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Aoki M, Miyata R, Kamimura G, Harada Takeda A, Suetsugu T, Mizuno K, Ueda K. Effect of Tegafur-Uracil in Resected Stage IB Lung Adenocarcinoma According to Presence or Absence of Epidermal Growth Factor Receptor Gene Mutation: A Retrospective Cohort Study. Ann Thorac Cardiovasc Surg 2024; 30:23-00134. [PMID: 38105006 PMCID: PMC10902659 DOI: 10.5761/atcs.oa.23-00134] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2023] [Accepted: 11/19/2023] [Indexed: 12/19/2023] Open
Abstract
PURPOSE Tegafur-uracil (UFT) is the standard postoperative adjuvant therapy for stage IB lung adenocarcinoma (LUAD) in Japan. This study aimed to determine whether UFT is effective in stage IB LUAD with and without epidermal growth factor receptor (EGFR) mutations. METHODS This retrospective study included 169 patients with stage IB LUAD who underwent complete resection at our department between 2010 and 2021. We investigated the clinicopathological and prognostic impact of EGFR mutations as well as the postoperative use of UFT. RESULTS EGFR mutation-positive cases tended to show a higher cumulative recurrence rate than EGFR mutation-negative cases (p = 0.081), while overall survival was comparable between the groups (p = 0.238). In the entire cohort, UFT administration was not an independent prognostic factor in the multivariate regression analysis (p = 0.112). According to a stratification analysis, UFT administration was independently associated with favorable overall survival (p = 0.031) in EGFR mutation-negative cases, while it was not associated with recurrence-free survival (p = 0.991) or overall survival (p = 0.398) in EGFR mutation-positive cases. CONCLUSION UFT administration can improve the prognosis of EGFR mutation-negative LUAD but not EGFR mutation-positive LUAD. Thus, clinical trials of adjuvant-targeted therapy for EGFR mutation-positive stage IB LUAD should also be conducted in Japan.
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Affiliation(s)
- Masaya Aoki
- Department of General Thoracic Surgery, Kagoshima University Graduate School of Medical and Dental Sciences, Kagoshima, Kagoshima, Japan
| | - Ryo Miyata
- Department of General Thoracic Surgery, Kagoshima University Graduate School of Medical and Dental Sciences, Kagoshima, Kagoshima, Japan
| | - Go Kamimura
- Department of General Thoracic Surgery, Kagoshima University Graduate School of Medical and Dental Sciences, Kagoshima, Kagoshima, Japan
| | - Aya Harada Takeda
- Department of General Thoracic Surgery, Kagoshima University Graduate School of Medical and Dental Sciences, Kagoshima, Kagoshima, Japan
| | - Takayuki Suetsugu
- Department of Pulmonary Medicine, Kagoshima University Graduate School of Medical and Dental Sciences, Kagoshima, Kagoshima, Japan
| | - Keiko Mizuno
- Department of Pulmonary Medicine, Kagoshima University Graduate School of Medical and Dental Sciences, Kagoshima, Kagoshima, Japan
| | - Kazuhiro Ueda
- Department of General Thoracic Surgery, Kagoshima University Graduate School of Medical and Dental Sciences, Kagoshima, Kagoshima, Japan
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Miyata R, Morizono S, Umehara T, Harada‐Takeda A, Kamimura G, Aoki M, Nagata T, Ueda K. A case of attempted transbronchial spigot insertion for fistulous pyothorax in the residual pleural airspace after pleurectomy/decortication for malignant pleural mesothelioma. Respirol Case Rep 2024; 12:e01286. [PMID: 38269312 PMCID: PMC10807502 DOI: 10.1002/rcr2.1286] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/19/2023] [Accepted: 01/16/2024] [Indexed: 01/26/2024] Open
Abstract
Pleurectomy/decortication for malignant pleural mesothelioma is a relatively recent surgical approach for which there is a dearth of information on complications, especially in the late postoperative period. A 70-year-old man was diagnosed with right epithelioid malignant pleural mesothelioma and underwent pleurectomy/decortication. Computed tomography at 6 months after surgery revealed nodules on the surface of the right lung. These nodules gradually increased in size and were diagnosed as recurrent disease. Immunotherapy was started, but treatment was discontinued a few days after the first course due to pneumonitis. Subsequent oral prednisolone therapy for about 2 months ameliorated pneumonitis, but fistulous pyothorax developed. During attempted transbronchial occlusion of the responsible bronchus, some spigots penetrated the empyema cavity. Open window thoracotomy was performed on the following day. This case suggests that if there is no change in diameter between the proximal and distal parts of the responsible bronchus, transbronchial occlusion should not be chosen.
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Affiliation(s)
- Ryo Miyata
- Department of Thoracic SurgeryKagoshima University HospitalKagoshimaJapan
| | - Shoichiro Morizono
- Department of Thoracic SurgeryKagoshima University HospitalKagoshimaJapan
| | - Tadashi Umehara
- Department of Thoracic SurgeryKagoshima University HospitalKagoshimaJapan
| | - Aya Harada‐Takeda
- Department of Thoracic SurgeryKagoshima University HospitalKagoshimaJapan
| | - Go Kamimura
- Department of Thoracic SurgeryKagoshima University HospitalKagoshimaJapan
| | - Masaya Aoki
- Department of Thoracic SurgeryKagoshima University HospitalKagoshimaJapan
| | - Toshiyuki Nagata
- Department of Thoracic SurgeryKagoshima University HospitalKagoshimaJapan
| | - Kazuhiro Ueda
- Department of Thoracic SurgeryKagoshima University HospitalKagoshimaJapan
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3
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Aoki M, Jin ZW, Ueda K, Kamimura G, Takeda-Harada A, Murakami G, Sato M. Localization of macrophages and dendritic cells in human thoracic lymph nodes: An immunohistochemical study using surgically obtained specimens. J Anat 2023; 243:504-516. [PMID: 37024113 PMCID: PMC10439373 DOI: 10.1111/joa.13870] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2022] [Revised: 03/15/2023] [Accepted: 03/15/2023] [Indexed: 04/08/2023] Open
Abstract
Both dendritic cells (DCs) and macrophages are bone marrow-derived cells that perform antigen presentation. The distribution of DCs and CD68-positive macrophages were immunohistochemically examined in 103 thoracic nodes obtained from 23 lung cancer patients (50-84 years old) without metastasis. Among three antibodies tested initially-CD209/DCsign, fascin, and CD83-DCsign was chosen as the DC marker. For comparison, 137 nodes from 12 patients with cancer metastasis were also examined histologically. In patients without metastasis, DCs were found as (1) clusters along the subcapsular sinus and in a border area between the medullary sinus and cortex (mean sectional area of multiple nodes at one site, 8.4%) and, (2) rosette-like structures in the cortex (mean number in multiple nodes at one site, 20.5). Notably, DC clusters and rosettes contained no or few macrophages and were surrounded by smooth muscle actin (SMA)-positive, endothelium-like cells. The subcapsular linear cluster corresponded to 5%-85% (mean, 34.0%) of the nodal circumferential length and was shorter in older patients (p = 0.009). DC rosettes, solitary, or communicating with a cluster, were usually connected to a paracortical lymph sinus. Few differences were found between nodes with or without metastasis, but DC cluster sometimes contained abundant macrophages in cancer metastasis patients. The subcapsular DC cluster is not known in the rodent model, in which the subcapsular sinus is filled with macrophages. This quite different, even complementary, distribution suggests no, or less, cooperation between DCs and macrophages in humans.
