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Volume 40, Issue 2
Displaying 1-13 of 13 articles from this issue
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Hiroshi Hashimoto, Hiroto Takahashi, Motoyasu Sagawa, Masami Sato, Chi ...2000 Volume 40 Issue 2 Pages 85-91
Published: April 20, 2000
Released on J-STAGE: August 10, 2011
JOURNAL FREE ACCESSWe investigated the immunohistochemical expression of carcinoma-associated MUC 1 in human lung cancer tissues using the monoclonal antibody MUSE 11. We also investigated the expression of sialyl-Lewis x (sLex) using monoclonal antibody FH-6.
According to the histological type of lung cancer, MUSE 11 positivity was observed in 90% of patients with adenocarcinoma (72/80), 51.6% of patients with squamous cell carcinoma (49/95), and 54.5% of patients with large cell carcinoma (12/22).
A significant difference was detected in the expression of MUSE 11 between adenocarcinoma and the two other histological types. Thus, MUSE 11 appears to be a candidate for a tumor-associated marker in patients with lung adenocarcinoma. There was no relationship between the expression of MUSE 11 and T factors, N factors, pathological stage, grade of differentiation, or prognosis. A significant relationship was detected between the expression of MUSE 11 and that of FH-6. Earlier studies have revealed that part of sLex is associated with the MUC1 polypeptide. Our results suggested that the relationship also existed in human lung cancer specimens.View full abstractDownload PDF (2820K) -
Masayuki Iwasaki, Hiroshi Inoue2000 Volume 40 Issue 2 Pages 93-97
Published: April 20, 2000
Released on J-STAGE: August 10, 2011
JOURNAL FREE ACCESSObjectives: In January 1993, we developed a two-windows, video-assisted thoracoscopic surgery (VATS) method for treating lung cancer. Access to the pleural cavity was achieved by making two skin incisions: for right thoracotomies, 2-cm and 3-cm incisions were made anterior and posterior, respectively, to the inferior angle of the scapula in the fourth intercostal space. For left thoracotomies, the incisions were 3 cm and 2 cm, respectively.
The two-windows method can thus be regarded as the least invasive current VATS procedure for lung cancer.
Methods: Using this procedure, we performed pulmonary lobectomies and mediastinal lymph node dissections in 50 lung cancer patients (Stage IA, T1NOMO according to pre-and post-operative histological classifications). Various features of these operations were compared to those of 50 other Stage IA, T1NOMO lung cancer patients who received standard thoracotomies (posterolateral open chest surgery) in the same period.
Results: The mean operation time using the two-windows VATS method was 2 hours and 35 minutes; the mean blood loss was 45.6ml; and an average of 28 mediastinal lymph nodes were dissected. The four-year cumulative survival rates were 94.6% by this method and 78.7% for the standard thoracotomy.
Conclusion: We believe that the two-windows VATS method will become the standard surgical procedure for Stage IA lung cancer.View full abstractDownload PDF (1770K) -
Akinobu Yoshimura, Masahiro Andoh, Shoji Kudoh, Jun Watari, Hiroyuki T ...2000 Volume 40 Issue 2 Pages 99-105
Published: April 20, 2000
Released on J-STAGE: August 10, 2011
JOURNAL FREE ACCESSObjective: We performed a pilot study to evaluate the efficacy of lung cancer screening with low-dose spiral CT (CT screening) from June to December 1996.
Methods: Volunteers from participants in conventional lung cancer screening with computed radiography and sputum cytological assessment (CR screening) in the same period were enrolled into this study. CT scans of the chest were made in a single breath-hold with low-dose spiral CT for lung-cancer screening.
Results: Overall 431 individuals (22.9%) out of 1, 880 participants were judged to need further examinations by either conventional or CT screening. Two hundred and ninety eight individuals (15.9%) of them were classified as “e” judgement which means possible or probable lung cancer by CT screening. Then 418 individuals had further examinations. Eight cases were diagnosed as having lung cancer (detection rate: 0.43%), of whom only two cases were detected by CR screening. Therefore, the positive predictive value in CT screening was 0.027. All cases had adenocarcinomas, located in peripheral lung regions. The mean diameter of tumors was 17 mm (range 8-25mm) and three small cancers less than 10mm were detected. There were 5 stage IA cases, 1 stage IB case, 1 stage IIIA case and 1 stage IV case. Six patients with stage IA or IB disease underwent surgical treatment.
