All issues
Volume 37, Issue 6
Displaying 1-16 of 16 articles from this issue
- |<
- <
- 1
- >
- >|
-
Shinji Maebeya, Yasuaki Naito1997 Volume 37 Issue 6 Pages 817-824
Published: October 20, 1997
Released on J-STAGE: August 10, 2011
JOURNAL FREE ACCESSThe Wakayama Lung Cancer Study Group, consisting of 13 hospitals in Wakayama prefecture, registered 1599 (1235 men and 364 women) primary lung cancer patients diagnosed from 1989 to 1993. The mean age of the patients was 68 years for men and 67 years for women, respectively. Symptoms were present in 830 patients (51.3%) before visiting hospitals while 148 cases (9.2%) were detected by screening. There were 344 patients (20.8%) with stage I disease, 105 patients (6.6%) with stage II disease, 667 patients (41.7%) with stage ilia, b disease and 446 (27.9%) with stage N disease. Six hundred and ninety-two patients (43.3%) were treated by chemotherapy, 472 patients (29.5%) by radiation therapy and 462 patients (28.9%) by resection. In the 148 patients detected by screening, 67 patients (45.9%) had stage I disease and 87 patients (58.8%) underwent resection. This results suggested that screening was useful to detect early stage primary lung cancer.View full abstractDownload PDF (5381K) -
Takashi Hirose, Kiyoshi Mori, Suguru Machida, Keigo Tominaga, Haruhisa ...1997 Volume 37 Issue 6 Pages 825-831
Published: October 20, 1997
Released on J-STAGE: August 10, 2011
JOURNAL FREE ACCESSThe purpose of our study was to evaluate the usefulness of computed tomography (CT) fluoroscopy-guided transthoracic needle biopsy. Between March 1996 and March 1997, 36 patients underwent CT fluoroscopy-guided transthoracic needle biopsy using a 18-gauge automatic biopsy gun. Examinations involved 30 pulmonary lesions (15 lung carcinomas, 3 pulmonary metastases, 12 benign lesions), 3 mediastinal lesions, and 3 pleural lesions.
Sufficient materials for diagnosis were obtained from 34 of 36 lesions (94%). The sensitivity, specificity, and accuracy of CT fluoroscopy-guided transthoracic needle biopsy were 86.4%, 100%, and 91.7%, respectively. There were no cell-type misidentifications in cases in which resection was performed for carcinoma.
Complications occurred in 19 of 36 cases (53%). The most common complication was pneumothorax, which occurred in 17 of 36 cases (47%). Chest tube insertion was required in 3 of 17 cases of pneumothorax. Intrapulmonary hemorrhage and hemoptysis occurred in 3 (8%) and 1 (3%) cases, respectively. No fatalities occurred after biopsy.
In conclusion, CT fluoroscopy-guided transthoracic needle biopsy is useful.View full abstractDownload PDF (7948K) -
Toshiaki Fujikane, Nobuhiko Sasaki, Masaaki Takahashi, Akinori Takeda, ...1997 Volume 37 Issue 6 Pages 833-840
Published: October 20, 1997
Released on J-STAGE: August 10, 2011
JOURNAL FREE ACCESSPrognostic factors for survival were retrospectively evaluated in 105 patients with advanced non-small-cell lung cancer [clinical stage III or N, performance status (PS) 0-3 and age≤75]. All patients were treated with cisplatin-containing combination chemotherapy.
Univariate analysis revealed that a PS of 0-1, prognostic nutritional index*(PNI) of greater than 45, normal serum NSE levels, no body weight loss, clinical stage III and normal serum LDH levels were favorable prognostic factors. Multi-variate analysis using Cox's proportional hazard model revealed that PNI (P<0.0001), PS (P=0.0002) and clinical stage (P=0.0139) contributed independently to survival.
Three prognostic subgroups were defined through the recursive partitioning and amalgamation method. Subgroup 1 (PNI; 45<, PS; 0-1 and stage III), Subgroup 2 (PNI; 45<, PS; 2-3 and stage III or PNI; 45<, PS; 0-1 and stage N) and Subgroup 3 (PNI;≤45 or PNI; 45<, PS; 2-3 and stage N) showed median survival times of 15.9, 9.3 and 5.5 months, respectively.
