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Volume 42, Issue 6
Displaying 1-14 of 14 articles from this issue
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Takayuki Shirakusa, Koichi Kobayashi2002 Volume 42 Issue 6 Pages 555-566
Published: October 20, 2002
Released on J-STAGE: August 10, 2011
JOURNAL FREE ACCESSLung cancer cases (7408 cases) that were surgically resected during 1994 were registered and collected for analysis. The survival rate for the total cases was 51.9%. The 5-year survival rate was 48.2% in male (n=5029) and 61.0% in female (n=2150). The 5-year survival rates by c-STAGE were: c-STAGE IA (n=2618), 71.5%; c-STAGE IB (n=1646), 50.1%; c-STAGE IIA (n=169), 47.8%; c-STAGE IIB (n=793), 40.4%; c-STAGE IIIA (n=1385), 34.6%; c-STAGE IIIB (n=395), 27.6%; c-STAGE IV (n=162), 19.9%. The 5-year survival rate by p-STAGE was: p-STAGE IA (n=2142), 79.2%; p-STAGE IB (n=1488), 60.1%; p-STAGE IIA (n=261), 58.6%; p-STAGE IIB (n=785), 42.2%; p-STAGE IIIA (n=1337), 28.4%; p-STAGE IIIB (n=759), 20.0%; p-STAGE IV (n=275), 19.3%. Of the surgically resected cases, the most frequent histological type was adenocarcinoma at 55.7%; next, squamous cell carcinoma, 33.0%, large cell carcinoma 3.6%, and small cell carcinoma 3.4%. Operative death amounted to 101 cases (1.4%), hospital deaths to 122 cases (1.7%). Operation/hospital death mortality rate in surgically resected cases was 3.0%. (JJLC. 2002; 42: 555-566)View full abstractDownload PDF (1458K) -
Daisuke Okada, Kiyoshi Koizumi, Masashi Kawamoto, Shinobu Henmi, Kyoji ...2002 Volume 42 Issue 6 Pages 567-572
Published: October 20, 2002
Released on J-STAGE: August 10, 2011
JOURNAL FREE ACCESSObjective. In 9 patients operated on for idiopathic interstitial pneumonia (IIP) associated with primary lung cancer, we clinicopathologically examined the predictive factors of postoperative acute exacerbation of IIP. Methods. We collected 9 patients who had been operated on for lung cancer and in whom a pathological diagnosis of usual interstitial pneumonia (UIP) pattern had been made based on resected tissues. We studied some predictive factors related to the acute exacerbation of IIP preoperatively and during operation, and analyzed the pathological findings of UIP. Results. The incidence of postoperative acute exacerbation of IIP was 22%(2 of 9 patients). No correlation between the two patients who developed acute exacerbation of IIP and the seven patients who did not was observed, in terms of CRP, LDH, WBC, PaO2 and %VC of preoperation, blood loss, operation time and postoperative maximum CPK. Pathologically, abundant fibroblastic foci were observed in 4 patients and a half of them developed acute exacerbation of IIP at 7 and 9 days postoperatively. Conclusion. It was difficult to predict the development of acute exacerbation of HP because most patients were in a controlled stable state of IIP preoperatively. However, we considered that abundant fibroblastic foci in the tissue specimens known as pathologically active lesions of UIP were possibly one of the predictive factors in the acute exacerbation of IIP.View full abstractDownload PDF (3124K) -
Haruhiro Saito, Kozo Yamada, Rie Suzuki, Fumihiro Oshita, Haruhiko Nak ...2002 Volume 42 Issue 6 Pages 573-581
Published: October 20, 2002
Released on J-STAGE: August 10, 2011
JOURNAL FREE ACCESSObjective. To determine the initial appearance of lung adenocarcinoma on computed tomography and the appropriate follow-up duration. Study Design. Retrospective review of 17 cases in which computed tomography (CT) of the chest was performed about 2 years prior to the diagnosis of lung cancer. The diagnosis was confirmed by surgical resection in all cases. Result. The lung cancers were divided into four types based on their appearance on the initial CT: 1. Ground-glass opacity (GGO)-like images in which the lesion appeared as a faint opacity, 2. BLA (bubblelike appearance) image, in which the lesion resembled a focal collection of air, 3. A small solitary nodule, and 4. A scarlike image. Vascular involvement, air-bronchogram, and pleural indentation were all more prominent during a serial scan obtained just prior to