Conclusions: It was suggested that low-dose spiral CT was superior in the detection of peripheral lung cancer and is a promising tool in lung cancer screening. It is necessary to establish a system of annual CT screening and the method of comparative reading of CT scan in order to improve the positive predictive value of CT screening.View full abstractDownload PDF (2063K) -
Kenichi Okubo, Tatsuo Kato, Isao Okazaki, Yasumasa Kani, Nobuhiro Miya ...2000 Volume 40 Issue 2 Pages 107-110
Published: April 20, 2000
Released on J-STAGE: August 10, 2011
JOURNAL FREE ACCESSObjective: We studied the effectiveness of cytological diagnosis for detecting metastasis of lung cancer in mediastinal lymph nodes.
Methods: One hundred forty stations of mediastinal nodes in 50 patients with lung cancer were excised through mediastinoscopy. Each specimen was examined for metastasis with imprint cytology and hematoxylin-eosin stained histology. Sensitivity and accuracy were compared between cytological and histological examinations.
Results: Cytological examination showed 22 positive stations in 14 patients, while histological examination showed 18 positive stations in 12 patients. All histological positive stations were positive cytologically and the final diagnosis was identical with cytological examination. The sensitivity and accuracy of cytological examination were 100% and 100%, while those of histological examination were 81.8% and 97.1%.
Conclusion: Imprint cytology for detecting metastasis in mediastinal lymph nodes showed high sensitivity and accuracy, and was no less effective than histological examination.View full abstractDownload PDF (1780K) -
Kikuo Nakano, Takehiko Hiramoto, Masasi Kanehara, Mihoko Doi, Yosihiro ...2000 Volume 40 Issue 2 Pages 111-115
Published: April 20, 2000
Released on J-STAGE: August 10, 2011
JOURNAL FREE ACCESSObjective: Patients with unresectable non-small cell lung cancer were treated to evaluate the toxicity and efficacy of high-dose thoracic irradiation (RT) combined with concurrent daily low-dose cisplatin plus vindesine.
Methods: Twenty five evaluable patients were treated with continuous-course RT (70Gy in 35 fractions of 2.0 Gy once daily) and concurrent daily intravenous cisplatin (6 mg/m2) plus vindesine (3 mg/m2 on day 1 and day 8).
Results: Leukopenia (48%) was the most severe sign of toxicity, but there were no episodes of discontinuation of treatment. Two patients (8%) had a grade 3 acute radiation esophagitis, but there was no severe late radiation esophagitis. Ten patients experienced late radiation pneumonitis and 9 of those were grade 1 or 2. There was only one lifethreatening toxicity (grade 5 pneumonitis). The objective response rate was 72%, and one patient achieved a radiographic complete response. The median survival duration for all patients was 14 months, and the 3-and 5-year actuarial survival rates were 27.2% and 27.2%, respectively.