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Affiliation(s)
- Masaya Aoki
- Department of General Thoracic Surgery, Kagoshima University School of Medicine, Kagoshima, Japan
| | - Zhe-Wu Jin
- Department of Anatomy, Wuxi School of Medicine, Jiangnan University, Wuxi, China
| | - Kazuhiro Ueda
- Department of General Thoracic Surgery, Kagoshima University School of Medicine, Kagoshima, Japan
| | - Go Kamimura
- Department of General Thoracic Surgery, Kagoshima University School of Medicine, Kagoshima, Japan
| | - Aya Takeda-Harada
- Department of General Thoracic Surgery, Kagoshima University School of Medicine, Kagoshima, Japan
| | - Gen Murakami
- Department of Anatomy, Tokyo Dental College, Tokyo, Japan
| | - Masami Sato
- Department of General Thoracic Surgery, Kagoshima University School of Medicine, Kagoshima, Japan
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4
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Kamimura G, Ueda K, Aoki M, Takeda A, Maeda K, Sato M. Computed tomography of an air-inflated resected lung is useful for verifying the intraoperative findings of complete resection in a reduction operation. Quant Imaging Med Surg 2023; 13:4029-4031. [PMID: 37284075 PMCID: PMC10240012 DOI: 10.21037/qims-22-1149] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/20/2022] [Accepted: 03/21/2023] [Indexed: 06/08/2023]
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Takumi K, Nagano H, Ueda K, Umehara T, Tokunaga T, Kamimura G, Sato M, Nakanosono R, Yoshiura T. Left atrial CT volume and CHA 2DS 2-VASc score predict early pulmonary vein stump thrombus after left upper lobectomy. Sci Rep 2023; 13:4965. [PMID: 36973354 PMCID: PMC10042883 DOI: 10.1038/s41598-023-32240-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/21/2022] [Accepted: 03/24/2023] [Indexed: 03/29/2023] Open
Abstract
The purpose of this study is to clarify the feasibility of left atrial (LA) volume measurement and CHA2DS2-VASc score for predicting the development of pulmonary vein (PV) stump thrombus after left upper lobectomy (LUL). The study population comprised 50 patients who underwent LUL for pulmonary lesions. All patients were evaluated for the development of PV stump thrombus at 7 days after LUL. LA volume was measured using preoperative CT and the CHA2DS2-VASc score was evaluated. LA volume and CHA2DS2-VASc score were compared between patients with and without the development of PV stump thrombus using the Mann-Whitney U test. Receiver-operating characteristic (ROC) curve analysis was performed to evaluate the accuracy of prediction of PV stump thrombus development. PV stump thrombus was detected in 17 (33.4%) of the 50 patients. LA volume was significantly greater in patients who developed PV stump thrombus than in those without thrombus (79.7 ± 19.4 vs. 66.6 ± 17.0 mL, p = 0.040). CHA2DS2-VASc score was significantly higher in patients with PV stump thrombosis than in those without thrombus (3.4 ± 1.5 vs. 2.5 ± 1.5, p = 0.039). Area under the ROC curve values for predicting PV stump thrombus were 0.679, 0.676, and 0.714 for LA volume, CHA2DS2-VASc score, and their combination, respectively. In conclusion, LA volume measured using preoperative CT and CHA2DS2-VASc score may help predict the development of PV stump thrombus after LUL.
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Affiliation(s)
- Koji Takumi
- Departments of Radiology, Kagoshima University Graduate School of Medical and Dental Sciences, 8-35-1 Sakuragaoka, Kagoshima City, 890-8544, Japan.
| | - Hiroaki Nagano
- Departments of Radiology, Kagoshima University Graduate School of Medical and Dental Sciences, 8-35-1 Sakuragaoka, Kagoshima City, 890-8544, Japan
| | - Kazuhiro Ueda
- Departments of General Thoracic Surgery, Kagoshima University Graduate School of Medical and Dental Sciences, 8-35-1 Sakuragaoka, Kagoshima City, 890-8544, Japan
| | - Tadashi Umehara
- Departments of General Thoracic Surgery, Kagoshima University Graduate School of Medical and Dental Sciences, 8-35-1 Sakuragaoka, Kagoshima City, 890-8544, Japan
| | - Takuya Tokunaga
- Departments of General Thoracic Surgery, Kagoshima University Graduate School of Medical and Dental Sciences, 8-35-1 Sakuragaoka, Kagoshima City, 890-8544, Japan
| | - Go Kamimura
- Departments of General Thoracic Surgery, Kagoshima University Graduate School of Medical and Dental Sciences, 8-35-1 Sakuragaoka, Kagoshima City, 890-8544, Japan
| | - Masami Sato
- Departments of General Thoracic Surgery, Kagoshima University Graduate School of Medical and Dental Sciences, 8-35-1 Sakuragaoka, Kagoshima City, 890-8544, Japan
| | - Ryota Nakanosono
- Departments of Radiology, Kagoshima University Graduate School of Medical and Dental Sciences, 8-35-1 Sakuragaoka, Kagoshima City, 890-8544, Japan
| | - Takashi Yoshiura
- Departments of Radiology, Kagoshima University Graduate School of Medical and Dental Sciences, 8-35-1 Sakuragaoka, Kagoshima City, 890-8544, Japan
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Fujimoto A, Koutake Y, Hisamatsu D, Ookubo N, Yabuuchi Y, Kamimura G, Kai T, Kozono A, Ootsu T, Suzuki H, Matsuo K, Kuwahara K, Oiwane Y, Nagata Y, Tanimoto K, Sato E, Suenaga M, Uehara T, Ikari A, Endo S, Hiraki Y, Kawamata Y. Risk factors indicating immune-related adverse events with combination chemotherapy with immune checkpoint inhibitors and platinum agents in patients with non-small cell lung cancer: a multicenter retrospective study. Cancer Immunol Immunother 2023:10.1007/s00262-023-03408-4. [PMID: 36849845 DOI: 10.1007/s00262-023-03408-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/08/2022] [Accepted: 02/12/2023] [Indexed: 03/01/2023]
Abstract
PURPOSE Immune checkpoint inhibitors (ICI) ushered in a new era for the treatment of non-small cell lung cancer (NSCLC). However, they carry the risk of immune-related adverse events (irAEs). Recently, various studies have been conducted on the predictive factors for irAEs, but there are no reports focusing only on ICI plus platinum agents. The present study aimed to identify the risk factors for irAEs due to ICI combined with platinum-based induction immunochemotherapy in NSCLC patients, focusing only on the period of combined therapy and excluding the period of ICI maintenance therapy. METHODS This retrospective study included 315 NSCLC patients who started ICI combined with platinum-based chemotherapy treatment at 14 hospitals between December 2018 and March 2021. A logistic regression analysis was used to explore the predictive factors. RESULTS Fifty patients (15.9%) experienced irAEs. A multivariate analysis revealed that squamous cell carcinoma (P = 0.021; odds ratio [OR]: 2.30; 95% confidence interval [Cl]: 1.14-4.65), anti-programmed death 1 antibody (anti-PD-1) plus anti-cytotoxic T-lymphocyte antigen-4 antibody (anti-CTLA-4) regimens (P < 0.01; OR: 22.10; 95% Cl: 5.60-87.20), and neutrophil-to-lymphocyte rate (NLR) < 3 (P < 0.01; OR: 2.91; 95% Cl: 1.35-6.27) were independent predictive factors for irAEs occurrence. CONCLUSION Squamous cell carcinoma, anti-PD-1 plus anti-CTLA-4 regimens, and NLR < 3 may be predictive factors for the occurrence of irAEs due to induction immunochemotherapy in patients with NSCLC. By focusing on the potential risk of irAEs in patients with these factors, irAEs can be appropriately managed from an early stage.
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Affiliation(s)
- Airi Fujimoto
- Department of Pharmacy, National Hospital Organization Beppu Medical Center, 473 Uchikamado, Beppu, Oita, 874-0011, Japan.
