Your browser doesn't support javascript.
loading
Show: 20 | 50 | 100
Results 1 - 20 de 27
Filter
1.
Kyobu Geka ; 65(8): 701-5, 2012 Jul.
Article in Japanese | MEDLINE | ID: mdl-22868432

ABSTRACT

Thoracic surgery poses a risk for complications in the respiratory system. In particular, for patients with bronchial asthma, we need to care for perioperative complications because it is well known that these patients frequently have respiratory complications after surgery, and they may have bronchial spasms during surgery. If we can get good control of their bronchial asthma, we can usually perform surgery for these patients without limitations. For safe postoperative care, it is desirable that these patients have stable asthma conditions that are well-controlled before surgery, as thoracic surgery requires intrabronchial intubation for anesthesia and sometimes bronchial resection. These stimulations to the bronchus do not provide for good conditions because of the risk of bronchial spasm. Therefore, we should use the same agents that are used to control bronchial asthma if it is already well controlled. If it is not, we have to administer a ß2 stimulator, aminophylline, or steroidal agents for good control. Isoflurane or sevoflurane are effective for the safe control of anesthesia during surgery, and we should use a ß2 stimulator, with or without inhalation, or steroidal agents after surgery. It is important to understand that we can perform thoracic surgery for asthma patients if we can provide perioperative control of bronchial asthma, although these patients still have severe risks.


Subject(s)
Asthma/complications , Thoracic Surgical Procedures , Asthma/therapy , Female , Humans
2.
Thorax ; 63(7): 642-7, 2008 Jul.
Article in English | MEDLINE | ID: mdl-18390633

ABSTRACT

BACKGROUND: Endobronchial ultrasound-guided transbronchial needle aspiration (EBUS-TBNA) is an accurate tool for lymph node staging of non-small cell lung cancer (NSCLC). Most patients with NSCLC require systemic chemotherapy during their treatment, with relatively poor responses. If the response to chemotherapy could be predicted, ideally at the time of the initial bronchoscopic examination, the therapeutic benefit could be maximised while limiting toxicity. A study was therefore undertaken to investigate the feasibility of EBUS-TBNA for obtaining tissue samples from mediastinal lymph nodes that can be used for immunohistochemical analysis, and to stratify patients with molecular-based pN2-NSCLC into chemo-responsive and chemoresistant subgroups who might benefit from tailoring of chemotherapy. METHODS: The expression of six cell cycle-related proteins (pRb, cyclin D1, p16(INK4A), p53, p21(Waf1), Ki-67) in mediastinal lymph node specimens obtained by EBUS-TBNA was investigated by immunohistochemistry in 36 patients with pN2-NSCLC. Their predictive role(s) in the response to platinum-based chemotherapy was examined. RESULTS: Immunostaining was feasible in all studied specimens. Univariate analysis revealed that p53 and p21(Waf1) expressions were significantly related to the response to chemotherapy (p = 0.002 and p = 0.011, respectively). Multivariate logistic regression analysis revealed that only p53 overexpression was associated with a poor response to chemotherapy (p = 0.021). CONCLUSIONS: These results suggest that EBUS-TBNA is a feasible tool for obtaining mediastinal nodal tissue samples amenable for immunohistochemical analysis. Immunostaining of p53 in EBUS-TBNA-guided specimens may be useful in predicting the response to chemotherapy in patients with N2-NSCLC and helping in the selection of patients who might benefit from certain chemotherapeutic strategies.


Subject(s)
Antineoplastic Agents/therapeutic use , Carcinoma, Non-Small-Cell Lung/drug therapy , Cell Cycle Proteins/metabolism , Lung Neoplasms/drug therapy , Lymph Nodes/pathology , Mediastinum/pathology , Aged , Biopsy, Fine-Needle/methods , Carcinoma, Non-Small-Cell Lung/metabolism , Feasibility Studies , Female , Humans , Lung Neoplasms/metabolism , Lymph Nodes/metabolism , Lymphatic Metastasis , Male , Treatment Outcome , Ultrasonography, Interventional
3.
Thorac Cardiovasc Surg ; 54(2): 117-9, 2006 Mar.
Article in English | MEDLINE | ID: mdl-16541353

