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Volume 41, Issue 2
Displaying 1-14 of 14 articles from this issue
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Hidehiko Matsumoto, Hiroki Ogawa, Hironobu Toyoyama, Masakazu Yanagi, ...2001 Volume 41 Issue 2 Pages 99-104
Published: April 20, 2001
Released on J-STAGE: August 10, 2011
JOURNAL FREE ACCESSObjective and Methods: Clinicopathological features and outcome of 190 women with lung cancer were analysed incomparison with 446 male patients treated between 1973 and 1999.
Result: A comparison of the characteristics according to gender showed that, the prevalence in women with a smokinghistory was significantly lower than that in men. On the other hand, the incidence of adenocarcinoma was higher in femalecases detected by mass surveys. The prognosis of adenocarcinoma of the lung in women was significantly better than thatin men. However when death due to unrelated diseases, (respiratory failure, cardiac failure etc.) was excluded, there wasno significant difference in prognosis between male and female patients with stagel, II and IIIA lung adenocarcinoma.
Conclusion: The reason why female patients with lung cancer have better prognoses than male patients is not due tobiological behavior but due to the incidence of postoperative complications and difference of causes of death betweenmale and female patients with lung cancer.View full abstractDownload PDF (668K) -
Masayuki Chida, Masashi Handa, Syuichi Ono, Satomi Takahashi, Tatsuo T ...2001 Volume 41 Issue 2 Pages 105-109
Published: April 20, 2001
Released on J-STAGE: August 10, 2011
JOURNAL FREE ACCESSObjective: To evaluate the usefulness of computed tomography (CT) for detection of interstitial pneumonia (IP) asa risk factor of postoperative acute interstitial pneumonia (AIP).
Subjects and Methods: A total of 553 patients with primary lung cancer underwent thoracotomy. Nine (1.6%) hadpostoperative AIP. Six of the 9 died due to AIP and 8 of the 9 had localized IP findings on chest CT. Chest CT of 303 patientswere reviewed retrospectively, and 36 (11.9%) had IP findings (diffuse 2.3%, localized 9.6%). Postoperative AIPoccurred in 11.8% of patients with IP findings, but only in 0.2% without such findings (p=0.0001).
Conclusion: Detection of IP findings by chest CT is important to identify the high-risk patients who may have postoperative AIP after thoracotomy.View full abstractDownload PDF (2539K) -
Tatsuya Yoshimasu, Nariaki Matsuura, Ichiro Ota, Naoyuki Tani, Shoji O ...2001 Volume 41 Issue 2 Pages 111-115
Published: April 20, 2001
Released on J-STAGE: August 10, 2011
JOURNAL FREE ACCESSObjective: Integrins are related to the growth, invasion, and metastasis of cancer cells, and lung cancer cellsexpress multiple integrin subunits. This study was designed to determine the integrin subunits which playmajor roles in the growth and metastasis of non-small cell lung cancer (NSCLC).
Methods: NSCLC cell lines EBC-1, LK-2, LC-1F, PC-14, PC-3, VMRC-LCD and IA-5 were transplanted into athymic mice both subcutaneouslyand intravenously. Subcutaneous tumor sizes were measured twice a week. Carcinoma cells from evidentmetastatic lesions were obtained and cultured. The patterns of integrin subunit expression were evaluatedusing immunofluorescence flowcytometric analysis.
Results: Maximal subcutaneous tumor size in theexponential growth phase was negatively correlated with integrin α5 and β1 expression (p=0.028, p=0.035). Three months after transplantation, carcinoma cells from 11 evident metastatic lesions were obtained andcultured. Expression of integrins α1, α2, α3, α4, α5, α6, αv, β1, β3, β4 and β5 was evaluated by flowcytometry. Expression of integrins α2, α3, α5, α6, β1, β4 and β5 was commonly detected inoriginal cell lines. The evidentchanges at the sites of metastasis were increases in α2 (p=0.04), αv (p=0.05), β1 (p=0.008) and β5 (p=0.09) expression. Conclusion: These results suggest that integrins α2β1 and αvβ5 are related to metastasis, and that α5β1 isrelated to tumor growth of NSCLC.View full abstractDownload PDF (708K) -
Yoshinori Yamashita, Eiji Miyahara, Yoshiyuki Yamaguchi, Katsuhiko Shi ...2001 Volume 41 Issue 2 Pages 117-122
Published: April 20, 2001
Released on J-STAGE: August 10, 2011
JOURNAL FREE ACCESSPurpose: Prognosis of malignant mesothelioma is extremely poor despite various treatments. In order to improve qualityof life for malignant mesothelioma, we attempted to control malignant effusion by local immunotherapy with activatedautologous lymphocytes.