- Department of Pharmacy, Clinical Research Institute, National Hospital Organization Kyushu Medical Center, Fukuoka, Japan.
| | - Yoshimichi Koutake
- Department of Pharmacy, Clinical Research Institute, National Hospital Organization Kyushu Medical Center, Fukuoka, Japan
| | - Daisuke Hisamatsu
- Department of Pharmacy, National Hospital Organization Kyushu Cancer Center, Fukuoka, Japan
| | - Noriko Ookubo
- Department of Pharmacy, National Hospital Organization Miyakonojo Medical Center, Miyazaki, Japan
| | - Yurika Yabuuchi
- Department of Pharmacy, National Hospital Organization Fukuokahigashi Medical Center, Fukuoka, Japan
| | - Go Kamimura
- Department of Pharmacy, National Hospital Organization Minamikyusyu Hospital, Kagoshima, Japan
| | - Tatsuo Kai
- Department of Pharmacy, National Hospital Organization Miyazaki Higashi Hospital, Miyazaki, Japan
| | - Aki Kozono
- Department of Pharmacy, National Hospital Organization Kumamoto Saishun Medical Center, Kumamoto, Japan
| | - Takahiro Ootsu
- Department of Pharmacy, National Hospital Organization Nagasaki Medical Center, Nagasaki, Japan
| | - Hiroto Suzuki
- Department of Pharmacy, National Hospital Organization Okinawa National Hospital, Okinawa, Japan
| | - Keisuke Matsuo
- Department of Pharmacy, National Hospital Organization Beppu Medical Center, 473 Uchikamado, Beppu, Oita, 874-0011, Japan
| | - Kimiko Kuwahara
- Department of Pharmacy, National Hospital Organization Ureshino Medical Center, Saga, Japan
| | - Yoshita Oiwane
- Department of Pharmacy, National Hospital Organization Omuta National Hospital, Fukuoka, Japan
| | - Yuko Nagata
- Department of Pharmacy, National Hospital Organization Fukuoka National Hospital, Fukuoka, Japan
| | - Kenya Tanimoto
- Department of Pharmacy, National Hospital Organization Kagoshima Medical Center, Kagoshima, Japan
| | - Eri Sato
- Department of Pharmacy, National Hospital Organization Miyakonojo Medical Center, Miyazaki, Japan
| | - Mei Suenaga
- Department of Pharmacy, National Hospital Organization Kumamoto Saishun Medical Center, Kumamoto, Japan
| | - Tomohiro Uehara
- Department of Pharmacy, National Hospital Organization Okinawa National Hospital, Okinawa, Japan
| | - Akira Ikari
- Laboratory of Biochemistry, Department of Biopharmaceutical Sciences, Gifu Pharmaceutical University, Gifu, Japan
| | - Satoshi Endo
- Laboratory of Biochemistry, Department of Biopharmaceutical Sciences, Gifu Pharmaceutical University, Gifu, Japan
| | - Yoichi Hiraki
- Department of Pharmacy, National Hospital Organization Beppu Medical Center, 473 Uchikamado, Beppu, Oita, 874-0011, Japan
| | - Yosei Kawamata
- Department of Pharmacy, Clinical Research Institute, National Hospital Organization Kyushu Medical Center, Fukuoka, Japan
- Department of Pharmacy, National Hospital Organization Miyazaki Higashi Hospital, Miyazaki, Japan
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Tabata K, Aoki M, Miyata R, Umehara T, Harada-Takeda A, Kamimura G, Nagata T, Okizono R, Terazono H, Takeda Y, Suetsugu T, Ueda K, Sato M. Successful Treatment with Osimertinib Based on Therapeutic Drug Monitoring in a Hemodialysis Patient with Non-Small Cell Lung Cancer: A Case Report. Case Rep Oncol 2023; 16:705-710. [PMID: 37936662 PMCID: PMC10626281 DOI: 10.1159/000531840] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/11/2023] [Accepted: 06/29/2023] [Indexed: 11/09/2023] Open
Abstract
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.
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Affiliation(s)
- Keisuke Tabata
- Department of General Thoracic Surgery, Kagoshima University Graduate School of Medical and Dental Sciences, Kagoshima, Japan
| | - Masaya Aoki
- Department of General Thoracic Surgery, Kagoshima University Graduate School of Medical and Dental Sciences, Kagoshima, Japan
| | - Ryo Miyata
- Department of General Thoracic Surgery, Kagoshima University Graduate School of Medical and Dental Sciences, Kagoshima, Japan
| | - Tadashi Umehara
- Department of General Thoracic Surgery, Kagoshima University Graduate School of Medical and Dental Sciences, Kagoshima, Japan
| | - Aya Harada-Takeda
- Department of General Thoracic Surgery, Kagoshima University Graduate School of Medical and Dental Sciences, Kagoshima, Japan
| | - Go Kamimura
- Department of General Thoracic Surgery, Kagoshima University Graduate School of Medical and Dental Sciences, Kagoshima, Japan
| | - Toshiyuki Nagata
- Department of General Thoracic Surgery, Kagoshima University Graduate School of Medical and Dental Sciences, Kagoshima, Japan
| | - Ryuya Okizono
- Department of Clinical Pharmacy and Pharmacology, Kagoshima University Graduate School of Medical and Dental Sciences, Kagoshima, Japan
| | - Hideyuki Terazono
- Department of Clinical Pharmacy and Pharmacology, Kagoshima University Graduate School of Medical and Dental Sciences, Kagoshima, Japan
| | - Yasuo Takeda
- Department of Clinical Pharmacy and Pharmacology, Kagoshima University Graduate School of Medical and Dental Sciences, Kagoshima, Japan
| | - Takayuki Suetsugu
- Department of Pulmonary Medicine, Kagoshima University Graduate School of Medical and Dental Sciences, Kagoshima, Japan
| | - Kazuhiro Ueda
- Department of General Thoracic Surgery, Kagoshima University Graduate School of Medical and Dental Sciences, Kagoshima, Japan
| | - Masami Sato
- Department of General Thoracic Surgery, Kagoshima University Graduate School of Medical and Dental Sciences, Kagoshima, Japan
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Kamimura G, Ueda K, Takeda A, Miyata R, Aoki M, Nagata T, Sato M. A case of ectopic cervical thymoma with myasthenia gravis mimicking a parathyroid tumour. Respirol Case Rep 2022; 10:e01052. [PMID: 36303708 PMCID: PMC9593103 DOI: 10.1002/rcr2.1052] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/27/2022] [Accepted: 10/02/2022] [Indexed: 11/06/2022] Open
Abstract
Reports of cervical thymoma with myasthenia gravis are rare. In addition, 99mTc‐MIBI (methoxyisobutylisonitrile:sestamibi) scintigraphy is a useful diagnostic examination for enlarged parathyroid tumours; however, there are a few reports of its accumulation in thymoma. Among them, there are no reports of cervical thymomas with 99mTc‐MIBI accumulation complicated by myasthenia gravis. In this study, we performed surgery on a patient with preoperative myasthenic crisis accompanied by a cervical thymoma and a parathyroid tumour. Preoperatively, the cervical mass was determined to be a parathyroid tumour and was complicated by myasthenia gravis without thymic tumour. However, a pathological examination revealed that the cervical tumour with 99mTc‐MIBI accumulation was a Type B2 thymoma, and a parathyroid tumour was identified in the vicinity. We report a very rare case in which symptoms improved with surgery.