ABSTRACT

BACKGROUND: Obtaining a definitive preoperative diagnosis plays a critical role in deciding upon the treatment approach for lung carcinoma. However, success in making definitive diagnoses of small primary lung cancers will require new approaches because these cancers are difficult to detect using standard biopsy procedures. METHODS: We evaluated the results of morphologic definitive diagnosis together with various clinical factors in 1003 primary lung cancers resected surgically. Patients underwent transbronchial brushing, fine needle aspiration cytology, forceps biopsy, and/or forceps biopsy-stamp cytology for preoperative diagnoses, in conjunction with the use of Diff-Quik to confirm that hits had been made on the radiographic shadows before terminating the examinations. RESULTS: Sensitivities of the diagnostic procedures for primary lung cancers were as follows: 64.8% for brushing, 56.1% for transbronchial forceps biopsy, 72.0% for transbronchial forceps biopsy-stamp cytology, and 86.4% for transbronchial fine needle aspiration. The four transbronchial biopsy procedures had a combined overall sensitivity of 92.7%. In patients with peripheral lung cancers of 2 cm or less in diameter, transbronchial fine needle aspiration had a sensitivity of 75.9%, which was the highest sensitivity for all transbronchial examinations. In the subset of 296 patients who underwent all four transbronchial biopsy examinations, transbronchial fine needle aspiration had the highest sensitivity of preoperative diagnosis of all the transbronchial examination methods. CONCLUSIONS: The sensitivity of preoperative cytological diagnosis for primary lung cancers, especially transbronchial aspiration cytology, is high. Transbronchial fine needle aspiration cytology is useful for the preoperative diagnosis of primary lung cancer.


Subject(s)
Biopsy, Fine-Needle/methods , Bronchoscopy , Carcinoma/pathology , Lung Neoplasms/pathology , Adolescent , Adult , Aged , Aged, 80 and over , Bronchi , Carcinoma/surgery , Child , Diagnosis, Differential , Female , Humans , Lung Neoplasms/surgery , Male , Middle Aged , Pneumonectomy , Prognosis , Retrospective Studies , Sensitivity and Specificity
4.
Thorac Cardiovasc Surg ; 53(2): 114-7, 2005 Apr.
Article in English | MEDLINE | ID: mdl-15786011

ABSTRACT

BACKGROUND: Tumor cells of lung cancer exhibit genetic abnormalities as well as high proliferative activity. The purpose of this study was to evaluate the relationship of genetic abnormalities and smoking status, histological type, and tumor proliferative activity in resected samples of stage I non-small cell lung cancer (NSCLC). METHODS: We evaluated 126 samples of stage I NSCLC from patients who underwent complete resection between 1988 and 1993. Loss of heterozygosity (LOH) was assessed using primers that amplified polymorphic microsatellite markers at D3S1300, D3S643, D3S1317, D9S171, IFNA, D13S153, and TP53. Expression of Ki-67 nuclear antigen was examined using immunohistochemical methods to assess tumor proliferative activity. RESULTS: The Fractional Regional Loss index (FRL) was significantly higher in squamous cell carcinoma samples than in adenocarcinoma samples (p < 0.0001). In smokers, Ki-67 labeling index (LI) in high-FRL cases was significantly higher than in low-FRL cases (p < 0.0001). CONCLUSION: The frequency of LOH at 3 p, 9 p, 13 q, and 17 p was related to proliferative activity in smokers with stage I non-small cell lung cancer.


Subject(s)
Carcinoma, Non-Small-Cell Lung/genetics , Loss of Heterozygosity , Lung Neoplasms/genetics , Smoking/pathology , Chromosomes, Human, Pair 13/genetics , Chromosomes, Human, Pair 17/genetics , Chromosomes, Human, Pair 3/genetics , Chromosomes, Human, Pair 9/genetics , Female , Humans , Immunohistochemistry , Ki-67 Antigen/metabolism , Lung/pathology , Male , Middle Aged , Neoplasm Staging , Prognosis
5.
Thorac Cardiovasc Surg ; 52(4): 196-9, 2004 Aug.
Article in English | MEDLINE | ID: mdl-15293155

ABSTRACT

BACKGROUND: The appropriateness of limited resection for small-sized lung cancer continues to be debated. It is not yet clear whether tumor size alone is a reliable indicator for limited resection. METHODS: From 1980 to 2002, 27 patients with clinical N0 peripheral lung cancers having diameters of 1 cm or less underwent pulmonary resection. Clinicopathological features of these cases were reviewed retrospectively. RESULTS: Histological analysis showed that there were 23 cases of adenocarcinoma (81.5 %), two large cell carcinomas (7.4 %), and two carcinoid tumors. Twenty-two cases were classified as pathological stage 1, one was stage II, and four were stage III. Four patients (14.8 %) had lymphatic vessel invasion, three (11.1 %) had lymph node metastasis, and two (7.4 %) had intrapulmonary metastasis. The 5-year disease-free survival rate was 76.6 %. CONCLUSIONS: It is impossible to predict the effectiveness of an intentional limited resection for lung cancer using only tumor size.


