All issues
Volume 40, Issue 4
Displaying 1-15 of 15 articles from this issue
- |<
- <
- 1
- >
- >|
-
Yukihisa Saida, Yuka Kujiraoka, Takashi Fuchigami, Noboru Yanai, Yoko ...2000 Volume 40 Issue 4 Pages 247-253
Published: August 20, 2000
Released on J-STAGE: August 10, 2011
JOURNAL FREE ACCESSObjective: To compare the positive rates of lung lesions on previous films among different histologic types, and to elucidate radiographic findings of long-standing lesions.
Study Design: In the past five years 252 patients (182 males and 70 females, median 68.6 years) were identified by a mass screening program in Ibaraki Prefecture and later confirmed histologically to have lung cancer. By reviewing previous films, the pattern of tumor growth was analyzed according to histologic types.
Results: Of the 252 lung cancers, 60% were detectable on previous films. In cases of adenocarcinoma, positive rate was 80% one year before, 50% two years before and 31% three years before. In cases of squamous cell carcinoma, the positive rate was 42% one year before, 7% two years before and 4% three years before. Of the 19 lesions identifiable radiographically three years before or more, all except one were adenocarcinoma and five cases were stage I when diagnosed. Radiographically most lesions first appeared as a lesion measuring less than 15 mm in diameter, and 80% of such small-sized adenocarcinomas with positive findings 2 or 3 years before showed an ill-defined hazy opacity.
Conclusion: In this study, 60% of all lung cancers and 80% of adenocarcinomas were detectable one year previously. It is very important to pick up ill-defined hazy opacities for early detection of lung cancers and at the same time it should be kept in mind that some adenocarcinomas show extremely slow progression.View full abstractDownload PDF (2843K) -
Takeshi Shiraishi, Kenshi Watanabe, Masafumi Hiratsuka, Osamu Ichiguch ...2000 Volume 40 Issue 4 Pages 255-260
Published: August 20, 2000
Released on J-STAGE: August 10, 2011
JOURNAL FREE ACCESSObjective: The charts of 534 patients who underwent surgical resection for primary lung cancer from 1993 to 1998 were analyzed to elucidate the factors influencing 30-day operative mortality or long hospitalization period (more than 30 days) following surgery.
Method: The factors influencing operative death or long hospital stay were analyzed using multivariate logistic regression analysis.
Results: Among 534 patients, the 30-day operative mortality was 2.3%(12 cases). Sixty cases (11.6%) stayed more than 30 days after surgical treatment because of complications. A multivariate logistic regression analysis indicated that reconstruction of the central airway, reconstruction of the main pulmonary artery, and T-factor were significantly associated with mortality, and combined resection/reconstruction of the chest wall, the presence of COPD, pneumonectomy, and bronchoplastic procedures were significantly associated with long hospital stay.
Conclusion: In summary, COPD is only one significant factor based on patient characteristics for long hospital stay. Among surgical factors, combined resection and reconstruction of the main pulmonary artery, central airway, or chest wall were associated independently with operative death or long hospital stay. However, the extent of lymph node dissection was not associated with either operative death or long hospital stay.View full abstractDownload PDF (753K) -
Yoshifumi Makimoto, Katsunobu Kawahara, Takeshi Shiraishi, Kan Okabaya ...2000 Volume 40 Issue 4 Pages 261-265
Published: August 20, 2000
Released on J-STAGE: August 10, 2011
JOURNAL FREE ACCESSObjective: In order to establish indications for surgical treatment of lung cancer in octogenarian, we reviewed our operative experiences.
Patients: Fifty-five patients 80 years of age or older (mean age, 82.7; range from 80 to 92 years) underwent surgical treatment in our institute from 1983 to 1999. There were 37 men and 18 women. Twenty-eight patients had clinical stage I disease, 12 had stage II disease, 14 had stage III disease, and 1 had stage IV disease. The operations consisted of 3 pneumonectomies, 38 lobectomies, 6 segmentectomies, and 8 partial resections.
Results: Postoperative complications occurred in 25 (56%) patients. Respiratory complications occurred in 15 patients, cardiac complications in 7, transient delirium in 10, gastrointestinal bleeding in 2, and operative mortality was 3.6%. The over all actual 5-year survival rate was 34%, and 54% in clinical stage I, 11% in stage II. The relative 5-year survival rate (survival rate of our subjects/that of mached population) was 60%.