surgery than on the initial scan. An increase in vascular involvement occurred prior to the other changes. High attenuation areas appeared in the GGO-like lesions prior to an increase in the size of the lesion. The growth pattern was classified as slow growing, rapidly growing, and initially slow growing with accelerated growth. The doubling time was similar in lesions with the same appearance. This information can be used to guide follow-up of images suspected of lung cancer. The appropriate follow-up duration is estimated from 6 to 12 months for GGO and BLAlike images, and from 2 to 3 months for small solitary nodules. Conclusion. The biological behavior of lung cancer is reflected in their initial appearance on CT.View full abstractDownload PDF (6614K) -
Riichiro Morita, Koichi Kaneko, Satomi Nakamura, Toru Akaishi, Nobuhir ...2002 Volume 42 Issue 6 Pages 583-587
Published: October 20, 2002
Released on J-STAGE: August 10, 2011
JOURNAL FREE ACCESSObjective. In order to elucidate whether interlobar pleural invasion of lung cancer should be categorized T2 or T3, we examined the results of the operations for lung cancers with interlobar pleural invasion (interlobarp3). Methods. Among 402 patients who were operated on for primary lung cancer in our hospital between 1984 and 1999, we studied 17 non-small cell lung cancer patients with interlobar p3, excluding patients who were diagnosed as t3 or t4 disease, or those with distant metastasis. The results of those 17 patients were compared with those of 32 patients with t3 non-small cell lung cancer and those of 152 patients with t2 non-small cell lung cancer. Results. The 5-year survival rate for patients with interlobar p3 was 38.5%. The 5-year survival rate for patients with t3 disease was 16.2%, and that for patients with t2 disease was 44.5%. The survival rate for patients with t2 disease was significantly higher, compared with that for patients with t3 disease. However there were no significant differences among the survival rate for patients with interlobar p3 and that for patients with t2 or t3 disease. Regarding the survival rate curve, that of patients with interlobar p3 is close to that of patients with t3 up to 18 months, but it is close to that of t2 cases for over 6-year survival. In patients without lymph node metastasis, similar results were obtained. Regarding the difference of survival rates in each operation procedure for patients with interlobar p3, the 5-year survival rate by bilobectomy or pneumonectomy was 37.5%, while by lobectomy plus partial resection of the invaded lobe there was no 5-year survivor, and the 4-year survival rate was 40%. There was no significant difference between the survival rate by bilobectomy or pneumonectomy and that by lobectomy plus partial resection. Conclusion. The survival rate of patients with interlobar p3 is close to that of patients with t3, one or two years after operation; and close to that of patients with t2, in case of long term survivors.View full abstractDownload PDF (668K) -
Tadashi Akiba, Makoto Yamashita, Shuji Sato, Toru Nagata, Yoji Yamazak ...2002 Volume 42 Issue 6 Pages 589-593
Published: October 20, 2002
Released on J-STAGE: August 10, 2011
JOURNAL FREE ACCESSObjective. To gain insight into the feelings and concerns of patients with lung cancer and their families. Method. We announced on our Department of Thoracic Surgery website (http://www.jikei.ac.jp) and a lung cancer treatment website (http://www.akiba.gr.jp/tcp/) that we would accept requests for second opinions from patients and their families. We analyzed comments and questions received from May 1998 through February 2001. Results. We received 430 messages by e-mail, telephone, or facsimile concerning 386 patients. Messages concerning 87% of these patients were sent by e-mail. Of the 386 patients, 79% had lung cancer and additional 8% were suspected of having lung cancer. The male-to-female ratio of patients was 1.9: 1. The patients' ages ranged from 16 to 90 years and the average age was 61.7 years. Eighty-two% of patients were aged 50 to 79 years. Of the persons sending messages, 60% were children of patients. The male-to-female