The Journal of the Japan Society for Respiratory Endoscopy
Online ISSN : 2186-0149
Print ISSN : 0287-2137
ISSN-L : 0287-2137
Volume 37, Issue 2
Displaying 1-41 of 41 articles from this issue
  • Article type: Cover
    2015 Volume 37 Issue 2 Pages Cover1-
    Published: March 25, 2015
    Released on J-STAGE: October 29, 2016
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  • Article type: Appendix
    2015 Volume 37 Issue 2 Pages App1-
    Published: March 25, 2015
    Released on J-STAGE: October 29, 2016
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  • Article type: Appendix
    2015 Volume 37 Issue 2 Pages App2-
    Published: March 25, 2015
    Released on J-STAGE: October 29, 2016
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  • Article type: Index
    2015 Volume 37 Issue 2 Pages Toc1-
    Published: March 25, 2015
    Released on J-STAGE: October 29, 2016
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  • Article type: Index
    2015 Volume 37 Issue 2 Pages Toc2-
    Published: March 25, 2015
    Released on J-STAGE: October 29, 2016
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  • [in Japanese]
    Article type: Article
    2015 Volume 37 Issue 2 Pages 135-136
    Published: March 25, 2015
    Released on J-STAGE: October 29, 2016
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  • [in Japanese]
    Article type: Article
    2015 Volume 37 Issue 2 Pages 137-141
    Published: March 25, 2015
    Released on J-STAGE: October 29, 2016
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  • [in Japanese]
    Article type: Article
    2015 Volume 37 Issue 2 Pages 142-144
    Published: March 25, 2015
    Released on J-STAGE: October 29, 2016
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  • [in Japanese]
    Article type: Article
    2015 Volume 37 Issue 2 Pages 145-146
    Published: March 25, 2015
    Released on J-STAGE: October 29, 2016
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  • [in Japanese]
    Article type: Article
    2015 Volume 37 Issue 2 Pages 147-
    Published: March 25, 2015
    Released on J-STAGE: October 29, 2016
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  • Takehiko Kobayashi, Satoshi Marumo, Motokazu Kato
    Article type: Article
    2015 Volume 37 Issue 2 Pages 148-152
    Published: March 25, 2015
    Released on J-STAGE: October 29, 2016
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    Background. Transbronchial biopsy (TBB) and brushing by flexible bronchoscopy are useful diagnostic tools, and are both recommended to improve the diagnostic yield of peripheral lung lesions. However, sometimes these procedures cannot be performed because of their adverse effects. Purpose. In the present study, we investigated whether the choice of the first procedure may influence diagnostic yield and adverse effects. Methods. The subjects included those who underwent pulmonary surgical resection and were diagnosed with lung cancer at Kishiwada City Hospital from October 2009 to September 2012. The subjects were divided into two groups according to the preceding procedure: biopsy or brushing. We compared the diagnostic yield and adverse effects between the two groups. Results. There were 116 patients in the final analysis (33 patients in the TBB group and 83 patients in the brushing group). There were no significant differences of the baseline characteristics between the two groups. In the TBB group, the diagnostic yield was significantly higher, and bleeding events were lower than those in the brushing group (54.5% vs 31.3%, p=0.002 and 30.0% vs 66.3%, p=0.001, respectively). Conclusion. The diagnostic yield of peripheral lung lesions may be improved by performing TBB before brushing using flexible bronchoscopy.
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  • Yasushi Murakami, Masahide Oki, Hideo Saka, Chiyoe Kitagawa, Masatoshi ...