Subject(s)
Adenocarcinoma/pathology , Carcinoma, Large Cell/pathology , Lung Neoplasms/pathology , Adenocarcinoma/mortality , Adenocarcinoma/surgery , Adult , Aged , Carcinoma, Large Cell/mortality , Carcinoma, Large Cell/surgery , Female , Humans , Lung Neoplasms/mortality , Lung Neoplasms/surgery , Lymphatic Metastasis , Male , Middle Aged , Neoplasm Staging , Pneumonectomy/methods , Predictive Value of Tests , Retrospective Studies , Survival Analysis
6.
Kyobu Geka ; 57(1): 4-8, 2004 Jan.
Article in Japanese | MEDLINE | ID: mdl-14733091

ABSTRACT

Small-sized peripheral lung cancers have been detected more frequently as a result of recent developments in diagnostic imaging including high-resolution computed tomography (HRCT). Although the diagnosis of small-sized peripheral lung cancers is difficult, it makes an adequate diagnosis possible using transbronchial fine needle aspiration cytology or a new thin-type bronchoscope. Surgical treatment using mini-thoracotomy or video-assisted thoracic surgery is effective for early stage small-sized peripheral lung cancers. Lesser resection of lung cancer may provide many benefits to patients, such as preserving vital lung tissue and providing the chance for further resection if a second primary lung cancer develops, however, lobectomy with systematic hilar and mediastinal lymph node dissection should remain the standard surgical treatment, and an intentional limited resection should be adopted for very limited patients with a definitive early stage because of recurrence rates.


Subject(s)
Lung Neoplasms/diagnosis , Lung Neoplasms/surgery , Lung/pathology , Pneumonectomy , Tomography, X-Ray Computed/methods , Biopsy, Fine-Needle , Humans , Lung Neoplasms/pathology , Lymph Node Excision , Pneumonectomy/methods , Thoracic Surgery, Video-Assisted
7.
Thorax ; 58(11): 989-95, 2003 Nov.
Article in English | MEDLINE | ID: mdl-14586056

ABSTRACT

BACKGROUND: We investigated the use of high magnification bronchovideoscopy combined with narrow band imaging (NBI) for the detailed examination of angiogenic squamous dysplasia (ASD). This was carried out in relation to bronchial vascular patterns with abnormal mucosal fluorescence in heavy smokers at high risk for lung cancer. METHODS: Forty eight patients with sputum cytology specimens suspicious or positive for malignancy were entered into the study. Conventional white light and fluorescence bronchoscopic examination was first performed. Observations by high magnification bronchovideoscopy with conventional white light were made primarily at sites of abnormal fluorescence, and then repeated with NBI light to examine microvascular networks in the bronchial mucosa. Spectral features on the RGB (Red/Green/Blue) sequential videoscope system were changed from the conventional RGB broadband filter to the new NBI filter. The wavelength ranges of the new NBI filter were B1: 400-430 nm, B2: 420-470 nm, and G: 560-590 nm. ASD tissues were also examined using a confocal laser scanning microscope equipped with argon-krypton (488 nm) and argon (514 nm) laser sources. RESULTS: The microvessels, vascular networks of various grades, and dotted vessels in ASD tissues were clearly observed in NBI-B1 images. Diameters of the dotted vessels visible on NBI-B1 images agreed with the diameters of ASD capillary blood vessels diagnosed by pathological examination. Capillary blood vessels were also clearly visualised by green fluorescence by confocal laser scanning microscopy. There was a significant association between the frequency of dotted vessels by NBI-B1 imaging and tissues confirmed as ASD pathologically (p=0.002). CONCLUSIONS: High magnification bronchovideoscopy combined with NBI was useful in the detection of capillary blood vessels in ASD lesions at sites of abnormal fluorescence. This may enable the discrimination between ASD and another pre-invasive bronchial lesion.


Subject(s)
Bronchoscopy/methods , Diagnostic Imaging/methods , Lung Neoplasms/blood supply , Lung/blood supply , Smoking/pathology , Adult , Aged , Bronchoscopy/standards , Capillaries , Female , Humans , Image Enhancement , Male , Microscopy, Confocal , Middle Aged , Neovascularization, Pathologic , Precancerous Conditions , Respiratory Mucosa/blood supply , Risk Factors , Sensitivity and Specificity , Sputum/cytology , Video Recording
8.
Cancer ; 92(7): 1798-806, 2001 Oct 01.
Article in English | MEDLINE | ID: mdl-11745252

