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Volume 38, Issue 3
Displaying 1-12 of 12 articles from this issue
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Toshiya Bessho, Shinichiro Miyoshi, Shinji Maebeya, Takaomi Suzuma, Is ...1998 Volume 38 Issue 3 Pages 205-213
Published: June 20, 1998
Released on J-STAGE: August 10, 2011
JOURNAL FREE ACCESSThirty five patients with brain metastases after lung resection for primary lung cancer were retrospectively reviewed. Of there, 19 patients (54.3%) had a solitary brain metastasis and 16 patients (45.7%) had multiple brain metastases. Eighteen (51.4%) of the 35 patients underwent brain operations. The five-year survival rate and median survival time (MST) were 20.0% and 9.5 months in patients with brain operations. In patients without brain operations, the MST was 4 months and no patients survived more than 13 months. The analysis of the several prognostic factors in the patients with brain operations revealed that only no metastases to other organs than brain at brain surgery significantly prolonged the survival. Five (27.8%) of 18 patients with brain surgery survived more than 3 years. All had a solitary brain metastasis without metastases to other organs. Four of them underwent operations from two to four times for brain metastasis. Such an aggressive surgical treatment may permit long-term survival in patients with a single brain metastasis.View full abstractDownload PDF (5789K) -
Tadashi Uehara, Tokujiro Yano, Hideki Yokoyama, Yasuro Fukuyama, Hiros ...1998 Volume 38 Issue 3 Pages 215-221
Published: June 20, 1998
Released on J-STAGE: August 10, 2011
JOURNAL FREE ACCESSObjective: In order to establish the treatment of non-small cell lung cancer in octogenarians, we retrospectively reviewed our experiences.
Patients: The present study included 109 patients with a mean age of 82 ranging from 80 to 94, who were treated at our institute from 1972 through 1996. There were 74 men and 35 women. Sixty-one patients had adenocarcinoma, 35 had squamous cell carcinoma and 13 had other histological types. Thirty patients had clinical stage I disease, 13 had stage II, 22 had stage IIIA, 12 had stage IIIB and 32 had stage IV.
Results: In clinical stage I, 18 patients (58.1%) underwent an operation with a 5 yearsurvival rate of 48.6%, including two operation-related deaths. On the other hand, no patients survied 5 years after either radiation treatment (6 patients) or other treatment (6 patients). In clinical stage III, only 3 patients underwent surgical resection. Twenty patients received radiotherapy with (2 patients) or without (18 patients) chemotherapy. There were 5 treatment-related deaths (25%). Concerning other patients, 3 received chemotherapy, 2 received pleural drainage, and 6 had no other treatment. There was no significant difference in survival between the radiotherapy group and the other treatment group (MST 8M: 20M, p=0.36). In clinical stage IV, there was no significant difference in survival between the treatment group (systemic chemotherapy, radiotherapy, etc.; n=19) and the non-treatment group (n=13).
Conclusion: In clinical stage I, surgical resection is considered to be the treatmentof choice while the best supportive care is so in the advanced stages.View full abstractDownload PDF (665K) -
Masahisa Miyazawa, Masayuki Haniuda, Hikotaro Komatsu1998 Volume 38 Issue 3 Pages 223-227
Published: June 20, 1998
Released on J-STAGE: August 10, 2011
JOURNAL FREE ACCESSA 42-year-old man with primary lung cancer and pulmonary hypertrophic osteoarthropathy was admitted with complaints of slight bilateral foot edema and severe pain of the extremities. A chest X-ray film revealed a tumor shadow in the left upper lung field, and bone scintigraphy showed abnormal linear uptake along the cortical margin in both lower legs. Video-assisted left upper lobectomy was performed. The pain and edema rapidly disappeared within one week after operation and bone scintigraphy findings became normal 5 months after operation. Bone scintigraphy was valuable in the diagnosis and following of PHO.View full abstractDownload PDF (6108K) -
Takashi Hirose, Keigo Tominaga, Kiyoshi Mori, Suguru Machida, Masaya F ...1998 Volume 38 Issue 3 Pages 229-233
Published: June 20, 1998
Released on J-STAGE: August 10, 2011
JOURNAL FREE ACCESSWe report a 63-year-old man with lung adenocarcinoma who presented with diabetes insipidus due to pituitary metastasis. He also had polydipsia and polyuria. His urine volume ranged from 4 to 5 liters daily with a similar volume of water intake. The specific gravity and osmotic pressure of his urine were 1.003 and 102mOsm/kg, respectively. The serum osmotic pressure and antidiuretic hormone (ADH) were 298mOsm/kg and 0.7pg/ml, respectively. In a water deprivation test, despite an elevated serum osmotic pressure (313mOsm/kg), the peak serum ADH level (0.8pg/ml), and osmotic pressure (137mOsm/kg) of the urine remained low. Chest X-ray revealed a mass lesion in the right upper lobe. Lung adenocarcinoma was diagnosed by fiberoptic bronchoscopy. Plain skull films showed destruction of the sellar floor and posterior clinoids. T1-weighted magnetic resonance images showed a sellar mass, bony destruction, and absence of a high signal intensity in the posterior lobe. Diabetes insipidus caused by pituitary metastasis of lung cancer was diagnosed. Although he was treated with radiation therapy to the pituitary gland and chemotherapy by cisplatin and irinotecan, the pituitary metastatic lesion did not improve.View full abstractDownload PDF (4968K) -
Hiroyuki Hirahara, Takahiro Souma, Akira Iwashima, Hiroshi Tsukada1998 Volume 38 Issue 3 Pages 235-240
Published: June 20, 1998
Released on J-STAGE: August 10, 2011
JOURNAL FREE ACCESSA 75-year-old man underwent a lobectomy for primary lung cancer which was associated with an abnormally elevated serum alpha-fetoprotein (AFP) level of 3, 871ng/ml. The serum AFP level declined to the normal range soon after the operation. Cancer recurrence in the contralateral lung was detected by follow-up chest X-ray and CT 6 months after surgery, although the serum AFP level remained normal. There was no further recurrence, after a second operation was performed in which the recurrent lesions were completely resected.
