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Volume 38, Issue 7
Displaying 1-14 of 14 articles from this issue
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Peter Goldstraw1998 Volume 38 Issue 7 Pages 789-793
Published: December 20, 1998
Released on J-STAGE: August 10, 2011
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Harvey I. Pass1998 Volume 38 Issue 7 Pages 795-805
Published: December 20, 1998
Released on J-STAGE: August 10, 2011
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Michiaki Suzuki, Jun Kobayashi, Satoshi Kitamura1998 Volume 38 Issue 7 Pages 807-813
Published: December 20, 1998
Released on J-STAGE: August 10, 2011
JOURNAL FREE ACCESSWe retrospectively studied the 62 patients with primary lung cancer (56 males and 6 females) who were admitted to our department from January 1990 to December 1996. They were treated with radiation therapy (twice daily) for the chest, including the esophagus. The total radiation dose was 55.6Gy (mean). Esophagitis occurred in 48 patients (77%) after 29.7Gy (mean) of radiation. The symptoms of esophagitis included pharyngeal or chest pain, especially during swallowing. The incidence of esophagitis in the patients (n=46) who received chemotherapy before radiation was significantly higher than that in the patients (n=16) who did not receive it (87% vs. 50% p< 0.05). Esophagitis occurred in 22 (81%) among 27 patients who were given the preventive medicine. In spite of the optimal or supplemental administration of mucosal coating agents, esophagitis improved only in six patients (12%). Severe esophagitis was also observed in some patients, including two patients whose irradiation was terminated and one patient who was treated with intravenous hyperalimentation. Although radiation esophagitis is a very common complication in the treatment for lung cancer, it is refractory to usual treatments. Consequently, it is necessary to develop more effective prophylactic and treatment methods for radiation esophagitis.View full abstractDownload PDF (1762K) -
Hiroyuki Deguchi, Nariyoshi Shinomiya, Yuichi Ozeki, Mitsuharu Sato, M ...1998 Volume 38 Issue 7 Pages 815-823
Published: December 20, 1998
Released on J-STAGE: August 10, 2011
JOURNAL FREE ACCESSTo evaluate its utility as a supplemental diagnostic aid, we measured telomerase activity in bronchial lavage specimens of 33 lung cancer cases and 15 non-lung cancer cases by the non-RI TRAP method. Lung cancers showed a higher proportion of positive telomerase activity (78.8%) than non-lung cancer cases (26.7%). The proportion of positive telomerase activity in lung cancers by histological typing was squamous cell carcinoma 88.9%, adenocarcinoma 81.3%, large cell carcinoma 50%, and small cell carcinoma 66.7%, respectively. When divided by cytological appearance, the proportion of positive telomerase activity was class II 36.4%, class III 33.3%, class N and V 91.3%, suggesting that the proportion of positive telomerase activity increases as the grade of cytologic abnormality rises (Spearman: p =0.0001). Class II cases finally diagnosed as lung cancer showed a higher proportion of positive telomerase activity (57.1%) than nonlung cancer cases (26.7%). These results suggest that the measurement of telomerase activity in the cells of bronchial lavage fluid may be useful as a supplemental diagnostic aid for lung cancers, particularly in cases negative on cytological examination.View full abstractDownload PDF (6466K) -
Solitary Fibrous Tumors of the Pleura with Special Reference to Histogenesis and Biological BehaviorShinya Okada, Yoshiro Ebihara, Motoshige Kudo, Hiromi Serizawa, Harubu ...1998 Volume 38 Issue 7 Pages 825-835
Published: December 20, 1998
Released on J-STAGE: August 10, 2011
JOURNAL FREE ACCESSTwenty-three foci in 20 cases of solitary (localized) fibrous tumor of the pleura (SFTP) were studied to ascertain their immunohistochemical and electron microscopical characteristics and the biological behavior. The tumors were pedunculated and solid and had arisen from either visceral or parietal pleura.
Microscopically, SFTPs presented diverse features from sclerotic to cellular, but basically showed a “patternless” pattern. Seven tumors were sclerotic type, 8 were cellular type and the remaining 8 were mixed type.