PNI may be useful for the detection of inappropriate subgroups for chemotherapy in advanced non-small cel+l lung cancer.
PNI*: 10×serum albumin (g/dl) +0.005×total lymphocyte count (/mm3)[T. Onodera]View full abstractDownload PDF (769K) -
Mayumi Seto, Keiko Kuriyama, Shoji Kido, Chikazumi Kuroda, Masahiko Hi ...1997 Volume 37 Issue 6 Pages 841-848
Published: October 20, 1997
Released on J-STAGE: August 10, 2011
JOURNAL FREE ACCESSTo assess a thin-section computed tomography (CT) findings of small peripheral adenocarcinoma, we compared the edge and internal characteristics on thin-section CT images with the histological structure of the resected specimen in 77 patients with pulmonary adenocarcinomas measuring 2 cm or less in maximal diameter. Histologically, classification was based on tumor growth patterns reported by Noguchi et al, because these classifications correlate well with patient prognoses. Types A and B (29 cases) are adenocarcinomas showing a growth pattern involving replacement of alveolar lining cells, and these types had excellent outcome. In these tumor types, the lesion appears as a round and lobulated nodule with air bronchogram and ground-glass opacity was observed in more than half the area of the lesion on thin-section CT. The lung-tumor interface tends to be irregular and poorly defined. In type C, the lesion appears as a round and lobulated nodule with ground-glass opacity at the periphery. In the type A and B, a grater area of ground-glass opacity was observed than in type C on thin-section CT. Types D, E and F are adenocarcinoma showing a growth pattern involving no replacement of alveolar lining cells. In types D, E and F, the lesions appear as well defined nodules without areas of ground-glass opacity on thin-section CT. Based on our findings, quantitative evaluation of ground-glass opacity on CT correlates well with the area of alveolar lining pattern on hematoxylin-eosin specimen. Hence, the lesions with areas of ground-glass opacity on CT suggest to have excellent prognosis.View full abstractDownload PDF (8105K) -
Takuhito Tada, Kazuo Minakuchi, Mayuko Koda, Noriyuki Masuda, Kaoru Ma ...1997 Volume 37 Issue 6 Pages 849-854
Published: October 20, 1997
Released on J-STAGE: August 10, 2011
JOURNAL FREE ACCESSProphylactic cranial irradiation (PCI) in patients with small cell lung cancer has been performed in many countries. While a consensus that PCI decreased the rate of tumor recurrence in the brain has been obtained, the survival advantage of PCI remains controversial. To improve results of PCI, a retrospective study was carried out. Twentyfive patients and 16 patients underwent PCI with doses of 24 Gy (accelerated hyperfractionation) and 30 Gy. Overall survival at 2 and 5 years was 60% and 26% for the patients with a dose of 24 Gy, and 33% and 20% for those with a dose of 30 Gy, respectively. Brain metastasis as the first relapse site was 16% and 13% for the patients with doses of 24 Gy and 30 Gy, and brain metastasis as the only relapse site was 12% and 6%, respectively. As prognostic factors, there were significant differences between patients with less than 65 years of age and 65 or more, and between patients with stage IIIA and stage III B. A prospective randomized study with more strict patient selection (stage III A disease) and appropriate dose (27-30Gy) for PCI may prove that PCI provides significant survival benefit.View full abstractDownload PDF (680K) -
Katsuo Usuda, Yasuki Saito, Satomi Takahashi, Masashi Handa, Tsutomu S ...1997 Volume 37 Issue 6 Pages 855-865
Published: October 20, 1997
Released on J-STAGE: August 10, 2011
JOURNAL FREE ACCESSIntensive follow-up was conducted on 203 patients following pulmonary resection for lung cancer. The follow-up program included chest X-ray, chest CT, sputum cytology, brain CT, abdominal ultrasonic examination, bone scintigraphy and serum tumor markers.