Conclusion: We suggested that indications for surgical treatment of lung cancer in octgenarian were (1) performance status≤2, (2) witho-ut severe complications, (3) with good understanding and cooperation for surgical treatment from patient's family, and (4) clinical stage I and II.View full abstractDownload PDF (610K) -
Takashi Hirose, Naoya Horichi, Munehide Noda, Toshimitsu Yamaoka, Tets ...2000 Volume 40 Issue 4 Pages 267-271
Published: August 20, 2000
Released on J-STAGE: August 10, 2011
JOURNAL FREE ACCESSObjective: The aim of this study was to evaluate the diagnostic accuracy of high-resolution computed tomography (HRCT) and thick-section CT for the bronchoscopic diagnosis of solitary pulmonary nodules.
Methods: Between April 1997 and March 2000, 86 patients with solitary pulmonary nodules without calcification, 30mm or less in diameter were retrospectively evaluated. Thick sections were obtained from the lung apices through the diaphragm with a pitch of 1.3 and 10 mm colimination in all patients before bronchoscopy. In group A (n=47), only thicksection CT was performed. In group B (n=39), HRCT was additionally performed with a pitch of 1 and 3 mm colimination from the hilum through the nodules.
Result: In groups A and B, the average sizes were 20.9 mm and 20.4 mm. In both groups, there were 30 and 23 cases of lung cancers and 17 and 16 cases of benign diseases, respectively. The diagnostic accuracy of all cases was 71%(61/86), and those of groups A and B were 65%(31/47) and 76%(30/39), respectively. There were no statistically significant differences in diagnostic accuracy between groups A and B (p=0.26). In group B, HRCT depicted a CT bronchus sign significantly more than thick-section CT did (p<0.05). However, there were no statistically significant differences in diagnostic accuracy between those with and without CT bronchus signs (p=0.13). Moreover, the diagnostic accuracy did not differ with the involvement of the pulmonary artery or vein, location, character of the lesion border, and the presence of a cavity.
Conclusion: HRCT from the hilum through the nodule did not substantially alter the bronchoscopic diagnostic accuracy of solitary pulmonary nodules.View full abstractDownload PDF (1392K) -
Hidetaka Uramoto, Toshihiro Osaki, Yoshinobu Ichiki, Naohiro Nose, Hid ...2000 Volume 40 Issue 4 Pages 273-278
Published: August 20, 2000
Released on J-STAGE: August 10, 2011
JOURNAL FREE ACCESSObjective: In order to establish the role of bilobectomy in the treatment of lung cancer, we retrospectively reviewed our experiences.
Patient: The present study included 62 patients with a mean age of 64, ranging from 41 to 79, who were treated our institute from 1979 through 1998. There were 45 men and 17 women. Thirty patients had squamous cell carcinoma, 25 had adenocarcinoma and 7 had another histological type. Twenty three patients had pathological stage I disease, 13 had stage II, 24 had stage III, 2 had stage IV.
Results: Indications for bilobectomy were lymph node involvement of lobar bronchus (37.1%), interlobular P3 (33.8%), tumor invasion to the truncus intermedius (8.1%), invasion to pulmonary artery (3.2%), absence of a fissure between lobes (3.2%), and others (14.4%). Postoperative complications occured in 24 patients (38.7%) and 3 died within 30 days after operation (operative mortality rate 4.8%). Incidences of local recurrence and complications in patients with bilobectomy, or lobectomy with partial resection were 4.8% and 43%, 19% and 19%, respectively for interlobular P3 cases at operation. Five-year survival rate of the patients with bilobectomy for lung cancer was 48.0%.
Conclusion: Cosidering the incidence of local recurrence according to surgical methods, the treatment for patients with interlobular P3 lesions at operation needs to be studied further.View full abstractDownload PDF (651K) -
Computed Tomographic Findings Based on Radiologic-Pathologic CorrelationGaku Tanaka, Kouzo Yamada, Fumihiro Oshita, Ikuo Nomura, Kazumasa Noda ...2000 Volume 40 Issue 4 Pages 279-285
Published: August 20, 2000
Released on J-STAGE: August 10, 2011
JOURNAL FREE ACCESSObjective: With the introduction of computed tomography (CT) for chest screening in recent years, more cases of resected peripheral small lung carcinomas have been reported. Many of these were adenocarcinomas. To focus on CT findings of peripheral non-adenocarcinoma nodules, we performed a retrospective analysis based on radiographic-pathologic correlations.
Study Design: We analyzed CT findings based on the pathology of peripheral small lung carcinomas, excluding the histological type of adenocarcinomas. We compared our findings with those observed in adenocarcinomas. We reviewed 28 peripheral small lung carcinoma nodules less than 20 mm in diameter, including 13 squamous cell carcinomas, 4 small cell carcinomas, 2 adeno- squamous cell carcinomas, 1 large cell carcinoma, and 8 carcinoids.