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Affiliation(s)
- Go Kamimura
- Department of General Thoracic SurgeryGraduate School of Medical and Dental Sciences, Kagoshima UniversityKagoshimaJapan
| | - Kazuhiro Ueda
- Department of General Thoracic SurgeryGraduate School of Medical and Dental Sciences, Kagoshima UniversityKagoshimaJapan
| | - Aya Takeda
- Department of General Thoracic SurgeryGraduate School of Medical and Dental Sciences, Kagoshima UniversityKagoshimaJapan
| | - Ryo Miyata
- Department of General Thoracic SurgeryGraduate School of Medical and Dental Sciences, Kagoshima UniversityKagoshimaJapan
| | - Masaya Aoki
- Department of General Thoracic SurgeryGraduate School of Medical and Dental Sciences, Kagoshima UniversityKagoshimaJapan
| | - Toshiyuki Nagata
- Department of General Thoracic SurgeryGraduate School of Medical and Dental Sciences, Kagoshima UniversityKagoshimaJapan
| | - Masami Sato
- Department of General Thoracic SurgeryGraduate School of Medical and Dental Sciences, Kagoshima UniversityKagoshimaJapan
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Jin ZW, Aoki M, Ueda K, Kamimura G, Takeda-Harada A, Murakami G, Sato M. Human lymph node degeneration in the thoracic region: A morphometric and immunohistochemical analysis using surgically obtained specimens. Front Physiol 2022; 13:990801. [PMID: 36187759 PMCID: PMC9515507 DOI: 10.3389/fphys.2022.990801] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/10/2022] [Accepted: 08/25/2022] [Indexed: 11/27/2022] Open
Abstract
Lymph node degeneration was examined in 539 mediastinal and intrapulmonary nodes removed from 78 patients, aged 49–82 years, without cancer metastasis. Medullary sinus hyalinization observed in 36.2% of the hilar and 38.5% of the interlobar nodes. Early and smaller lesions were eosinophilic and factor VIII-positive, whereas advanced and large lesions contained a bulky mass of collagenous fiber bundles with few slender cells positive for smooth muscle actin (SMA) and factor VIII, as well as anthracotic macrophages. Subcapsular sinus hyalinization, observed in 4.3% of hilar nodes, was detected as a thick fibrous layer (over 0.2 mm) between the surface cortex and the thickened capsule. The fibrous layer contained SMA-positive slender cells, whereas the thickened capsule contained fibers positive for elastin and factor VIII. These hyalinization lesions occupied 3.6% and 0.8% of the sectional areas of hilar and lower paratracheal nodes, respectively. Areas of early and small cortical degeneration, surrounded by fibers positive for SMA and vimentin, did not contain lymphocytes and macrophages, but contained abundant small stromal cells. Silver staining suggested that advanced cortical degeneration was composed of collagen fibrils other than type I. Fatty tissues, seen in 47.8% of hilar nodes, often extended into and replaced medullary sinus tissue. Island-like remnants of medullary sinuses in areas of fatty degeneration contained various stromal cells positive for SMA, elastin, factor VIII and/or CD34. These degenerative morphologies, however, did not correlate with either age or smoking index. The present cortical degeneration usually seemed to follow hyalinization, but both were likely to occur independently.
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Affiliation(s)
- Zhe-Wu Jin
- Department of Anatomy, Wuxi School of Medicine, Jiangnan University, Wuxi, China
- *Correspondence: Zhe-Wu Jin,
| | - Masaya Aoki
- Department of General Thoracic Surgery, Kagoshima University School of Medicine, Kagoshima, Japan
| | - Kazuhiro Ueda
- Department of General Thoracic Surgery, Kagoshima University School of Medicine, Kagoshima, Japan
| | - Go Kamimura
- Department of General Thoracic Surgery, Kagoshima University School of Medicine, Kagoshima, Japan
| | - Aya Takeda-Harada
- Department of General Thoracic Surgery, Kagoshima University School of Medicine, Kagoshima, Japan
| | - Gen Murakami
- Department of Anatomy, Tokyo Dental College, Tokyo, Japan
| | - Masami Sato
- Department of General Thoracic Surgery, Kagoshima University School of Medicine, Kagoshima, Japan
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Kamimura G, Ueda K, Takeda A, Maeda K, Aoki M, Sato M. A case of schwannoma at the origin of the right recurrent laryngeal nerve resected under uniportal video‐assisted thoracic surgery. Respirol Case Rep 2022; 10:e01023. [PMID: 36017485 PMCID: PMC9396629 DOI: 10.1002/rcr2.1023] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/04/2022] [Accepted: 08/07/2022] [Indexed: 11/16/2022] Open
Abstract
Mediastinal neurogenic tumours are mostly derived from sympathetic nerves and intercostal nerves, and vagus nerve‐derived schwannomas are rare. We encountered a tumour originating from the origin of the recurrent laryngeal nerve that was accompanied by the azygos lobe, which made it difficult to approach; it was ultimately able to be removed via uniportal video‐assisted thoracic surgery. This case involved a 63‐year‐old female patient. There were no particular symptoms, but an abnormal chest shadow was noted on an imaging examination. Chest imaging revealed a smooth‐surfaced mass in the upper right mediastinum with the azygos lobe. A diagnosis of schwannoma was made by imaging, and the patient underwent resection via uniportal video‐assisted thoracic surgery. The tumour, which originated from the origin of the right recurrent laryngeal nerve, was sharply removed without causing recurrent laryngeal nerve palsy.
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Affiliation(s)
- Go Kamimura
- Department of General Thoracic Surgery, Graduate School of Medical and Dental Sciences Kagoshima University Kagoshima Japan
| | - Kazuhiro Ueda
- Department of General Thoracic Surgery, Graduate School of Medical and Dental Sciences Kagoshima University Kagoshima Japan
| | - Aya Takeda
- Department of General Thoracic Surgery, Graduate School of Medical and Dental Sciences Kagoshima University Kagoshima Japan
| | - Koki Maeda
- Department of General Thoracic Surgery, Graduate School of Medical and Dental Sciences Kagoshima University Kagoshima Japan
| | - Masaya Aoki
- Department of General Thoracic Surgery, Graduate School of Medical and Dental Sciences Kagoshima University Kagoshima Japan
| | - Masami Sato
- Department of General Thoracic Surgery, Graduate School of Medical and Dental Sciences Kagoshima University Kagoshima Japan
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11
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Aoki M, Ueda K, Kamimura G, Iwamoto Y, Ikehata M, Tabata K, Sakagami Y, Morizono S, Tokunaga T, Umehara T, Harada-Takeda A, Maeda K, Nagata T, Kariatsumari K, Furukawa T, Tsujikawa K, Sato M. Clinical significance of ALKBH4 expression in non-small cell lung cancer. Transl Cancer Res 2022; 11:2040-2049. [PMID: 35966331 PMCID: PMC9372245 DOI: 10.21037/tcr-22-39] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/05/2022] [Accepted: 05/11/2022] [Indexed: 11/18/2022]
Abstract
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.
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Affiliation(s)
- Masaya Aoki
- Department of General Thoracic Surgery, Graduate School of Medical and Dental Sciences, Kagoshima University, Kagoshima, Japan
| | - Kazuhiro Ueda
- Department of General Thoracic Surgery, Graduate School of Medical and Dental Sciences, Kagoshima University, Kagoshima, Japan
| | - Go Kamimura
- Department of General Thoracic Surgery, Graduate School of Medical and Dental Sciences, Kagoshima University, Kagoshima, Japan
| | - Yoshiyuki Iwamoto
- Department of General Thoracic Surgery, Graduate School of Medical and Dental Sciences, Kagoshima University, Kagoshima, Japan
| | - Mizuki Ikehata
- Department of General Thoracic Surgery, Graduate School of Medical and Dental Sciences, Kagoshima University, Kagoshima, Japan
| | - Keisuke Tabata
- Department of General Thoracic Surgery, Graduate School of Medical and Dental Sciences, Kagoshima University, Kagoshima, Japan
| | - Yuri Sakagami
- Department of General Thoracic Surgery, Graduate School of Medical and Dental Sciences, Kagoshima University, Kagoshima, Japan
| | - Shoichiro Morizono
- Department of General Thoracic Surgery, Graduate School of Medical and Dental Sciences, Kagoshima University, Kagoshima, Japan
| | - Takuya Tokunaga
- Department of General Thoracic Surgery, Graduate School of Medical and Dental Sciences, Kagoshima University, Kagoshima, Japan
| | - Tadashi Umehara
- Department of General Thoracic Surgery, Graduate School of Medical and Dental Sciences, Kagoshima University, Kagoshima, Japan
| | - Aya Harada-Takeda
- Department of General Thoracic Surgery, Graduate School of Medical and Dental Sciences, Kagoshima University, Kagoshima, Japan
| | - Koki Maeda
- Department of General Thoracic Surgery, Graduate School of Medical and Dental Sciences, Kagoshima University, Kagoshima, Japan
| | - Toshiyuki Nagata
- Department of General Thoracic Surgery, Graduate School of Medical and Dental Sciences, Kagoshima University, Kagoshima, Japan
| | - Kota Kariatsumari
- Department of General Thoracic Surgery, Graduate School of Medical and Dental Sciences, Kagoshima University, Kagoshima, Japan
| | - Tatsuhiko Furukawa
- Department of Molecular Oncology, Graduate School of Medical and Dental Sciences, Kagoshima University, Kagoshima, Japan
| | - Kazutake Tsujikawa
- Laboratory of Molecular and Cellular Physiology, Graduate School of Pharmaceutical Sciences, Osaka University, Suita, Japan
| | - Masami Sato
- Department of General Thoracic Surgery, Graduate School of Medical and Dental Sciences, Kagoshima University, Kagoshima, Japan
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12
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Kitazono M, Fujita M, Oyama T, Ikeda N, Eguchi M, Kamimura G, Sato R, Uchiyama S, Toyosaki R, Suenaga T, Shimaoka S. Robot‐assisted excision of rectal duplication cysts: A case report. Clin Case Rep 2022; 10:e05457. [PMID: 35198207 PMCID: PMC8841026 DOI: 10.1002/ccr3.5457] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/06/2021] [Revised: 01/13/2022] [Accepted: 01/25/2022] [Indexed: 11/17/2022] Open
Abstract
Rectal duplication cysts are extremely rare and account for only 4% of all gastrointestinal duplication cysts. They may become challenging for removal in the case of a large tumor in a narrow pelvis. Herein, we report a case of rectal duplication cysts excision via robotic‐assisted laparoscopic surgery and its utility.