Relapse occurred in 61 patients and metachronous second lung cancer in 5 patients. Lesions were detected by follow-up in 42 patients (64%) with no symptoms, and in 23 patients (35%) with symptoms. The follow-up proved effective for patients with adenocarcinoma, squamous cell carcinoma or with nO lung cancer, but ineffective for patients with small cell carcinoma, large cell carcinoma or with nl·n2 lung cancer. Chest CT, serum tumor marker, chest X-ray, sputum cytology and brain CT were useful for detecting early relapse and metachronous lung cancer. Recurrence was greater as T factor, N factor became larger, degree of cure lesser and cancer differentiation poorer. The first relapse generally occurred within 3 years following operation and the risk of relapse decreased thereafter. Follow-up should thus be conducted on lung cancer patients in consideration of the risk of relapse.View full abstractDownload PDF (1097K) -
Mitsunobu Tamura, Kenzo Hiroshima, Tetsuya Toyozaki, Hiromasa Kohno, K ...1997 Volume 37 Issue 6 Pages 867-876
Published: October 20, 1997
Released on J-STAGE: August 10, 2011
JOURNAL FREE ACCESSProliferative pattern of cancer cells in 56 primary lung carcinomas (papillary adenocarcinoma) was assessed by immunostaining of proliferating cell nuclear antigen (PCNA) and silver staining of argyrophilic nucleolar organizer regions (AgNORs). Invasiveness of the carcinomas was assessed by immunostaining of cathepsin B. They were divided into three groups according to the proliferative pattern of cancer cells in the fibroelastic foci. Carcinomas which proliferate with many cancer nests in the fibrotic foci were classified as group H, and carcinomas in which cancer cells were hardly observed in the fibrotic foci as group L. In group M, cancer cells were observed in the degree between group H and group L. Carcinomas whose the diameters of which were greater than 3 centimeters, or those which had lymph node metastasis or pleural invasion tended to be classified as group H. Mean AgNORs counts were 4.6±1.1 in group H, 4.5±0.9 in group M, 4.2±1.1 in group L. PCNA labeling index (L.I.) was 69.4±9.8 in group H, 58.9±12.9 in group M, 51.1±7.6 in group L. The difference of L.I. between group H and group M, and between group H and group L was statistically significant. Degree of expression of Cathepsin B was high in group H, moderate in group M, and low in group L. We conclude that the proliferating pattern of cancer cells in the fibrotic foci is a good indicator of the proliferation and invasiveness of pulmonary adenocarcinomas.View full abstractDownload PDF (6736K) -
Takashi Oishi, Yasunobu Noda, Hideo Gonda, Yoshimasa Tanikawa, Kenzo T ...1997 Volume 37 Issue 6 Pages 877-886
Published: October 20, 1997
Released on J-STAGE: August 10, 2011
JOURNAL FREE ACCESSWe sent out a questionnaire on the truth-telling and treatment of lung cancer to three groups: 1) patients who will take part in a fibroptic bronchoscopic survey, 2) their families, and 3) the medical staff consisting of nurses, doctors, and technicians. Each group was found to have its own opinion. Patients wished to be told the truth even though their families objected to their being told the truth. The families tended to oppose the patients' opinion if it were opposite to theirs. This pattern could be seen more frequently among younger patients and their families. The medical staff did not always agree with telling the patient, however, they tended to respect the patient's wishes in the end. By evaluating and comprehending the differences among the three groups, we could develop the most appropriate approach to each patient. Therefore, questionnaires act as a good tool to establish a better understanding of truth-telling for the patient and family.View full abstractDownload PDF (8854K) -
Shouichi Matsumoto, Shuji Adachi, Michio Kono, Yoshitaka Abe, Yoshihir ...1997 Volume 37 Issue 6 Pages 887-891
Published: October 20, 1997
Released on J-STAGE: August 10, 2011
JOURNAL FREE ACCESSWe reported a case of atypical adenomatous hyperplasia (AAH) of the lung without lung cancer, which was incidentally found on CT, and reviewed the literature. HRCT scan showed a pulmonary nodule with ground-glass attenuation, which had no evidence of a high attenuation area within it. Multiplanar reconstruction (MPR) also showed a localized round nodule with ground-glass attenuation. The lesion was considered to be spherical. Resection of the right middle lobe was performed. Microscopic examination of the removed lesion revealed hyperplastic alveolar cuboidal cells arranged along the alveolar septa and showed slight nuclear atypia. The lesion was pathologically diagnosed as AAH. A pulmonary nodule with ground-glass attenuation on CT corresponded to the area in which hyperplastic alveolar cuboidal cells arranged along the alveolar septa. MPR was considered to be useful to obtain the 3D-image of tumorous lesions.
