記述言語：英語  

DOI： 10.1186/s40792-024-01972-0

PubMed

記述言語：英語   出版者・発行元：(一社)日本外科学会  

36歳女性。非小細胞肺癌(ypT2aN0M0 stage IB)に対して化学放射線療法後に左肺全摘術を行い、経過観察中であった。手術から2年1ヵ月後に呼吸困難が出現した。CTでは極度の縦隔偏位がみられ、右主気管支と右下葉気管支が閉塞していた。また、心膜表面と壁側胸膜の癒着により左胸腔に空洞を認めなかった。X線検査でも、縦隔偏位により左胸腔がほぼ消失していた。以上より、気道閉塞による呼吸不全と診断し、非侵襲的陽圧換気を導入したが、呼吸状態は増悪し緊急手術となった。緊急開胸術を行い、左胸腔内に空気を注入したところ、呼吸状態は速やかに改善した。その後、空になった胸腔に生理食塩水1Lを注入し、その後六フッ化硫黄(SF6)ガスに切り替えた。SF6注入後は無事退院となった。SF6注入の間隔は、術後経過観察中に3ヵ月毎から11ヵ月毎へと延長された。再発はなく、CTで胸腔内の状態が改善していることが示された。

記述言語：日本語   出版者・発行元：Case Reports in Oncology  

Although osimertinib is a key drug in the treatment of non-small cell lung cancer (NSCLC) with epidermal growth factor receptor (EGFR) mutation, the safety in hemodialysis patients has not been established. A 76-year-old man was diagnosed with NSCLC with EGFR deletion mutation in exon 19. After treatment failure with first- and second-generation EGFR tyrosine kinase inhibitors, a T790M mutation was revealed by liquid biopsy. Hemodialysis was started three times a week because chronic renal failure worsened during treatment. Although the subsequent administration of osimertinib (80 mg daily) resulted in a tumor shrinkage and a gradual increase in the plasma concentration of osimertinib, which resulted in grade 3 general fatigue, reducing the dosage of osimertinib decreased its plasma concentration, leading to an improvement in his adverse event. Subsequently, with by adjusting the dosage while periodically measuring the plasma concentration of osimertinib, a stable therapeutic effect was sustained over the long term with no symptoms. Periodic plasma concentration measurements may be indispensable for successful treatment with osimertinib in hemodialysis patients.

DOI： 10.1159/000531840

Scopus

PubMed

記述言語：日本語   出版者・発行元：Anticancer Research  

Background/Aim: Dendritic cells (DCs) are difficult to evaluate in lung regional lymph nodes because of region-specific structures, such as abundant trabeculae connecting the medullary and subcapsular sinuses, the latter of which contains few anthracotic macrophages. Therefore, DC-specific intercellular adhesion molecule-3-grabbing non-integrin (DCsign)-positive DCs and CD68-positive macrophages are unlikely to show a typical distribution. The present study therefore explored quantitative factors connecting the nodal DC morphology to the patient outcome. Materials and Methods: Lymph nodes from 34 non-small-cell lung cancer patients who underwent complete resection were used for immunohistochemical assessments of DCsign and CD68 and terminal deoxynucleotidyl transferase dUTP nick-end labeling. Preoperative patient blood samples were used for the quantitative evaluation of monocytes. Results: The nodal DCs showed a complementary distribution with macrophages, thus few DCs were seen in clusters of macrophages. DCs often presented as a mesh-like rosette that was solitary or connected to a DC cluster. DCs disappeared, and some macrophages were apoptotic when surrounded by cancer cells that have metastasized to lymph nodes. The proportional area of a DC cluster was significantly associated with the histological differentiation of cancer (p=0.013), with a higher ratio tending to lead to a better overall survival (p=0.059), and significantly so in adenocarcinoma (p=0.007). The rosette number was significantly correlated with the smoking index and blood monocyte number (p=0.013 and p=0.005, respectively). Conclusion: The nodal DC morphology appears useful as a prognostic factor and may lead to a new phase of clinicopathological studies of solid cancers.

DOI： 10.21873/anticanres.16471

Scopus

PubMed

記述言語：日本語   出版者・発行元：(一社)日本呼吸器外科学会  

記述言語：日本語   出版者・発行元：(一社)日本移植学会  

記述言語：日本語   出版者・発行元：(一社)日本移植学会  

記述言語：日本語   出版者・発行元：(一社)日本呼吸器内視鏡学会  

記述言語：日本語   出版者・発行元：鹿児島県臨床外科学会  

65歳男性。半年前に失神で当院で救急搬送され、完全房室ブロックの診断で、前医でペースメーカー埋め込みを受けた。今回、胸部精査CT検査で右肺中葉にすりガラス陰影を伴う部分充実結節を偶発的に指摘され、原発性肺癌の疑いで当科へ紹介となった。胸部画像検査を行ったところ、右中葉肺腺癌が最も疑われたが、心サルコイドーシスの合併を認めたため、肺サルコイドーシスを鑑別疾患に挙げた。胸腔鏡下右肺中葉部分切除術を行った結果、病理組織学的に肺サルコイドーシスと確定診断された。