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Affiliation(s)
| | - Makoto Fujita
- Division of Medical Support Nanpuh Hospital Kagoshima‐city Japan
| | - Tomohiro Oyama
- Department of Surgery Nanpuh Hospital Kagoshima‐city Japan
| | - Naotaka Ikeda
- Department of Surgery Nanpuh Hospital Kagoshima‐city Japan
| | - Mayumi Eguchi
- Department of Surgery Nanpuh Hospital Kagoshima‐city Japan
| | - Go Kamimura
- Department of Surgery Nanpuh Hospital Kagoshima‐city Japan
| | - Rikiya Sato
- Department of Surgery Nanpuh Hospital Kagoshima‐city Japan
| | | | | | | | - Shunji Shimaoka
- Department of Gastroenterology Nanpuh Hospital Kagoshima‐city Japan
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13
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Kamimura G, Ueda K, Suzuki S, Maeda K, Hakamada H, Sato M. Intraoperative computed tomography of a resected lung inflated with air to verify safety surgical margin. Quant Imaging Med Surg 2022; 12:1281-1289. [PMID: 35111623 DOI: 10.21037/qims-21-562] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/26/2021] [Accepted: 09/22/2021] [Indexed: 11/06/2022]
Abstract
Background During sublobar resection for small, indistinct lung cancer, surgeons may be uncertain as to whether or not the target lesion has been resected and the surgical margin is sufficient. We herein report our procedure for confirming the success of sublobar resection without incising the resected specimen. Methods We reviewed our initial experience of 12 patients with intrapulmonary lesions (consolidation diameter ≤1 cm) who underwent thoracoscopic pulmonary wedge resection using autostapler. Six patients had primary adenocarcinoma showing part solid lesion, and remaining six patients had metastatic carcinoma showing purely solid lesion. Intraoperatively, the resected specimen was inflated with air and subjected to computed tomography (CT). The maximum tumor diameter and surgical margin length were measured intraoperatively on CT and postoperatively on formalin-fixed specimen. Surgical stump cytology was also done to verify surgical margin. Results According to the intraoperative CT, complete resection was confirmed in all patients. The intraoperative CT-based maximum tumor diameter closely correlated with the macroscopically measured one (r=0.971, P<0.0001). However, the tumor shrunk after formalin-fixation by 16.0% in patients with primary lung cancer (P<0.01), but not in patients with metastatic lung cancer. The intraoperative CT-based margin length closely correlated with the macroscopically measured one (r=0.984, P<0.0001). However, the margin shrunk after formalin-fixation in both patients with primary lung cancer and metastatic lung cancer, by 15.1% and 15.7%, respectively. Stump cytology was negative in all patients. Consequently, no recurrence was found during postoperative follow-up of 23 months (range, 14-31 months). Conclusions Intraoperative CT is reliable for diagnosing the presence of a target lesion within the resected specimen as well as for estimating the surgical margin length in patients undergoing sublobar resection for intrapulmonary indistinct lesions.
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Affiliation(s)
- Go Kamimura
- Department of General Thoracic Surgery, Nanphu Hospital, Kagosima, Japan.,Department of Radiology, Nanphu Hospital, Kagosima, Japan
| | - Kazuhiro Ueda
- Department of Radiology, Nanphu Hospital, Kagosima, Japan
| | - Soichi Suzuki
- Department of Radiology, Nanphu Hospital, Kagosima, Japan
| | - Koki Maeda
- Department of Radiology, Nanphu Hospital, Kagosima, Japan
| | - Hiroto Hakamada
- Department of General Thoracic Surgery, Kagoshima University Graduate School of Medical and Dental Sciences, Kagoshima, Japan
| | - Masami Sato
- Department of Radiology, Nanphu Hospital, Kagosima, Japan
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14
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Ueda K, Aoki M, Kamimura G, Imamura N, Tokunaga T, Suzuki S, Sato M. Intraoperative cone-beam computed tomography to secure the surgical margin in pulmonary wedge resection for indistinct intrapulmonary lesions. JTCVS Tech 2022; 13:219-228. [PMID: 35711212 PMCID: PMC9196256 DOI: 10.1016/j.xjtc.2022.01.028] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/12/2021] [Accepted: 01/12/2022] [Indexed: 11/26/2022] Open
Abstract
Objective The objective of this study was to use cone-beam computed tomography (CBCT) for intraoperative imaging of a pulmonary wedge resection line that contributes to securing the required surgical margin in patients undergoing thoracoscopic surgery for indistinct intrapulmonary lesions. Methods Data of 16 consecutive patients with potentially impalpable intrapulmonary lesions were retrospectively reviewed. Preoperatively, we simulated a rhomboidal cut line on the surface of a 3-dimensional lung model with reference to multiplanar reconstruction computed tomography images. Intraoperatively, we imaged the rhomboid on the real lung surface using trial and error adjustment with CBCT. Wedge resection was performed thoracoscopically by stapling along the outline of the rhomboid. Results The mean consolidation diameter and mean distance between the tumor and the visceral pleura were 2 mm and 11 mm, respectively. In all cases, we only performed single CBCT scanning to localize the rhomboid on the real lung surface. The mean radiological distance between the approximate location and the correct location was 8 mm (range, 0-34 mm). Wedge resection was successful with a mean surgical margin of 11 mm (range, 7-16 mm), without conversion to anatomical resection or open conversion. This simulation was also helpful for planning port placement for the use of an autostapler. Conclusions We established a novel procedure for imaging the cut line on the lung surface with intraoperative CBCT, which facilitated the performance of wedge resection with the required surgical margin in patients with potentially impalpable intrapulmonary small lesions. Our method might be beneficial for patients and surgeons because it can be applied without preoperative intervention.
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15
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Kamimura G, Ueda K, Suzuki S, Aoki M, Nagata T, Sato M. A case of intradiaphragmatic bronchogenic cyst with an abnormally high serum level of CA19-9. Respirol Case Rep 2021; 9:e0838. [PMID: 34589228 PMCID: PMC8459630 DOI: 10.1002/rcr2.838] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/21/2021] [Revised: 08/04/2021] [Accepted: 08/11/2021] [Indexed: 11/11/2022] Open
Abstract
Bronchogenic cysts that occur within the diaphragm are rare and difficult to diagnose preoperatively. We experienced the case of a patient with an abnormally high serum carbohydrate antigen 19-9 (CA19-9) level before surgery. The diagnosis of intradiaphragmatic bronchogenic cyst was made at the time of surgery. The patient was a 50-year-old woman with upper abdominal pain with an incidentally elevated serum CA19-9. Although the tumour location could not be established on images, a tumour within the diaphragm was confirmed during the operation. The diaphragm was incised and the tumour was removed together with the capsule. Bronchial cysts were diagnosed histopathologically, and immunohistochemical examination revealed that the bronchial epithelial cells were positive for CA19-9. When managing patients with bronchogenic cysts in the diaphragm, it is difficult to make a preoperative diagnosis or determine the location of the tumour; thus, careful planning is required before surgery.