ratio of message-senders was 0.94: 1. A majority of questions (59%) concerned future plans for medical treatments or standard medical treatments, and 18% of questions concerned nonstandard medical treatment plans. The messages included 67 complaints, which included requests for information about other hospitals. Questioners often expressed dissatisfaction with incomplete explanations from physicians and the long waiting times for hospitalization or operation. Conclusion. Patients and their families are most often concerned about medical treatment plans. They are often not satisfied with the treatment of malignant tumors, such as lung cancer. Although the communication between a patient or patient's family and a doctor is relatively good, communication needs to be improved, especially between physicians and patient's children. Patients and their families are often dissatisfied with the explanations or treatment plans of their general practitioner and want to hear the opinion of a specialist.View full abstractDownload PDF (881K) -
Seigo Minami, Kiyoshi Komuta, Masahiko Tsujimoto, Mitsuko Asai2002 Volume 42 Issue 6 Pages 595-599
Published: October 20, 2002
Released on J-STAGE: August 10, 2011
JOURNAL FREE ACCESSBackground. Gingival metastasis from lung cancer is very uncommon. Case. A 51-year-old woman was referred to our hospital because of a large tumor mass shadow in the right middle lobe on chest roentgenogram and the left mandibular gingival swelling. The gingival tumor, which grew rapidly, was resected and anaplastic carcinoma was diagnosed histopathologically. Thereafter, CT-guided lung biopsy also revealed that the pulmonary lesion was histopathologically similar to the gingival tumor and no distant metastatic lesions other than the gingiva were observed by systemic examination. Thus, pulmonary pleomorphic carcinoma with gingival metastasis was suspected. Even two cycles of combination chemotherapy of carboplatin and etoposide could not prevent the tumor growth and emergence of pleural effusion. Eventually, the patient died on the 76th hospital day. Conclusion. The prognosis of lung cancer with gingival metastasis is very poor. Early detection and appropriate therapy are necessary.View full abstractDownload PDF (904K) -
Ryuhi Shimura, Hirokazu Tojima, Tetsu Nishiwaki, Norifumi Abe, Ritsu K ...2002 Volume 42 Issue 6 Pages 601-605
Published: October 20, 2002
Released on J-STAGE: August 10, 2011
JOURNAL FREE ACCESSBackground. Choriocarcinoma most commonly occurs in the female genital tract associated with gestation, and in males, extragenital choriocarcinoma rarely occurs in the testis. Primary pulmonary choriocarcinoma (PCC) is an exceedingly rare and malignant tumor with a poor prognosis. Case. A 42-year-old man presented to our hospital with convulsion due to a metastatic brain tumor. Chest radiography and CT scan revealed a nodule in the right upper lobe, which had been detected adjacent to a bulla two years ago. The nodule increased in size and was diagnosed as giant cell carcinoma by percutaneous needle biopsy. Systemic screening for distant lesions showed no abnormalities except solitary brain metastasis. The patient underwent craniotomy and the metastatic tumor was removed after radiotherapy. Subsequently, he underwent right upper lobectomy with partial chest wall resection. The lesions of both the brain and the lung were pathologically diagnosed as being choriocarcinoma. No tumor was seen in the testis. Because pulmonary choriocarcinoma is known to be very aggressive and rapidly metastasizing, postoperative therapy is indispensable. Thoracic irradiation (40Gy) and four cycles of chemotherapy with cisplatin and etoposide were given sequentially. At last follow-up the patient was alive with no evidence of recurrence 18 months after surgery. Conclusion. We report a male case of PCC with brain metastasis, who underwent combined modality treatment and who has been alive without recurrence 18 months after surgery. PCC is very rare and histologically difficult to distinguish from human cho-rionic gonadotropin-producing giant cell carcinoma of the lung. We obtained a good outcome in this case of PCC by combined treatment including surgery and adjuvant therapy.View full abstractDownload PDF (3679K) -