    Article type: Article
    2015 Volume 37 Issue 2 Pages 153-158
    Published: March 25, 2015
    Released on J-STAGE: October 29, 2016
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    Background. Bf-NAVI^[○!R] is a virtual bronchoscopic navigation (VBN) system commonly used in Japan, which is useful for the diagnosis of peripheral lung lesions by bronchoscopy. The recommended CT slice thickness for Bf-NAVI is 1.0 mm and less to generate accurate virtual images. However, the optimal slice thickness still remains unclear. Subjects and Methods. We retrospectively analyzed the medical records of patients with peripheral lung lesions who underwent bronchoscopy from August to October 2013 at our institution. We created 2 types of DICOM files with different slice thicknesses (0.5 mm and 1.0 mm) from their CT images and generated virtual images using Bf-NAVI and performed comparative analysis between them. Results. Thirty patients were included in this study and the median lesion size was 23.2 mm. The time required to generate virtual images was significantly longer among 0.5-mm-slice thickness than 1.0-mm (median, 13.0 min vs. 8.3 min, p<0.01). We could visualize more distal bronchi using 0.5-mm-slices in 20 patients (67%) but there were no statistically significant differences in bronchial generation of virtual images (median, 5 vs. 4, p=0.16). The number of virtual images along the entire pathway to a target lesion was greater using 0.5-mm-slices (11 patients [37%] vs. 5 patients [17%], p<0.01). Conclusions. Although CT images using 0.5-mm-slice thickness require a longer time to construct virtual images, they are useful to generate more distal bronchi in virtual images.
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  • Katsuhiko Endo, Hiroyoshi Maeda, Yuki Tomita, Akiko Harada, Yuko Shima ...
    Article type: Article
    2015 Volume 37 Issue 2 Pages 159-162
    Published: March 25, 2015
    Released on J-STAGE: October 29, 2016
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    Background. Spontaneous hemopneumothorax is a relatively rare disease. We examined clinical characteristics of spontaneous hemopneumothorax cases. Subjects. We treated 91 cases of pneumothorax operations between November 2008 and October 2013. Of these, 5 cases had spontaneous hemopneumothorax, approximately 5.5%. Results. All patients were male, ranging in age from 18 to 74 years, and initially complained of chest pain. It was the first occurrence of pneumothorax for all patients. Three cases underwent emergency surgery when we diagnosed of hemopneumothorax on the day after admission. From admission to the start of the operation, the amount of blood loss ranged from 410 to 2100 ml (mean 1098 ml). No case had blood transfusion due to hemorrhagic shock. Four cases apart from one adhesion case were treated using video-assisted thoracic surgery (VATS). An interrupted end of the funicular structure from the top of the thoracic cavity was suspected as a site of bleeding, and we stopped the bleeding. Duration of drainage after surgery ranged from 2 to 4 days (mean 2.8 days), and postoperative stay ranged from 3 to 7 days (mean 4.2 days). Conclusions. We suggest that early VATS for spontaneous hemopneumothorax is a minimally invasive, safe, and useful treatment and that VATS may be the first choice for treatment.
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  • Atsushi Fujiwara, Norihito Okumura, Akihiko Yamashina, Kotaro Kameyama
    Article type: Article
    2015 Volume 37 Issue 2 Pages 163-167
    Published: March 25, 2015
    Released on J-STAGE: October 29, 2016
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    Case. A 49-year-old man was referred to our hospital due to recurrent pneumonia that was nonresponsive to antibiotics. A chest computed tomography scan revealed infiltration in the right S^<10> in addition to a calcified endobronchial nodule in the right B^<10>. Bronchoscopy was performed, which revealed a foreign body in the right B^<10>b that was subsequently removed. Thereafter, imaging showed an improvement in the pneumonia. After extensively taking the patient's history, it was found that he had suffered from the accidental aspiration of an air rifle pellet 37 years previously. Conclusions. We herein describe a case in which the presentation of pneumonia led to the removal of a foreign object under flexible bronchoscopy.
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  • Hiroki Takakura, Yuki Kamata, Keisuke Imasaka, Akio Komuro, Kouichi Su ...