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Affiliation(s)
- Go Kamimura
- Department of General Thoracic SurgeryNanphu HospitalKagoshimaJapan
- Department of General Thoracic Surgery, Graduate School of Medical and Dental SciencesKagoshima UniversityKagoshimaJapan
| | - Kazuhiro Ueda
- Department of General Thoracic Surgery, Graduate School of Medical and Dental SciencesKagoshima UniversityKagoshimaJapan
| | - Soichi Suzuki
- Department of General Thoracic Surgery, Graduate School of Medical and Dental SciencesKagoshima UniversityKagoshimaJapan
| | - Masaya Aoki
- Department of General Thoracic Surgery, Graduate School of Medical and Dental SciencesKagoshima UniversityKagoshimaJapan
| | - Toshiyuki Nagata
- Department of General Thoracic Surgery, Graduate School of Medical and Dental SciencesKagoshima UniversityKagoshimaJapan
| | - Masami Sato
- Department of General Thoracic Surgery, Graduate School of Medical and Dental SciencesKagoshima UniversityKagoshimaJapan
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16
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Kitazono M, Fujita M, Katsue K, Ikeda N, Oyama T, Eguchi M, Kamimura G, Sato R, Uchiyama S, Toyosaki R, Suenaga T. A case of emergency pancreatoduodenectomy for bleeding from the duodenal mucosa due to arteriovenous malformation of the pancreatic head. Clin Case Rep 2021; 9:e04824. [PMID: 34584707 PMCID: PMC8455972 DOI: 10.1002/ccr3.4824] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2021] [Revised: 08/24/2021] [Accepted: 08/25/2021] [Indexed: 11/08/2022] Open
Abstract
A rare case of bleeding from the duodenal mucosa due to arteriovenous malformation of the pancreatic head is reported. Caution needs to be observed, then excision may be necessary since noninvasive treatment such as coil embolization is not enough for complete hemostasis when patient suddenly decompensates.
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Affiliation(s)
- Masaki Kitazono
- Department of SurgeryPublic Interest Incorporated AssociationKagoshima KyosaikaiNanpuh HospitalKagoshima CityJapan
| | - Makoto Fujita
- Division of Medical SupportPublic Interest Incorporated AssociationKagoshima KyosaikaiNanpuh HospitalKagoshima CityJapan
| | - Katsugi Katsue
- Department of SurgeryPublic Interest Incorporated AssociationKagoshima KyosaikaiNanpuh HospitalKagoshima CityJapan
| | - Naotaka Ikeda
- Department of SurgeryPublic Interest Incorporated AssociationKagoshima KyosaikaiNanpuh HospitalKagoshima CityJapan
| | - Tomohiro Oyama
- Department of SurgeryPublic Interest Incorporated AssociationKagoshima KyosaikaiNanpuh HospitalKagoshima CityJapan
| | - Mayumi Eguchi
- Department of SurgeryPublic Interest Incorporated AssociationKagoshima KyosaikaiNanpuh HospitalKagoshima CityJapan
| | - Go Kamimura
- Department of SurgeryPublic Interest Incorporated AssociationKagoshima KyosaikaiNanpuh HospitalKagoshima CityJapan
| | - Rikiya Sato
- Department of SurgeryPublic Interest Incorporated AssociationKagoshima KyosaikaiNanpuh HospitalKagoshima CityJapan
| | - Shuichiro Uchiyama
- Department of SurgeryPublic Interest Incorporated AssociationKagoshima KyosaikaiNanpuh HospitalKagoshima CityJapan
| | - Ryoichi Toyosaki
- Department of SurgeryPublic Interest Incorporated AssociationKagoshima KyosaikaiNanpuh HospitalKagoshima CityJapan
| | - Toyokuni Suenaga
- Department of SurgeryPublic Interest Incorporated AssociationKagoshima KyosaikaiNanpuh HospitalKagoshima CityJapan
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17
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Kamimura G, Ueda K, Maeda K, Aoki M, Nagata T, Yokomakura N, Sato M. An extremely rare case with right superior pulmonary vein translocation. Surg Case Rep 2020; 6:96. [PMID: 32382810 PMCID: PMC7205928 DOI: 10.1186/s40792-020-00860-7] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/11/2020] [Accepted: 04/29/2020] [Indexed: 11/10/2022] Open
Abstract
Background There have been a number of reports on pulmonary venous anomalies. However, most of the reports focused on the anatomical branching pattern of the peripheral pulmonary veins. Case presentation We report a 75-year-old female whose right superior pulmonary vein V1 existed dorsal to the right main pulmonary artery and V2+3 existed dorsal to V4+5. Thus, we could not find V1 and V2+3 in the hilum just after a thoracotomy to perform right upper lobectomy for lung cancer. Thus, the right main pulmonary artery and the superior trunk (A1+3) were exposed without cutting the superior pulmonary vein. Conclusion There has been no report so far regarding this type of pulmonary vein translocation. Preoperative three-dimensional computed tomography images were helpful to identify this variant.
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Affiliation(s)
- Go Kamimura
- Department of General Thoracic Surgery, Kagoshima University Graduate School of Dental and Medical Science, 8-35-1 Sakuragaoka, Kagoshima, 890-8520, Japan
| | - Kazuhiro Ueda
- Department of General Thoracic Surgery, Kagoshima University Graduate School of Dental and Medical Science, 8-35-1 Sakuragaoka, Kagoshima, 890-8520, Japan.
| | - Koki Maeda
- Department of General Thoracic Surgery, Kagoshima University Graduate School of Dental and Medical Science, 8-35-1 Sakuragaoka, Kagoshima, 890-8520, Japan
| | - Masaya Aoki
- Department of General Thoracic Surgery, Kagoshima University Graduate School of Dental and Medical Science, 8-35-1 Sakuragaoka, Kagoshima, 890-8520, Japan
| | - Toshiyuki Nagata
- Department of General Thoracic Surgery, Kagoshima University Graduate School of Dental and Medical Science, 8-35-1 Sakuragaoka, Kagoshima, 890-8520, Japan
| | - Naoya Yokomakura
- Department of General Thoracic Surgery, Kagoshima University Graduate School of Dental and Medical Science, 8-35-1 Sakuragaoka, Kagoshima, 890-8520, Japan
| | - Masami Sato
- Department of General Thoracic Surgery, Kagoshima University Graduate School of Dental and Medical Science, 8-35-1 Sakuragaoka, Kagoshima, 890-8520, Japan
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Aoki M, Umehara T, Morizono S, Tokuda Y, Kamimura G, Tokunaga T, Suzuki S, Takeda AH, Maeda K, Nagata T, Yokomakura N, Kariatsumari K, Ueda K, Sato M. Computed tomography-guided thoracoscopic debridement for multiple loculated organizing empyema: a case report. Surg Case Rep 2019; 5:174. [PMID: 31701252 PMCID: PMC6838243 DOI: 10.1186/s40792-019-0731-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2019] [Accepted: 10/15/2019] [Indexed: 11/23/2022] Open
Abstract
Background Video-assisted thoracoscopic surgery (VATS) for organizing empyema is challenging because fibrous septa and peel within the cavity are thickened and hardened. Some patients have multiple isolated empyema cavities that require debridement individually because firm intrathoracic adhesion was developed during this phase. If the debridement was incomplete as a result of worrying about an accidental injury of the surrounding organ, additional interventions may be required due to the persistent empyema cavity or insufficient expansion of the ipsilateral lung. We here describe a representative case with multiple loculated organizing empyema that could safely and reliably perform VATS debridement under C-arm cone-beam computed tomography (CBCT). Case presentation A 67-year-old woman was admitted to our department for the treatment of right empyema. Chest computed tomography showed fluid collection in three independent spaces within the right thoracic cavity. It was assumed that a firm adhesion between the lung and chest wall was developed because about 7 weeks passed since the onset. Therefore, we decided to use CBCT to completely debride three empyema cavities separately by VATS. One cavity was only in a narrow range with the chest wall, and it was located on the back of cost rib cartilage. By clicking any intended anatomical structures on CBCT images, the position was readily depicted by lase projection on the body surface, which helped to place the best skin incision. Moreover, in other cavities, CBCT after initial debridement showed insufficiently dissected cavity. Additional debridement resulted in a successful shrinkage of the empyema cavity. Conclusion We believe that VATS debridement under CBCT guidance is one of the useful treatment options for multiple loculated organizing empyema.