Ultrastructurally, the tumor cells were classified into three types: spindle cells with profiles of long thin cytoplasmic processes and dendritic cells with complicated processes simulating dendrites of ganglion cells and intermediate cells. Spindle cell type were typical of the tumor cells. Dendritic cells were characteristic of the cellular and mixed tumor types.
Immunohistochemically, the tumors stained positively with vimentin (100%) and CD34 (73%). In addition, they were positive for synaptophysin, neurofilament, S-100 protein, MIC-2, NGFR, SMA and desmin.
Two recurrent cases had a high degree of cell atypia, with occasional intranuclear cytoplasmic inclusions, nuclear grooves and multinucleation. They were highly positive for p53, ki-67 and PCNA. Cell atypia and cellularity were considered to be two important factors in evaluating the malignancy of the tumors.
The present results suggest that the origin of SFTP may be undifferentiated mesenchymal cells with multipotential differentiation toward either neurons or muscle.View full abstractDownload PDF (9671K) -
Kazuya Mizobuchi, Yukihisa Fujita, Ichiro Yokomura, Mikio Ueda, Shinic ...1998 Volume 38 Issue 7 Pages 837-845
Published: December 20, 1998
Released on J-STAGE: August 10, 2011
JOURNAL FREE ACCESSTo examine the differences in the degree of malignancy between primary and metastatic sites, we compared the nuclear DNA contents of primary non-small cell lung cancers with those of their metastatic sites by flow cytometry in 10 freshly autopsied specimens using the multiple sampling method. All cases showed DNA aneuploidy and/ or DNA multiploidy pattern, and no diploid DNA pattern was observed. In 7 of 10 cases, the nuclear DNA contents of the metastatic sites corresponded to those of primary tumors, and only 3 cases were heterogeneous in DNA ploidy pattern between the primary and metastatic sites. It was concluded that a higher cellular DNA content may probably not have a high metastatic potential, and also suggested that an increase of nuclear DNA content may occur after the metastasis takes place.View full abstractDownload PDF (919K) -
Michihiko Tajiri, Youichi Kameda, Takamitsu Maehara, [in Japanese], Ka ...1998 Volume 38 Issue 7 Pages 847-853
Published: December 20, 1998
Released on J-STAGE: August 10, 2011
JOURNAL FREE ACCESSThirty-nine patients with minute peripheral lung cancer measuring 10 mm or less in diameter were evaluated. We analyzed the clinicopathological factors of these cases in order to examine the characteristics and indications for performing limited surgery on small-sized lung cancer since the numbers of such patients has recently been increasing. The type of operations performed included a lobectomy with an R2 node dissection in 25 and a wedge resection without node dissection in 14 cases. The cases undergoing node dissection were pathologically diagnosed to be Ni in one and NO in the other 24 cases. In addition, all cases were also classified as PMO. The tumors in all 39 cases consisted of 33 adenocarcinomas (25 well differentiated, 6 moderately differentiated, and 2 poorly differentiated), 5 carcinoids and 1 large cell carcinoma. Regarding the proliferative pattern in the adenocarcinomas, 25 were alveolar replacement type, and 8 were alveolar destructive type. Concerning fibrotic foci, 20 were non-fibrotic, 7 were elastic and 6 were collagenous type. Regarding the cell height, 3 were tall, 9 were medium height, and 21 were short. One patient with an adenocarcinoma had bone metastases but is alive. In addition, one patient with a carcinoid tumor had liver metastases and died due to recurrence, and one patient died due to heart disease, however all other 36 patients are still healthy and alive. The pathological findings of both the N1 case and the case withbone metastases were thus demonstrated to be either poorly or moderately differentiated adenocarcinoma with remarkable fibrosis and both were classified as alveolardestructive type.
