An autopsy case of malignant hemangiopericytoma in the left thorax in 41 year-old female is presented. The patient first complained of right back pain and dysphagia. Chest X-ray showed well-defined, homogenous mediastinal mass in the left lung field, which rapidly increased in size in a few months. She also had pulmonary tuberculosis. She died with evidence of cardiac failure 8 months after the manifestation of symptoms.
At autopsy the left thorax was filled with a large, gray to light brown, soft mass and the heart and mediastinum were shifted to the right. The left lung was completely replaced by the tumor except for a small portion of the upper hilus. There were residual bronchi passing through the tumor and mucosal involvement of the large bronchi was ascertained.
Microscopically the tumor was composed of tightly packed cells around thin walled, endothelium lined vascular channels, ranging from large gaping sinusoidal spaces to capillaries. The cells were oriented haphazardly and had ovoid or spindle-shaped hyperchromatic nuclei with ill defined cytoplasm. Mitotic figures were almost absent. The flattened endothelial cells lining the gaping sinusoidal vascular structures were separated from the surrounding reticulin meshwork by a basement membrane. Reticulin and collagen fibers also enmeshed the tumor cells outside the vascular channels. Small overt areas of hemorrhages and necrosis were seen.
The metastatic lesions were found in the right lung.
Hemangiopericytoma occurs wherever capillaries were found, however a review of the literature disclosed that cases located in the lung and/or mediastinum are rare.

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The present investigation was conducted to explore the effects of ACTH on the relaxation of guinea pig trachea with various bronchodilators.
1) It was shown that ACTH by itself was a very weak bronchodilator, and that ACTH did not show any relaxation of GPT at the dose of 100ng/ml, 500ng/ml and 1μg/ml.
2) Bronchodilating effects of Isop., Hexop., Salb. and Adr. were markedly potentiated with continuous infusion of ACTH (10ng/ml).
3) Bronchodilating effect of Isop. (5ng/ml) was potentiated, dose-dependently, by ACTH.
4) Bronchodilating effects of PGE₂ and Aminoph, were not potentiated with continuous infusion of ACTH.
5) These results suggest that ACTH has a direct effect on GPT by potentiating the bronchodilating effects with various β-stimulators.

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Two cases of spontaneous pneumothorax with Marfan syndrome are reported.
The first patient, a 22-year-old man, was admitted to Keio University Hospital with diagnosis of right pneumothorax.
The patient was of tall, thin habitus with long tapered extremities. Kyphoscoliosis, arachnodactyly and high-arched palate were the obvious skeletal malformations that were present. The lenses were normal. Family histoty revealed that in the case of a younger sister was of thin habitus and heart disease, Marfan syndrome had been diagnosed. Aortography showed dissection of the aorta, and aortic insufficiency. A diagnosis of Marfan syndrome was established on the basis of characteristic skeletal and cardiovascular manifestations and the highly suggestive family history. Surgical treatment for resection of bullae was undertaken.
The second patient, a 13-year-old boy, was admitted because of right chest pain. He had several episodes of spontaneous pneumothorax and had undergone thoractomy for left spontaneous pneumothorax. The chest film revealed 100% pneumothorax on the right side. Review of the physical signs revealed arachnodactyly, dolichostenomelia, kyphoscoliosis and high-arched palate. The lenses were short sighted. Aortography showed dilatation of aorta. The diagnosis of Marfan syn-drome established on the basis of characteristic skeletal and cardiovascular manifestations. At thoracotomy, several bullae arising from the apical segment of his right lung were removed by means of wedge resection. Microscopically, bullae of this case resembled the usual bullae.
Pulmonary disease occurred in approximately 10% of the cases of Marfan syndrome which were reviewed. These include pulmonary malformations, cystic disease, pneumothorax and bullae emphysema. Spontaneous pneumothorax with Marfan syndrome has been noted in the literature recently. The supposition remains that pneumothorax with Marfan syndrome may reflect a localized pulmonary abnormality related to the generalized connective tissue defect.

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M.O., a 23-year-old woman, was admitted to the Toranomon Hospital on August, 1976, because of increasingly exertional despnea for several months and recurrent bilateral pneumothorax since 1970. Chest roentgenogram showed a fine reticulomicronodulation of both fields. Lenoangiography revealed left angiomyolipoma. Open lung biopsy revealed changes subsequently recognized as being typical for pulmonary hamartogiomyomatosis.

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38才女子会社員, 妊娠の既往はない. 過去4回月経の数日前に右側気胸を再発している. 開胸すると右肺は正常, 横隔膜項部に10×6mm大の黒色の隆起と, 周囲に多数の小出血斑を認める. 同部は生検により子宮内膜症と診断された. 肺胸膜, 横隔膜に欠損孔なく, 気胸の原因は不明, pleurodese とホルモン療法により術後1年間再発をみない. catamenial preumothorax で胸腔内子宮内膜症が証明されたのは本邦では本症例が第1例目である.

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