients using enzyme immunoassay. Of the 33 patients, 6 had high levels of G-CSF, consisting of each 2 cases of large cell carcinoma, adenocarcinoma, and squamous cell carcinoma. All 6 were histologically undifferentiated or poorly differentiated type. However, no case of small cell lung carcinoma showed a high G-CSF level. We immunohistochemically detected production of G-CSF in three cases consisting of one undifferentiated large cell carcinoma, one poorly differentiated squamous cell carcinoma, and one poorly differentiated adenocarcinoma.View full abstractDownload PDF (6228K) -
Kousuke Mori, Kazuhiko Yamamoto, Haruyuki Kawai, Reiji Haba1997 Volume 37 Issue 1 Pages 67-73
Published: February 20, 1997
Released on J-STAGE: August 10, 2011
JOURNAL FREE ACCESSA 52-year-old man was admitted complaining of increasing dyspnea and bloody sputum. Chest X-ray revealed an 8cm sized tumor in the left lower lobe. The tumor showed diffuse punctate calcification by chest computed tomography (CT), and showed hyperintense on Tl-weighted images and hypointense on T2-weighted images in MRI.
A conventional CT of the chest showed diffuse amorphous calcification of neck, hilar and mediastinal nodes. However thin-slice CT demonstrated that this calcification was punctate and irregulary arranged along the peripheral zone of lymph nodes. The pathologic diagnosis of the neck node biopsy specimen was adenocarcinoma with psammoma bodies.
Bronchoscopy showed mucosal invasion of the tumor and small white nodules in the left lower bronchus. Biopsy specimens of these small nodes showed many submucosal psammoma bodies as well.
It is very rare to identify diffuse calcification on CT scan corresponding to psammoma bodies not only in the primary adenocarcinoma of the lung but also in metastatic lymph nodes.
It is very rare to identify diffuse calcification on CT scan corresponding to psammoma bodies not only in the primary adenocarcinoma of the lung but also in metastatic lymph nodes.View full abstractDownload PDF (5073K) -
Yoshinori Kusajima, Masataka Segawa, Hiroyuki Nakamura, Masami Sugihar ...1997 Volume 37 Issue 1 Pages 75-82
Published: February 20, 1997
Released on J-STAGE: August 10, 2011
JOURNAL FREE ACCESSFour cases of malignant fibrous histiocytoma (MFH) in the thoracic cage (1 originating in the lung, 2 in the mediastinum, 1 in the chest wall) were reported. Three cases were men and one was a woman, and the average age was 65 years. All four cases had inflammatory reactions. Two cases in which serum ferritin was measured, revealed high levels accompanying tumor enlargement. Ferritin was detected by immunohistochemical staining in the cytoplasm of a few tumor cells as well as reactive histiocytes proliferating in the tumor or surrounding inflammatory sites. These results demonstrated the production of ferritin from the tumor and suggested that the serum ferritin level may be a useful marker for tumor growth of MFH. This tumor revealed extremely rapid growth and MFH could not be diagnosed preoperatively. Although two cases were resected, both died within 7 months.
The importance of making an early and correct pathological diagnosis by open lungbiopsy, followed by multimodal treatment was emphasized.View full abstractDownload PDF (11752K) -
Yasushi Uchida, Shouichi Inoue, Toyoharu Yokoi1997 Volume 37 Issue 1 Pages 83-86
Published: February 20, 1997
Released on J-STAGE: August 10, 2011
JOURNAL FREE ACCESSWe encountered an extremely rare case of thymoma with distant metastasis. The case was a 66-year-old woman, who had been treated with hydrocortisone for Addison's disease. A right hilar mass lesion was first detected on roentgenographic examination of the chest. The case underwent total resection of the thymus. The tumor was proved to be mixed-cell type thymoma histopathologically, with direct invasion to the lung and the pericardium. The patient began to suffer from nausea, vomiting and headache 30months after the operation. Since a heterogeneously enhanced mass lesion suggesting brain metastasis was detected on computed tomography, the lesion was resected. The resected lesion was definitively diagnosed as metastatic on postoperative immunohistochemical investigation, which revealed positive staining with keratin and Leu-7 of tumorous tissues obtained from the thymus and the brain. As no signs of relapse have been present for three years after resection of the metastatic lesion, the surgical treatment is considered to have been effective.View full abstractDownload PDF (5287K) -
Masanori Sakurai, Makoto Nishio, Atuya Karato, Izumi Hayashi, Takahiro ...1997 Volume 37 Issue 1 Pages 87-91
Published: February 20, 1997
Released on J-STAGE: August 10, 2011
JOURNAL FREE ACCESSA 36 year-old man with adenocarcinoma of the lung was referred to our hospital for treatment. The clinical stage was IIIB (T4N2M0). Radiotherapy with low-dose daily cisplatin administration (5mg/body/day) was started. Muscle weakness appeared with characteristic rashes on his face and finger joints, which led to the diagnosis of dermatomyositis. Although dermatomyositis improved with prednisolone administration, the lung cancer progressed, spreading to thoracic and lumbar vertebrae and eventually multiple intrapulmonary and liver metastases, causing death in 7 months after admission. It is noteworthy that the bone metastases were not detected by bone scintigraphy. We demonstrated a rare case of a 36 year-old man with adenocarcinoma of the lung associated with dermatomyositis.View full abstractDownload PDF (5035K) -
