[The History and Development of Experimental Rodent Models of Chronic Lung Allograft Dysfunction after Lung Transplantation].

Chronic lung allograft dysfunction (CLAD) is a critical impediment to the long-term survival after lung transplantation. A rat orthotopic lung transplantation model was developed in the early 1970s, and using this model, our laboratory has shown that the immunopathogenesis of CLAD involves both allogeneic immunity and autoimmunity. However, further investigation of CLAD is limited by the scarcity of transgenic and knockout strains. The model most widely used to study CLAD, the mouse model of heterotopic tracheal transplantation, has some incomplete pathophysiologic features of CLAD, which limits the utility of this model. Unlike other solid organ transplants, vascularized and aerated murine lung transplantation has only recently been developed. We have also reported that minor, but not major, histocompatibility antigens mismatch induced the development of CLAD in murine orthotopic lung transplants and that CLAD development was interleukin-17-dependent. This mini-review underscores the history and development of rodent models of CLAD after lung transplant, including the findings from our previous studies. In addition, the future direction of rodent models is also discussed.

[Surgical treatment of primary chest wall tumor].

BACKGROUND: Primary chest wall tumors are uncommon and there is limited information in the literature regarding treatment strategies for these tumors. METHODS: We retrospectively reviewed 14 patients who were referred for surgical resection for a primary chest wall tumor. RESULTS: Except for neurogenic tumors, 14 primary chest wall tumors were resected among 3,260 surgical cases during a 13-year period in our institution. Complete resection was attempted for all 14 patients;8 had benign tumors and 6 had malignant tumors. Tumor pathology was extremely varied as they arose from all anatomic structures of the chest wall. Chest wall reconstruction was performed for 7 patients;2 patients underwent an additional extended resection because their tumors were diagnosed as malignant during or after surgery;and only 1 patient with a primitive neuroectodermal tumor died of recurrence after surgery. CONCLUSIONS: The data and results for primary chest tumors are limited due to the uncommon nature of this entity and the extremely variable histology. In general, a preoperative diagnosis is difficult and a definitive diagnosis can only be made during or after surgery. Wide radical resection of these tumors should be attempted, particularly if malignancy is diagnosed.

Cavernous hemangioma of the posterior mediastinum with bony invasion.

We herein report a case of a cavernous hemangioma of the posterior mediastinum treated with surgical resection. Mediastinal hemangiomas are rare and diagnosis is difficult prior to operation. A 58-year-old female was referred to our hospital for back pain and a tumor in the left posterior mediastinum that was detected by chest computed tomography (CT). CT showed a tumor adjacent to the left side of the fifth thoracic vertebrae measuring 60 × 50 mm with invasion into and destruction of the 5th rib. The tumor was resected successfully via hemilaminectomy with costotransversectomy, and was revealed to be a cavernous hemangioma histologically. 1 year and 5 months after surgery, the patient was asymptomatic and without a recurrence. Hemangiomas are usually considered benign but sometimes behave aggressively with destruction of the neighboring structures. We consider en bloc resection to be safe and effective for aggressive cavernous hemangiomas of the posterior mediastinum.

Late recurrence of a tumor of Ewing's sarcoma family of tumors: report of a case.

A 27-year-old female presented with a history of a right chest wall tumor at 3 years of age. At that time, the tumor was surgically resected and diagnosed as Ewing's sarcoma (EWS), and postoperative chemoradiotherapy was administered. The patient remained disease-free for 25 years. At age 27, chest computed tomography revealed a mass adjacent to the anterolateral thoracic wall. After surgery, the diagnosis was primitive neuroectodermal tumor (PNET). She died of the disease 10 months later. PNET and EWS were integrated into a single item in the 2002 WHO classification; thus, they are considered clinically and pathologically identical. The morphologic, immunohistochemical, and molecular biological characteristics of both specimens showed that the second tumor was a local recurrence of Ewing's sarcoma family of tumors (ESFT). Our case is the longest duration local recurrence reported. Long-term recurrences of ESFT and patients with recurrent ESFT have a poor prognosis; thus, long-term follow-up is necessary.