AAH is pathologically similar to Noguchi's type A adenocarcinoma and is considered a precursor disease of adenocarcinoma of the lung, but it is considered to be difficult to differentiate those from each other on CT.View full abstractDownload PDF (6022K) -
Hisashi Tsukada, Hiroaki Osada, Koji Kojima, Noboru Yamate1997 Volume 37 Issue 6 Pages 893-898
Published: October 20, 1997
Released on J-STAGE: August 10, 2011
JOURNAL FREE ACCESSA 52-year-old man was admitted with fever and left back pain. A chest X-ray filmdisclosed a 3cm round shadow in the left hilum, an infiltrative shadow in the left lower lung field and left pleural effusion. CT also demonstrated an enlarged paraaortic lymph node. The laboratory data revealed plasma CEA elevation. However, no primary lesion was detected despite a thorough systemic examination. We planned biopsy of the left thoracic lesions by thoracoscopy. Intraoperative diagnosis was none-small cell lung cancer of left S3 and metastasis to the paraaortic lymph node. We performed left upper lobectomy and mediastinal lymphadenectomy. The pathological diagnosis was a metastatic lesion of the adenocarcinoma in hilar and mediastinal lymph nodes but there was no primary lesion in the resected lung. After the operation the plasma CEA level normalized immediately and there was no re-elevation. We have followed the patient for about 10 months after the operation and there is no evidence of a new lesion or tumor recurrence. We consider this is a very rare case of TON2M0 lung cancer.View full abstractDownload PDF (5608K) -
Ikuma Kasuga, Masayuki Kikawada, Akira Kunisawa, Yasushi Torii, Yuichi ...1997 Volume 37 Issue 6 Pages 899-902
Published: October 20, 1997
Released on J-STAGE: August 10, 2011
JOURNAL FREE ACCESSA 28-year-old non-smoking man was referred to our hospital with complaints of fever and chest pain in March 1996. His chest X-ray on admission showed a tumorous mass in the left lower lung field and pleural effusion. Fiberoptic bronchoscopy revealed stenosis of left lower lobe bronchus, and biopsied tumor specimen at the site confirmed the diagnosis of small cell carcinoma. Systemic chemotherapy with radiotherapy were performed, and he was discharged after achieving partial response. However, he was soon readmitted because of leg pain and gait disturbance. The spinal cord MRI showed intramedullar metastasis, and we performed radiotherapy for the lumbar medullar lesion. However, primary site and pleural effusion gradually worsened. He died due to respiratory failure 8 months after on admission. In view of the rarity of intramedullary metastasis associated with small cell carcinoma in such a young patient as the present case, a brief report seems warranted.View full abstractDownload PDF (5415K) -
Hidetomi Ryo, Kazuhiro Kimura, Mayumi Yoshida, Katuhiro Toyama, Takako ...1997 Volume 37 Issue 6 Pages 903-906
Published: October 20, 1997
Released on J-STAGE: August 10, 2011
JOURNAL FREE ACCESSA 69-year-old man had a tumor detected in one of the right ethmoid sinuses in October 1993. The tumor was diagnosed as non-Hodgkin's lymphoma. The patient received 8 courses of modified COP-BLAM chemotherapy with 50 Gy of radiation. The tumor disappeared, but the patient continued to receive outpatient chemotherapy. After administration of an additional 24 courses of the regimen over a 2-year period, CT scans demonstrated enlarged mediastinal lymph nodes and a hilar tumor in September 1997. A diagnosis of squamous cell carcinoma of the lung was made by endoscopic mediastinal lymph node biopsy. Chemotherapy with MVP (CDDP, VDS, and MMC) and CDDP+CPT-11 was started, but was ineffective. The patient has been followed without treatment since