ABSTRACT

BACKGROUND: Mediastinal teratomas are the most frequent mediastinal germ cell tumor. Whereas mature teratomas are benign tumors, immature teratomas are malignant. The purpose of this study was to find characteristics that could be used to distinguish between the growth and prognosis of the two teratoma types. METHODS: Twenty-four mediastinal teratomas (18 mature and 6 immature) were examined for apoptosis by 3'-end labeling of DNA and stained immunohistochemically for proliferating cell nuclear antigen, Bcl-2, Bax, p53 protein, and alpha-fetoprotein (AFP) expression in formalin fixed, paraffin embedded specimens. RESULTS: AFP was expressed in both immature teratomas and mature teratomas. Whereas p53 protein was expressed by most teratomas, p53 gene mutation was observed in only one patient with an immature teratoma in which the same mutation occurred in all tumor tissue components tested. Bax protein expression was relatively diffuse in mature teratomas but was focally expressed in immature teratomas. Bcl-2 protein was expressed focally in both mature and immature teratomas. Although the proliferative index was significantly higher in immature teratomas compared with mature teratomas (P < 0.001), the apoptotic index (AI) was significantly higher in mature teratomas compared with immature teratomas (P < 0.05). All patients except one in this study remain alive and disease free after undergoing tumor resection. CONCLUSIONS: The relatively high AI in mature teratomas may be due to the overexpression of the p53 protein. In contrast, immature teratomas exhibited higher proliferative activity and lower rates of apoptosis, which may explain the more aggressive behavior of these tumors. However, patients with immature mediastinal teratomas have a good prognosis if the tumor is resected completely after chemotherapy.


Subject(s)
Mediastinal Neoplasms/pathology , Teratoma/pathology , Adolescent , Adult , Apoptosis , Cell Division , Child , DNA, Neoplasm/analysis , Female , Humans , Immunohistochemistry , In Situ Nick-End Labeling , Male , Mediastinal Neoplasms/metabolism , Middle Aged , Polymerase Chain Reaction , Polymorphism, Single-Stranded Conformational , Prognosis , Proliferating Cell Nuclear Antigen/metabolism , Proto-Oncogene Proteins/metabolism , Proto-Oncogene Proteins c-bcl-2/metabolism , Teratoma/classification , Teratoma/genetics , Teratoma/metabolism , Tumor Suppressor Protein p53/metabolism , alpha-Fetoproteins/metabolism , bcl-2-Associated X Protein
9.
Cancer ; 92(5): 1108-12, 2001 Sep 01.
Article in English | MEDLINE | ID: mdl-11571722

ABSTRACT

BACKGROUND: In 1999, the World Health Organization categorized large cell neuroendocrine carcinoma, large cell carcinoma with neuroendocrine differentiation, and large cell carcinoma with neuroendocrine morphology as a variant of large cell carcinoma. Patients with large cell carcinoma with neuroendocrine features have poor prognoses, comparable to those for small cell lung carcinoma. Small cell lung carcinoma is sensitive to chemotherapy; however, it is still unclear whether large cell carcinoma with neuroendocrine features is responsive to adjuvant chemotherapy. METHODS: The authors analyzed 73 patients with large cell carcinoma with neuroendocrine features who underwent resection of the tumor and studied the effect of adjuvant chemotherapy for large cell carcinoma with neuroendocrine features. RESULTS: In patients with Stage I disease, the overall survival for patients with adjuvant chemotherapy based on cisplatin, carboplatin, or cyclophosphamide, which were used as standard chemotherapy for small cell lung carcinoma, were significantly higher than the overall survival for patients without adjuvant chemotherapy. In patients with Stage II, III, and IV disease, there was no significant difference between patients with adjuvant chemotherapy and without adjuvant chemotherapy. CONCLUSIONS: Adjuvant chemotherapy based on cisplatin, carboplatin, or cyclophosphamide prolongs survival of patients with large cell carcinoma with neuroendocrine features in early stage.


Subject(s)
Antineoplastic Combined Chemotherapy Protocols/therapeutic use , Carcinoma, Large Cell/drug therapy , Carcinoma, Large Cell/pathology , Lung Neoplasms/drug therapy , Lung Neoplasms/pathology , Adult , Aged , Carboplatin/administration & dosage , Carcinoma, Large Cell/surgery , Carcinoma, Neuroendocrine , Chemotherapy, Adjuvant , Cisplatin/administration & dosage , Cyclophosphamide/administration & dosage , Female , Humans , Lung Neoplasms/surgery , Male , Middle Aged , Neoplasm Staging , Pneumonectomy , Retrospective Studies , Survival Analysis
10.
Oncol Rep ; 8(5): 1139-43, 2001.
Article in English | MEDLINE | ID: mdl-11496331