Mutsumi Kondo, Kouzo Yamada, Kazumasa Noda, Michihiko Tajiri, Youichi ...1997 Volume 37 Issue 1 Pages 93-98
Published: February 20, 1997
Released on J-STAGE: August 10, 2011
JOURNAL FREE ACCESSA 74-year old man, a heavy smoker, was admitted with left side chest pain. The chest radiograph showed an abnormal shadow with a cavity in the left upper lobe. Pulmonary tuberculosis was suspected based on the chest X-ray films, carcinoma was diagnosed following cytology via fibropticbronchoscopy. Left upper lobectomy was performed. Examination of the resected specimen revealed poorly differentiated squamous cell carcinoma and granuloma with caseous necrosis in the cavity wall and Mycobacterium in the necrosis. The Mycobacterium was later revealed to be Mycobacterium avium. The patient is alive nine months after surgery with no indication of recurrence of Mycobacterium avium or lung cancer.View full abstractDownload PDF (8257K) -
Shigetoshi Yoshida, Hideki Kimura, Naomichi Iwai, Makoto Suzuki, Yutak ...1997 Volume 37 Issue 1 Pages 99-103
Published: February 20, 1997
Released on J-STAGE: August 10, 2011
JOURNAL FREE ACCESSA case of a benign clear cell, so called “sugar” tumor of the lung is reported. It is a rare and most unusual pulmonary neoplasm. Since this disease was first described by Liebow and Castleman in 1963, only 20 further cases have been recorded in the Japanese literature.
A 63-year-old woman was found to have an abnormal shadow on her chest roento-genogram. The tumor was located in right S9b, and partial resection was performed by video assisted thoracoscopic surgery. Microscopically, there was a uniform pattern consisting of large clear cells. The cytoplasm of the clear cell contained an abundant amount of PAS positive glycogen. This case showed positive immunoreactivity for HMB-45, however, S-100 protein, EMA, factor-VIII, cytokeratin, chromogranin, NSE, actin and vimentin were all negative.
The histological origin of the tumor is still in dispute. We cannot guess the histogenesis in this case. We anticipate that the origin of the tumor may be elucidated by further studies.View full abstractDownload PDF (6240K) -
Madoka Matsuyama, Haruo Sasaki, Nobuya Sano, Emi Kiyokage, Tadashi Uya ...1997 Volume 37 Issue 1 Pages 105-110
Published: February 20, 1997
Released on J-STAGE: August 10, 2011
JOURNAL FREE ACCESSOn annual chest X-ray screening for pulmonary tuberculosis revealed an abnormal shadow in the left upper lung field in 1978 and 1979 of a 57-year-old office worker. In 1979, he was examined by fiberoptic bronchoscopy and percutaneous needle aspiration cytology, but findings at that time did not indicate lung cancer. He was treated with antituberculosis drugs for 21 months. Thereafter he was screened for tuberculosis every year. The abnormal shadow gradually increased in size. Fiberoptic bronchoscopy was performed again in 1992, 14 years after the first detection of the shadow. Brushing cytology revealed adenocarcinoma. We reexamined the previous slides of brushing and aspiration cytology and found cancer cells similar to those detected in 1992. Left upper lobectomy was performed. Histologically, the tumor contained abundant mucus and consisted of two cmponents, tubular adenocarcinoma imitating the structure of the bronchial gland and papillary adenocarcinoma.View full abstractDownload PDF (5768K) -
Yoshihiro Kobashi, Satoshi Kawabata, Naoyuki Miyashita, Masamitsu Naka ...1997 Volume 37 Issue 1 Pages 111-116
Published: February 20, 1997
Released on J-STAGE: August 10, 2011
JOURNAL FREE ACCESSTwo rare cases of extensive multiple intestinal metastasis from adenocarcinoma of the lung were presented.
Case 1: In a 59-year-old male in whom metastasis of adenocarcinoma of the lung to the mediastinal lymph nodes had been diagnosed surgically half a year previously. He was later readmitted to our hospital with a chief symptom of severe anemia. Endoscopic examination of the upper gastrointestinal tract revealed seven submucosal tumors in the gastric corpus. The pathological diagnosis revealed poorly differentiated adenocarcinoma with the same findings as the lung cancer that had been resected half a year ago. Autopsy two months after the second admission revealed metastasis to the duodenum, small intestine and large intestine in addition to stomach.
Case 2: Adenocarcinoma of the lung was diagnosed on first admission in a 65-yearold man. He was readmitted to our hospital with a chief symptom of hemiplegia of the left lower limb. To determine the cause of melena after his second admission, a barium enema of the small intestine was performed and four submucosal tumors were detected in the duodenum and jejunum. Autopsy and microscopic examination of the metastatic lesions of small intestine three months after the second admission revealed the same pathological diagnosis as in the primary adenocarcinoma of the lung.View full abstractDownload PDF (9079K) -
1997 Volume 37 Issue 1 Pages 117-131
Published: February 20, 1997
Released on J-STAGE: August 10, 2011
JOURNAL FREE ACCESSDownload PDF (2177K)
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