    Article type: Article
    2015 Volume 37 Issue 2 Pages 168-172
    Published: March 25, 2015
    Released on J-STAGE: October 29, 2016
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    Background. Some over-the-counter drugs contain products that even medical professionals find difficult to recognize as Chinese herbal medicines. Case. A 49-year-old man developed a fever and dyspnea. One week before admission to our hospital, he had started taking the over-the-counter medicine, Nistor^[○!R]. A diagnosis of drug-induced pneumonitis was suspected based on the findings of ground-glass opacity on chest CT. Therefore, we obtained a detailed treatment history. Notably, bofu-tsusho-san had been prescribed by a local doctor as a dietary supplement eight months earlier. When the patient noted fever and malaise after starting treatment with bofu-tsusho-san, he discontinued the supplement by himself, and his symptoms improved. On the current admission, his symptoms were attributed to the use of Nistor^[○!R], which incidentally contains bofu-tsusho-san as an important constituent. Conclusions. The possibility of drug-induced pneumonitis must be kept in mind in patients who consume over-the-counter medicines. Therefore, a detailed treatment history must be obtained in addition to medical tests in patients who report using such medications.
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  • Hidenori Mori, Norihiko Funaguchi, Daizo Kaito, Komei Yanase, Megumi M ...
    Article type: Article
    2015 Volume 37 Issue 2 Pages 173-177
    Published: March 25, 2015
    Released on J-STAGE: October 29, 2016
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    Background. Pulmonary cryptococcosis often presents with nodules similar in shape to those of lung cancer or tuberculosis. Case. A 69-year-old man developed facial paralysis and hemiplegia. He had been treated for chronic myeloproliferative disorder and old myocardial infarction. T2-weighted brain magnetic resonance imaging revealed lesions with high signal intensity and enhancement in the right nucleus basalis and cerebrum. Chest computed tomography showed a 15-mm nodule in the right middle lobe and 5-mm nodule in the left apical segment. The transbronchial biopsy specimen contained multiple bulbar organisms stained with periodic acid-Schiff and Grocott's staining. Cultures of the lung specimen and cerebrospinal fluid showed Cryptococcus spp. We therefore diagnosed the patient with pulmonary cryptococcosis and meningitis. He did not complain of fever, respiratory symptoms or signs of meningeal irritation. He was subsequently treated with liposomal amphotericin B and flucytosine, followed by fluconazole, which improved the lung and intracranial lesions. Conclusions. We encountered a case of rare cryptococcal meningitis causing hemiplegia as the initial symptom. This case suggests that the diagnosis of cryptococcosis should be considered in cases involving multiple brain nodules that appear to be metastatic tumors of pulmonary lesions.
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  • Yoshihiro Suzuki, Naoya Takeda, Hirofumi Shibata, Keisuke Oka, Hiroyos ...
    Article type: Article
    2015 Volume 37 Issue 2 Pages 178-182
    Published: March 25, 2015
    Released on J-STAGE: October 29, 2016
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    Background. Reexpansion pulmonary edema (RPE) is a known complication of chest drainage for pneumothorax and pleural effusion; however, few reports have documented the development of contralateral edema. Case. A 62-year-old woman visited our hospital because of dyspnea. Chest radiography showed a large left pleural effusion and mediastinal shift. Thoracoscopy and biopsy of the parietal pleura were performed under local anesthesia, along with drainage tube placement. She complained of dyspnea after returning to her hospital room. Chest radiography showed a ground-glass opacity in the right lower lung field. We diagnosed RPE and treated her with a systemic steroid and noninvasive positive pressure ventilation. Her symptoms and edema on chest radiograph had improved the next day. We assumed the complication, RPE, was caused by a rapid expansion of the right middle lobe, compressed by the heart shifting to the right. Conclusion. A pleural effusion with a mediastinal shift should be drained in advance, even with a full atelectasis, because development of an RPE in the contralateral lung is possible.
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  • Naoko Takeuchi, Toru Arai, Kazunobu Tachibana, Masanori Kitaichi, Seij ...