ABSTRACT

The cytologic findings of the tumor cells characteristic of the stages of thymomas were investigated to assess the invasiveness of the tumors. Forty-six patients with thymoma who underwent extensive thymectomy without pre-operative corticosteroid therapy were included in this study. The histologic subtypes included 18 round/oval, 20 mixed, and 8 spindle type. The stages of thymoma classified according to Masaoka's clinicopathological classification included 16 stage I, 20 stage II, 6 stage III, 2 stage IVa, and 2 stage IVb, and myasthenia gravis was recognized in 5 patients. Cytologic findings were retrospectively analyzed in the Papanicolaou-stained stamp smears obtained from the cut surfaces of thymoma specimens. Morphometry of the epithelial tumor cells using Cosmozone-1A was performed to evaluate the validity of our cytologic categories. Compared with the cytologic findings of stage I or II thymomas, those of epithelial tumor cells in stage III or IV more frequently showed necrotic background (50.0%-stage III or IV vs 11.1%-stage I or II, p=0.006), large clusters of epithelial tumor cells (70.0% vs 36.1%, p=0.055), marked nuclear enlargement (90.0% vs 52.7%, p=0.033), marked anisokaryosis (100% vs 52.7%, p=0.006), marked nuclear polymorphism (40.0% vs 5.5%, p=0.004), hyperchromasia (50.0% vs 11.4%, p=0.007) and prominent nucleoli (50.0% vs 16.6%, p=0.028) whereas no significant correlation was observed between cytologic findings and tumor volume. Morphometric studies of thymoma tumor cells revealed that the nuclear size (mean values, 78.8 microm(3)-stage III or IV vs 58.2 microm(3)-stage I or II), the coefficient of variation of the nuclear size (0.326 vs 0.282), and the nuclear rotundity (0.849 vs 0.858) differed significantly between the two categories (p<0.05). Our findings demonstrated that there were significant differences between the cytologic findings of epithelial tumor cells of stage I or II thymomas and those of stage III or IV thymomas, and that the cytologic findings of thymoma tumor cells appear to be useful for distinguishing between non-invasive and invasive thymomas.


Subject(s)
Thymoma/pathology , Thymus Neoplasms/pathology , Adolescent , Adult , Aged , Aged, 80 and over , Cell Nucleus/pathology , Epithelium/pathology , Female , Humans , Male , Middle Aged , Myasthenia Gravis/pathology , Neoplasm Staging , Thymectomy , Thymoma/surgery , Thymus Neoplasms/surgery
11.
Ann Thorac Surg ; 71(5): 1635-9, 2001 May.
Article in English | MEDLINE | ID: mdl-11383813

ABSTRACT

BACKGROUND: A body of data indicates that vascular endothelial growth factor (VEGF) expression by carcinomas is closely related to the prognosis of carcinomas. However, the relationship between VEGF expression and the prognosis of sarcomas is contradictory. METHODS: Tissue from 27 cases of thoracic sarcoma was analyzed immunohistochemically for VEGF expression while tumor vascularity was quantified using an antibody directed against endothelial CD34. The relationship between VEGF expression and the prognosis of patients with sarcomas was then evaluated semiquantitatively. RESULTS: The microvessel count in sarcomas with strong VEGF expression was significantly higher than that in sarcomas with absent or faint VEGF expression. The disease-free survival rates of sarcomas with strong VEGF expression were significantly lower than those of sarcomas with absent or faint VEGF expression. We found that strong VEGF expression impacted on the disease-free survival in multivariate analyses. CONCLUSIONS: VEGF expression of thoracic sarcomas is directly related to angiogenesis and tumor vascularity, and our findings suggest that strong VEGF expression is an independent prognostic factor in patients with thoracic sarcomas.


Subject(s)
Endothelial Growth Factors/analysis , Lymphokines/analysis , Neovascularization, Pathologic/pathology , Sarcoma/blood supply , Thoracic Neoplasms/blood supply , Adolescent , Adult , Aged , Child , Child, Preschool , Disease-Free Survival , Endothelium, Vascular/pathology , Female , Humans , Male , Microcirculation/pathology , Middle Aged , Prognosis , Sarcoma/pathology , Thoracic Neoplasms/pathology , Vascular Endothelial Growth Factor A , Vascular Endothelial Growth Factors
12.
Cancer ; 91(11): 1992-2000, 2001 Jun 01.
Article in English | MEDLINE | ID: mdl-11391577