Conclusion: We concluded that the regimen of high-dose thoracic RT combined with concurrent daily low-dose cisplatin plus vindesine was a well-tolerated regimen. The survival results were encouraging.View full abstractDownload PDF (856K) -
Motoki Sakuraba, Masahiro Mae, Takamasa Onuki, Kunihiro Oyama, Hirosi ...2000 Volume 40 Issue 2 Pages 117-120
Published: April 20, 2000
Released on J-STAGE: August 10, 2011
JOURNAL FREE ACCESSCase: A rare case of ACTH-producing thymic carcinoid is reported. A 42-year-old man was admitted because of hyperglycemia and hypertension. Endocrinological examination revealed high plasma ACTH and serum cortisol levels. Cushing's syndrome, i. e.osteoporosis, pigmentation, hypertension, hyperglycemia, and moonface, was recognized. No tumor was seen in the pituitary gland and adrenal gland. We suspected an ectopic ACTH-producing tumor. An anterior mediastinal tumor was detected on chest CT. The tumor was totally resected through median sternotomy. Histopathologically the tumor was stained with synaptophysin, NSE, chromogranin-A and ACTH. After the operation, hyperglycemia was recovered and plasma ACTH levels decreased.View full abstractDownload PDF (3428K) -
A Clinical Review of 104 Reported Cases in JapaneseKazuhiko Suzuki, Yuuji Mori, Hisashi Nakata, Tetsuro Ohnishi, Shosaku ...2000 Volume 40 Issue 2 Pages 121-127
Published: April 20, 2000
Released on J-STAGE: August 10, 2011
JOURNAL FREE ACCESSBackground: Mucoepidermoid carcinoma of the bronchus is a relatively rare tumor. We report here a case of mucoepidermoid carcinoma of the truncus intermedius which was successfully resected. We also reviewed the clinical features of 104 cases reported in the Japanese literature.
Case: A 23-year-old man was admitted complaining of cough, sputum, and stridor. His chest X-ray film showed volume loss of the right middle and lower lobes. Bronchoscopy revealed a polypoid tumor which almost occluded the lumen of the truncus intermedius. Bronchoscopic biopsy yielded a diagnosis of mucoepidermoid carcinoma. Since the mucosa affected normal and there was no extra-luminal invasion of the truncus intermedius, sleeve resection of the truncus inermedius, including the tumor, with end-to-end anastomosis was performed in addition to hilar lymph node dessection. There was no involvement of lymph nodes, and the tumor was pathologically classified as p T1NOMO, stagel A. The patient has been well and free of recurrence for one year postoperatively, and bronchoscopic findings showed clear healing of the anastomoticsite.
Conclusion: Sleeve resection can be an effective method for local cure and preservation of postoperative respiratory function.View full abstractDownload PDF (3654K) -
Naoyuki Yoshino, Teruaki Koike, Tsuneyo Takizawa, Masanori Terashima, ...2000 Volume 40 Issue 2 Pages 129-132
Published: April 20, 2000
Released on J-STAGE: August 10, 2011
JOURNAL FREE ACCESSCase: A 68-year-old woman producing much sputum had been treated as bronchitis from 1993. In January 1999, she was admitted to another hospital for pneumonia. She changed hospital because her dyspnea worsened, and underwent chest CT. A tumor in the right bronchus was pointed out. Bronchoscopy revealed the truncus intermedius to be obstructed by a white-yellow movable mass. It was suspected to be lung carcinoid based on washing cytology and chest CT. Right middle sleeve lobectomy was performed on April 1999. The mass had a stem at the orifice of the middle lobe bronchus diverging from the lateral side of truncus intermedius, and projected into the bronchial lumen. It had tumor component only in its stem. The white-yellow mass surrounding the component of tumor seemed to be mucoid material. Histologically this tumor was lung carcinoid, and a part of epithelium covering tumor had a cleft. We considered that this mucoid material was stratified from this cleft, indicating a unique growth pattern.View full abstractDownload PDF (3605K) -
Naoki Ishiwa, Kouzou Yamada, Haruhiko Nakayama, Kazumasa Noda, Youichi ...2000 Volume 40 Issue 2 Pages 133-137
Published: April 20, 2000
Released on J-STAGE: August 10, 2011
JOURNAL FREE ACCESSFew cases of squamous cell carcinoma of the trachea have been reported in non-smoking women. We report one case which was probably due to radiation therapy.
Case: A 50-year-old non-smoking woman was referred to our hospital because wheezing and dyspnea had been aggravated for 3 months. She had received radiation therapy (60Cobalt) after standard radical mastectomy for right breast can-cer 13 years previously. Bronchoscopic findings and chest CT scan showed tracheal stenosis due to the tumor. Sleeve resection of the trachea was performed, and the tumor was histologically diagnosed as poorly differentiated squamous cell carcinoma.
