[Show abstract][Hide abstract] ABSTRACT: Background:
To avoid a pneumonectomy and preserve the lung parenchyma, a bronchovascular double-sleeve plasty including an extended sleeve lobectomy is a good choice for locally advanced lung cancer.
We describe a case with lung adenocarcinoma enrolled in our new protocol for ex situ auto-lung transplantation following an en bloc pneumonectomy and back table procedure for central lung cancer. Following completion of the pneumonectomy, the excised lung was irrigated with a cold extracellular phosphate-buffered solution to protect the lung graft from ischemia-reperfusion injury during preparation of the graft of a right basal segment as a back-table procedure.
Although auto-lung transplantation is a complicated procedure, an en bloc pneumonectomy following a back table procedure makes preparation of the graft easy, while simultaneous mediastinal lymph node dissection by another surgeon shortens operation time.
Preview · Article · Dec 2016 · Journal of Cardiothoracic Surgery
[Show abstract][Hide abstract] ABSTRACT: Background
Catamenial pneumothorax (CP) is a type of spontaneous pneumothorax due to thoracic endometriosis occurring in reproductive women, and usually involves the right side of the thorax showing diaphragm lesions. For the present study, we defined juvenile CP (JCP) as patients with CP who were 19 years old and younger. Institutional findings and a systematic literature review are presented.
We retrospectively enrolled all patients with CP treated at our institutions from January 2002 to June 2013. In addition, we conducted a search of medical literature published using the PubMed and Japanese Ichushi databases with “catamenial pneumothorax” as the search term.
Thirteen female patients with CP, 1 on the left side, were treated at our institutions. The patient with left-side CP was classified as JCP, while that was also identified in 29 of 451 CPs reported in our literature review. Pneumothorax occurred more frequently on the left side in JCP as compared to usual CP (p<0.01). There was a significantly lower ratio of JCP cases with diaphragm lesions as compared to usual CP (p<0.01).
Significant laterality was not seen in JCP patients and fewer had diaphragm lesions as compared to usual CP. JCP may be a new entity of CP.
Full-text · Article · Jun 2015 · Journal of Cardiothoracic Surgery
[Show abstract][Hide abstract] ABSTRACT: An 76-year-old man was referred to our hospital due to right hydrothorax. The diffuse thickening of parietal pleura with increased fluoro-2-deoxy-D-glucose (FDG) uptake was noted by computed tomography (CT) and positron emission tomography (PET). Surgical biopsy was performed and the tumor was diagnosed as mucosal associated lymphoid tissue (MALT) lymphomas of parietal pleura origin by pathology. Complete remission was achieved by postoperative chemotheraphy (R-CHOP), and the patient is now alive without recurrence.
No preview · Article · Feb 2014 · Kyobu geka. The Japanese journal of thoracic surgery
[Show abstract][Hide abstract] ABSTRACT: Few have reported a concomitant malignant neoplasm with immunoglobulin G4 (IgG4)-related diseases. We describe a case of lung cancer and gastric cancer accompanied with IgG4-related disease. A 78-year-old man had an area of ground-glass opacity with central collapse in right upper lobe and a gastric cancer. The patient underwent a right upper lobectomy following a gastrectomy for the gastric cancer. Histological examination of the resected lung specimen revealed a lepidic pattern of an adenocarcinoma and a large amount of plasmacyte infiltration around the tumor. In immunohistochemical findings, the plasmacytes were stained for IgG4. Therefore, the lung tumor was considered to have associated with IgG4-related interstitial lesions.
[Show abstract][Hide abstract] ABSTRACT: A 77-year-old woman was admitted to our hospital with abnormal chest shadow detected on a medical checkup. Chest computed tomography(CT)showed a well-defined tumor in the upper lobe of the right lung. On positron emission tomography by fluorodeoxyglucose(FDG),the tumor revealed to be positive. We performed right upper lobectomy with hilar and mediastinal lymph node dissection. The histopathological diagnosis was lymphoepithelioma-like carcinoma (LELC). In the past 25-years, 41 cases have been reported in Japan. The average age is 64 years old, including 25 male cases and 16 female cases. Among these cases, more than half were in the early resectable stage.
No preview · Article · Dec 2012 · Kyobu geka. The Japanese journal of thoracic surgery
[Show abstract][Hide abstract] ABSTRACT: 60-year-old woman was admitted with an abnormal shadow on the chest roentgenogram. Computed tomography showed atelectasis of the right middle lobe and hilar and mediastinal lymphadenopathy. Bronchoscopic examination revealed an obstruction at the orifice of the right middle lobe bronchus and biopsy was performed. The biopsy suggested malignant lymphoma. A diagnosis of methotrexate-associated lymphoproliferative disorders was suspected because the patient was administered methotrexate to treat the rheumatoid arthritis. The video-assisted thoracoscopic surgery was performed. Histological examination showed no malignancy and sarcoidosis in the peribronchial lymph nodes. The compressed middle lobe bronchus by enlarged lymph nodes was consider to be the cause of the middle lobe atelectasis.