    Article type: Article
    2015 Volume 37 Issue 2 Pages 183-190
    Published: March 25, 2015
    Released on J-STAGE: October 29, 2016
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    Background. Although many cases of organizing pneumonia (OP) after radiation therapy to a breast cancer has been reported, but no case of OP combined with pulmonary alveolar hemorrhage after radiation therapy for postoperative breast cancer has been reported. We reported the case of OP combined with pulmonary alveolar hemorrhage after radiotherapy for breast cancer. Case. A 63-year-old woman underwent conservation surgery for right breast cancer, and received radiation to the postoperative breast. About four months later, she developed general fatigue and cough. High-resolution CT of the chest showed infiltrative shadows outside the radiation field in the right lung field. Bronchoalveolar lavage fluid (BALF) was bloody, and transbronchial lung biopsy specimens revealed OP. We considered that the patient had OP combined with pulmonary alveolar hemorrhage after radiotherapy for breast cancer. After treatment with prednisolone, her clinical symptoms and radiologic findings resolved. During the course of tapering the dose of prednisolone, she suffered from relapse. Follow-up bronchoscopy showed bloody BALF with many hemosiderin-laden macrophages, which revealed pulmonary alveolar hemorrhage. Conclusion. We considered that this case was a case of OP after radiotherapy for breast cancer in which pulmonary alveolar hemorrhage had been confirmed at the both initial and relapse time. We reported the first case of OP after radiation therapy for postoperative breast cancer combined with pulmonary alveolar hemorrhage.
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  • Kana Tomokuni, Yasuyuki Mizumori, Yasuharu Nakahara, Yoshiro Mochizuki ...
    Article type: Article
    2015 Volume 37 Issue 2 Pages 191-196
    Published: March 25, 2015
    Released on J-STAGE: October 29, 2016
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    Background. Endobronchial ultrasound-guided transbronchial needle aspiration (EBUS-TBNA) has been reported to be a useful and safe diagnostic method. However, there are reports of mediastinitis induced by EBUS-TBNA, and more information is thus needed to prevent this complication. We herein report two cases of mediastinitis following EBUS-TBNA and discuss the infectious complications of EBUS-TBNA in the context of the relevant literature. Case 1. EBUS-TBNA was performed to treat new mediastinal adenopathy (#7 lymph node) due to a relapse after surgery for lung cancer. The patient developed a fever seven days after the procedure and was diagnosed with mediastinitis. Treatment with antibiotics was successful. Case 2. EBUS-TBNA was performed to treat mediastinal adenopathy (#4R/#7 lymph nodes). Five days after the procedure, the patient developed a fever, and a diagnosis of mediastinitis was made. Although antibiotics were administered, the patient developed pericarditis and cardiac tamponade requiring urgent debridement and drainage with video-assisted thoracic surgery. In both cases, the specimens exhibited severe necrosis. Conclusions. Necrosis appears to be a risk factor for mediastinitis after EBUS-TBNA.
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  • Kei Morikawa, Noriaki Kurimoto, Naoki Furuya, Hirotaka Kida, Takeo Ino ...
    Article type: Article
    2015 Volume 37 Issue 2 Pages 197-202
    Published: March 25, 2015
    Released on J-STAGE: October 29, 2016
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    Background. Endobronchial ultrasonography with a guide-sheath (EBUS-GS) is useful for diagnosing peripheral pulmonary lesions. However, small cavitary lesions are often invisible under fluoroscopic guidance and it can be difficult to confirm whether EBUS has reached the target lesion. We report two cases in which the EBUS-GS was able to successfully access the periphery cavitary lesion using saline irrigation on bronchoscopic examination. Case Reports. Case 1 was a 36-year-old woman admitted with a nodule in the right upper lung field identified by chest X-ray during a medical checkup. Chest CT revealed a cavitary lesion (15 mm) in the area of S^2. On bronchoscopic examination, we selected B^2a ii βx as the access bronchus and irrigated with saline before inserting EBUS-GS. EBUS image displayed an oval-shaped lesion with retained saline that was collected by bronchial washing and diagnosed pathologically as Mycobacterium avium. Case 2 was a 66-year-old man referred to our department with a nodule (20 mm) in the right middle lung field during tapering of steroid treatment for microscopic polyangiitis with alveolar hemorrhage. Subsequently, the lesion grew larger with cavitation on follow-up and bronchoscopy was performed. The right B^3a ii αyx was selected as the access bronchus and the EBUS-GS was inserted while performing saline irrigation. We were able to confirm that the GS reached the cavitary lesion on the EBUS image. Conclusion. Saline solution irrigating the access bronchus of the cavitary lesion, was able to clearly delineate the cavity boundary on EBUS images. Therefore, we could easily estimate the spatial structure of the cavitary lesion and safely obtain tissue accurately.