ABSTRACT

BACKGROUND: Large cell carcinoma has been classified as four potential types based on its neuroendocrine morphology and evidence of neuroendocrine differentiation discernible by immunohistochemistry or electron microscopy. However, the clinical relation among these four categories has not been clearly defined. In 1999, the World Health Organization (WHO) categorized large cell neuroendocrine carcinoma as a variant of large cell carcinoma. MATERIAL AND METHODS The authors analyzed 119 cases of large cell carcinoma from a total of 2070 primary lung carcinoma cases resected surgically between 1969-1999. Using light microscopy, electron microscopy, and immunohistochemical staining, the authors reclassified these cases into large cell neuroendocrine carcinoma (LCNEC), large cell carcinoma with neuroendocrine differentiation (LCCND), large cell carcinoma with neuroendocrine morphology (LCCNM), and classic large cell carcinoma (CLCC). RESULTS: In multivariate analyses, the authors found that large cell carcinoma with neuroendocrine features, which combined LCNEC, LCCND, and LCCNM, impacted both the overall survival and disease-free survival of patients. The clinical behavior of LCCNM was similar to that of LCNEC. CONCLUSIONS: Large cell carcinomas with neuroendocrine features appear to be more clinically aggressive than CLCCs. The authors' findings suggest that the histologic identification of neuroendocrine features in tumor tissue from patients diagnosed with large cell carcinoma of the lung may have clinical relevance.


Subject(s)
Carcinoma, Large Cell/pathology , Carcinoma, Neuroendocrine/pathology , Carcinoma, Non-Small-Cell Lung/pathology , Lung Neoplasms/pathology , Adult , Aged , Disease-Free Survival , Female , Humans , Immunohistochemistry , Male , Middle Aged , Prognosis , Retrospective Studies , Survival Analysis
13.
Oncol Rep ; 8(4): 917-21, 2001.
Article in English | MEDLINE | ID: mdl-11410810

ABSTRACT

Few studies on sarcomas have examined the relationships between microsatellite alterations in particular loci, tumor prognosis and tumorigenesis, because sarcomas are uncommon and those prognoses can be confounded by coexisting factors, such as tumor site. We studied the relationship between microsatellite alterations and prognosis in 31 patients with thoracic sarcoma. The frequency of loss of heterozygosity (LOH) at 17p13 in stage IV sarcomas was significantly higher than that in stage I and III sarcomas (p<0.05). The 5-year survival for patients with LOH at 17p13 was significantly lower than that for patients without LOH (p<0.05). Six of 31 cases (19.4%) revealed replication error. These results suggest that p53 abnormality occurs during advanced stages of sarcoma and are related to patient prognosis, and it is possible that aberrations in mismatch repair activity are related to sarcoma tumorigenesis.


Subject(s)
Chromosomes, Human, Pair 17/genetics , Chromosomes, Human, Pair 19/genetics , Chromosomes, Human, Pair 3/genetics , DNA, Neoplasm/analysis , Microsatellite Repeats/genetics , Sarcoma/genetics , Thoracic Neoplasms/genetics , Adolescent , Adult , Aged , Diagnosis, Differential , Electrophoresis, Agar Gel , Female , Humans , Loss of Heterozygosity/genetics , Male , Middle Aged , Polymerase Chain Reaction , Survival Analysis
14.
Pathol Int ; 50(12): 979-83, 2000 Dec.
Article in English | MEDLINE | ID: mdl-11123765

ABSTRACT

Clear cell adenocarcinoma of the lung is extremely rare. On radiography, a 45-year-old female with fever was found to have an abnormal shadow in the left lower lung field. Bronchoscopy revealed a polypoid tumor in the left bronchus. On biopsy, the tumor was determined to be adenocarcinoma. Preoperative examination found no tumors outside of the lung. The patient underwent left lower lobectomy with bronchial wedge resection. The tumor had completely obstructed and dilated the left lower bronchus, but had not invaded the tissue outside the bronchial wall. Microscopically, the cytoplasm of the tumor cells contained abundant glycogen, and the tumor had solid and glandular structures. The tumor was diagnosed as clear cell adenocarcinoma of the lung.