Results: The carcinomas were classified into two different patterns; non-adenocarcinomas excluding carcinoids, and carcinoids. Both were solid-density types on high-resolution CT (HR-CT) images. The HR-CT findings regarding the shape and number of notching, and the presence or absence of ground glass opacity (GGO) were different between nonadenocarcinomas excluding carcinoids and adenocarcinomas. On the other hand, the HR-CT findings regarding spiculations, GGO and pleural indentations, and the absence of bronchial compression were different between carcinoids and adenocarcinomas.
Conclusion: The shape characteristics and internal and marginal analysis on HR-CT images can contribute to the differential diagnosis of the histological type of peripheral small lung carcinomas.View full abstractDownload PDF (3749K) -
Shinji Shimatani, Shuichi Sasamoto, Nobuhide Kato, Keigo Takagi, Shiro ...2000 Volume 40 Issue 4 Pages 287-291
Published: August 20, 2000
Released on J-STAGE: August 10, 2011
JOURNAL FREE ACCESSCase: A59year-01dmanpresentedtoanearbyhospitalcomplainingofproductivecough, bloodysputumandfever. ChestradiographyandchestCTshowedasolitarythin-walledcavity, about6.5cmindiameter, ntherightupperlobe. Thepatientwasreferredtoourhospitalandwasexamined.Theclinicaldiagnosiswasprimarylungcancer (adenocarcinoma) withathin-alledcavity.Rightupperlobectomywasperformed.Thepathologicaldiagnosisagreedwiththeclinicaldiagnosis (P-3NOMO).ChestradiographyandchestCTperformed5monthsaftersurgeryshowedmultiplethinwalledcavitiesintheleftmiddlelungfield; allcavitiesgrewrapidly.
Conclusion: Primarylungcancerwithathin-walledcavityisrare.Itwassuspectedthatcavityformationinthiscase wasduetothepathologicalcharacteristicsofthetumor, forexampleso-calledcellautophagia.View full abstractDownload PDF (3640K) -
Hideki Nishimura, Takaomi Hanaoka, Ryoichi Kondo, Keiichiro Takasuna, ...2000 Volume 40 Issue 4 Pages 293-296
Published: August 20, 2000
Released on J-STAGE: August 10, 2011
JOURNAL FREE ACCESSBackground: Prognosis is very poor in lung cancer with liver metastasis. We experienced a complete response case of liver metastasis treated with hepatic arterial infusion chemotherapy.
Case: A 64-year-old man with primary lung cancer underwent left upper lobectomy. Preoperative computed tomography (CT) revealed single mass in the liver which increased 4 weeks after the operation. Hepatic arterial infusion therapy with mitomycin C (2mg/day, days 1, 2, 3), vindesine (1mg/day, days 1, 2, 3) and cisplatin (20mg/day, days 1, 2, 3) was started 2 months after the operation and repeated every 4 weeks. After 3 cycles of this chemotherapy, the mass lesion dissapeared on CT scan. Six cycles of this therapy were completed without major complications. During a distal gastrectomy for early gastric cancer 2 years and 5 months after the pulmonary resection, intraoperative ultra-sonography was performed, but no liver mass could be detected. Local recurrence and distant metastasis to other organs including the liver were not observed 3 years and 10 months after the pulmonary resection.
Conclusion: Although the indications of hepatic arterial infusion chemotherapy is still controversial, we believe that this treatment should be tried in patients with liver metastasis from primary lung cancer.View full abstractDownload PDF (2572K) -
Takahiro Kinoshita, Shinji Maebeya, Motokazu Kato, Yasuaki Naito2000 Volume 40 Issue 4 Pages 297-300
Published: August 20, 2000
Released on J-STAGE: August 10, 2011
JOURNAL FREE ACCESSBackground: Pulmonary angiosarcoma is a rare malignant vascular tumor. We report a case of surgically resected pulmonary angiosarcoma.
Case: An 82-year-old man was admitted to our hospital because of bloody sputum and cough. The chest X-ray film and CT film showed a 50×45 mm mass in the right upper lobe (S1). The tumor was diagnosed as lung cancer by transbronchoscopic lung biopsy, so upper lobectomy with regional lymph node dissection was perfomed. The histological diagnosis was pulmonary angiosarcoma based on silver, factor VIII and CD34 stainings. The patient died of multiple bone metastases about 6 months after the operation.
