The Journal of the Japanese Association for Chest Surgery
Online ISSN : 1881-4158
Print ISSN : 0919-0945
ISSN-L : 0919-0945
Volume 32 , Issue 1
Showing 1-24 articles out of 24 articles from the selected issue
  • Yoshitaka Kasai, Kouichi Ito, Daiki Masuya, Naoya Takata, Yuya Tanaka, ...
    2018 Volume 32 Issue 1 Pages 2-6
    Published: January 15, 2018
    Released: January 15, 2018
    JOURNALS FREE ACCESS

    We investigated 12 surgical cases of non-tuberculous mycobacteriosis that were preoperatively suspected as malignant tumors from January 2010 to December 2016. Ten of the patients were male, 2 were female, and their mean age was 66 years old. M. avium was detected in 8 patients, M. intracellulare in 3 patients, and M. kansasii in 1 patient. The mean mass diameter was 30 mm (range: 11 to 74 mm), and mean maximum standardized uptake value in FDG-PET was 6.98 (range: 3.18 to 13.40). The surgical procedures included 4 lobectomies, 1 segmentectomy, and 7 wedge resections. Adjuvant chemotherapy was performed in 5 patients. There was no recurrence in any patient. According to this analysis, it is extremely difficult to preoperatively distinguish solitary non-tuberculous mycobacteriosis from a malignant tumor, and surgery for solitary non-tuberculous mycobacteriosis should be actively considered.

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  • Daisuke Matsumoto, Toshiyuki Hirose, Keisuke Fujimoto, Yasushi Nakagaw ...
    2018 Volume 32 Issue 1 Pages 7-11
    Published: January 15, 2018
    Released: January 15, 2018
    JOURNALS FREE ACCESS

    Objective. To analyze the treatment results and safety of thoracoscopic surgery for primary spontaneous pneumothorax by bulla excision and pleura suturing.

    Subjects. Fifty patients with primary spontaneous pneumothorax aged ≤35 years underwent thoracoscopic surgery from January 2010 and August 2016.

    Results. The median age was 19 years. Of the patients, 41 were male and 9 were female. The median number of treated bullae was two. The median operative time was 113 min. Two (4.0%) of the cases were complicated with surgical site infection. The median duration of drainage was 1 day. Seven cases (14.0%) of recurrence were observed, all of which involved patients aged ≤19 years; no recurrence was observed in those aged ≥20 years.

    Conclusion. The treatment results and safety of this method were favorable. Particularly, the local control rate was good, and we suggest that the treatment results could be further improved by performing an additional procedure for patients aged ≤19 years.

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  • Eiji Miyahara, Yukari Kawasaki, Atsuo Kimura, Tsuneo Okumichi
    2018 Volume 32 Issue 1 Pages 12-17
    Published: January 15, 2018
    Released: January 15, 2018
    JOURNALS FREE ACCESS

    The primary treatment of acute empyema involves drainage and the administration of antibiotics. Debridement and drainage using thoracoscopic surgery were performed in 22 patients with acute empyema that did not respond to thoracic drainage and antibiotic therapy. We evaluated the factors influencing the postoperative hospitalization period (PHP) after thoracoscopic surgery for acute empyema. There was no significant difference in PHP in the presence or absence of a drinking history, preoperative complications, preoperative drainage, or a positive or negative bacterial culture. Moreover, there were no significant correlations among the age, BMI, smoking index, operative time, blood loss, and PHP. When albumin was less than 2.5 g/dL before and one week after surgery, PHP was significantly longer than that in cases with a higher albumin level. There was a positive correlation between the period from symptom onset to surgery, and from medical institution visit to consulting our hospital and PHP. Patients with less than 23 days from symptom onset to surgery or with less than 15 days from medical institution visit to consulting our hospital showed a significant reduction in PHP compared with patients who took longer to visit the hospital. In the case of a diagnosis of acute empyema, early consultation with a surgical specialist will decrease PHP.