記述言語：日本語   出版者・発行元：鹿児島県臨床外科学会  

19歳女性。大学入学時の検診にて胸部異常陰影を指摘され、前医の精査で胸腺腫の疑いで当科へ紹介となった。術前CTでは大動脈弓左側から左肺動脈に32×17×37mmの一部造影効果を認める多房性の嚢胞性腫瘤が認められ、MRIではT1で腫瘤は内部低信号、T2では内部高信号を呈した。以上、これらの所見を踏まえて、本症例は左縦隔腫瘍と診断のもと、当科オリジナルの3ポートアプローチ(3アーム+1アシスト)でロボット支援下手術が施行された。その結果、経過良好にて患者は術後5日で自宅退院となった。

記述言語：日本語   出版者・発行元：European Journal of Cardio Thoracic Surgery  

OBJECTIVES: The present study investigated whether or not pleural anthracosis is associated with changes in the pleural lymphatic structures or function, which would interfere with nodal skip metastasis. METHODS: This study comprised 2 different case series. In the first series, we observed pleural lymphatic drainage using near-infrared fluorescent endoscopy by the subpleural injection of indocyanine green immediately after thoracotomy for lung cancer. We also performed a histological assessment of the pleura. In the second series, we reviewed the nodal metastatic pattern (skip or non-skip metastasis) in pathological N2 lung cancer involving the pleura. These findings were compared with the severity of pleural anthracosis, which was quantified by thoracoscopic vision and a software-based imaging analysis. RESULTS: In the first series (n = 42), pleural lymphatic drainage was not visualized in 19 (45%) patients who had relatively severe anthracosis, while it was visualized in the remaining 23 (55%) patients who had relatively minimal anthracosis. Histologically, severe anthracosis was associated with pleural thickening accompanied by a decreased incidence of straight-running lymphatic vessels and, in turn, an increased incidence of short lymphatic vessels, which was suggested to be the result of pleural remodelling. In the second series (n = 53), a skip metastatic pattern was found in 24 (45%) patients who predominantly had less-severe anthracosis, while a non-skip metastatic pattern was found in 29 (55%) patients who predominantly had severe anthracosis. CONCLUSIONS: Pleural anthracosis was associated with pathological changes in the pleural lymphatics and decreased pleural lymphatic drainage, thereby interfering with nodal skip metastasis.

DOI： 10.1093/ejcts/ezac123

Scopus

PubMed

記述言語：日本語   出版者・発行元：Translational Cancer Research  

Background: Gene methylation is deeply involved in epigenetics and affects both the development and maintenance of homeostasis and carcinogenesis. ALKBH4 is a member of the AlkB homolog (ALKBH) family that controls demethylation of DNA and RNA. Methods: This study enrolled 160 patients with non-small cell lung cancer (NSCLC) who underwent complete resection. The expression of ALKBH4 in cancer tissue was evaluated by immunohistochemistry. The correlation among the expression of ALKBH4, clinicopathological factors, and prognostic outcome was evaluated. Results: In the NSCLC clinical samples, the expression of ALKBH4 was identified not only in cell membranes but also in the cytoplasm of cancer cells. In 140 of 160 cases, ALKBH4 was more highly expressed in the cancerous tissue than in the surrounding normal tissue. The proportion of cancer cells expressing ALKBH4 was higher in adenocarcinoma than in other histological types. In addition, the expression intensity of ALKBH4 in each cancer cell was also stronger in adenocarcinoma than in squamous cell carcinoma. The expression of ALKBH4 was not associated with clinicopathological factors, except for histological type. In adenocarcinoma, the recurrence-free survival (RFS) and overall survival (OS) rates were significantly lower in the ALKBH4-positive group than in the ALKBH4-negative group (P=0.008, 0.031, respectively). A multivariate logistic regression analysis indicated that the ALKBH4 expression was an independent prognostic factor for RFS (P=0.003) and OS (P=0.013). The expression of ALKBH4 was observed in all four patients with adenocarcinoma in situ. Conclusions: The ALKBH4 expression may be a useful predictor of the postoperative outcomes of lung adenocarcinoma (LUAD) patients.

DOI： 10.21037/tcr-22-39

Scopus

PubMed

記述言語：日本語   出版者・発行元：(一社)日本呼吸器内視鏡学会  

記述言語：日本語   出版者・発行元：(NPO)日本肺癌学会  

記述言語：日本語   出版者・発行元：(一社)日本胸部外科学会  

記述言語：日本語  

記述言語：日本語  

記述言語：日本語  

記述言語：日本語  

記述言語：日本語  

記述言語：日本語  

記述言語：日本語  

記述言語：日本語  

記述言語：日本語  

記述言語：日本語  

記述言語：日本語  

記述言語：日本語  

記述言語：日本語  

記述言語：日本語  

記述言語：日本語  

記述言語：日本語  

記述言語：日本語  

記述言語：日本語  

記述言語：日本語