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  • Taku Oikawa, Ryo Kato, Shoko Kitadate, Shohei Shinomiya, Yutaka Takaha ...
    Article type: Article
    2015 Volume 37 Issue 2 Pages 203-208
    Published: March 25, 2015
    Released on J-STAGE: October 29, 2016
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    Background. The development of allergic bronchopulmonary aspergillosis (ABPA) complicated by bronchial stenosis following treatment with lung lobectomy is rare. We herein report a case of an ABPA-like clinical condition associated with bronchial stenosis after lung lobectomy. Case. A 44-year-old man was referred to our hospital due to dyspnea. He had a history of wheezing in childhood and had undergone lobectomy and bronchoplasty of the left lower lobe for left pneumothorax and a carcinoid tumor at the age of eighteen. He had experienced a cough since the end of December 20XX-1, followed by the development of dyspnea on January 20XX, and was subsequently referred to our hospital for the treatment of atelectasis of the left lung. Results. Bronchoscopy revealed occlusion of the left main bronchus, and a transbronchial biopsy showed submucosal eosinophilic infiltration. Aspergillus fumigatus (A. fumigatus) was detected in the bronchial lavage fluid. The lung atelectasis improved following expectoration of the mucus plugs, and only bronchial stenosis due to lung surgery was observed after treatment. Conclusions. In this case, we concluded that bronchial stenosis due to lung surgery was attributable to the patient's infection with A. fumigatus and the ABPA-like clinical condition.
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  • Yukihiro Sugimoto, Mio Nakazato, Masanori Takayama
    Article type: Article
    2015 Volume 37 Issue 2 Pages 209-213
    Published: March 25, 2015
    Released on J-STAGE: October 29, 2016
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    Background. Most pulmonary hamartoma are usually the parenchymal type and the endobronchial type is relatively rare. We report a case of endobronchial hamartoma occurring in the right main bronchus removed by microwave coagulation therapy. Case. A 70-year-old man who had rectal cancer was found to have a tumor with calcification in the right main bronchus at a local hospital in April 2013. He was referred to our hospital because his wishes. Bronchoscopic examination revealed a pedunculated polypoid tumor occluding the right orifice of the truncus intermedius. We excised this polypoid tumor by endoscopic microwave coagulation therapy. It was histologically diagnosed as endobronchial hamartoma. Conclusion. Endoscopic microwave coagulation therapy can be useful in treating pedunculated endobronchial hamartoma safely.
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  • Takeshi Satomura, Kenichi Ogata
    Article type: Article
    2015 Volume 37 Issue 2 Pages 214-218
    Published: March 25, 2015
    Released on J-STAGE: October 29, 2016
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    Background. Drug-induced pulmonary disease can be caused by a variety of drugs including supplements. We examined a case of drug-induced organizing pneumonia induced by a supplement containing chondroitin. Case. An 80-year-old man had been taking supplements for knee pain since early July 2013 and subsequently developed a cough and fever. A chest radiograph demonstrated infiltrative shadows, and he was admitted to our hospital. His condition did not improved with antibiotic treatment and bronchoscopy was performed for diagnostic purposes. A transbronchial lung biopsy specimen showed organizing pneumonia, and the patient's condition was ameliorated with steroid therapy. We established a diagnosis of drug-induced pulmonary disease based on the results of a lymphocyte stimulation test for a supplement containing chondroitin. Conclusions. We conclude that the use of supplements containing chondroitin may result in drug-induced pulmonary disease.