Conclusion: Pulmonary angiosarcoma is rare, and we could find only 11 cases in the Japanese literature. The prognosis is said to be very poor. The patient died of distant metastases about 6 months after the curative operation.View full abstractDownload PDF (2569K) -
Hiroshi Hosoda, Kenichi Atarashi, Kazuhito Saito, Meiyo Tamaoka, Makot ...2000 Volume 40 Issue 4 Pages 301-304
Published: August 20, 2000
Released on J-STAGE: August 10, 2011
JOURNAL FREE ACCESSA 62-year-old man was given a diagnosis of primary lung cancer in the right lower lobe with chronic bacterial empyema and cavitary tuberculosis in the right upper lobe. He underwent complete pleuropneumonectomy. Pathological examination revealed that the tumor was pT2N1M0 squamous cell lung cancer. There was no direct communication between the neoplasm and free pleural cavity microscopically. The empyema might have occurred secondary to obstructive pneumonia caused by the tumor involvement of the lower respiratory tract. The empyema microbe was identified as staphylococcus aureus (MSSA). Mycobacterium tuberculosis was detected from the cavitary lesion of upper lobe. His clinical course was good and no recurrence of lung cancer, empyema or pulmonary tuberculosis has been detected at 20 months after the operation.View full abstractDownload PDF (3208K) -
Yasuhiro Takahashi, Mitsuo Kawamura, Kimito Orino, Arata Kobayashi, Yu ...2000 Volume 40 Issue 4 Pages 305-310
Published: August 20, 2000
Released on J-STAGE: August 10, 2011
JOURNAL FREE ACCESSBack ground: Extracranial meningiomas in the lungs are quite rare, and their occurrence has been reported only sporadically.
Case: An asymptomatic 54-year-old-woman was admitted with an abnormal shadow on her chest X-ray. Her chest CT scans showed a well-defined small nodule in the peripheral left lower lung. Left S6 partial resection was performed by video-assisted thoracoscopic surgery. The resected specimens revealed typical classical meningioma including such features as eosinophilic tumor cells, psammomatous bodies and cellular whorls. Immunohistochemically, the tumor cells showed positive staining for vimentin, cytokeratin and neuron specific enolase, and were negative for epithelial membrane antigen (EMA). The magnetic resonance images of her head demonstrated no evidence of intracranial meningioma. She is alive and well 12 months after the operation.
Conclusion: We report a case of primary pulmonary meningioma.View full abstractDownload PDF (3814K) -
Tomoko Yamamoto, Ken Hatta, Wataru Nishio, Kouji Eno, Kouji Maniwa2000 Volume 40 Issue 4 Pages 311-314
Published: August 20, 2000
Released on J-STAGE: August 10, 2011
JOURNAL FREE ACCESSBackground: Since a solid pulmonary nodule is likely to be malignant, it should be followed with thin-slice chest CT every month for the first three months, then, every two months for at least one year. However, follow up with thin-slice chest CT every two months for at least one or two years seems to be sufficient for containing a cavity non-solid nodules.
Case: We encountered two cases of patients with peripheral micronodular pulmonary lesions which were incidentally found only on chest CT.
Conclusion: Necessity of regular follow up study for incidentally found minute nodule in chest CT mainly depends on its radiological characteristics i. e.whether it is solid or cavitary non-solid lesions. However, if any significant change in nodular size or character is found during the follow up period, histological diagnosis by thoracoscopic biopsy should be carried out without hesitation.View full abstractDownload PDF (2740K) -
Akio Yamazaki, Sadahiko Masuda, Minoru Tahara, Kazuki Nakahara, Toshia ...2000 Volume 40 Issue 4 Pages 315-320
Published: August 20, 2000
Released on J-STAGE: August 10, 2011
JOURNAL FREE ACCESSBackground: Pulmonary hypertrophic osteoarthropathy (PHO) is often associated with bronchogenic carcinoma, but the etiology of PHO is still unknown.
Case: A 61-year-old man was admitted with an abnormal shadow on chest X-ray film. He had clubbed fingers and gonalgia. A diagnosis of bronchogenic carcinoma, associated with pulmonary hypertrophic osteoarthropathy (PHO) was made and right middle-lower lobectomy was performed in August, 1998. After the operation, gonalgia improved, but finger clubbing remained. The histological diagnosis was poorly differentiated squamous cell carcinoma with no evidence of lymph node metastasis, and immunohistochemically some tumor cells were positive for chromogranin A, synaptophysin and gastrin-releasing peptide (GRP).
Conclusion: Hormone assay could not determine the mechanism of occurrence of PHO in this case.View full abstractDownload PDF (2853K) -
2000 Volume 40 Issue 4 Pages 321-338
Published: August 20, 2000
Released on J-STAGE: August 10, 2011
JOURNAL FREE ACCESSDownload PDF (3408K) -
2000 Volume 40 Issue 4 Pages e1
Published: 2000
Released on J-STAGE: August 10, 2011
JOURNAL FREE ACCESSDownload PDF (28K)
- |<
- <
- 1
- >
- >|