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  • Tsutomu Tatematsu, Yushi Saito, Ryosuke Chiba, Yosuke Yamakawa
    2018 Volume 32 Issue 1 Pages 18-23
    Published: January 15, 2018
    Released: January 15, 2018
    JOURNALS FREE ACCESS

    We report the case of a metastatic lung tumor in a patient with congenital hemophilia A discovered by APTT prolongation on preoperative testing. A 67-year-old male who was referred to our hospital had undergone low anterior resection for rectal cancer in another hospital four years previously. Two nodules were detected in the right lung by computed tomography (CT) nine months previously and they were clinically diagnosed as pulmonary metastases. Although chemotherapy was administered, CT showed the growth of the two metastatic lung tumors, resulting in the patient's referral to our hospital for surgical treatment. Chest CT showed a 1.8-cm solid nodule in the S3 segment of the right upper lobe and a 3.0-cm solid nodule in the right middle lobe. Because blood tests showed a mild prolongation of the APTT, the activity of the coagulation factors was measured: decreased factor VIII activity and no factor VIII inhibitor were detected. The patient was diagnosed with congenital hemophilia A. Factor VIII concentrate was administered just prior to the planned thoracoscopic right middle lobectomy and S3 segmentectomy. Although bleeding was greater than predicted, the operation was performed safely by changing to a right S3 partial resection from the planned S3 segmentectomy and avoiding sublation around the bronchus and vessel. The postoperative management was completed safely without significant postoperative bleeding by periodic administrations of factor VIII concentrate and APTT monitoring. Although few clinical problems may result from a mild APTT prolongation, it is necessary to keep in mind the probable underlying diagnosis of hemophilia.

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  • Go Kamimura, Kazuhiro Wakita, Kouichi Sakasegawa, Masakazu Yanagi, Mas ...
    2018 Volume 32 Issue 1 Pages 24-28
    Published: January 15, 2018
    Released: January 15, 2018
    JOURNALS FREE ACCESS

    Background. Talc, which is used for pleurodesis, is considered to be a safe drug without serious side effects.

    Case. A 79-year-old woman was diagnosed with pleural effusion four years ago. The patient was then diagnosed with pulmonary adenocarcinoma via cytological examination of the pleural effusion. The pleural effusion became exacerbated. Thoracentesis and pleural effusion drainage were carried out, followed by pleurodesis treatment using talc. After pleurodesis, chemotherapy was administered, which improved the disseminated lesions and pleural effusion. However, two calcified masses were observed in the thoracic cavity and chest wall. FDG-PET showed a significantly high uptake in these masses. During the course of chemotherapy, the chest wall masses increased in size. Therefore, we excised these masses. The excised masses were diagnosed as foreign body granulomas caused by talc.

    Conclusion. When talc pleurodesis causes a foreign body granuloma, as seen in this case, it becomes difficult to distinguish the foreign body granuloma from malignant diseases. Particularly, when FDG-PET shows a significantly high uptake in pleural masses after talc pleurodesis, we should consider carefully whether these masses are granuloma, disseminated disease, or both.

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  • Hitoshi Suzuki, Shin Shomura, Ryo Maeshiro, Kentaro Inoue, Akira Shima ...
    2018 Volume 32 Issue 1 Pages 29-33
    Published: January 15, 2018
    Released: January 15, 2018
    JOURNALS FREE ACCESS

    Thoracolithiasis is a rare condition, especially bilateral multiple thoracolithiasis. Herein, we report a case of bilateral multiple thoracolithiasis. A 73-year-old man showed white free nodules in the right thoracic cavity during an operation for right pulmonary cancer. Preoperative CT revealed multiple nodules in both thoracic cavities, yielding a diagnosis of bilateral multiple thoracolithiasis. The free nodules were formed from circumferentially arranged fibrous hyaline tissue and many nodules in lymph nodes and in the right lung, being different from many other reports. We suggest that some types of thoracolith are formed by different processes.

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  • Yoshimasa Tokunaga, Taku Okamoto, Yusuke Kita
    2018 Volume 32 Issue 1 Pages 34-38
    Published: January 15, 2018
    Released: January 15, 2018
    JOURNALS FREE ACCESS

    An abnormal lung shadow was detected in a 35-year-old man during a physical examination, and he was followed-up carefully at a nearby hospital. Since the abnormal lung shadow had slightly enlarged after 4 years, the patient was referred to our hospital for further examination. Chest computed tomography revealed a 5-mm well-circumscribed nodular shadow in the right upper lobe of the lung. A benign tumor such as hamartoma was suspected preoperatively; partial resection of the right upper lobe with video-assisted thoracoscopic surgery was performed for both diagnosis and treatment. The intraoperative diagnosis was a myxoid tumor, very rare as a lung tumor, and it was difficult to diagnose as benign or malignant. Histologically, it was identified as an extra osseous benign notochordal cell tumor, based on tumor cells lying in a sheet-like arrangement, immunopositivity for brachyury, and lack of both nuclear atypia and a lobulated structure. Systemic screening performed postoperatively revealed no suspected primary lesion, and the tumor was diagnosed as a benign notochordal cell tumor of the lung.