then. This patient had received a total of 19, 840 mg of cyclophosphamide over 35 months before the detection of the lung cancer. Reports on cancer secondary to chemotherapy have occasionally been published, but lung cancer arising during treatment of malignant lymphoma has seldom been reported. Because interdiscriplinary therapy for cancer has prolonged the life of patients with hematopoietic neoplasms, the incidence of secondary lung cancer will increase. We report this case to remind physicians to take such an increase into consideration.View full abstractDownload PDF (2981K) -
Tadashi Aoki, Masanori Terashima, Teruaki Koike, Tsuneyo Takizawa, Hir ...1997 Volume 37 Issue 6 Pages 907-911
Published: October 20, 1997
Released on J-STAGE: August 10, 2011
JOURNAL FREE ACCESSA 74-year-old man, a heavy smoker, visited our hospital after category E was detected by screening of sputum cytology. The chest X-ray film confirmed the absence of an abnormal shadow but the computed tomography image showed an abnormal shadow that in right S1. Small cell carcinoma was diagnosed by brushing cytology from right B1. The clinical stage was I (T1NOMO), right upper lobectomy and mediastinal lymph node dissection was performed. The pathological specimen showed small cell carcinoma, intermediate type. The tumor size was 4 by 3mm. The pathological stage was I (T1N0M0). We reported a rare case of peripheral early small cell lung carcinoma detected by screening with sputum cytology.View full abstractDownload PDF (3288K) -
Takuji Kitajima, Hiroshi Ueoka, Katsuyuki Kiura, Masahiro Tabata, Mine ...1997 Volume 37 Issue 6 Pages 913-917
Published: October 20, 1997
Released on J-STAGE: August 10, 2011
JOURNAL FREE ACCESSA 48-year-old man was referred to us, of a mass shadow in the infected emphysematous bulla by chest CT scannings. Neither bronchofiberscopic examination nor CT-guided transcutaneous biopsy could yielded a definitive diagnosis. By surgical resection of the extrapleural tumor directly invading the chest wall, poorly differentiated adenocarcinoma was diagnosed. Three cycles of chemotherapy consisting of cisplatin (20mg/m2×5 days) and 5-fluorouracil (500mg/m2×5 days), and simultaneous hyperfractionated thoracic irradiation (70Gy in a total dose with 1.25Gy×2/day) were immediately started and the mass shadow markedly regressed. Lung cancer with a coexisting bulla is frequently advanced and considered to have poor prognosis. Chemoradiotherapy may be useful for the treatment of unresectable advanced cases.View full abstractDownload PDF (5591K) -
Akiko Matsumoto, Kazuhiro Daidou, Kenichi Arita, Yukiharu Sasaki1997 Volume 37 Issue 6 Pages 919-924
Published: October 20, 1997
Released on J-STAGE: August 10, 2011
JOURNAL FREE ACCESSAlveolar soft part sarcoma (ASPS) is a rare malignant soft tissue tumor of unknown origin, affecting mainly extremities of children and young adults. Metastases develop most commonly in the lungs, bone, and brain.
A 23-year-old woman was admitted because of the abnormalities of the chest X-ray film with no respiratory symptoms. Her chest X-ray film showed a mass lesion on the left hilum and multiple small nodular lesions, predominantly in bilateral lower lung fields. Other lesions in the abdominal cavity, brain and the right thigh were demonstrated by diagnostic imaging. Open lung biopsy specimens revealed ASPS. We estimated that the primary site of these systemic lesions was the right thigh.
She died of respiratory failure about 6 months later.View full abstractDownload PDF (7950K) -
1997 Volume 37 Issue 6 Pages 925-957
Published: October 20, 1997
Released on J-STAGE: August 10, 2011
JOURNAL FREE ACCESSDownload PDF (6333K)
- |<
- <
- 1
- >
- >|