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ABSTRACT: This case report describes a 64-year-old woman with interstitial lung disease associated with clinically amyopathic dermatomyositis. Chest computed tomography revealed consolidations along bronchovascular bundles in the periphery of the lower lungs. Interstitial lung disease developed acutely, and the patient died 3 months after the clinical diagnosis. An autopsy was performed, and a large section of the lung specimen was prepared. Various interstitial lesions including organizing pneumonia, cellular and fibrotic nonspecific interstitial pneumonia, and diffuse alveolar damage were seen in the large section. Correlating the large section and computed tomography images was useful for determining the distribution of diffuse alveolar damage.
Journal of thoracic imaging 10/2012; · 1.42 Impact Factor
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ABSTRACT: Buffalo chest refers to the pleuro-pleural communication that results in a single pleural cavity. Iatrogenic buffalo chest can occur following heart or heart-lung transplantation and other major thoracic surgeries. We present the case of malignant pleural mesothelioma in which iatrogenic buffalo chest after extended thymectomy caused bilateral pneumothoraces and contralateral dissemination of the disease. The free communication between bilateral pleural cavities had facilitated the rapid progression of tumor and the consequent bilateral malignant pleural effusions had made the management of disease much more difficult, leading to the early fatal outcome. To our knowledge, this is the first case of buffalo chest that was associated with bilateral malignant pleural effusions.
General Thoracic and Cardiovascular Surgery 05/2012; 60(9):595-8.
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Kizuku Watanabe,
Tomohiro Handa,
Kiminobu Tanizawa,
Yuji Hosono,
Yoshio Taguchi,
Satoshi Noma, Yoichiro Kobashi,
Takeshi Kubo,
Kensaku Aihara,
Kazuo Chin,
Sonoko Nagai,
Tsuneyo Mimori,
Michiaki Mishima
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ABSTRACT: Antisynthetase syndrome (ASS) is characterized by autoantibodies to aminoacyl-tRNA synthetases (anti-synthetase) and it is frequently associated with interstitial lung disease. The purpose of this study was to elucidate the prevalence and characteristics of the anti-synthetase positive subpopulation among idiopathic interstitial pneumonias (IIPs) and to clarify the importance of screening for these antibodies.
A retrospective study was performed in 198 consecutive cases with IIPs. Screening for six anti-synthetase antibodies was performed in all cases. Clinical profiles of all cases were compared with reference to the presence of anti-synthetase. High-resolution computed tomography (HRCT) findings of anti-synthetase positive cases were also analyzed.
13 cases (6.6%) were positive for anti-synthetase. Anti-EJ was most prevalent, followed by anti-PL-12. Onset ages of anti-synthetase positive cases were younger than those of anti-synthetase negative cases. Extrapulmonary features of ASS were absent in 6 anti-synthetase positive cases (46.2%). Histologically, among 5 UIP with lymphoid follicles and 11 NSIP cases, the prevalence of anti-synthetase positive cases was 8/16 (50%). On HRCT, ground glass opacity and traction bronchiectasis were the major findings in anti-synthetase positive cases, while honeycombing was absent.
Anti-synthetase positive cases were not rare among IIPs. Anti-synthetase should be screened for in IIPs, especially in pathological NSIP or UIP with lymphoid follicles. These patients should be screened for anti-synthetase even if no suggestive extrapulmonary manifestation exists.
