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Volume 44, Issue 3
Displaying 1-9 of 9 articles from this issue
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Hiroyuki Oura, Hirokazu Aikawa, Mikihito Ishiki, Nobukazu Tomichi, Tor ...2004 Volume 44 Issue 3 Pages 153-157
Published: June 20, 2004
Released on J-STAGE: August 10, 2011
JOURNAL FREE ACCESSBackground. Paragangliomas (PG) of the mediastinum are rare neoplasms. Here we report a case of non-functioning aorticopulmonary PG with an 8-year survival following surgical resection. Case. A 48-year-old man presented an abnormal shadow on chest roentgenogram during routine mass screening in June 1995, and was admitted to our hospital for further examination. His chest X-ray film showed a well-defined tumor shadow in the left upper mediastinum protruding into the lung field. His chest CT scan revealed a homogeneous tumor in the aorticopulmonary window (APW), with no apparent invasion to the surrounding tissues. The preoperative level of serum catecholamines and their metabolites were normal. Subsequently, the patient underwent an operation in October 1995, a5×4×4 cm sized invasive tumor revealed in the APW. Because of the high risk of malignancy, an en bloc excision of the tumor was performed, including both the partial resection of the pericardium and repair of the left main pulmonary artery. The histologic examination and immunohistochemical staining of the tumor revealed PG of the mediastinum, with no apparent histologic features of malignancy. The patient remains alive and well, with no sign of recurrence or metastasis at 8 years after the operation. Conclusion. Long-term follow-up is generally recommended for PG since metastasis and/or local recurrence has been difficult to predict accurately using only histological evidence. The present case is accordingly unusual.View full abstractDownload PDF (4251K) -
Yukiyasu Takeuchi, Akinori Akashi, Kazuhide Okuma, Tomofumi Oda, Yoshi ...2004 Volume 44 Issue 3 Pages 159-162
Published: June 20, 2004
Released on J-STAGE: August 10, 2011
JOURNAL FREE ACCESSBackground. It is often difficult to detect early lung cancer in spite of careful observation when a lesion does not show a mass shadow. Case. A 68-year-old man was admitted to our hospital with one-year history of honeycomb lung and recent bloody sputum. Chest X-ray showed ground glass opacities in the lower field of the right lung, and the chest CT scan showed honeycomb lung in the right lower lobe. Adenocarcinoma of the lung was diagnosed by sputum cytological examination and transbronchial lung biopsy of thelesion. Right lower lobectomy was performed on January 21, 2003. Macroscopic examination showed honeycomb lung butno apparent mass. Histological finding showed papillary adenocarcinoma with findings of carcinoma cells growing along the cyst walls in the interstitial pneumonia and protruding into the cyst lumen. Conclusion. For early detection of lung cancer, it is necessary to note that the cancer may exist within the honeycomb lung even if it does not form a mass.View full abstractDownload PDF (3115K) -
Hitoshi Suzuki, Toshiya Tokui, Naoyuki Imai, Tomoji Abe, Toru Hara, At ...2004 Volume 44 Issue 3 Pages 163-166
Published: June 20, 2004
Released on J-STAGE: August 10, 2011
JOURNAL FREE ACCESSBackground. In the case of resected multiple pulmonary metastases from gastric and colon cancer, it was difficult to differentiate the pulmonary metastases from primary cancer. Case. A 62-year-old woman underwent subtotal gastrectomy and hemicolectomy because of gastric and the colon cancer. Eighteen months later, she was found to have a pulmonary nodule in the left upper lobe on a chest computed tomography (CT). She underwent left upper lobectomy because the tumor was not diagnosed by the frozen microscopic findings. The tumor was diagnosed as a lung metastasis from colon cancer pathologically. She was found to have an another pulmonary nodule in the right upper lobe on the follow up CT scan. She underwent right upper lobectomy and the tumor was diagnosed as lung metastases from gastric cancer. Conclusion. We report a case of multiple metastases from gastric cancer and colon cancer.View full abstractDownload PDF (2904K) -
Keisei Chin, Katsuhiko Aoyama, Hidekazu Matsushima, Katsumi Murai, Yos ...2004 Volume 44 Issue 3 Pages 167-171
Published: June 20, 2004
Released on J-STAGE: August 10, 2011
JOURNAL FREE ACCESSBackground. Careful examination of resected lung for lung cancer is important not only to know histological typing, degree of malignancy, and degree of progression of lung cancer but also to understand the background lung like coexisting idiopathic pulmonary fibrosis. We experienced drug-induced pneumonia which was found and finally suspected by the histological examination of the background lung lesion. Case. A 72-year-old man was diagnosed to have primary lung cancer cT1NOMO stage IA, and he underwent right middlelobectomy. He complained of dyspnea on the 4th postoperative day. New shadows appeared in the right lower lung field on chest X-rays, and antibiotics were given but pulmonary shadows rapidly extended. Chest CT showed ground-glass opacities in both lungs. The histologic examination of resected lung tissue revealed the presence of acute eosinophilic pneumonia, and bronchoalveolar lavage fluid showed the increase of eosinophils. We suspected acute eosinophilic pneumonia as the cause of pulmonary shadows. By careful history taking, he admitted that he had taken health food including Agaricus and phellinus linteus before admission. The symptoms and chest X-ray findings improved only on the cessasion of the health food. Therefore, we diagnosed drug-induced pneumonia. Conclusion. We could diagnose drug-induced pneumonia partly by the histological examination of the background change of resected lung.There are a few reported cases of drug-induced pneumonia by health food such as Agaricus, and we must be careful from now on.View full abstractDownload PDF (3621K) -