Pathological examination of these lesions revealed poorly differentiated adenocarcinoma, as at the primary site. Immunohistochemical staining confirmed AFP in cancer cells, however, the number of AFP-positive cells in the recurrent lesions was much greater than in the primary lesion. At 10 months after the second surgery, the patient remains alive without further recurrence. This case suggests that monitoring serum AFP is not necessarily useful for predicting the recurrence of AFP-producing lung cancer, and that systemic radiological examination, including computed tomography, is more appropriate to detect recurrence.View full abstractDownload PDF (5343K) -
Shuichi Tachibana, Manpei Kawakami, Keiichi Nakao, Kousuke Tokitsu, Sh ...1998 Volume 38 Issue 3 Pages 241-247
Published: June 20, 1998
Released on J-STAGE: August 10, 2011
JOURNAL FREE ACCESSWe observed that cell death induced by hyperthermia was related to apoptosis on the basis of histological findings of a patient undergoing neoadjuvant hyperthermia for squamous cell carcinoma of the lung. Effective heating was confirmed by measuring the temperature in the tumor. The antitumor effects of hyperthermia were evaluated using resected specimens and the relation between hyperthermia and apoptosis was studied. The paraffin-embedded sections were prepared for H. E. staining, the TUNEL method and immunohistochemistry for Fas antigen and Fas ligand.
The H. E. staining showed that cells with chromatin condensation were scattered in tumor areas of non viable tissue and the nuclei of these cells were strongly positive for TUNEL staining.
Moreover, the cells with anti Fas antibody were present in cancer cells in the viable tumor area. In contrast, cells with Fas ligands were present only in the tumor areas of non viable tissue and most of them were lymphocytes.
These findings suggest that apoptosis induced by the Fas-Fas ligand may have played a role in the development of the cytotoxic effects of this case.View full abstractDownload PDF (8551K) -
Hitoshi Haneda, Makoto Koizumi1998 Volume 38 Issue 3 Pages 249-253
Published: June 20, 1998
Released on J-STAGE: August 10, 2011
JOURNAL FREE ACCESSA 65-year-old woman visited our hospital to investigate a headache and abnormal chest shadow. She had lung adenocarcinoma in the right upper lung, and multiple bone and lung metastasis. Skull frontal bone biopsy confirmed the diagnosis of the metastasis of lung adenocarcinoma. Immunohistochemical staining showed positive findings for platelet derived growth factor, but negative finding for TGFβ. PDGFs are potent bone cell mitogens and promote metastatic cell growth in target organs. PDGF may also be related to osteoplastic metastasis of lung adenocarcinoma.View full abstractDownload PDF (4462K) -
Ko Tsuji, Takashi Hirano, Norihiko Kawate, Chimori Konaka, Yoshiro Ebi ...1998 Volume 38 Issue 3 Pages 255-260
Published: June 20, 1998
Released on J-STAGE: August 10, 2011
JOURNAL FREE ACCESSA 52-year-old man was found to have a small adenocarcinoma of the right upper lobe of the lung, based on X-ray findings and TV-brushing. The clinical stage was IA, and he was referred to the surgical department for operation. Preoperative bronchofiberscopy showed mucosal redness and edema from the carina both to the bifurcation of the right upper lobe bronchus and the truncus intermedius and to the bifurcation of the left upper and the lower lobe bronchi. Bronchial biopsy showed remarkable submucosal lymph duct invasion of carcinoma cells. Therefore we concluded that there was no indication of surgery.
