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Publications (12)0 Total impact

  • [show abstract] [hide abstract]
    ABSTRACT: A 36-year-old man was admitted to our hospital for examination of a nodular shadow in the left lung. Chest 3-dimensional computed tomography (3D-CT) revealed a pulmonary arteriovenous fistula (PAVF) of 21 mm in diameter composed of the feeding artery (A4) and the draining vein (V4) in the left S4. Abdominal enhanced CT revealed multiple hepatic arteriovenous fistula. Brain CT revealed a cavernous hemangioma in right occipital cerebrum. He had a family history, habitual epistaxis, and oral telangiectasia and was diagnosed as Rendu-Osler-Weber disease (hereditary hemorrhagic telangiectasia:HHT). According to his family history, PAVF was likely to be a risk factor of brain infarction and abscess, and the wedge resection of the lingual lobe was performed to remove PAVF.
    Kyobu geka. The Japanese journal of thoracic surgery 09/2012; 65(10):862-5.
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    ABSTRACT: A 61-year-old man was pointed out a solitary nodule located in the left lung (S9) measuring 18 × 29 mm in size along with lymphadenopathy by chest computed tomography (CT). Positron emission tomography( PET) scan showed a positive sign corresponding to the nodule[ standardized uptake value (SUV) max 5.8]. No diagnostic material was obtained from the transbronchial tumor biopsy, since it was difficult to rule out malignancy, surgical biopsy was performed with sampling of mediastinal lymph nodes. Histopathological examination showed marked infiltration of inflammatory cells, many of which were demonstrated to be immunoglobulin (Ig) G4-positive plasma cells by immunohistochemical staining. Hence, IgG4-related inflammatory pseudotumor of the lung was diagnosed.
    Kyobu geka. The Japanese journal of thoracic surgery 07/2012; 65(7):542-5.
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    ABSTRACT: A 64-year-old man was admitted to our hospital for 6th-line chemotherapy. Chest X-ray film and computed tomographic (CT) scan showed right-sided pleural thickening with multiple lung tumors. Repeated treatment with carboplatin (AUC 6), paclitaxel (200 mg/m(2)) and bevacizumab (150 mg/kg) on day 1 every 21 days was effective for this patient. Chemotherapy with bevacizumab may be effective for patients with multi-recurrent adenocarcinoma.
    Gan to kagaku ryoho. Cancer & chemotherapy 12/2011; 38(13):2631-3.
  • M Segawa, M Touge, Y Kusajima, K Saito
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    ABSTRACT: We reported a case of catamenial pneumothorax caused by diaphragmatic endometriosis that was histologically confirmed. A 49-year-old female who had recurrent chest pain and cough appearing on the day preceding each menstruation from 5 years ago. These episode suggested catamenial pneumothorax. Thoracotomy revealed the characteristic appearances of catamenial pneumothorax such as blueberry spots and multiple small holes on the central tendon of the right diaphragm. But there were no lesions on the visceral pleura of the lung. Partial resection of the diaphragm including these lesions were performed. Histological examination showing positive for estrogen receptor and progesterone receptor confirmed the presence of endometrial tissue on the diaphragm. The patient has been well controlled by therapy with gonadotropin releasing hormone, without recurrence of catamenial pneumothorax.
    Kyobu geka. The Japanese journal of thoracic surgery 05/2011; 64(5):430-3.
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    ABSTRACT: Syndrome of inappropriate secretion of antidiuretic hormone (SIADH) shows various symptoms based on hyponatremia and brings catastrophic outcome occasionally. A 75-years-old man was found to have an abnormal shadow of the right lung on chest X-ray. Bronchoscopic examination showed that the abnormal shadow was aterectasis caused by the squamous cell carcinoma of middle lobe bronchus, and middle and lower lobectomy of the right lung was performed. On the postoperative day 2, suddenly the serum sodium concentration decreased to 116 mEq/l and serum osmolarity also decreased to 246 mOsm/l. Inspite of hyponatremia, the urine sodium level elevated to 73 mEq/l. So the urine osmolarity elevated to 752 mOsm/l, too. In addition to these data, edema and dehydration were absent, and both renal and adrenal function were normal. So we diagnosed that this abnormal conditions-hyponatremia with corresponding serum hypoosmolality and an inappropriately high urinary osmolality due to continued sodium excretion was induced by SIADH. Fluid restriction and antibiotics therapy for pneumonia resulted in an appropriate rise in the serum sodium level to 138 mEq/l on the postoperative day 21. To avoid catastrophic outcome in the cases of hyponatremia after surgery, it is important to remember that hyponatremia may be induced by SIADH.
    Kyobu geka. The Japanese journal of thoracic surgery 02/2010; 63(2):133-7.
  • M Segawa, K Seki, Y Kusajima, K Saito
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    ABSTRACT: Clear cell adenocarcinoma with endobronchial polypoid growth of the lung is extremely rare. A 65-year-old male with hemosputum was found to have an abnormal shadow in the hilum of the left lung. Computed tomography of the chest revealed that a heterogeneous mass occupied the lumen extending outside the upper lobe bronchus of the left lung. By biopsy, the tumor was determined to be adenocarcinoma. The patient underwent left pneumonectomy with mediastinal lymph node dissection. Macroscopically, the tumor showed a polypoid growth along with the bronchial tree. Microscopically, most of the tumor was composed of large clear cells with partial glandular formation, indicating the tumor to be adenocarcinoma Lymph node metastasis was seen in #5 and #12u. The lung cancer was diagnosed as clear cell adenocarcinoma with endobronchial polypoid growth.