    This is a very rare case; the fifth case report of benign notochordal cell tumor of the lung. The post-operative course was uneventful and there had been no recurrence as of 6 months after surgery.

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  • Shotaro Hashimoto, Yuki Nishioka, Masato Morimoto, Koichi Yoshikawa
    2018 Volume 32 Issue 1 Pages 39-45
    Published: January 15, 2018
    Released: January 15, 2018
    JOURNALS FREE ACCESS

    A 58-year-old man was referred to our hospital because of a nodule in the left lower lung detected by chest-Xp. CT showed a 20-mm round tumor in the left S8. Bronchoscopic findings revealed a smooth-surface tumor obstructing the orifice of B8b in the left lower lobe. The preoperative diagnosis was a salivary gland tumor based on a biopsy specimen. We performed a left lower lobectomy by three-port complete VATS. Histological examination revealed that the tumor showed a biphasic proliferation of myoepithelial cells and glandular epithelial cells. The former form a small ductal or alveolar structure, and the latter proliferate in the lumen of that ductal structure. Immunohistochemical staining was positive for cytokeratin AE1/AE3 in most epithelial cells, positive for p63 in most cells, positive for SMA in a part of myoepithelial cells, and also positive for S-100 in a part of myoepithelial cells. We diagnosed this tumor as primary epithelial-myoepithelial carcinoma of the lung. There had been no recurrence as of one year after the surgery.

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  • Masatoshi Yamaoka, Shinji Kikuchi, Takahiro Yanagihara, Mitsuaki Sakai ...
    2018 Volume 32 Issue 1 Pages 46-51
    Published: January 15, 2018
    Released: January 15, 2018
    JOURNALS FREE ACCESS

    Intractable empyema with a bronchial fistula is often only treatable by long-term fenestration. We report a case with a good prognosis using bronchial occlusion and vacuum-assisted closure after open-window thoracostomy without surgical closure. A 62-year-old man was admitted to another hospital for a cough and fever. He received antibiotic treatment and drainage for a pulmonary abscess of the middle lobe and empyema. He was referred to our hospital for surgical treatment for his thoracic empyema with a bronchopleural fistula. First, open-window thoracostomy was performed. For postoperative leakage, we performed bronchial occlusion using an Endobronchial Watanabe Spigot® (EWS). For the closure of the open-window cavity, vacuum-assisted closure (VAC) was applied. Six months postoperatively, complete closure of the wound was confirmed without thoracoplasty.

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  • Yoshimasa Tokunaga, Taku Okamoto, Yusuke Kita
    2018 Volume 32 Issue 1 Pages 52-56
    Published: January 15, 2018
    Released: January 15, 2018
    JOURNALS FREE ACCESS

    An abnormal lung shadow was detected in an 18-year-old woman on physical examination at a nearby hospital, and she was referred to our hospital for further examination. Chest computed tomography (CT) revealed a 27-mm well-circumscribed nodular shadow in the left lower lobe of the lung. FDG-PET showed significant uptake by the nodule.

    A malignant tumor was suspected preoperatively; partial resection of the left lower lobe with video-assisted thoracoscopic surgery was performed for both diagnosis and treatment. Since the intraoperative diagnosis was a suspected malignant solitary fibrous tumor, the patient underwent left lower lobectomy with systemic lymph node dissection.

    Histologically, the tumor was diagnosed as myoepithelial carcinoma of the lung, based on spindle tumor cells with clear cytoplasm growing in a bronchus, and immunopositivity for calponin and CD10.

    The post-operative course was uneventful and there had been no recurrence as of 4 months after surgery.

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  • Kazuyuki Oda, Masanobu Hayakawa
    2018 Volume 32 Issue 1 Pages 57-63
    Published: January 15, 2018
    Released: January 15, 2018
    JOURNALS FREE ACCESS

    A 32-year-old, asymptomatic man was referred to our hospital because of the incidental finding of left pneumothorax on a chest radiograph obtained during a medical checkup. Chest computed tomography (CT) revealed an emphysematous giant bulla that occupied the entire left hemithorax and was accompanied by massive atelectasis of the remaining left lung. First, we performed intracavitary suction of the giant bulla with a 7 Fr-balloon tube, after which we observed a gradual reduction in the size of the bulla and the re-expansion of the atelectatic left lung. Subsequently, bullectomy was performed by video-assisted thoracic surgery, with an excellent outcome. Preoperative intracavitary suction of an emphysematous giant bulla that is associated with massive pulmonary atelectasis not only allows for preoperative evaluation of the re-expanded lung parenchyma and residual pulmonary function, but also minimizes the risk of perioperative complications.