We evaluated the E-cadherin-associated cell-to-cell adhesion based on the immunohistochemical expression of E-cadherin and three kinds of undercoat proteins (alphacatenin, beta-catenin and plakoglobin). All undercoat proteins lost their normal expression. The results suggested that this case was the E-cadherin dysfunctional type. The TV-brushing specimen showed many solitary carcinoma cells. Clusters displayed a slight tendency to overlap, with poor cellular adherence. It is necessary to carefully investigate the bronchofiberscopic findings even in small peripheral adenocarcinomas.View full abstractDownload PDF (6093K) -
Koji Onishi, Akio Hiraki, Hiroshi Ueoka, Akio Ando, Nobuyoshi Shimizu, ...1998 Volume 38 Issue 3 Pages 261-265
Published: June 20, 1998
Released on J-STAGE: August 10, 2011
JOURNAL FREE ACCESSAn abnormal shadow was found out on the chest radiograph of 57-year-old Japanese man during a regular check-up. A CT scan of the chest at a local clinic demonstrated a nodule in the right upper lobe. He was admitted to our hospital. Transbronchial lung biopsy yielded a diagnosis of moderately differentiated adenocarcinoma of the lung. A CT scan of the chest revealed swelling of the subcarinal lymph nodes. He underwent mediastinoscopy for subcarinal lymph node biopsy, and a diagnosis of a small cell carcinoma, intermediate cell type, was made.
He was treated with concurrent radiotherapy and chemotherapy consisting of cisplatin and etoposide. He achieved a partial response for small cell lung carcinoma and a minor response for the adenocarcinoma. He was further treated with thoracoscopic resection of the adenocarcinoma and mediastinal lymph node dissection. No residual tumor cells were detected in the mediastinal lymph nodes. Only a few cases of synchronous primary lung cancer comprising small cell and non-small cell have been reported.View full abstractDownload PDF (6490K) -
Makoto Tanaka, Masaki Ohtawa, Naohiko Chohnabayashi, Masahiro Aoshima, ...1998 Volume 38 Issue 3 Pages 267-273
Published: June 20, 1998
Released on J-STAGE: August 10, 2011
JOURNAL FREE ACCESSThree case reports of lung cancer under maintenance hemodialysis.
Case 1 was a 63-year-old woman who had received maintenance hemodialysis for 3 years. She was admitted due to an abnormality on chest X-ray, and right upper lobectomy was performed. Histological findings revealed bronchioloalveolar cell carcinoma and the postoperative staging was T2NOMO. She is alive without any signs of recurrence for three years.
Case 2 was a 59-year-old woman who had received hemodialysis for 12 years. She was admitted due to an abnormality on chest X-ray. Right upper and middle lobectomy was performed, and because of massive air leakage re-thoracotomy was performed on the first postoperative day. Histological findings revealed moderately differentiated adenocarcinoma, and the postoperative staging was T2N0M0. She is alive without any signs of recurrence for 18 months.
Case 3 was a 62-year-old man who had received hemodialysis for one year. He was admitted because of dyspnea and hemosputum. Squamous cell carcinoma of the left lung was diagnosed. Irradiation therapy was performed because of pulmonary metastasis, but after 6 months he died of respiratory failure.
Under careful perioperative management, operation for lung cancer in patients under hemodialysis can be performed safely. Appropriate chemotherapy strategy should be designed immediately.View full abstractDownload PDF (8427K) -
Katsuya Watanabe, Yasushi Hayashi, Takamitsu Maehara, Takao Morohoshi, ...1998 Volume 38 Issue 3 Pages 275-278
Published: June 20, 1998
Released on J-STAGE: August 10, 2011
JOURNAL FREE ACCESSA 73-year-old patient with emphysematous bulla had undergone annual X-ray examinations. The most recent chest X-ray showed a coin lesion in the right upper lung field. A CT scan revealed a well defined nodular mass in right S2 and bilateral multiple bullous lesions in S6. Comparison with former CT films revealed that two bullous lesions had been replaced by the nodular mass suggesting that the tumor had originated from the wall of the bulla and developed into the bullous lumen. Because the shadow enlarged relatively rapidly, which suggested the present of neoplasm, we performed an open lung biopsy. Firm pleural adhesion was found around the bullae. Squamous cell carcinoma was diagnosed based on pathological examination of the frozen section and we performed a right upper lobectomy and lymph node dissection (R2a). Annual examination by chest CT scan is essential for patients with bulla, considering the possible coexistence of lung cancer. If lung cancer is suspected in such patients, an open lung biopsy should be considered.View full abstractDownload PDF (4839K) -
1998 Volume 38 Issue 3 Pages 279-293
Published: June 20, 1998
Released on J-STAGE: August 10, 2011
JOURNAL FREE ACCESSDownload PDF (2202K)
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