[Show abstract][Hide abstract] ABSTRACT: A 48-year-old woman was admitted to our hospital for sixth-line chemotherapy.A chest X-ray film and computed tomographic( CT)scan revealed a right-sided massive tumor with multiple lung tumors.Repeated treatment with carboplatin(AUC 6)on day 1 and nab-paclitaxel(100mg/m2)on days 1, 8, and 15, every 28 days were effective in this patient.Chemotherapy with nab-paclitaxel may be effective for patients with multi-recurrent adenocarcinoma.
No preview · Article · Apr 2015 · Gan to kagaku ryoho. Cancer & chemotherapy
[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.
No preview · Article · Sep 2012 · Kyobu geka. The Japanese journal of thoracic surgery
[Show abstract][Hide abstract] 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.
No preview · Article · Jul 2012 · Kyobu geka. The Japanese journal of thoracic surgery
[Show abstract][Hide abstract] 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.
No preview · Article · Dec 2011 · Gan to kagaku ryoho. Cancer & chemotherapy
[Show abstract][Hide abstract] 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.
No preview · Article · May 2011 · Kyobu geka. The Japanese journal of thoracic surgery
[Show abstract][Hide abstract] 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.
No preview · Article · Feb 2010 · Kyobu geka. The Japanese journal of thoracic surgery
[Show abstract][Hide abstract] 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.
No preview · Article · Dec 2009 · Kyobu geka. The Japanese journal of thoracic surgery
[Show abstract][Hide abstract] 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.
No preview · Article · Aug 2007 · Kyobu geka. The Japanese journal of thoracic surgery
[Show abstract][Hide abstract] 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.
No preview · Article · Mar 2007 · Kyobu geka. The Japanese journal of thoracic surgery
[Show abstract][Hide abstract] 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.
No preview · Article · Jun 2006 · Kyobu geka. The Japanese journal of thoracic surgery
[Show abstract][Hide abstract] 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.
No preview · Article · Jun 2005 · Kyobu geka. The Japanese journal of thoracic surgery
[Show abstract][Hide abstract] ABSTRACT: Objective: We prospectively assessed the usefulness of extended radical segmentectomy for peripheral non-small cell lung cancer 2 cm or less in diameter. Study Design: Retrospectively, 36 patients seen between 1984 and 1993, and who had peripheral non-small cell lung cancers 2 cm or less in diameter on resected specimens, who had undergone a lobectomy with hilar and mediastinal lymph node dissection, were examined for correlation between tumor location and intrapulmonary lymph node or parenchymal metastases histopathologically. The results suggested that extended radical segmentectomy with exploration of lymph nodes by intraoperative examination of frozen sections is acceptable for complete resection of small peripheral lung cancer. Based on those results, from 1993 to 1999, extended radical segmentectomy was prospectively performed for 28 patients with peripheral non-small cell lung cancer 2 cm or less in diameter on computed tomography. Results: The 5-year survival was 72.8% with the extended radical segmentectomy and 75.4% with the standard lobectomy. The frequency of recurrence in the extended radical segmentectomy group (p-Stage IA) was 3.7% and that in the standard lobectomy group (p-Stage IA) was 8.3%. No statistically significant difference between those two groups was detected. Postoperative pulmonary function tests showed that extended segmentectomy was superior to standard lobectomy in terms of recovery of pulmonary function. Conclusion: We concluded that an extended radical segmentectomy is as effective as standard lobectomy for treatment of small peripheral non-small cell lung cancer.
[Show abstract][Hide abstract] ABSTRACT: Background: Endotracheal metastasis of lung cancer is rare. Only 14 cases have been reported in Japan Case: A 65-year-old man was admitted complaining of bloody sputum. He had a history of S1+S2a segmental excision of the right lung and mediastinal lymph node dissection on a diagnosis of the adenocarcinoma of S1a segment (pT1N0M0) about 45 months before. Bronchoscopic examination revealed a submucosal growth tumor 3cm in diameter in the left lateral wall of the middle third of trachea, obstructing more than half of the lumen. The tumor was sessile and soft, and had a reddish smooth surface. The biopsy specimen of the tumor was suspected to be metastasis from lung cancer. The radiological findings showed the tracheal cancer to be localized in the tracheal wall and no other malignant lesions were pointed out. He was treated with excision of the tracheal tumor under tracheotomy followed by 60Gy radiation therapy. The tracheal cancer and the lung cancer had similar histological findings. These tumors were diagnosed as poorly differentiated adenocarcinoma. Immunohistochemically, both the tumor cells of the trachea and the lung were positive for CEA. Moreover, the serum CEA level elevated before the operation and dropped to the normal range after treatment. This evidence supports the diagnosis of endotracheal metastasis of the lung cancer. Conclusion: We presented a rare case of endotracheal metastasis of lung cancer.
[Show abstract][Hide abstract] ABSTRACT: Four cases of malignant fibrous histiocytoma (MFH) in the thoracic cage (1 originating in the lung, 2 in the mediastinum, 1 in the chest wall) were reported. Three cases were men and one was a woman, and the average age was 65 years. All four cases had inflammatory reactions. Two cases in which serum ferritin was measured, revealed high levels accompanying tumor enlargement. Ferritin was detected by immunohistochemical staining in the cytoplasm of a few tumor cells as well as reactive histiocytes proliferating in the tumor or surrounding inflammatory sites. These results demonstrated the production of ferritin from the tumor and suggested that the serum ferritin level may be a useful marker for tumor growth of MFH. This tumor revealed extremely rapid growth and MFH could not be diagnosed preoperatively. Although two cases were resected, both died within 7 months. The importance of making an early and correct pathological diagnosis by open lung biopsy, followed by multimodal treatment was emphasized.