Patients: Eight patients with malignant mesothelioma who had malignant effusion were studied. Their characteristicswere as follows: mean age 59.6, male/female 6/2, and epithelial/sarcomatous/biphasic 5/2/1.
Results: Four cases with pleural effusion and two cases with peritoneal effusion were completely controlled by infusionof OK-432, Interleukin-2 (IL-2), lymphocyte activated killer (LAK) and tumor-infiltrating lymphocyte (TIL) to thepleural or peritoneal cavity. A 48 year-old woman revealed shrinkage of the chest wall tumor by intratumoral injection of LAK. She could keep working while receiving treatment in the outpatient clinic until she died of respiratory insufficiency 52 moths after initial treatment. A60-year-old man who had previously received panpleuro-pneumonectomy combinedwith resection of diaphragm revealed symptoms of ileus and niveau on abdominal X-P which disappeared by intraperitonealinjection. However, he died of bronchial fistula after rehabilitation during 10 months. Another 61-year-old man hadmassive bleeding in the thoracic cavity after infusion of IL-2, which may be major problem.
Conclusion: Local immunotherapy with activated autologous lymphocyte contributed to the excellent control ofmalignant effusion and better QOL for malignant mesothelioma.View full abstractDownload PDF (2754K) -
Comparison With Whole Brain Radiation TherapyToru Serizawa, Toshihiko Iuchi, Junichi Ono, Katsunobu Osato2001 Volume 41 Issue 2 Pages 123-129
Published: April 20, 2001
Released on J-STAGE: August 10, 2011
JOURNAL FREE ACCESSObjective: The purpose of this retrospective study is to compare the effectiveness of gamma knife radiosurgery (GKS) with that of whole-brain radiation therapy (WBRT) for multiple cerebral metastases from non-small cell lung cancer.
Study Design: Among 302 cases with cerebral metastases from non-small cell lung cancer treated at the Chiba Cardiovascular Center and Chiba Cancer Center between 1990 and 1999, 100 consecutive patients filling the following 4 entrycriteria were analyzed in this study: 1) Up to 10 multiple brain lesions at initial MRI study; 2) No surgically inaccessibletumors with more than 30mm in diameter; 3) No carcinomatous meningitis; 4) More than 3 months of life expectancy.The patients were divided into two groups: the GKS group (66 patients) and the WBRT group (34 patients). In the GKS group, large lesions (≥30mm) were removed microsurgically and all other small lesions (<30mm) weretreated by GKS. New distant lesions were treated by repeated GKS without prophylactic WBRT. In the WBRT group, thepatients were treated by the traditional combined therapy of WBRT and surgery. In both groups, chemotherapy was administeredaccording to the primary physician's protocol.
Results: The two groups did not differ in terms of age, gender, initial Karnofsky Performance Scale (KPS) score, pathologyof lung cancer, number, and size of brain lesion, systemic control, and chemotherapy. Overall survival (OS), neurologicalsurvival (NS) and qualitative survival (QS) of the GKS group were longer than those of the WBRT group accordingto Kaplan-Meier's method. In a multivariate analysis the WBRT group also had significant poor prognostic factors forOS, NS and QS.