Subject(s)
Adenocarcinoma, Clear Cell/pathology , Bronchial Neoplasms/pathology , Lung Neoplasms/pathology , Polyps/pathology , Adenocarcinoma, Clear Cell/metabolism , Adenocarcinoma, Clear Cell/ultrastructure , Female , Humans , Immunohistochemistry , Keratins/analysis , Lung Neoplasms/metabolism , Lung Neoplasms/ultrastructure , Male , Microscopy, Electron , Middle Aged , Mucin-1/analysis
15.
Surg Today ; 30(9): 831-4, 2000.
Article in English | MEDLINE | ID: mdl-11039713

ABSTRACT

The expressions of some growth factors have been immunohistochemically confirmed in several kinds of tumors, and in particular the expression of vascular endothelial growth factor (VEGF) has been reported to be closely related to tumor cell proliferation. We report herein a case of undifferentiated spindle-cell sarcoma arising in the chest wall with VEGF expression. A 67-year-old man, who presented with coughing, was found to have an abnormal shadow on his right chest wall. He was admitted to Chiba Rosai Hospital and preoperative diagnosis of the tumor was sarcoma. The tumor was thus resected along with the right chest wall and right lower lobe of the lung. Histopathologically, the tumor cells were spindle-shaped and showed severe atypism. The tumor cells were positive for vimentin and VEGF antibody with immunohistochemical staining, but they did not show differentiation to any special type of sarcoma. The tumor was diagnosed to be undifferentiated spindle-cell sarcoma. The microvessel density of the tumor was measured using CD34 and it was found to be higher than the average density of usual sarcomas. The prognosis of this case was poor. The patient died of tumor metastasis to the lung and bone 1 year later in spite of the fact that the tumor was resected.


Subject(s)
Endothelial Growth Factors/analysis , Lymphokines/analysis , Sarcoma/chemistry , Thoracic Neoplasms/chemistry , Aged , Humans , Immunohistochemistry , Lung Neoplasms/secondary , Male , Prognosis , Protein Isoforms/analysis , Sarcoma/mortality , Sarcoma/pathology , Thoracic Neoplasms/mortality , Thoracic Neoplasms/pathology , Vascular Endothelial Growth Factor A , Vascular Endothelial Growth Factors , Vimentin/analysis
16.
Surg Today ; 30(5): 473-6, 2000.
Article in English | MEDLINE | ID: mdl-10819491

ABSTRACT

We report a case of Castleman's disease which developed in the posterior mediastinum, with a review of the Japanese literature. A 19-year-old female patient with asthma was pointed out to have an abnormal shadow in the right posterior mediastinum on chest X-ray. We had tried to perform thoracoscopic surgery for this tumor, but we had to convert the surgical approach from thoracoscopy to a thoracotomy because of both tight adhesion of the tumor and muscle and profuse bleeding from the tumor. The tumor was diagnosed to be the hyaline vascular type of Castleman's disease histopathologically. In the Japanese literature, Castleman's disease, which develops in the posterior mediastinum, has been reported to often accompany tight adhesion between the tumor and surrounding tissue, and profuse bleeding thus cannot be avoided at surgery. The large amount of bleeding observed during the surgery of a patient with Castleman's disease in the posterior mediastinum may be due to tight adhesion and hypervascularity of the tumor. Therefore, care should be exercised in choosing the surgical approach if Castleman's disease is suspected in cases of posterior mediastinal tumor.


Subject(s)
Castleman Disease/diagnosis , Castleman Disease/surgery , Mediastinum/pathology , Adult , Biopsy, Needle , Castleman Disease/pathology , Female , Follow-Up Studies , Humans , Magnetic Resonance Imaging , Mediastinum/surgery , Thoracoscopy/methods , Thoracotomy/methods , Treatment Outcome
17.
Anticancer Res ; 20(5C): 3723-6, 2000.
Article in English | MEDLINE | ID: mdl-11268445

ABSTRACT

We encountered a case of mediastinal immature teratoma which revealed the feature of the so-called growing teratoma syndrome. A 20-year-old male with a cough was discovered to have an abnormal shadow in the mediastinum. The serum AFP was elevated to 3600 ng/ml. The specimen with percutaneous needle biopsy revealed mature teratoma. The tumor was suspected to be mature teratoma with a malignant component because of the high level of serum AFP and he underwent chemotherapy. The serum AFP declined markedly but the tumor further enlarged. The resected tumor was diagnosed as immature teratoma, although most of the tumor tissue was mature component.


Subject(s)
Mediastinal Neoplasms/diagnosis , Teratoma/diagnosis , Adult , Antineoplastic Combined Chemotherapy Protocols/therapeutic use , Biopsy, Needle , Carboplatin/administration & dosage , Cisplatin/administration & dosage , Cough , Doxorubicin/administration & dosage , Etoposide/administration & dosage , Humans , Magnetic Resonance Imaging , Male , Mediastinal Neoplasms/drug therapy , Mediastinal Neoplasms/pathology , Mediastinal Neoplasms/surgery , Radiography, Thoracic , Syndrome , Teratoma/drug therapy , Teratoma/pathology , Teratoma/surgery , Treatment Outcome , alpha-Fetoproteins/analysis
18.
Surg Today ; 29(11): 1209-12, 1999.
Article in English | MEDLINE | ID: mdl-10552344