Improvement of Thrombocytopenia After Treatment for Helicobacter pyloriShigeki Hatakeyama, Nobuo Saoyama, Takanori Miyoshi, Masaru Tsuyuguchi ...2004 Volume 44 Issue 3 Pages 173-177
Published: June 20, 2004
Released on J-STAGE: August 10, 2011
JOURNAL FREE ACCESSBackground. Recent studies have suggested a high prevalence of Helicobacter pylori infection in patients with idiopathic thrombocytopenic purpura (ITP). We report a patient who experienced improvement of uncontrollable thrombocytopenia after Helicobacter pylori eradication whilst receiving chemotherapy for lung cancer. Case. A 56-year-old woman was admitted to our hospital because her chest X-ray film showed a mass and pleural effusion and lung cancer was diagnosed. The thrombocytopenia was considered due to disseminated intravascular coagulation (DIC) since elevated fibrin degradation products (FDP) was observed. The thrombocytopenia was not controlled by standard therapy for DIC, but following a combination of chemotherapy and monthly platelet transfusions her condition improved. Because she was treated with chemotherapy, platelet transfusions were required. Re-evaluation of thrombocytopenia showed normal FDP levels, and ITP was diagnosed because of elevated levels of PAIgG. Urea breath test showed Helicobacter pylori infection at the end of June. Eradication therapy for Helicobacter pylori let to a recovery in platelet count. Conclusion. Helicobacter pylori is hypothesized to be causally related with ITP associated lung cancer in addition to cancer associated DIC and myelosuppression due to chemotherapy.View full abstractDownload PDF (2508K) -
Hirokazu Taniguchi, Hitoshi Abo, Samon Miyata, Hideki Miyazawa, Hirofu ...2004 Volume 44 Issue 3 Pages 179-182
Published: June 20, 2004
Released on J-STAGE: August 10, 2011
JOURNAL FREE ACCESSBackground. Metastasis from lung cancer to the spinal cord or the optic chiasm is rare. Case. A 65-year-old man was given a diagnosis as T1N2M0 localized small cell lung cancer. He responded well to systemic chemotherapy and radiotherapy. Seven months after the first admission, his brain MRI revealed multiple brain metastases, and whole brain irradiation was performed. Thirteen months after the first admission, he experienced paresis of his legs and bitemporal hemianopia. His spinal cord MRI revealed multiple intramedullary metastasis, and cerebrospinal fluid showed malignancy. Leptomeningeal metastasis from small cell lung cancer was diagnosed. Spinal cord irradiation was performed, and his lower limbs paresis improved slightly. His eyesight failed gradually, and brain MRI revealed optic chiasm metastasis. Optic chiasm irradiation was performed, but his eyesight deteriorated. Paralysis of his legs and his body gradually increased, and 18 months after the first admission, he died. Conclusion. We report a case of metastasis from small cell lung cancer to the spinal cord and the optic chiasm.View full abstractDownload PDF (2394K) -
Hidefumi Takei, Teppei Nishii, Takamitsu Maehara, Yukio Kakuta2004 Volume 44 Issue 3 Pages 183-187
Published: June 20, 2004
Released on J-STAGE: August 10, 2011
JOURNAL FREE ACCESSBackground. Ectopic production of adrenocorticotropic hormone (ACTH) associated with Cushing's syndrome has been identified with a variety of malignant tumors, including small cell lung cancer and bronchial carcinoid. However, carcinoid tumors of the thymus associated with Cushing's syndrome are extremely rare. Case. A 58-year-old woman was admitted to our hospital with moon face, worsening edema of legs, and hypokalemia. Laboratory values disclosed a high serum ACTH level and a high level of serum cortisol. A chest CT scan revealed a 2-cm anterior mediastinal tumor. Thoracoscopic tumor resection was performed under the diagnosis of an ectopic ACTH secreting thymic tumor. Histologic examination revealed a spindle cell carcinoid of the thymus with immunoreactivity for ACTH. The serum ACTH level decreased and her clinical symptoms resolved after tumor resection. Conclusion. We described a rare case of spindle cell carcinoid of the thymus associated with Cushing's syndrome.View full abstractDownload PDF (2625K) -
Shin Shomura, Motoshi Takao, Kazuya Fujinaga, Isao Yada2004 Volume 44 Issue 3 Pages 189-192
Published: June 20, 2004
Released on J-STAGE: August 10, 2011
JOURNAL FREE ACCESSBackground. We report a rare case of pediatric thymoma. Case. An incidental chest radiograph of a 7-year-old girl revealed an anterior mediastinal tumor during treatment of pneumonia. A 6-cm mass was identified on the left side of the diaphragm. The tumor originated from the lower portion of the left lobe of the thymus. Resection of the mass was performed successfully via a left lateral thoracotomy. Histological examination revealed an encapsulated thymoma (Masaoka stage II, WHO classification Type B1). The patient received full mediastinal irradiation (50 Gy) following surgery, and the patient is currently without any evidence of recurrence. Conclusion. A pediatric thymoma was treated with complete resection and post-operative mediastinal irradiation. Thymoma in children is rare, and careful follow-up is necessary.View full abstractDownload PDF (3203K) -
2004 Volume 44 Issue 3 Pages 193-197
Published: June 20, 2004
Released on J-STAGE: August 10, 2011
JOURNAL FREE ACCESSDownload PDF (963K)
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