Conclusions: GKS without prophylactic WBRT could be a primary choice of treatment method for patients with asmany as 10 cerebral metastases from non-small cell lung cancer.View full abstractDownload PDF (1084K) -
Hiroyuki Ito, Yasufumi Hayashi, Takamitsu Maehara, Yoshinori Takanashi ...2001 Volume 41 Issue 2 Pages 131-135
Published: April 20, 2001
Released on J-STAGE: August 10, 2011
JOURNAL FREE ACCESSBackground: Biphasic pulmonary blastoma is a rare disease. On the basis of mesenchymal components, this tumor was classified into high-grade adenocarcinoma of fetal lung type (H-FLAC) and low-grade adenocarcinoma of fetal lung type (L-FLAC). Case: A 69-year-old woman had a cough, shortness of breath, and dyspnea in December 1994, and these symptoms gradually worsened. A local physician found an abnormal shadow on a chest radiogram in April 1995, and the patient was subsequently admitted to our hospital. A computed tomographic scan of the chest revealed a solid tumor in S6 of the left lung. Histopathological examination of a specimen obtained by transbronchial biopsy showed evidence of malignancy, but a definitive diagnosis could not be established. The tentative diagnosis was a primary malignant tumor of the lung, and a left pneumonectomy was performed in June 1995. Pathological examination, including immunohistochemical analysis, suggested a biphasic pulmonary blastoma, which had an epithelial component of high-grade adenocarcinoma of fetal lung type. Conclusion: We describe a case of biphasic pulmonary blastoma associated with H-FLAC epithelial components.View full abstractDownload PDF (2878K) -
Nobuhisa Ishikawa, Atsuko Kawamura, Haruko Daga, Masahiro Yamasaki, Te ...2001 Volume 41 Issue 2 Pages 137-141
Published: April 20, 2001
Released on J-STAGE: August 10, 2011
JOURNAL FREE ACCESSBackground: Leptomeningeal carcinomatosis occurs in patients with lung cancer, breast cancer, and melanomas. Thisdisorder is being diagnosed with increasing frequency as patients live longer and as neuro-imaging studies improve.
Case: A 59-year old man was admitted to our hospital with an abnormal shadow on chest roetenography. Non-smallcell lung cancer was diagnosed by neck biopsy and computed tomography (CT) guided percutaneous lung biopsy.Although he was treated with chemotherapy, he was soon readmitted because of back pain, muscle weakness, and gaitdisturbance, bowel/bladder dysfunction. The brain MRI showed multiple brain metastases and leptomeningial metastasis, and the spinal cord MRI showed intramedular metastases at Th12, L1, S1 levels. Malignant cells were detected by lumbarpuncture and leptomeningeal carcinomatosis was diagnosed. He died due to respiratory failure 2 weeks after admissionwith subacute disturbance of consciousness. Autopsy revealed widespread leptomeningeal carcinomatosis. Microscopicfindings showed that the tumor was a metastasis from small cell lung cancer (oat cell type with keratinization) of the lung.
Conclusion: We report a case of leptomeningeal carcinomatosis of lung cancer. The diagnosis of leptomeningeal carcinomatosisshould be considered if lung cancer patients complain of back pain and lumbago.View full abstractDownload PDF (3677K) -
Haruhisa Matsuguma, Kohei Yokoi, Masaki Anraku, Yukari Kamiyama, Kiyos ...2001 Volume 41 Issue 2 Pages 143-146
Published: April 20, 2001
Released on J-STAGE: August 10, 2011
JOURNAL FREE ACCESSBackground: In the treatment of centrally located intraluminal typical carcinoid, bronchoscopic therapy, such as Nd-YAG laser or electrocautery, has been recently advocated. High-resolution computed tomography (HRCT) has been used at the selection of such patients.
Cases: We have recently observed two cases of typical bronchial carcinoid tumor with intraluminal growth. Bronchoscopic study revealed one patient had a movable polypoid tumor occupying the lumen of the right truncus intermedius and the other had similar tumor in the left main bronchus. HRCT was performed for evaluating the tumor invasion to the bronchial wall. In both cases, HRCT with contrast medium showed an intraluminal slightly enhanced lesion in the bronchus and no obvious evidence of extra bronchial invasion. One patient underwent left pneumonectomy and the other had sleeve resection of the truncus intermedius, resulting in complete resections. Pathologic examination of the resected specimen disclosed that tumors, measuring 3.0×1.8×1.2cm and 2.0×1.3×1.0cm, respectively, invaded beyond the bronchial cartilage.