ABSTRACT

A 47-year-old man was admitted to our hospital for treatment of an odontogenic infection. He presented with a fever, signs of sepsis, and neck swelling, and was initially diagnosed as having a neck abscess. After cervical drainage, he showed no improvement, and mediastinitis was detected by chest X-ray and computed tomography. A thoracotomy and mediastinal drainage was subsequently performed for descending necrotizing mediastinitis, which resulted in marked improvement. To date, only 83 cases of descending necrotizing mediastinitis have been reported in Japan. We present herein an additional case, followed by a review of the Japanese literature.


Subject(s)
Focal Infection, Dental/complications , Mediastinitis/diagnosis , Mediastinitis/etiology , Streptococcal Infections/diagnosis , Drainage/methods , Focal Infection, Dental/diagnosis , Focal Infection, Dental/surgery , Follow-Up Studies , Humans , Male , Mediastinitis/pathology , Mediastinitis/surgery , Middle Aged , Necrosis , Streptococcal Infections/complications , Streptococcal Infections/surgery , Thoracotomy/methods , Tooth Extraction/adverse effects , Treatment Outcome
19.
Anticancer Res ; 19(1B): 699-702, 1999.
Article in English | MEDLINE | ID: mdl-10216479

ABSTRACT

Thymic undifferentiated carcinoma has a poor prognosis. We encountered a patient with thymic carcinoma associated with an intrathoracic disseminated lesion, who underwent surgery combined with intrathoracic hyperthermic perfusion after systemic chemotherapy and showed good results. The 45-year-old man was diagnosed as having a thymoma with an intrathoracic disseminated lesion. After he underwent three courses of systemic chemotherapy, he was admitted to our hospital. An anterior mediastinal tumor and an intrathoracic disseminated lesion remained, and were treated by surgical resection combined with intrathoracic hyperthermic perfusion. The tumors were histopathologically diagnosed as thymic undifferentiated carcinomas with pleural dissemination. At present, approximately 16 months after surgery, the patient is alive without recurrence.


Subject(s)
Hyperthermia, Induced , Mediastinal Neoplasms/therapy , Thoracic Neoplasms/therapy , Thymoma/therapy , Thymus Neoplasms/therapy , Antineoplastic Combined Chemotherapy Protocols/therapeutic use , Combined Modality Therapy , Disease-Free Survival , Humans , Male , Mediastinal Neoplasms/diagnostic imaging , Mediastinal Neoplasms/secondary , Mediastinal Neoplasms/surgery , Middle Aged , Perfusion , Thoracic Neoplasms/diagnostic imaging , Thoracic Neoplasms/secondary , Thoracic Neoplasms/surgery , Thymoma/diagnostic imaging , Thymoma/surgery , Thymus Neoplasms/diagnostic imaging , Thymus Neoplasms/surgery , Tomography, X-Ray Computed , Treatment Outcome
20.
Tohoku J Exp Med ; 189(4): 307-14, 1999 Dec.
Article in English | MEDLINE | ID: mdl-10739166

ABSTRACT

We report six cases of pulmonary dirofilariasis diagnosed at our laboratory with clinical and pathological features. The nodules of dirofilariasis were round in three cases as previously reported, however dumbbell-shaped in two cases. The nodule did not attach to the pleura in four cases. Microscopically, the nodules were granulomas composed of central coagulation necrosis and peripheral fibrosis with round cell infiltration, histiocytes, and multinucleated giant cells. Necrotic pulmonary artery with single or multiple sections of degenerated nematode was observed in the center of the nodule. Dilated bronchioles with inflammation were observed in the nodule in four cases. Collapse of the alveoli, organizing pneumonia, hemosiderin-laden macrophages were observed around the nodule. We suppose that the nodule is not an infarction but a granuloma caused by antigen released from the nematode. Because the pulmonary dirofilariasis is difficult to be differentiated from primary or metastatic lung carcinoma, and the inflammation exists around the nodule, the nodule should be removed surgically.


Subject(s)
Dirofilariasis/diagnosis , Lung Diseases, Parasitic/diagnosis , Aged , Animals , Diagnosis, Differential , Dirofilaria/isolation & purification , Dirofilariasis/pathology , Dirofilariasis/surgery , Female , Humans , Lung/pathology , Lung Diseases, Parasitic/pathology , Lung Diseases, Parasitic/surgery , Male , Middle Aged , Tomography, X-Ray Computed
SELECTION OF CITATIONS
SEARCH DETAIL