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Affiliation(s)
- Masaya Aoki
- Department of General Thoracic Surgery, Kagoshima University Graduate School of Dental and Medical Science, 8-35-1 Sakuragaoka, Kagoshima, 890-8520, Japan
| | - Tadashi Umehara
- Department of General Thoracic Surgery, Kagoshima University Graduate School of Dental and Medical Science, 8-35-1 Sakuragaoka, Kagoshima, 890-8520, Japan
| | - Shoichiro Morizono
- Department of General Thoracic Surgery, Kagoshima University Graduate School of Dental and Medical Science, 8-35-1 Sakuragaoka, Kagoshima, 890-8520, Japan
| | - Yasuhiro Tokuda
- Department of General Thoracic Surgery, Kagoshima University Graduate School of Dental and Medical Science, 8-35-1 Sakuragaoka, Kagoshima, 890-8520, Japan
| | - Go Kamimura
- Department of General Thoracic Surgery, Kagoshima University Graduate School of Dental and Medical Science, 8-35-1 Sakuragaoka, Kagoshima, 890-8520, Japan
| | - Takuya Tokunaga
- Department of General Thoracic Surgery, Kagoshima University Graduate School of Dental and Medical Science, 8-35-1 Sakuragaoka, Kagoshima, 890-8520, Japan
| | - Souichi Suzuki
- Department of General Thoracic Surgery, Kagoshima University Graduate School of Dental and Medical Science, 8-35-1 Sakuragaoka, Kagoshima, 890-8520, Japan
| | - Aya Harada Takeda
- Department of General Thoracic Surgery, Kagoshima University Graduate School of Dental and Medical Science, 8-35-1 Sakuragaoka, Kagoshima, 890-8520, Japan
| | - Koki Maeda
- Department of General Thoracic Surgery, Kagoshima University Graduate School of Dental and Medical Science, 8-35-1 Sakuragaoka, Kagoshima, 890-8520, Japan
| | - Toshiyuki Nagata
- Department of General Thoracic Surgery, Kagoshima University Graduate School of Dental and Medical Science, 8-35-1 Sakuragaoka, Kagoshima, 890-8520, Japan
| | - Naoya Yokomakura
- Department of General Thoracic Surgery, Kagoshima University Graduate School of Dental and Medical Science, 8-35-1 Sakuragaoka, Kagoshima, 890-8520, Japan
| | - Kota Kariatsumari
- Department of General Thoracic Surgery, Kagoshima University Graduate School of Dental and Medical Science, 8-35-1 Sakuragaoka, Kagoshima, 890-8520, Japan
| | - Kazuhiro Ueda
- Department of General Thoracic Surgery, Kagoshima University Graduate School of Dental and Medical Science, 8-35-1 Sakuragaoka, Kagoshima, 890-8520, Japan.
| | - Masami Sato
- Department of General Thoracic Surgery, Kagoshima University Graduate School of Dental and Medical Science, 8-35-1 Sakuragaoka, Kagoshima, 890-8520, Japan
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19
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Aoki M, Kamimura G, Umehara T, Takeda AH, Watanabe Y, Maeda K, Nagata T, Otsuka T, Sato M. Tumor enucleation for Castleman's disease in the pulmonary hilum: a case report. Surg Case Rep 2019; 5:95. [PMID: 31183765 PMCID: PMC6557939 DOI: 10.1186/s40792-019-0652-3] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2019] [Accepted: 05/29/2019] [Indexed: 11/14/2022] Open
Abstract
Background The development of Castleman’s disease in the pulmonary hilum is extremely rare. Although resection of only the lesion is sufficient because of its benign nature, lobectomy or more extensive procedures performed for the pulmonary hilar tumor have been reported. Case presentation The patient was a 15-year-old male with a tumor in the right pulmonary hilum. Endobronchial ultrasound-guided transbronchial needle aspiration was performed but no specific findings were obtained from the cytological and histological evaluation. 18F-fluorodeoxyglucose positron emission tomography showed moderate accumulation in the tumor, which suggested potential malignancy. Intraoperative frozen section diagnosis did not show any malignant findings. Thus, we performed only tumor enucleation without any lung resection. The pathological diagnosis was hyaline vascular type Castleman’s disease. No recurrence has been observed for seven years. Conclusion Because hyaline vascular type Castleman’s disease in solitary pulmonary hilar tumor is one of the benign diseases common in young people, intraoperative frozen section diagnosis is recommended to avoid unnecessary lung resection.
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Affiliation(s)
- Masaya Aoki
- Department of General Thoracic Surgery, Graduate School of Medical and Dental Sciences, Kagoshima University, 8-35-1 Sakuragaoka, Kagoshima, 890-8520, Japan.
| | - Go Kamimura
- Department of General Thoracic Surgery, Graduate School of Medical and Dental Sciences, Kagoshima University, 8-35-1 Sakuragaoka, Kagoshima, 890-8520, Japan
| | - Tadashi Umehara
- Department of General Thoracic Surgery, Graduate School of Medical and Dental Sciences, Kagoshima University, 8-35-1 Sakuragaoka, Kagoshima, 890-8520, Japan
| | - Aya Harada Takeda
- Department of General Thoracic Surgery, Graduate School of Medical and Dental Sciences, Kagoshima University, 8-35-1 Sakuragaoka, Kagoshima, 890-8520, Japan
| | - Yui Watanabe
- Department of General Thoracic Surgery, Graduate School of Medical and Dental Sciences, Kagoshima University, 8-35-1 Sakuragaoka, Kagoshima, 890-8520, Japan
| | - Koki Maeda
- Department of General Thoracic Surgery, Graduate School of Medical and Dental Sciences, Kagoshima University, 8-35-1 Sakuragaoka, Kagoshima, 890-8520, Japan
| | - Toshiyuki Nagata
- Department of General Thoracic Surgery, Graduate School of Medical and Dental Sciences, Kagoshima University, 8-35-1 Sakuragaoka, Kagoshima, 890-8520, Japan
| | - Tsunayuki Otsuka
- Department of General Thoracic Surgery, Graduate School of Medical and Dental Sciences, Kagoshima University, 8-35-1 Sakuragaoka, Kagoshima, 890-8520, Japan
| | - Masami Sato
- Department of General Thoracic Surgery, Graduate School of Medical and Dental Sciences, Kagoshima University, 8-35-1 Sakuragaoka, Kagoshima, 890-8520, Japan
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20
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Aoki M, Umehara T, Kamimura G, Imamura N, Morizono S, Nonaka Y, Tokunaga T, Takeda AH, Maeda K, Watanabe Y, Nagata T, Otsuka T, Yokomakura N, Kariatsumari K, Yanagi M, Sato M. Expression of Bone Morphogenetic Protein-7 Significantly Correlates With Non-small Cell Lung Cancer Progression and Prognosis: A Retrospective Cohort Study. Clin Med Insights Oncol 2019; 13:1179554919852087. [PMID: 31191069 PMCID: PMC6540490 DOI: 10.1177/1179554919852087] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/02/2018] [Accepted: 04/26/2019] [Indexed: 11/15/2022]
Abstract
Background Bone morphogenetic protein-7 (BMP-7) is a signaling molecule belonging to the transforming growth factor-β superfamily. Recent studies have demonstrated that BMP-7 is expressed in various human cancers and plays an important role in the progression of their cancers. The purpose of this study was to investigate the clinicopathologic and prognostic impact of BMP-7 expression in clinical samples of non-small cell lung cancer. Methods This study enrolled 160 patients with non-small cell lung cancer who underwent complete resection. Expression of BMP-7 in cancer tissue was evaluated by immunohistochemistry. Correlations between expression of BMP-7 and clinicopathologic factors and prognosis were analyzed. Results In non-small cell lung cancer, BMP-7 expression was identified not only in cell membranes but also in the cytoplasm of cancer cells. Expression of BMP-7 correlated with p-T (P = .047), N factor (P = .013), and p-stage (P = .046). Overall survival rate was significantly lower in the BMP-7-positive group than in the BMP-7-negative group (P = .004). Multivariate analysis indicated that BMP-7 expression was one of the independent prognosis factors of overall survival (P = .021). Furthermore, among patients with postoperative recurrence (n = 58), the BMP-7-positive group (n = 29) had a significantly poorer prognosis than the BMP-7-negative group (n = 29) (P = .012). Conclusions Expression of BMP-7 in non-small cell lung cancer was correlated with clinicopathologic factors and poorer prognosis. BMP-7 expression may be a useful predictor of aggressive activity of tumor behavior and postoperative outcome of patients with non-small cell lung cancer.