Respiratory medicine 08/2011; 105(8):1238-47. · 2.33 Impact Factor
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Hitoshi Nakaji,
Hisako Matsumoto,
Akio Niimi,
Tomohiro Handa,
Isao Ito,
Makiko Kanai,
Hisako Tabata,
Hiroaki Sakai, Yoichiro Kobashi,
Yoshiro Mochizuki,
Kazuo Chin,
Michiaki Mishima
Nitric Oxide 03/2011; 24(4):173-5. · 3.55 Impact Factor
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Minako Hijikata,
Ikumi Matsushita,
Goh Tanaka,
Tomoko Tsuchiya,
Hideyuki Ito,
Katsushi Tokunaga,
Jun Ohashi,
Sakae Homma, Yoichiro Kobashi,
Yoshio Taguchi,
Arata Azuma,
Shoji Kudoh,
Naoto Keicho
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ABSTRACT: Diffuse panbronchiolitis (DPB) is a rare complex genetic disease affecting East Asians and is strongly associated with the class I human leukocyte antigens (HLA)-B54 in Japanese and HLA-A11 in Koreans. We recently showed that an HLA-associated major susceptibility gene for DPB is probably located within the 200 kb in the class I region 300 kb telomeric of the HLA-B locus on the chromosome 6p21.3. We cloned two novel mucin-like genes designated panbronchiolitis related mucin-like 1 and 2 (PBMUCL1 and PBMUCL2) in the candidate region, which form a mucin-like gene cluster together with two adjacent genes, MUC21 and DPCR1. PBMUCL1 gene expression was remarkably upregulated by polyinosine-polycytidylic acid [poly(I:C)] stimulation in normal human bronchial epithelial cells redifferentiated at the air-liquid interface. We found genetic polymorphisms in PBMUCL1 gene which were associated with DPB: the A-allele of the PBMUCL1 intron 2 single nucleotide polymorphism (SNP) was positively associated and variable numbers of tandem repeats (VNTR) polymorphism in exon 3 (1,890-base pair deletion) was negatively associated. Despite a strong association with HLA-B in the Japanese, the mucin-like gene PBMUCL1 is also one of the candidate genes of DPB susceptibility.
Human Genetics 10/2010; 129(2):117-28. · 5.07 Impact Factor
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Journal of thoracic oncology: official publication of the International Association for the Study of Lung Cancer 08/2010; 5(8):1303-4. · 4.55 Impact Factor
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ABSTRACT: A 37-year-old man was referred to our hospital with a cough. His blood test result and chest radiography findings were normal. High resolution chest computed tomography (HRCT) showed diffuse ground glass attenuation (GGA) with centrilobular distribution in the bilateral upper lung fields. As diagnosis could not be made using transbronchial lung biopsy and bronchoalveolar lavage, video-assisted lung biopsy was performed. The histological findings were a thickening of the alveolar walls with infiltration of lymphocyte-dominant inflammatory cells, and exudation of pigmented macrophages in the air spaces of the respiratory bronchioles and alveolis. We diagnosed his illness as respiratory bronchiolitis-associated interstitial lung disease. Six months after stopping smoking, his symptoms, and the GGA on chest HRCT improved.
Nihon Kokyūki Gakkai zasshi = the journal of the Japanese Respiratory Society. 04/2010; 48(4):307-11.
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Kiminobu Tanizawa,
Yusuke Kaji,
Eisaku Tanaka,
Tetsuro Inoue,
Minoru Sakuramoto,
Masayoshi Minakuchi,
Yuji Maeda,
Ko Maniwa,
Kunihiko Terada,
Shunsuke Goto,
Tomoshi Takeda,
Masaki Okamoto,
Seishu Hashimoto,
Satoshi Noma, Yoichiro Kobashi,
Yoshio Taguchi
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ABSTRACT: We report a case of Churg-Strauss syndrome (CSS) presenting as a massive pleural effusion. A 52-year-old asthmatic Japanese woman presented with progressive dyspnea caused by an eosinophilic pleural effusion (EPE). She also had chronic sinusitis, skin lesions and blood eosinophilia, but no antineutrophil cytoplasmic antibodies. Skin biopsy and the late onset of mononeuritis multiplex led to the diagnosis of CSS. The pleural effusion resolved soon after corticosteroid treatment was started. CSS is rare as a cause of EPE, but should be included in the differential diagnosis of EPE in asthmatic patients. This is the first report showing that EPE can precede other vasculitic symptoms in CSS.