Conclusion: We may consider this case to be radiation-induced cancer compatible with the most strict criteria of radiation induced malignancy.View full abstractDownload PDF (3144K) -
Keiko Shinjo, Tomohiko Ogasawara, Toshinobu Nakamura, Masayuki Suzuki2000 Volume 40 Issue 2 Pages 139-142
Published: April 20, 2000
Released on J-STAGE: August 10, 2011
JOURNAL FREE ACCESSBackground: Pleural lymphoma occurs exclusively in patients with long-standing pyothorax, and primary malignant lymphoma of the chest wall is rare.
Case: A 84-year-old woman was hospitalized with a painful mass in the right anterior chest wall. A chest CT revealed a mass along right chest wall, which was diagnosed as malignant lymphoma (Non-Hodgkin's lymphoma, diffuse large cell, B cell type) by transcutaneous needle biopsy.
We assumed this had originated from the soft tissue in the chest wall by radiographical findings. The EB virus genome, frequently detected in pyothorax-associated malignant lymphomas, was proved negative by the in situ hybridization technique, therefore further examination was warranted for etiologic factors.
Conclusion: This is quite a rare case of malignant lymphoma in the chest wall without chronic empyema.View full abstractDownload PDF (2451K) -
Tomonori Nakasone, Hiroyoshi Ayabe2000 Volume 40 Issue 2 Pages 143-147
Published: April 20, 2000
Released on J-STAGE: August 10, 2011
JOURNAL FREE ACCESSBackground: There have been very few reports describing slowly progressive adenocarcinomas. We here present the case with a review of the literature.
Case: A 1.5cm ill-defined faint round shadow was pointed out in the right middle lung field on a chest X-ray film of a 74-year-old woman in 1993. Chest CT scan revealed a low density oval shadow in right S2. The shadow was followed up as an inflammatory disease. Chest CT scan in January 1999 revealed a solid high density area in the low density shadow. The high density area was thought to be lung cancer associated with inflammatory disease. CT-guided percutaneous lung biopsy revealed malignant findings. Right upper lobectomy was performed with mediastinal lymph node dissection (R2a). Microscopically the solid high density area on the chest CT was moderately differentiated papillary adenocarcinoma, but the circumferential low density area was well differentiated papillary adenocarcinoma. Metastasis to mediastinal lymph node #11 was recognized. The pathological staging was T1N1M0, stage IIA.
Conclusion: Our case was a slow progressive adenocarcinoma of the lung with a 6-year clinical history detected by the change of density of the shadow on chest CT.View full abstractDownload PDF (3622K) -
Kenji Hazama, Akinori Akashi, Yoshito Maehata2000 Volume 40 Issue 2 Pages 149-152
Published: April 20, 2000
Released on J-STAGE: August 10, 2011
JOURNAL FREE ACCESSBackground: Primary lung cancer with thin-walled cavity is rare. There are few reported cases of lung cancer with a thin-walled cavity presenting a round shadow on a chest X ray.
Case: A 59-year-old man was admitted for further examination of a round shadow on a chest X-ray. The shadow had been an irregular lesion with a thin-walled cavity six months previously. The patient rejected bronchoscopic examination and thoracoscopic resection was performed. Histological examination revealed the tumor to be squamous cell carcinoma. Right lower lobectomy and mediastinal lymphadenectomy was performed subsequently. The tumor was 50mm in diameter. It was filled with a white jelly-like substance. Microscopic examination showed well differentiated squamous cell carcinoma in a wall of the cavity and the substance. The pathological stage was IB (T2NOMO). He is well and disease-free ten months after the operation. This is thought to be a very rare case of primary lung cancer with thin-walled cavity which presented an atypical round shadow on chest X-ray.
Conclusion: Aggressive treatment including VATS is considered to be necessary for abnormal shadows on chest X-ray presenting a thin-walled cavity in which lung cancer is suspected.View full abstractDownload PDF (2543K) -
2000 Volume 40 Issue 2 Pages 153-175
Published: April 20, 2000
Released on J-STAGE: August 10, 2011
JOURNAL FREE ACCESSDownload PDF (4570K)
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