Generally patients presenting with tumors measuring 10 mm or less in diameter tend to have a good prognosis, but some cases with the above characteristics may also have pathologically advanced cancer, and thus are not suitable to undergo limited surgery using either a wedge resection or a segmental resection.View full abstractDownload PDF (4150K) -
Yuji Kato, Kouzo Yamada, [in Japanese], Ikuo Nomura, Kazumasa Noda, Na ...1998 Volume 38 Issue 7 Pages 855-862
Published: December 20, 1998
Released on J-STAGE: August 10, 2011
JOURNAL FREE ACCESSWith regard to thymoma, the location of the tumors, their internal structure, and their relationship with surrounding structures are the most important factors in clinical diagnosis. A positive finding influences not only the surgical procedure selected but also the prognosis of the patient as well.
To investigate the usefulness of thin-section computed tomography (CT) in detecting invasion to structures surrounding tumors, we performed a prospective study of 20 patients with tumors, including 10 cases of non-invasive thymoma, 6 of invasive thymoma, and 4 of thymic cancer.
A comparison of diagnoses based on the findings of a thin-section CT and pathologic examination showed that thin-section CT was 90% accurate indetecting invasion to structures surrounding tumors and 90% accurate for septum on internal analysis. Conventional CT, on the other hand, showed 45% accuracy forpleural invasion of interlobar fissures and 45% accuracy for septum.
This leads to the conclusion that thin-section CT is helpful in attaining accurate evaluation of internal structures and invasion of structures by thymoma, especially in patients in whom findings by conventional CT suggests possible tumor invasion of surrounding structures.View full abstractDownload PDF (15215K) -
Yushi Saito, Yosuke Yamakawa, Masanobu Kiriyama, Ichiro Fukai, Satoshi ...1998 Volume 38 Issue 7 Pages 863-870
Published: December 20, 1998
Released on J-STAGE: August 10, 2011
JOURNAL FREE ACCESSWe present two surgically treated cases of thymic carcinoma which were misclassified as atypical thymoma by preoperative needle biopsy which showed epithelial tumors with mild cytological atypia and lymphocytic infiltration. Immunohistochemical staining for bcl-2 and MIB-1 was performed on paraffin-embedded sections from these two thymic carcinomas and four thymomas underwent mediastinal needle biopsy. Strong immunoreactivity for bcl-2 expression of thymic carcinomas and little staining of thymomas were seen. MIB-1 labeling indices of thymic carcinomas (14.0%, 14.6%) were higher than those of thymomas (1.0%-3.6%). In some cases, it may be difficult to distinguish thymic carcinoma from thymoma by small needle biopsy specimens, and immunostaining reactivity of bcl-2 and MIB-1 may be a useful adjunct to differentiate thymic carcinoma from thymoma even in needle biopsy specimens.View full abstractDownload PDF (15350K) -
Akio Yamazaki, Sadahiko Masuda, Yoshio Oose, Minoru Tahara, Kazuki Nak ...1998 Volume 38 Issue 7 Pages 871-875
Published: December 20, 1998
Released on J-STAGE: August 10, 2011
JOURNAL FREE ACCESSA 62-year-old man was admitted with an abnormal shadow on chest X-ray film. He had an anamnesis of hypertension and was taking an antihypertensive agent. The irregular 45×25 mm shadow was recognized in the left upper lung field on chest X-ray and CT. Whole body CT examination revealed that the left adrenal gland had an internal heterogeneous shadow. Tests on hormone values in the blood and urine, abdominal MRI, and 123I-MIBG scintiscaning yielded a diagnosis of pheochromocytoma preoperatively. Considering the preoperative and postoperative hemodynamics, surgery for pheochromocytoma was performed initially. Extirpation of tumor on the left adrenal gland method was performed on January 27, 1997. The neoplasm had developed outside the adrenal body and there was no infiltration to the adrenal body. One month after the first operation, on February 27, 1997, left upper lobectomy and mediastinal lymph node dissection (R2b) were performed. The pathologic diagnosis was poorly-differentiated adenocarcinoma, and the postoperative classification was p-t3nomo stage II B. The preoperative and postoperative hemodynamics were stable and were safely controlled. It was considered that, in lung cancer accompanied by pheochromocytoma, lobectomy can be conducted safely it surgery for pheochromocytoma is performed beforehand.View full abstractDownload PDF (7879K) -