Internal Medicine 01/2010; 49(9):841-5. · 0.94 Impact Factor
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ABSTRACT: Although the association between seminoma and sarcoidosis or a sarcoid-like reaction has been well recognized, a paradoxical case during chemotherapy for seminoma has not been reported. We report the first case of a sarcoid-like reaction that developed paradoxically during successful chemotherapy for recurrent seminoma. A 36-year-old Japanese man had recurrent seminoma in abdominal lymph nodes four years after left orchiectomy. Chemotherapy consisting of bleomycin, etoposide and cisplatin had reduced the abdominal mass, but mediastinal and bilateral hilar lymphadenopathy newly appeared. Surgical biopsy of the mediastinal lymph nodes and left nephrectomy and retroperitoneal lymphadenectomy revealed noncaseating granulomas only in mediastinal lymph nodes and confirmed complete remission of seminoma. Nine months later the thoracic lymphadenopathy had resolved spontaneously.
Internal Medicine 01/2010; 49(14):1423-6. · 0.94 Impact Factor
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ABSTRACT: A 36-year-old man began painting his car as a hobby every weekend in early February 2007 using a paint containing isocyanate. In March, 2007, he developed a dry cough, dyspnea and fever of 40 degrees C. These symptoms appeared repeatedly several hours after engaging in painting activity. His chest X-ray film showed diffuse small granular and reticular shadows in bilateral lung fields. His computed tomogram showed ground glass images in bilateral lung fields. Pulmonary function tests showed significantly decreased DLco. Histological findings of transbronchial lung biopsy revealed cellular interstitial pneumonia. These symptoms improved after cessation of painting and administration of prednisolone. Based on these results, we diagnosed this patient's illness as hypersensitivity pneumonitis due to isocyanate exposure.
Nihon Kokyūki Gakkai zasshi = the journal of the Japanese Respiratory Society. 11/2009; 47(11):1002-7.
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ABSTRACT: We reported the clinical features of 4 cases with pulmonary Langerhans' cell histiocytosis. All of them were men who had a history of smoking. They ranged in age from 23 to 46 years. Cases 1 and 3 did not stop smoking, while Cases 2 and 4 did stop smoking. All of the chest CTs revealed small nodules and cysts, and during the follow-up period of 8 to 13 years, the numbers of nodules decreased and the walls of the cysts became thin in all of the cases. Their pulmonary function tests revealed restrictive impairment in 3 cases and reduced diffusion capacity in 2 cases, but none showed obstructive impairment. FEV1% and DL(CO) deteriorated during the follow-up period. Case 1 died of respiratory failure after 8 years. Cases 2 and 4 were both alive with home oxygen therapy after 11 and 12 years, respectively. Case 3 was alive but complained of dyspnea on exertion after 13 years. In conclusion, all of the 4 cases showed deterioration of pulmonary function, and one of them died due to respiratory failure. The prognosis of patients with pulmonary Langerhans' cell histiocytosis appears to be poor.
Nihon Kokyūki Gakkai zasshi = the journal of the Japanese Respiratory Society. 08/2009; 47(8):675-81.
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ABSTRACT: A 39-year-old man was referred to our hospital with anterior chest discomfort, dry cough and shortness of breath. His blood test revealed mild inflammatory change and high serum KL-6 levels. Chest radiograph and computed tomography (CT) showed ground glass attenuation with volume loss in both lower lung fields, and in particular a reversed halo sign was shown on high-resolution CT (HRCT). As transbronchial lung biopsy and bronchoalveolar lavage did not enable a diagnosis, video-assisted thoracic surgery was performed. The histological findings of the resected specimen showed cellular nonspecific interstitial pneumonia. This suggested the possibility of collagen vascular disorder (CVD) associated with interstitial pneumonitis, but no criteria of CVD were fulfilled. Although the reversed halo sign is relatively specific for cryptogenic organizing pneumonia, we report a case of cellular nonspecific interstitial pneumonia showing this sign on chest HRCT.
Nihon Kokyūki Gakkai zasshi = the journal of the Japanese Respiratory Society. 04/2007; 45(3):248-52.
