[A SURGICAL CASE OF MYCOBACTERIUM KANSASII LUNG DISEASE MIMICKING PRIMARY LUNG CANCER].

We report a rare surgical case of a solitary pulmonary nodule due to Mycobacterium kansasii. A 59-year-old man was admitted to our hospital for examination of an abnormal shadow in the left upper lobe incidentally found on a chest radiogram. Computed tomography of the chest showed that the nodule was located in the left segment 1+2 and was irregularly shaped with a diameter of 35 mm. Thoracic fluorine-18 fluoro-deoxy-glucose positron emission tomography showed a high metabolic pulmonary lesion, with a maximum standardized uptake value of 5.1, consistent with findings for lung cancer. A bronchoscopy was performed to establish the diagnosis of lung cancer; however, it failed to show malignant cells. Because we could not confirm the diagnosis by bronchoscopic examination, video-assisted thoracoscopic surgery was performed. The intraoperative rapid diagnosis of the nodule was epithelioid cell granuloma. Smear test of the resected specimen was positive for acid-fast bacilli, and a culture was also positive for mycobacteria, which were identified as Mycobacterium kansasii. Antibiotic treatment for M. kansasii infection was administered for a year after the surgical resection. Few cases of Mycobacterium kansasii infection present with solitary pulmonary nodules.

[Bronchial hamartoma in subsegmental bronchus; report of a case].

We report a rare surgical case of a bronchial hamartoma in subsegmental bronchus. A 70-year-old man was incidentally pointed out an abnormal chest shadow without any complaints. Chest computed tomography revealed a round nodule with diameter of 15 mm in the right upper lobe. The bronchoscopic examination revealed complete obstruction of right B2a by the tumor. Right S2 segmentectomy was done to make a definite diagnosis and to prevent possible obstructive pneumonia. Histopathological examination revealed that the tumor was a benign cartilage bronchial hamartoma.

[Synchronous multiple primary lung and colon cancers].

We report a rare surgical case of synchronous multiple primary lung cancers with synchronous multiple colon cancers. A 74-year-old woman was incidentally pointed out abnormal chest shadows. Chest computed tomography revealed 2 nodules in the right upper and middle lobe. Transbronchilal lung biopsy (TBLB) was done, and the tumor in the middle lobe was diagnosed as adenocarcinoma. In addition, positron emission tomography pointed out colon cancer. Colon fiber revealed multiple colon polyps and colon cancers. Immunostaining with thyroid transcription factor (TTF)-1 and Napsin-A for TBLB specimen was done to distinguish their association. With the diagnosis as primary lung cancer, we performed right upper and middle lobectomy with lymph node dissection. These tumors were pathologically diagnosed as synchronous multiple primary lung cancers with adenocarcinoma and squamous cell carcinoma. Several months later, colon regions were resected through colonoscopic endometric mucosal resection and left hemicolectomy.

IL-2 and proteoglycans synergistically induce antigen-specific B-cell responses--a possible immune response in the hyperplastic myasthenia thymus.

To understand developmental mechanisms of effector B-cells in the hyperplastic MG thymus, we have evaluated immunological roles of IL-2 and the 100-kDa haemopoietic biglycan, because the number of their producers increases pathologically there. When these two factors were added to an immune system together, the number of antibody-producing cells was markedly increased in a synergistic fashion. Further, IL-2 and the conditioned medium of myoid cells induced immunoglobulin isotype switches, suggesting that new B-cell stimulatory microenvironments were generated in the hyperplastic thymus. In relation to this, we also discuss a new biological feature, an immunomodulator, of conventional biglycan and decorin.

[Surgical treatment for pulmonary mycosis].

Although most human mycosis develops in immunocompromised patients as an opportunistic infection, its frequency will be influenced by historical changes in diseases and by progress in medical technology. An example of local occurrence is pulmonary aspergilloma in an open negative cavity, and a systemic example is the onset of invasive pulmonary aspergillosis in neutropenic patients with hematologic malignancies. Surgical candidates for mycotic lung disease are usually patients who do not improve with medical treatment The author also stresses the prophylactic indications for prevention of unexpected impairment due to mycotic lung disease. The usefulness of surgery for pulmonary fungal infection has gradually been recognized Additional efforts should be made by surgeons to achieve better outcomes and to minimize operative complications by choosing the appropriate surgical technique.