No preview · Article · Nov 2012 · Kyobu geka. The Japanese journal of thoracic surgery
[Show abstract][Hide abstract] ABSTRACT: Background. In the Japanese Lung Cancer guidelines, gefitinib is recommended as a first-line or later chemotherapy drug for patients with epidermal growth factor receptor (EGFR) mutation-positive advanced or recurrent non-small cell lung cancer. However, acquired drug resistance is common. Case. A 65-year-old woman complaining of back pain was admitted to our hospital. She had a metastatic bone tumor in her thoracic spine area and underwent metastasectomy. Chest computed tomography also revealed a lung tumor in the left lower lobe. A pathological examination of the excised spine tumor resulted in a diagnosis of metastatic cancer from lung adenocarcinoma (cT1N0M1, c-stage IV). Gefitinib was administered following 2 courses of carboplatin (CBDCA) + paclitaxel (PTX). The lung tumor shrank following gefitinib administration, but then grew slowly during the subsequent 6 years. Thereafter, bronchofiberscopic examination revealed adenocarcinoma with T790M-tolerant gene expression. As no distant metastasis was observed, we considered that the primary tumor, but not the metastasis, had become resistant to gefitinib, and therefore, we performed a left lower lobectomy and lymph node dissection. The patient was disease-free at 20 months after the second operation. Conclusion. We achieved a good outcome in salvage surgery for stage IV non-small cell lung cancer following long-term control by gefitinib and thoracic spine metastasectomy. Salvage surgery should be considered when acquired resistance is localized in the primary tumor site.
[Show abstract][Hide abstract] ABSTRACT: A mediastinal Mullerian cyst was initially reported as a new category of congenital cyst by Hattori, et al. in 2005. We treated a 53-year-old female referred to us with a posterior mediastinal tumor found at the Th5 prevertebral level by chest-computed tomography during a medical check-up. She had a history of mediastinal teratoma, which was removed at the age of 35. Chest magnetic resonance imaging revealed homogenous, high-intensity signals in T2-weighted images. The lesion was resected using a thoracoscopic procedure, and histologic and immunohistochemical staining revealed a ciliated cyst of Mullerian origin. The newly established mediastinal Mullerian cyst should be included in the differential diagnosis of posterior mediastinal cysts.
[Show abstract][Hide abstract] ABSTRACT: We report a case of metastatic diaphragm tumor from uterine corpus cancer. A 72-year-old female had a tumor on right diaphragm 4-years after operation for uterine corpus cancer. After chemotherapy, tumor resection was performed by right lung basal segmentectomy, partial liver resection, and partial diaphragm resection. The pathological examination revealed adenocarcinoma, compatible with uterine corpus cancer, metastasizing in diaphragm and involving lung and liver. After the operation, a local recurrence occurred at parasternal lymph node, which is considered to be present on the efferent route of lymph flow from diaphragm.
No preview · Article · Aug 2011 · Kyobu geka. The Japanese journal of thoracic surgery
[Show abstract][Hide abstract] ABSTRACT: An 85-year-old male with superior sulcus tumor was referred to our hospital complaining right brachial pain and omalgia. Chest computed tomography showed right apical lung tumor involving the 1st rib, and bronchoscopy established a diagnosis of squamous cell carcinoma, cT3NOM0. After concurrent chemoradiotherapy [cisplatin (CDDP) + 60 Gy], functional examination indicated him to be tolerable to lobectomy, and he underwent right upper lobectomy + chest wall resection (1st-3rd ribs) + lymph-node dissection. Pathological examination revealed that the effect of chemoradiotherapy was Ef. 3. The postoperative course was uneventful. He is free from recurrence for 7 years after the surgery.
No preview · Article · Jun 2011 · Kyobu geka. The Japanese journal of thoracic surgery
[Show abstract][Hide abstract] ABSTRACT: The use of 18F-fluorodeoxyglucose-positron emission tomography (FDG-PET) for staging nonsmall cell lung cancer is widely recognized, whereas the value of fluorodeoxyglucose-positron emission tomography imaging in the evaluation of response to induction chemotherapy is still controversial. We describe a case of a 57-year-old man who had a sarcoid-like reaction develop during induction chemotherapy for a pathologically proven N2 lung cancer. Re-evaluation of the nodal status using fluorodeoxyglucose-positron emission tomography showed false-positive accumulation in the mediastinal and hilar lymph nodes, which led us to suspect lung cancer progression after induction chemotherapy.
No preview · Article · Dec 2010 · The Annals of thoracic surgery
[Show abstract][Hide abstract] ABSTRACT: We report a rare case of sarcoidosis that developed during induction chemotherapy for primary lung cancer, mimicking progressive disease. A 63-year-old man had an abnormal shadow in the right upper lung, and a bronchoscopic examination revealed a squamous cell carcinoma. Swelling of a pretracheal lymph node was also noted. Thus, we gave induction chemotherapy consisting of paclitaxel (days 1, 8) + carboplatin (days 1, 8) for two cycles under clinical staging of T2N2M0. After induction chemotherapy, (18)F-fluorodeoxyglucose positron emission tomography (FDG-PET) showed positive accumulation of FDG in mediastinal and bilateral hilar lymph nodes that had been negative in a previous FDG-PET examination, which led us to suspect disease progression. Transbronchial lymph node biopsy results showed sarcoid granulomas in the specimens. Following complete resection of the lung cancer, sarcoid granulomas were revealed in both nonneoplastic lung tissue and lymph nodes, which resulted in a diagnosis of lung cancer accompanied with sarcoidosis.
No preview · Article · Aug 2010 · General Thoracic and Cardiovascular Surgery