Katsuyuki Asai, Enjo Hata, Hirozou Sakaguchi, Shingo Ikeda, Ryouji Kaw ...1998 Volume 38 Issue 7 Pages 877-883
Published: December 20, 1998
Released on J-STAGE: August 10, 2011
JOURNAL FREE ACCESSA 54-year-old man with left anterior chest pain and dullness of the left arm was referred to our hospital. We diagnosed his disease as left apical invading lung adenocarcinoma with left isolated adrenal metastasis (cT3NOM1 stage IV). Radiation therapy was given to the lung tumor preoperatively in 15×30-Gy doses, which subsequently reduced the tumor size from 5.0×4.2 cm to 3.6×2.5 cm. Resection of the primary lesion was then performed. As the tumor was found to have invaded the left subclavian artery and the brachial plexus, we carried out left upper lobectomy with left cervical and bilateral mediastinal lymph node dissection and combined partial resection of the left subclavian artery and brachial plexus. The defect of the left subclavian artery was repaired with a Gore TexR tube graft. The left adrenal metastatic lesion was 5.8×4.2 cm in size and was resected through a retroperitoneal approach 28 days following the thoracic operation. Postoperative radiation therapy was also administrated to the resected stump of the primary lesion in 10×20-Gy doses. Pathologically, both resected lesions were poorly differentiated adenocarcinoma and their pathological stage was N (pT3N0M1). Twelve months after adrenalectomy, this patient is well without recurrent disease and has resumed a normal lifestyle. This case confirms that synchronism between lung cancer and isolated adrenal metastasis does not necessarily represent an unfavorable prognostic factor. In selected cases, combined resection of both tumors can increase the long-term survival period.View full abstractDownload PDF (8698K) -
Yoshinobu Hattori, Yoshikazu Mizoguchi, Kouji Negi, Ryou Hoshino, Toor ...1998 Volume 38 Issue 7 Pages 885-889
Published: December 20, 1998
Released on J-STAGE: August 10, 2011
JOURNAL FREE ACCESSPrimary tracheal carcinoma is rare. A 58-year-old man had hemoptysis in early March, 1997 and was treated for a polypoid vocal cord by an otorhinolaryngologist. When he was admitted to another hospital on Aug. 23 because of a traffic accident, he expectorated bloody sputum, a cytological examination of which revealed class III cells. He was referred to our hospital for more examinations on Sep. 6. Bronchoscopy demonstrated a polypoid tumor in the trachea and a biopsy revealed squamous cell carcinoma. There was no metastasis. Tracheal resection from the 4th to 8th tracheal ring and end-to-end anastomosis was performed on Oct. 21. Pathological examination demonstrated a moderately differentiated squamous cell carcinoma in situ and immunohistochemical examination and in situ hybridization showed positive stainings. A relationship with human papillomavirus was strongly suspected. The postoperative course was uneventful.View full abstractDownload PDF (7384K) -
Surgical and Pathologic CorrelationTetsu Kanauchi, Toshiko Hoshi, Hidekazu Matsushima, Toshikazu Aihara, ...1998 Volume 38 Issue 7 Pages 891-896
Published: December 20, 1998
Released on J-STAGE: August 10, 2011
JOURNAL FREE ACCESSThe CT appearance of pulmonary infarction associated with lung cancer was analyzed and correlated with pathologic findings in 3 cases. The infarctions totalled 13 including 6 lesions in areas apart from the pleura. Both proximal pulmonary arteries and veins were invaded by tumors in 2 cases. In another case, only the pulmonary artery was stenotic. All lesions were found peripheral to the stenotic pulmonary arteries. The characteristics of pulmonary infarctions associated with lung cancer were as follows:(i) shadows appear in the periphery of stenotic pulmonary artery invaded by tumor, (ii) the frequency is nearly the same in subpleural areas as in areas apart from the pleura, (iii) distribution is sometimes along the bronchovascular bundles, (iv) various type of shadows are observed at the same time.View full abstractDownload PDF (8567K) -
1998 Volume 38 Issue 7 Pages 897-904
Published: December 20, 1998
Released on J-STAGE: August 10, 2011
JOURNAL FREE ACCESSDownload PDF (1220K)
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