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  • Hiroyuki Osawa, Kohei Ando
    2018 Volume 32 Issue 1 Pages 64-68
    Published: January 15, 2018
    Released: January 15, 2018
    JOURNALS FREE ACCESS

    A 78-year-old woman had atherosclerotic thrombotic cerebral infarction 9 years ago and was medicated with anti-platelet drugs. However, she has repeatedly suffered strokes over the last 3 years. One year ago, she had a dissecting aortic aneurysm (Stanford B), and computed tomography (CT) of the chest revealed the presence of a pulmonary arteriovenous fistula (PAVF) in the right lower lobe of the lung. Because the paradoxical brain embolism was associated with PAVF, we performed a partial pulmonary resection by video-assisted thoracoscopic surgery (VATS). Thus, partial pulmonary resection by VATS is effective for treating a small PAVF existing directly under the pleura.

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  • Koichi Ito, Yoshitaka Kasai, Daiki Masuya, Sachie Kume, Sayaka Inoue, ...
    2018 Volume 32 Issue 1 Pages 69-73
    Published: January 15, 2018
    Released: January 15, 2018
    JOURNALS FREE ACCESS

    Birt-Hogg-Dube syndrome is a rare autosomal dominant inherited disorder characterized by skin fibrofolliculomas, renal neoplasms, and multiple lung cysts with pneumothorax. A 62-year-old woman who was admitted with pneumothorax had a history of left and right pneumothorax. Two family members had also experienced pneumothorax. After pulmonary wedge resection, a genetic test revealed a mutation in the FLCN gene, indicating a diagnosis of Birt-Hogg-Dube syndrome. Chest CT of patients with this syndrome shows multiple lung cysts, predominantly in the middle lobe, lower lobe, and lingular segment. If Birt-Hogg-Dube syndrome is suspected preoperatively, a surgical procedure to reduce the recurrence of pneumothorax is needed.

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  • Teruo Iwata, Shoko Monji, Kenji Ono, Takeshi Hanagiri, Fumihiro Tanaka
    2018 Volume 32 Issue 1 Pages 74-77
    Published: January 15, 2018
    Released: January 15, 2018
    JOURNALS FREE ACCESS

    A 39-year-old woman was admitted to our hospital due to spontaneous pneumothorax. She suffered from left chest pain and dyspnea. She had no skin eruptions or renal tumors. She had no family history of pneumothorax or renal tumor. Video-assisted thoracic surgery was performed. Eight bullae were resected surgically by pulmonary wedge resection. BHD syndrome was suggested clinically, because of thin-walled lung cysts at an atypical site. On genetic analysis, the BHD gene mutation was identified.

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  • Kenji Inafuku, Teppei Nishii, Hiroyuki Ito, Takuya Nagashima, Haruhiko ...
    2018 Volume 32 Issue 1 Pages 78-83
    Published: January 15, 2018
    Released: January 15, 2018
    JOURNALS FREE ACCESS

    The patient was a 69-year-old female with a history of total mastectomy for left breast cancer. Before the surgery, two mediastinal tumors were detected on chest computed tomography. Myasthenia was not present. Acetylcholine receptor antibodies were not increased. Five years later, both tumors had slightly increased, and she underwent partial thymectomy by video-assisted thoracoscopic surgery through the right thoracic cavity. The histopathological diagnosis of the right tumor was Masaoka stage II type B1 thymoma, and the left tumor was Masaoka stage II micronodular thymoma with lymphoid stroma (MNT). Each tumor was of a different histologic type. Therefore, they were considered to be of a multicentric origin. Synchronous multiple thymoma is rare and its frequency is reportedly 2.2% among cases of surgically resected thymoma. Thymoma may have a multicentric origin or show intrathymic metastasis; therefore, careful radiological examination should be performed before limited resection.