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ABSTRACT: A 74-year-old man had been given a diagnosis of myelodysplastic syndrome (MDS), and had been treated with granulocyte-colony stimulating factor (G-CSF). 1 year later, he suffered from fever and his chest X-ray lung biopsy did not provide a diagnosis, video-assisted thoracoscopic lung biopsy was performed, which yielded a histological diagnosis of organizing pneumonia. His pulmonary disease was diagnosed as secondary organizing pneumonia due to MDS, and was treated successfully with steroids. Vigorous efforts to establish a histological diagnosis is needed for the antibiotics-resistant pneumonia in the case of MDS.
Nihon Kokyūki Gakkai zasshi = the journal of the Japanese Respiratory Society. 01/2007; 44(12):933-7.
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Tetsuro Inoue,
Eisaku Tanaka,
Minoru Sukuramoto,
Masayoshi Minakuchi,
Yuji Maeda,
Ko Maniwa,
Kunihiko Terada,
Kiminobu Tanizawa,
Seishu Hashimoto,
Shunsuke Goto,
Tomoshi Takeda,
Masaki Okamoto, Yoichiro Kobashi,
Yoshiaki Yuba,
Satoshi Noma,
Yasuyuki Yoshizawa,
Yoshio Ohtani,
Yoshio Taguchi
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ABSTRACT: We retrospectively evaluated 8 cases of bird related hypersensitivity pneumonitis in Tenri hospital, all of whom underwent surgical lung biopsy. They had a history of contacting with birds and had serological studies using lymphocyte stimulation test to pigeon serum or antibody in serum and bronchoalveolar lavage fluid to pigeon dropping extracts yielded positive results. Computed tomography revealed a radiographic pattern unlike typical UIP. The result of pathological diagnosis of surgical lung biopsy was 'others' or NSIP pattern. Only one case had pathological findings of granuloma. Four cases had an improved or stable course only offer segregation from bird antigens. The other four cases needed corticosteroids and immunosuppressants, and two of the four cases had a progressive course and died of respiratory failure.
Nihon Kokyūki Gakkai zasshi = the journal of the Japanese Respiratory Society. 09/2006; 44(8):550-5.
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Tetsuro Inoue,
Eisaku Tanaka,
Minoru Sakuramoto,
Masayoshi Minakuchi,
Yuji Maeda,
Ko Maniwa,
Kiminobu Tanizawa,
Tomoshi Taked,
Masaki Okamoto, Yoichiro Kobashi,
Yoshiaki Yuba,
Satoshi Noma,
Yoshio Taguchi
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ABSTRACT: A 66-year-old man complaining of fever was given intravenous antibiotic therapy, but he did not improve. After subsequent admission, chest X-ray film and computed tomography scans showed large bullae and consolidation in the right lung field. A transbronchial lung biopsy specimen revealed infiltration of mononuclear cells in alveolar septa and organizing lesions in alveolar ducts. We considered this case to be cryptogenic organizing pneumonia (COP) from its clinical course and pathological findings. Treatment with corticosteroid resulted in disappearance of the large bullae and consolidations. COP accompanied by large bullae is very rare. The large bullae may have been caused by check-valve mechanism.
Nihon Kokyūki Gakkai zasshi = the journal of the Japanese Respiratory Society. 08/2006; 44(7):517-21.
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Nihon Naika Gakkai Zasshi 07/2006; 95(6):998-1003.
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ABSTRACT: The patient was a 69-year-old woman who had undergone breast-conserving surgery of the right breast, followed by tangential irradiation of 50 Gy to the remaining breast. Her subsequent progress was monitored by endocrine therapy with toremifene. Symptoms consisting of cough and slight fever developed 5 months after completion of radiation therapy. A chest X-ray image revealed an infiltrating shadow in the right middle and lower pulmonary fields, and the patient visited our hospital. BOOP was diagnosed by thoracoscopic biopsy. Spontaneous remission was observed during monitoring of the patient's progress. A shadow subsequently reappeared, for which a steroid was administered. Improvement was rapid. This case suggests that when tangential irradiation with or without endocrine therapy is provided, subsequent to breast-conserving treatment, patients should be monitored for the occurrence of BOOP.