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  • Chie Kohmura, Ayako Yokoe, Rie Anazawa, Toyoaki Aizawa, Masakazu Kono, ...
    Article type: Article
    2015 Volume 37 Issue 2 Pages 219-222
    Published: March 25, 2015
    Released on J-STAGE: October 29, 2016
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    Background. Benign asbestos pleural effusion is thought to be caused by relatively high-level occupational exposure to asbestos; however, the nature of the disease remains largely unknown due to the insufficient number of relevant epidemiological studies. Case. The patient was a 76-year-old man who had no history of occupational exposure to asbestos, but had lived and often played near an operating asbestos factory as a child. Right-sided pleural effusion was identified during a routine health check and the patient was followed-up. However, an increase in pleural effusion was seen and the patient was consequently hospitalized. The pleural effusion was bloody and exudative with lymphocyte predominance. To obtain a definitive diagnosis, thoracoscopy was performed under local anesthesia, which revealed plaque on the parietal pleura, but no findings suggestive of a tumor. A biopsy of the reddened area also revealed no malignant cells. On the basis of these findings, benign asbestos pleural effusion was diagnosed, and at present, after more than two years of follow-up, no malignant tumors have developed. Conclusion. We encountered a case of benign asbestos pleural effusion thought to be caused by neighborhood exposure. Benign asbestos pleural effusion can develop even after relatively low-level exposure to asbestos and, therefore, this disease should be taken into consideration in the differential diagnosis of idiopathic pleural effusion. It is important to take a patient's residential history as well as their occupational history.
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  • Kazuyoshi Nakamura, Kazuaki Sugahara, Hidenori Ichiyasu, Toshihiro Esa ...
    Article type: Article
    2015 Volume 37 Issue 2 Pages 223-229
    Published: March 25, 2015
    Released on J-STAGE: October 29, 2016
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    Background. We report two cases of acute eosinophilic pneumonia (AEP) possibly induced by menthol cigarette smoking. Case 1. A 16-year-old man was admitted to our hospital complaining of fever and dyspnea. Chest radiograph and CT revealed patchy ground-glass opacities in the right lung field with thickened interlobular septa and bilateral pleural effusions. Laboratory data showed leukocytosis with neutrophilia and hypoxemia. Case 2. A 18-year-old man was admitted to our hospital complaining of fever and dyspnea. Chest radiograph and CT revealed patchy ground-glass opacities in the both lung fields with thickened interlobular septa and bilateral pleural effusions. The bronchoalveolar lavage fluid (BALF) of both cases revealed an increase in eosinophil. Both of cases were diagnosed as AEP induced by menthol cigarette smoking. Corticosteroid therapy immediately improved their symptoms, ground-glass opacities and pleural effusions. Conclusions. In these 2 cases, menthol cigarette induced AEP but non-menthol cigarette did not. These two cases suggested that menthol cigarette smoking may induce AEP.
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  • Norihiko Funaguchi, Daizo Kaito, Komei Yanase, Junki Endo, Fumitaka It ...
    Article type: Article
    2015 Volume 37 Issue 2 Pages 230-233
    Published: March 25, 2015
    Released on J-STAGE: October 29, 2016
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    Background. Operative treatment is usually undertaken in patients with intractable pneumothorax. However, surgery is contraindicated in some pneumothorax patients due to the presence of severe underlying diseases and the patient's high age. Case. A 16-year-old man was diagnosed to have osteosarcoma of the right femur at 14 years of age and was subsequently treated with chemotherapy and surgery. However, he developed multiple lung metastases that were difficult to treat and resulted in left-sided spontaneous pneumothorax. A chest drainage tube was inserted into the left side of the thoracic cavity, and although chest drainage and pleurodesis using autologous blood were performed, the pulmonary air leakage and pneumothorax remained. We selected treatment with the thoracographic fibrin glue sealing method (TGF) rather than surgery due to his poor condition. The point of air leakage was detected near the left side of a metastatic lung tumor in left S^3 on thoracography. The air leakage was successfully stopped by injecting fibrin glue directly into the point of air leakage using a double-lumen catheter via the chest drainage tube. Conclusions. TGF is an extremely useful and minimally invasive treatment for intractable pneumothorax in high-risk patients with contraindications to surgery and should thus be applied widely.