Fumihiko Hirai, Masato Kato, Hitoshi Ichimiya, Mitsuru Nakagaki, Nobuk ...2002 Volume 42 Issue 6 Pages 607-610
Published: October 20, 2002
Released on J-STAGE: August 10, 2011
JOURNAL FREE ACCESSBackground. Solitary fibrous tumor (SFT) is a rare neoplasm that commonly involves the pleuraand lung. Although SFT has generally been assumed to be benign, local recurrence sometimes occurs after surgery. Wereport two cases of SFT of the pleura. Cases. Case 1: A 23-year-old man had SFT of the parietal pleura. After the initialoperation, the patient received two more operations because of local recurrence. Case 2: A 25-year-old man had SFT ofthe visceral pleura. The tumor was removed by thoracoscopic surgery. There is no sign of recurrence. Conclusion. Thedetermination of the surgical margin is important to avoid local recurrence and patients should be strictly followed for along time after surgery.View full abstractDownload PDF (2648K) -
Mitsunobu Tamura, Kenzo Hiroshima, Kazuhiko Sugita, Satoru Kobayashi, ...2002 Volume 42 Issue 6 Pages 611-613
Published: October 20, 2002
Released on J-STAGE: August 10, 2011
JOURNAL FREE ACCESSBackground. Pulmonary metastases from gastric cancer are rarely resected because the most commonpatterns of metastases from gastric cancer are carcinomatous lymphangiosis or carcinomatous pleuritis. Cases.We studied 4 cases of solitary pulmonary metastases from gastric cancer that were completely resected, and comparedtheir characteristics with those of the primary lesions. Two of the cases were preoperatively diagnosed as primary pulmonarycarcinoma. The mean age of the cases was 63 years old, and all were male. All cases had undergone total gastrectomy.There cases were type III, moderately differentiated tubular adenocarcinoma, medullary type, INF beta. Lymphaticinvolvement was observed in all cases. All cases recurred and died after the operation, and the mean survivaltime after the resection of the metastatic lesion was 13.8 months. Conclusion. Solitary pulmonary lesion in cases witha history of gastric cancer should be resected only when the possibility of primary lung cancer could not be ruled out.View full abstractDownload PDF (448K) -
Eishu Hai, Toshihiro Ishikawa, Hiroshi Saito2002 Volume 42 Issue 6 Pages 615-618
Published: October 20, 2002
Released on J-STAGE: August 10, 2011
JOURNAL FREE ACCESSBackground. A pulmonary papilloma is considered as a benign tumor, especially, a peripheral andsolitary one is extremely rare. Case. A 70-year-old woman was admitted because chest X-ray film showed an abnormalshadow in the left lower lung field. Chest CT scan and bronchofiberscopic findings did not yield a definite diagnosis.Partial left lower lobectomy was carried out, and pathological diagnosis of the resected specimen was pulmonary papilloma, mixed squamous and glandular type. No malignant cells were detected in spite of further examinations. The patienthad no other tumor in her lungs and no new lesions were detected one year after the operation. Conclusion. Reviewof the literature showed peripheral solitary pulmonary papillomas to be extremely rare.View full abstractDownload PDF (2569K) -
Keisuke Eguchi, Koichi Kobayashi2002 Volume 42 Issue 6 Pages 619-623
Published: October 20, 2002
Released on J-STAGE: August 10, 2011
JOURNAL FREE ACCESSBackground. Leucocytosis arising from a high blood concentration of tumor-produced G-CSF andmetastasis to the small bowel are both rare events in patients with lung cancer. We report a case with G-CSF producingmetastatic tumors of the small bowel identified after induction chemotherapy for a primary lung cancer. Case. A 55-year-old man was with an abnormal shadow on his chest X-ray film was admitted and non-small cell lung cancer was diagnosed.Chemotherapy with carboplatin at AUC 5 (day 1) and CPT-11 (60mg/m2; days 1, 8, 15) was repeated 3 times (2 courses before the operation and one course after the operation) every 4 weeks. The primary lesion was almost completelyresected by a left upper lobectomy with lymph node dissection. Tumor