Conclusion: From these findings, HRCT is not considered to be useful for evaluation of tumor invasion to the bronchial wall in patients with centrally located intraluminal typical carcinoid.View full abstractDownload PDF (2893K) -
Toshihiko Sakamoto, Noriaki Tsubota, Hidehito Matsuoka, Yoshiki Takada ...2001 Volume 41 Issue 2 Pages 147-149
Published: April 20, 2001
Released on J-STAGE: August 10, 2011
JOURNAL FREE ACCESSBackground: A new marking method via a transbronchial approach has been developed to localize small pulmonary nodules situated deeply from the visceral pleura.
Case: A 45-year-old woman was admitted for further evaluation and treatment of a small lung nodule. High-resolution chest CT showed a nodule of 15mm in diameter with ground-glass attenuation in right S3a, that is the lateral subsegment of the anterior segment. Bronchoscopic brushing cytology revealed atypical adenomatous hyperplasia or bronchioloalveolar carcinoma. Inasmuch as the tumor was thought not to be visible or palpable during operation, preoperative marking by bronchoscopic dye injection was performed the day before operation. On confirming that the tip of the sheath catheter passed the tumor and reached the visceral pleura by CT fluoroscopy, 0.5mL of indigo carmine was injected through the bronchoscope into the lung parenchyma just under the visceral pleura. There were no complications related to the procedure. During the operation the dye marking was seen clearly. Segmental resection of S2b+S3a was performed through access thoracotomy. The marking located the tumor precisely. Pathological examination revealed localized bronchioloalveolar carcinoma with foci of alveolar structural collapse.
Conclusion: This technique proved to be a safe, reliable, and convenient marking method when video-assisted thoracic surgery (VATS) would be performed.View full abstractDownload PDF (1527K) -
Mitsunobu Tamura, Kenzo Hiroshima, Yasunori Ikeda, Sensuke Nagai, Koic ...2001 Volume 41 Issue 2 Pages 151-156
Published: April 20, 2001
Released on J-STAGE: August 10, 2011
JOURNAL FREE ACCESSBackground: We report a case of adenocarcinoma of the lung producing creatine kinase (CK) with elevated levels of serum macro-CK.
Case: A 56-year-old man was referred to our hospital because of a mass in the right lower lung field. Cells of squamous cell carcinoma were detected in smears obtained by bronchoscopy from the mass located in Sw. A diagnosis of primary lung cancer with a clinical stage of IIIB, (T2N3M0), was given after serial examinations with CT and scintigraphy. The serum CK level elevated to 423IU/l with a regular pattern in the electrophoretic mobility of its isoenzymes. Further studies revealed that the native CK was a macromolecule consisting of a CK-immunoglobulin complex and that the binding protein was IgA of which the light chain linking to CK was γ type. Clinical or neurophysiological examinations did not show any finding of either polymyositis (PM) or dermatomyositis (DM), suggesting that CK may be produced by lung cancer. After induction chemotherapy consisting of carboplatin (CBDCA) and etoposide (VP-16), right lower extended segmentectomy S10 with lymph node sampling was performed. The histologic type of the neoplasm was shown to be moderately differentiated papillary adenocarcinoma with foci of squamous cell carcinoma. Immunohistochemically, adenocarcinoma cells were stained focally with both anti-CK-MM and anti-CK-BB antibodies. Although both the chomotherapy and the surgical resection resulted in a transient decline of the serum CK level, it rapidly elevated with tumor relapse and metastasis. The patient died of disseminated intravascular coagulation (DIC) 9 months after surgery.