Nihon Kokyūki Gakkai zasshi = the journal of the Japanese Respiratory Society. 02/2006; 44(1):55-60.
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Tetsuro Inoue,
Eisaku Tanaka,
Minoru Sakuramoto,
Masayoshi Minakuchi,
Yuji Maeda,
Ko Maniwa,
Kunihiko Terada,
Shunsuke Goto,
Tomoshi Takeda,
Masaki Okamoto,
Yoshiaki Yuba, Yoichiro Kobashi,
Satoshi Noma,
Yoshio Taguchi
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ABSTRACT: We report a case of small cell lung cancer with an initial symptom of breast metastasis. A 55-year-old woman was admitted complaining of multiple breast masses. Chest computed tomography (CT) and magnetic resonance imaging (MRI) showed a left hilar mass. Specimens obtained from a breast mass and transbronchial biopsy revealed neoplastic cells suggesting small cell carcinoma Small cell lung cancer with breast metastasis was diagnosed. Systemic chemotherapy resulted in partial remission of the primary lesion and breast metastases.
Nihon Kokyūki Gakkai zasshi = the journal of the Japanese Respiratory Society. 02/2006; 44(1):39-42.
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Koichiro Kamio,
Ikumi Matsushita,
Minako Hijikata, Yoichiro Kobashi,
Goh Tanaka,
Koh Nakata,
Takafumi Ishida,
Katsushi Tokunaga,
Yoshio Taguchi,
Sakae Homma,
Koichiro Nakata,
Arata Azuma,
Shoji Kudoh,
Naoto Keicho
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ABSTRACT: Diffuse panbronchiolitis (DPB) is a chronic inflammatory airway disease predominantly affecting Asian populations. DPB is considered to be a complex genetic disease. Considering the mucous hypersecretion of the disease, we hypothesized that the transcriptional activity of mucin genes may be altered in DPB. We analyzed nucleotide sequences of regulatory region of six mucin genes--MUC1, MUC2, MUC4, MUC5AC, MUC5B, and MUC7--and detected their promoter polymorphisms. Among them, the insertion/deletion polymorphism identified in the MUC5B gene was significantly associated with the disease (p = 0.0001). Transcriptional activity observed in the three major promoter haplotypes corresponded to the strength of the disease association in which these haplotypes are involved. Immunohistochemistry of the lung tissues of DPB revealed that MUC5B was abundantly expressed not only in bronchial glands but also in increased numbers of goblet cells on the bronchial surface, where MUC5AC is predominant and MUC5B expression is generally scarce in the normal lung. Marked mucous hypersecretion observed in DPB may be partly explained by increased and aberrant expression of MUC5B. The possible involvement of MUC5B gene in DPB was demonstrated. A further role of the MUC5B polymorphism in its pathogenesis should be studied in the future.
American Journal of Respiratory and Critical Care Medicine 06/2005; 171(9):949-57. · 11.08 Impact Factor
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Tetsuro Inoue,
Eisaku Tanaka,
Minoru Sakuramoto,
Masayoshi Minakuchi,
Yuji Maeda,
Ko Maniwa,
Kunihiko Terada,
Shunsuke Goto,
Tomoshi Takeda,
Yoshiaki Yuba, Yoichiro Kobashi,
Satoshi Noma,
Yoshio Taguchi
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ABSTRACT: A 69-year-old woman was diagnosed with limited stage, small cell lung cancer in February 2001. Systemic chemotherapy and radiotherapy were performed resulting in complete remission of the disease. In October 2001, she complained of pain and numbness of her left arm. Magnetic resonance imaging (MRI) of the neck showed an intramedullary enhanced mass at the C4-5 level. Specimen obtained by tumor biopsy showed pathological diagnosis of metastasis from small cell lung cancer. Neurological symptoms improved after radiochemotherapy. Intramedullary metastasis of lung cancer is very rare, and early diagnosis and multidisciplinary treatment may improve quality of life.
Nihon Kokyūki Gakkai zasshi = the journal of the Japanese Respiratory Society. 01/2005; 42(12):1014-8.