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  • Ayumu Kato, Noriyuki Misaki
    2018 Volume 32 Issue 1 Pages 84-87
    Published: January 15, 2018
    Released: January 15, 2018
    JOURNALS FREE ACCESS

    The patient was a 74-year-old woman who underwent right upper lobectomy and mediastinal dissection for lung adenocarcinoma pT1bN0M0, stage IA. Her postoperative recovery was uneventful. Two months after surgery, she presented with a large right pleural effusion on chest radiograph and chest computed tomography. The triacylglycerol level in pleural fluid was >110 mg/dL; thus, she was diagnosed with late-onset chylothorax. Her general condition was stable, and she was therefore managed conservatively with a chest drainage tube, fasting, and octreotide administration. Three days after the start of chest drainag, the pleural fluid level rapidly began to decline; she was thus given a low-fat diet. As she was underweight, we increased her fat intake and gradually decreased the octreotide dose. On day 11 of chest drainage, the pleural effusion had resolved and we removed the tube. She did not experience pleural effusion recurrence after drainage tube removal. She was discharged on day 15, and has not shown chylothorax recurrence during the 1-year follow-up.

    The cause of late-onset chylothorax remains unknown. However, a low-fat diet was less burdensome than fasting; her general condition was stable, and the chylothorax was managed conservatively.

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  • Akifumi Nakamura, Teruhisa Takuwa, Masaki Hashimoto, Nobuyuki Kondo, D ...
    2018 Volume 32 Issue 1 Pages 88-93
    Published: January 15, 2018
    Released: January 15, 2018
    JOURNALS FREE ACCESS

    Methadone is a strong opioid that came into use in March 2013 in Japan. The patient was a 49-year-old man who underwent extrapleural pneumonectomy for malignant pleural pneumonectomy. After the operation, he presented with refractory post-thoracotomy pain, even though he took oxycodone at 80 mg/day and some adjuvants. To improve pain relief, opioid switch to methadone was performed. Methadone has shown marked promise in its treatment. Post-thoracotomy pain can be caused by a wide range of factors, including nociceptive and neuropathic pain. Methadone has been shown to exert an effect on neuropathic pain because of its high affinity for the N-methyl-D-aspartate (NMDA) receptor. Taken together, methadone remains a possible option for refractory post-thoracotomy pain. At the moment, however, methadone is not a candidate to treat post-thoracotomy pain. A prospective trial to investigate the clinical effects of this drug is warranted.

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  • Atsushi Kagimoto, Takeshi Mimura, Tatsuya Miyamoto, Yoshinori Yamashit ...
    2018 Volume 32 Issue 1 Pages 94-98
    Published: January 15, 2018
    Released: January 15, 2018
    JOURNALS FREE ACCESS

    A 68-year-old woman was diagnosed with an elevation of the left diaphragm on a chest radiograph more than 20 years ago. She experienced exertional dyspnea for one year and was referred to our hospital. Chest radiograph and CT revealed an elevation of the left diaphragm, with deviation of the peritoneal organ to the cranial side and deviation of the heart to the right side. Restrictive ventilatory impairment, with a vital capacity (VC) of 1.58 L and %VC of 66.7%, was detected on a pulmonary function test. Diaphragmatic eventration was diagnosed as the cause of her symptom. Therefore, three-dimensional (3D) complete video-assisted thoracoscopic surgery (VATS) diaphragmatic plication was performed. Pushing the diaphragm to the abdominal side, eight U stitches with predget were placed from the anteroposterior to posterolateral diaphragm. Three months after the surgery, her dyspnea had disappeared and VC and %VC had improved to 2.30 L and 97.5%, respectively.

    We suggest that diaphragmatic plication thorough a VATS approach may become a standard surgical method for diaphragmatic eventration. For an operative method of this type that requires a stereognostic sense, such as for a suture technique under monitoring, the adoption of a 3D thoracoscopic system might be useful.

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  • Koji Mochinaga, Ryusuke Machino, Hiroharu Tsuji, Tsutomu Tagawa
    2018 Volume 32 Issue 1 Pages 99-103
    Published: January 15, 2018
    Released: January 15, 2018
    JOURNALS FREE ACCESS

    We report a case of left lower segmentectomy involving a lung cancer patient with a mediastinal inferior lobar branch of the pulmonary artery. Right lower lobectomy+S2 segmentectomy was performed 2 months earlier. The mediastinal branch (A8b+9b+10b) from the left main pulmonary artery ran between the superior and inferior pulmonary vein and along the mediastinal side of the lower bronchus. A8b+9b ran in front of the inferior pulmonary vein, and A10b ran behind the inferior pulmonary vein. Mediastinal inferior lobar branching is rare and its variations are diverse. Additionally, segmentectomy for this variation has not been reported. Although such branching of the pulmonary artery is atypical, we were able to perform segmentectomy with video-assisted thoracic surgery as usual in this case. 3D-CT was very useful to ensure a safe segmentectomy even with an aberrant pulmonary arterial branch.