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  • Yu Sato, Kengo Murata, Akane Sasaki, Shoichi Okamoto, Akihiko Wada, Mi ...
    Article type: Article
    2015 Volume 37 Issue 2 Pages 234-239
    Published: March 25, 2015
    Released on J-STAGE: October 29, 2016
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    Background. Lung injuries caused by inhalation of waterproofing spray can, however rarely, be complicated by diffuse alveolar hemorrhage. Although corticosteroids are typically prescribed as a treatment for such conditions, their benefit or efficacy has not been proven. We present a case of spontaneously remitting diffuse alveolar hemorrhage following inhalation of waterproofing spray. Case. A 51-year-old man who smoked a cigarette after accidentally inhaling waterproofing spray while working in a closed space subsequently developed dyspnea and hemoptysis. A CT scan on admission revealed ground glass opacities with perihilar predominance. We diagnosed acute lung injury with diffuse alveolar hemorrhage caused by inhalation of waterproofing spray and heat, on the basis of the progressively hemorrhagic bronchoalveolar lavage fluid in serial specimens. The acute lung injury and dyspnea resolved spontaneously in 14 days. Conclusion. The spontaneous remission seen in the present case demonstrated that administration of corticosteroids may not be necessary to treat alveolar hemorrhage caused by waterproofing spray inhalation, further suggesting that the treatment for similar cases should be chosen on the basis of the individual clinical course and the risk of progression.
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  • Yutaka Takahara, Keisuke Nakase, Masafumi Nojiri, Ryo Kato, Shouhei Sh ...
    Article type: Article
    2015 Volume 37 Issue 2 Pages 240-244
    Published: March 25, 2015
    Released on J-STAGE: October 29, 2016
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    Background. Pulmonary Langerhans cell histiocytosis (PLCH) is a comparatively rare disease characterized by non-neoplastic proliferation and granuloma formation of the Langerhans cells, which is thought to be a smoking-related lung disease. However, the diagnostic yield of PLCH from bronchoalveolar lavage (BAL) and transbronchial lung biopsy (TBLB) specimens obtained by bronchoscopy is not high. Case. A 38-year-old woman who had smoked 20 cigarettes per day for 20 years was admitted to our hospital because of productive cough. Chest CT showed multiple micronodules, cavitary nodules, and thick-walled cysts predominantly in the bilateral upper lung fields. We performed BAL from the right B^5 and TBLB in the right S^4, S^5 with fiberoptic bronchoscopy. Although the TBLB specimens showed non-specific inflammation, microscopic findings of the cell block obtained by BAL showed a significantly increased number of Langerhans cells stained with CD1a and S-100 protein. From these observations, we made a diagnosis of PLCH. Conclusion. We reported a case of PLCH successfully diagnosed using a cell block from the BAL.
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  • Article type: Appendix
    2015 Volume 37 Issue 2 Pages 245-246
    Published: March 25, 2015
    Released on J-STAGE: October 29, 2016
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  • [in Japanese]
    Article type: Article
    2015 Volume 37 Issue 2 Pages 247-248
    Published: March 25, 2015
    Released on J-STAGE: October 29, 2016
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  • [in Japanese]
    Article type: Article
    2015 Volume 37 Issue 2 Pages 249-250
    Published: March 25, 2015
    Released on J-STAGE: October 29, 2016
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