Conclusion: We concluded that adenocarcinoma cells of the lung in this case produce CK, resulting in the formation of macromolecules consisting of CK-immunoglobulin complexes, and demonstrate that non-small cell lung cancer may produce not only CK-BB but CK-MM.View full abstractDownload PDF (3640K) -
Masahiro Kase, Tatsusi Yamagata, Kosirou Watanabe, Hirosi Kunikane, Hi ...2001 Volume 41 Issue 2 Pages 157-160
Published: April 20, 2001
Released on J-STAGE: August 10, 2011
JOURNAL FREE ACCESSCase: A 75-year-old man was hospitalized with bloody sputum. Chest X-ray film and CT scanning images detected a mass in the right upper lobe (S2) of the lung. Diagnosis could not be bronchoscopically confirmed and video-assisted thoracic surgery (VATS) was planned. The preoperative platelet count was as low as 4.6×104/mm3, suggesting idiopathic thrombocytopenic purpura (ITP). Because PAIgG was elevated to 267.7ng/107 cells and images of the aspirated bone marrow, the patient was eventually diagnosed as having ITP, and underwent preoperative high-dose intravenous immunoglobulin (HIVG) therapy. However, the platelet count only slightly increased 5 days later with hemorrhagic tendency, and therefore, the VATS was postponed. Investigations for all underlying autoimmune diseases causing the ITP were negative. During the test period, the platelet count remained at 7×104/mm3 but the hemorrhagic tendency improved. On day 21 after the HIVG therapy, VATS and right upper lobe lobectomy with complete mediastinal dissection were successfully car-ried out in combination with platelet transfusion. The histological diagnosis was large cell carcinoma, and the pathological stage was III A (T1N2M0).Conclusion: HIVG therapy is very useful for surgical operation of ITP-complicated lung cancer. However, the careful observation of the clinical findings are required to decide timely implementation of the surgery, and platelet transfusion may be required when the platelet count is not sufficiently increased.View full abstractDownload PDF (2123K) -
Yoko Sato, Susumu Sasano, Masahide Murasugi, Motoki Sakuraba, Takamasa ...2001 Volume 41 Issue 2 Pages 161-164
Published: April 20, 2001
Released on J-STAGE: August 10, 2011
JOURNAL FREE ACCESSBackground: Ectopic ACTH-producing tumor is a rare condition of which about 60% originate in the lung. The most common treatment for ectopic ACTH-producing tumors other than small-cell lung cancer is surgical resection.
Case: A 76-year-old woman with Cushing's syndrome from 1991 was given a diagnosis of ectopic ACTH-producing tumor in 1994. In 1996, chest CT revealed a lung tumor. Further observation showed no change in the size of the tumor, but symptoms worsened. Right middle lobectomy with video-assisted thoracoscopic surgery was performed in March 2000. The lung tumor was histologically diagnosed as a typical carcinoid. After resection of the tumor, serum ACTH levels decreased immediately, and several of the symptoms of Cushing's syndrome were relieved.
Conclusion: Symptoms were greatly relieved when VATS was used to operate in a case with a 10-year history of Cushing's syndrome accompanying an ectopic ACTH-producing tumor.View full abstractDownload PDF (3169K) -
Tomonori Nakasone2001 Volume 41 Issue 2 Pages 165-169
Published: April 20, 2001
Released on J-STAGE: August 10, 2011
JOURNAL FREE ACCESSBackground: The prognosis of lung cancers associated with emphysematous bulla is poor because of the difficulty in early diagnosis. The author encountered a case of early lung cancer discovered 7 months after lung resection for giant bulla.
Case: A 63-year-old man had been followed up after left upper division segmentectomy for giant bulla. His chest CT film 7 months after operation revealed a round shadow contiguous to the right apical pleural thickening. A lung cancer contiguous to the emphysematous bulla was diagnosed. Right upper lobectomy (ND2a) was performed on February 28, 2000. The microscopic findings revealed a moderately differentiated squamous cell carcinoma and the pathological staging was IA. It was assumed that the growth of carcinoma associated with the emphysematous bulla might have been affected by the surgical stress in the present case.
Conclusion: Combination of chest X-ray and chest CT examinations should be carefully performed after lung surgery for emphysematous bulla to discover associated early lung cancers.View full abstractDownload PDF (4479K) -
2001 Volume 41 Issue 2 Pages 170-186
Published: April 20, 2001
Released on J-STAGE: August 10, 2011
JOURNAL FREE ACCESSDownload PDF (3456K)
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