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  • Satoru Okada, Hiroaki Tsunezuka, Tatsuo Furuya, Daishiro Kato, Junichi ...
    2018 Volume 32 Issue 1 Pages 104-110
    Published: January 15, 2018
    Released: January 15, 2018
    JOURNALS FREE ACCESS

    A 79-year-old man with malnutrition underwent a right lower lobectomy with mediastinal lymph node dissection for lung squamous cell carcinoma (cT3N1M0 Stage IIIA). On postoperative day 11, he presented with a bronchopleural fistula involving a 5-mm defect with aspiration pneumonia, and underwent open-window thoracostomy. Enhanced nutritional support was implemented for malnutrition and a poor appetite, consisting of enteral nutrients provided via a nasal tube. We increased the nutritional support up to 3,600 kcal/day based on the nutritional index calculated using levels of serum pre-albumin, a rapid-turnover protein. Subsequently, there was significant recovery with granulation and a decrease in the pleural cavity size.

    Thoracomyoplasty using the latissimus dorsi was successfully performed 73 days after the open-window thoracostomy. The optimal quantity of nutritional support needed can vary and is based on the clinical condition. Thus, appropriate assessment and intensive care for patients receiving nutritional support may be useful when treating bronchopleural fistula.

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  • Yoshiteru Kidokoro, Wakako Fujiwara, Yasuaki Kubouchi, Yohei Yurugi, K ...
    2018 Volume 32 Issue 1 Pages 111-116
    Published: January 15, 2018
    Released: January 15, 2018
    JOURNALS FREE ACCESS

    We report a 38-year-old woman with congenital cystic adenomatoid malformation (CCAM) type I.

    She was admitted to undergo surgery following repeated recurrence on antibiotic therapy. Chest computed tomography showed multiple cystic lesions in the right lower lobe. After the third antibiotic treatment, right lower lobectomy was performed. The histopathological diagnosis was CCAM type I, and small cysts were found near the resection stump of S6. Two weeks after surgery, she developed a late-onset pulmonary fistula and was treated with chest tube drainage and pleurodesis. Therefore, it is necessary to pay attention to the extent of cysts and remove them completely.

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  • Sakiko Yura, Kazumasa Takenaka, Masayuki Miyake, Kyoko Hijiya
    2018 Volume 32 Issue 1 Pages 117-122
    Published: January 15, 2018
    Released: January 15, 2018
    JOURNALS FREE ACCESS

    We report two extremely rare cases of mediastinal cavernous lymphangioma in adults that spontaneously disappeared without treatment. Case 1 was a 68-year-old man with a tumor involving the common carotid and subclavian arteries in the left upper mediastinum. We performed tumor biopsy using video-assisted thoracoscopic surgery for diagnosis. Chest computed tomography (CT) performed 8 months after the biopsy showed the almost complete disappearance of the tumor shadow. Case 2 was a 58-year-old woman with a mediastinal tumor accompanied by an extensive lesion on the right hilum and lung. We performed surgical biopsy of the mediastinal tumor using mediastinoscopy. A chest radiograph revealed a gradual reduction of the tumor volume and, 6 months later, chest CT showed the marked regression of the tumor shadow. Histological examination of the biopsy specimens revealed that the tumors in both cases were cavernous lymphangioma. Although careful observation is required because of the potential for recurrence, conservative management can be considered a viable treatment option in patients with an unresectable lymphangioma.

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  • Shuihchi Shinohara, Takamitsu Onitsuka, Fujiko Fukatsu, Kazuhiko Machi ...
    2018 Volume 32 Issue 1 Pages 123-128
    Published: January 15, 2018
    Released: January 15, 2018
    JOURNALS FREE ACCESS

    A 77-year-old man with erythematous hyperkeratotic skin lesions on his fingers, face, and neck for more than 3 years presented to our hospital for the purpose of surgery to excise non-small cell lung cancer in the right upper lobe. He underwent right upper lobectomy, and then erythematous hyperkeratotic lesions markedly improved on postoperative day 4 and were cured 2 months after surgery. We finally diagnosed his skin lesions as Bazex syndrome. He has not shown the recurrence of the skin manifestations or lung cancer for four months.

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