    Kyobu geka. The Japanese journal of thoracic surgery 12/2009; 62(13):1182-5.
  • The Journal of The Japanese Association for Chest Surgery. 01/2008; 22(1):8-12.
  • Masataka Segawa, Y Kusajima, K Senda, K Saito
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    ABSTRACT: Granular cell tumor is found in various organs but is rare in the mediastinum. We report a case of 36-year-old woman with a granular cell tumor in the left upper mediastinum. She was admitted to our hospital because of hoarseness. Laryngoscopic examination revealed left vocal cord paralysis. Chest computed tomography (CT) showed a 3.0 x 2.0 cm well circumscribed tumor at the left side of the trachea in the left upper mediastinum. As hoarseness was suspected to be attributable to the mediastinal tumor, tumor resection was performed. It was found that the tumor involved the left recurrent nerve. The tumor was completely excised with combined resection of the left recurrent nerve. Histopathologically, the tumor consisted of cells with eosinophilic granules and S-100 protein positive materials in the cytoplasm, and diagnosed a granular cell tumor.
    Kyobu geka. The Japanese journal of thoracic surgery 08/2007; 60(7):595-8.
  • M Segawa, K Senda, Y Kusajima, K Saito
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    ABSTRACT: We experienced a case of interesting pulmonary metastasis from spindle cell carcinoma of the breast. A 68-year-old female who had undergone a radical mastectomy 32 months earlier was admitted to our hospital for the pulmonary tumor in the left S10 in January 2005. Pathological study of the breast tumor revealed mixture of carcinomatous portion and sarcomatoid portion with spindle cells. Because of the presence of transitional areas from one portion to the other, the tumor was diagnosed as spindle cell carcinoma of the breast. Partial resection of the left lower lobe was performed. Pathological examination of the pulmonary tumor revealed that the tumor was composed of the component similar to carcinomatous element of the breast cancer. In June 2005, She was admitted to our hospital again for the pulmonary tumor in the right S7. Partial resection of the right lower lobe was performed. The tumor was composed of both carcinomatous and sarcomatoid elements. After operation, as she complained of epigastralgia, a gastroscopic examination was performed. It showed 2 white polypi of the stomach. The biopsy specimen of the polypi were composed of the tumor similar to the sarcomatoid element of the breast cancer. She died of widespread metastasis 43 months after mastectomy.
    Kyobu geka. The Japanese journal of thoracic surgery 03/2007; 60(2):121-6.
  • The Journal of The Japanese Association for Chest Surgery. 01/2007; 21(4):544-549.
  • M Segawa, Y Kusajima, K Saito
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    ABSTRACT: Pleomorphic carcinoma of the lung is a type of carcinoma with spindle and/or giant cells with a poor diagnosis. A 73-year-old male was referred to our hospital because of the pulmonary tumor. Lung biopsy revealed that the tumor was poorly differentiated adenocarcinoma. No distant metastasis were observed by systemic examination. A right middle lobectomy with partial resection of the right upper lobe and lymph node dissection were performed, because the tumor (5.3 x 4.0 x 4.0 cm) was located in peripheral S' and invaded S3 via the interlobular space. Histological findings showed adenocarcinoma comprised of spindle cell components that reacted positively to epithelial membrane antigen (EMA) and no lymph node metastasis. Therefore, he was diagnosed with pleomorphic carcinoma of the lung, pT2N0M0, stage IB. But metastatic lesions newly appeared in the thoracic skin, the liver, the diaphragm, the bilateral adrenal glands, and the retroperitoneal space on the 30th postoperative day. He died of peritonitis and pleuritis on only 60 days after the operation.
    Kyobu geka. The Japanese journal of thoracic surgery 06/2006; 59(5):387-91.
  • Masataka Segawa, Y Kusajima
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    ABSTRACT: Pyopneumopericardium caused by transdiaphragmatic perforation of gastric ulcer is very rare. A 60-year-old man was admitted to our hospital because of chest pain with high fever. The chest computed tomography (CT) revealed hydropneumopericardium. The patient was diagnosed as purulent pericarditis. So emergent pericardiectomy and pericardial drainage were performed to relieve cardiac tamponade. Two findings enabled us to diagnose the causation of pyopneumopericardium as gastropericardial fistura. The first finding was that endoscopic examination of upper gastrointestinal tract revealed a deep peptic ulcer in the dome of gastric fundus. The second finding was that a dye solution which was injected into the pericardial cavity via the drainage tube leaked out into the gastric cavity through the ulcer. This patient improved successfully by the treatment of intravenous hyperalimentation including antibiotics and omeprazole. We think that expedient diagnosis and surgical drainage are essential for successful patient outcome.
    Kyobu geka. The Japanese journal of thoracic surgery 06/2005; 58(5):415-8.