recurrence in mediastinal lymph nodeswas diagnosed 5 months after the operation. Chemotherapy with gemcitabine (800mg/m2 weekly) was started soon after, but the patient developed leukocytosis (56100/mm3) with a high serum level of G-CSF and massive melena from metastatictumors of the small bowel. An emergency bowel resection was performed to stop the bleeding, and the peripheralwhite blood cell count and serum G-CSF level were decreased immediately after surgery. Immunohistochemicalstaining revealed G-CSF production not in the primary lung cancer tissue, but in the metastatic intestinal tumor tissue.The bleeding also decreased temporarily, but the patient died 10 months after the first operation. Conclusion. G-CSFproduction mainly occurred in the recurrent tumor of the small bowel after the start of induction chemotherapy for primarylung cancer. At this point, the clinical course is very unique among reported cases of G-CSF producing lung cancersView full abstractDownload PDF (4413K) -
Etsuko Takeda, Yasuyuki Takeuchi, Kiyoyuki Furuse, Akira Masaoka2002 Volume 42 Issue 6 Pages 625-629
Published: October 20, 2002
Released on J-STAGE: August 10, 2011
JOURNAL FREE ACCESSBackground. Lung cancer with a dendritic appearance due to intrabronchial growth is rare. We reporta case of lung cancer with sarcomatoid elements which branched into a tree-like processes. Case. A 68-year-oldman was admitted for treatment of diabetes mellitus. The chest radiograph on admission revealed a dendritic shadow inthe right upper lobe. Bronchoscopic examination revealed a nodular tumor obliterating the right B1 bronchus. Poorlydifferrentiated lung cancer was diagnosed by biopsy. Later, he suffered right pneumothorax. Though chest drainage wasperformed, atelectasis of the right upper lobe continued. As the tumor was judged to be c T2N0M0, stage IB, a right upperlobectomy was performed. Pathological examination revealed adenosquamous carcinoma of the lung of the sarcomatousvariety. The tumor originated from the B1 orifice and grew in a polypoid manner in the right upper lobe bronchus, proliferating into peripheral direction intraluminally along the bronchial bifurcations. Furthermore, it invaded thepulmonary parenchyma beyond the bronchial wall. Conclusion. The dendritic shadow of the tumor was caused bygrowth along the bronchial bifurcations.View full abstractDownload PDF (4145K) -
Shunji Endo, Kenji Nakamura, Masahiro Sakaguchi, Takehiko Hiramoto, Ki ...2002 Volume 42 Issue 6 Pages 631-635
Published: October 20, 2002
Released on J-STAGE: August 10, 2011
JOURNAL FREE ACCESSBackground. Malignant fibrous histiocytoma (MFH) originating in the lung is a rare tumor. We reporta surgically resected case. Case. A 76-year-old man had a complaint of cough for six months. A chest X-ray revealedan abnormal shadow in the left lung. A computed tomography of the lung showed a tumor 6cm in diameter inthe superior segment of his left lower lobe. At first, preoperative cytological examination of the curetted specimenthrough fiberoptic bronchoscope revealed squamous cell carcinoma. Left lower lobectomy with systematic lymph nodedissection was performed. The tumor was 10×6.5×5.5cm in size. Postoperative histopathological findings revealed MFH of the lung. Lymph node metastasis was not recognized. Adjunctive chemotherapy was intended but so far notdone because of prolonged postoperative elevation of fever and his age. Six months after the operation, right adrenalmetastasis was pointed out, so right adrenectomy was done. He is doing well without any sign of recurrence one yearsince then. Conclusion. We found only 54 cases of MFH originating in the lung in the Japanese literature, but recentlythe number of reported cases has been increasing. The prognosis of MFH of the lung is said to be poor. Effectiveness ofchemotherapy or radiation therapy has not been established, so only curative surgical resection is effective.View full abstractDownload PDF (2077K) -
2002 Volume 42 Issue 6 Pages 636-668
Published: October 20, 2002
Released on J-STAGE: August 10, 2011
JOURNAL FREE ACCESSDownload PDF (6732K)
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