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Affiliation(s)
- Masaya Aoki
- Department of General Thoracic Surgery, Graduate School of Medical and Dental Sciences, Kagoshima University, Kagoshima, Japan
| | - Tadashi Umehara
- Department of General Thoracic Surgery, Graduate School of Medical and Dental Sciences, Kagoshima University, Kagoshima, Japan
| | - Go Kamimura
- Department of General Thoracic Surgery, Graduate School of Medical and Dental Sciences, Kagoshima University, Kagoshima, Japan
| | - Nobuhiro Imamura
- Department of General Thoracic Surgery, Graduate School of Medical and Dental Sciences, Kagoshima University, Kagoshima, Japan
| | - Shoichiro Morizono
- Department of General Thoracic Surgery, Graduate School of Medical and Dental Sciences, Kagoshima University, Kagoshima, Japan
| | - Yuto Nonaka
- Department of General Thoracic Surgery, Graduate School of Medical and Dental Sciences, Kagoshima University, Kagoshima, Japan
| | - Takuya Tokunaga
- Department of General Thoracic Surgery, Graduate School of Medical and Dental Sciences, Kagoshima University, Kagoshima, Japan
| | - Aya Harada Takeda
- Department of General Thoracic Surgery, Graduate School of Medical and Dental Sciences, Kagoshima University, Kagoshima, Japan
| | - Koki Maeda
- Department of General Thoracic Surgery, Graduate School of Medical and Dental Sciences, Kagoshima University, Kagoshima, Japan
| | - Yui Watanabe
- Department of General Thoracic Surgery, Graduate School of Medical and Dental Sciences, Kagoshima University, Kagoshima, Japan
| | - Toshiyuki Nagata
- Department of General Thoracic Surgery, Graduate School of Medical and Dental Sciences, Kagoshima University, Kagoshima, Japan
| | - Tsunayuki Otsuka
- Department of General Thoracic Surgery, Graduate School of Medical and Dental Sciences, Kagoshima University, Kagoshima, Japan
| | - Naoya Yokomakura
- Department of General Thoracic Surgery, Graduate School of Medical and Dental Sciences, Kagoshima University, Kagoshima, Japan
| | - Kota Kariatsumari
- Department of General Thoracic Surgery, Graduate School of Medical and Dental Sciences, Kagoshima University, Kagoshima, Japan
| | - Masakazu Yanagi
- Department of General Thoracic Surgery, Graduate School of Medical and Dental Sciences, Kagoshima University, Kagoshima, Japan
| | - Masami Sato
- Department of General Thoracic Surgery, Graduate School of Medical and Dental Sciences, Kagoshima University, Kagoshima, Japan
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21
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Aoki M, Umehara T, Kamimura G, Tokunaga T, Nagata T, Takeda A, Yokomakura N, Kariatsumari K, Yanagi M, Sato M. P2.01-08 Conversion Surgery for Locally Advanced Lung Adenocarcinoma Harboring Driver Gene Mutation After TKI Followed by Cytotoxic Agent. J Thorac Oncol 2018. [DOI: 10.1016/j.jtho.2018.08.1062] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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22
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Tokunaga T, Takeda A, Watanabe Y, Umehara T, Suzuki S, Kamimura G, Maeda K, Aoki M, Nagata T, Otsuka T, Yokomakura N, Kariatsumari K, Sakasegawa K, Nakamura Y, Yanagi M, Sato M. P2.16-004 Alternative Subpreural Lymph Flow Pathways in Human Lung – a Hundred Cases Experience and Analysis. J Thorac Oncol 2017. [DOI: 10.1016/j.jtho.2017.09.1413] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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23
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Umehara T, Aoki M, Kamimura G, Wakida K, Nagata T, Otsuka T, Sato M. Coil Intrabronchial Migration in an Arteriovenous Malformation Patient Treated 10 Years Ago. Ann Thorac Cardiovasc Surg 2017; 23:200-202. [PMID: 28450683 DOI: 10.5761/atcs.cr.16-00250] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
A 56-year-old male who had received transcatheter coil deposition 10 years ago for an arteriovenous malformation (AVM) was admitted to our hospital because of persistent hemosputum. Chest radiograph and bronchoscopy revealed straightened coil bundles in his air way. Recently, less invasive transcatheter intervention has been performed more frequently for treatment of AVM than surgical resection. In our case, however, chest radiography and bronchoscopy showed that the coils might migrate from the deposited site to the airway. Then, right lower lobectomy was undertaken. In AVM patient who received coil deposition, a long-term follow-up is recommended, and surgical resection should be carried out if necessary.
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Affiliation(s)
- Tadashi Umehara
- Department of General Thoracic Surgery, Graduate School of Medical and Dental Sciences, Kagoshima University, Kagoshima, Kagoshima, Japan
| | - Masaya Aoki
- Department of General Thoracic Surgery, Graduate School of Medical and Dental Sciences, Kagoshima University, Kagoshima, Kagoshima, Japan
| | - Go Kamimura
- Department of General Thoracic Surgery, Graduate School of Medical and Dental Sciences, Kagoshima University, Kagoshima, Kagoshima, Japan
| | - Kazuhiro Wakida
- Department of General Thoracic Surgery, Graduate School of Medical and Dental Sciences, Kagoshima University, Kagoshima, Kagoshima, Japan
| | - Toshiyuki Nagata
- Department of General Thoracic Surgery, Graduate School of Medical and Dental Sciences, Kagoshima University, Kagoshima, Kagoshima, Japan
| | - Tsunayuki Otsuka
- Department of General Thoracic Surgery, Graduate School of Medical and Dental Sciences, Kagoshima University, Kagoshima, Kagoshima, Japan
| | - Masami Sato
- Department of General Thoracic Surgery, Graduate School of Medical and Dental Sciences, Kagoshima University, Kagoshima, Kagoshima, Japan
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Harada A, Watanabe Y, Murakami Y, Nagata T, Kamimura G, Wakida K, Aoki M, Yokomakura N, Kariatsumari K, Nakamura Y, Hiraki T, Sato M. [Metastatic Lung Tumor Diagnosed as Primary Lung Cancer due to its Accompanying Lesion Mimicking Atypical Adenomatous Hyperplasia by Intraoperative Needle Biopsy Findings;Report of a Case]. Kyobu Geka 2016; 69:804-807. [PMID: 27476574] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/06/2023]
Abstract
We reported a case of metastatic lung tumor, which was suspected as being a primary lung cancer because of its accompanying lesion mimicking atypical adenomatous hyperplasia(AAH) based on intraoperative needle biopsy findings. AAH is a preinvasive lesion or marginal lesion of primary lung cancer that is not accompanied by metastatic tumor. However, it needs to be distinguished pathologically from secondary changes of inflammation or fibrosis. In our case, the needle biopsy revealed AAH-like pathological findings, which indicates a primary lung cancer, and the standard lobectomy with lymph node dissection was performed, however, the final diagnosis turned out to be metastatic tumor. The rapidly enlarging tumor led to surrounding obstructive pneumonitis, which may have caused pathological changes mimicking AAH findings. In the case of obstructive pneumonitis, we must be careful to diagnose AAH, in addition to decisions about the surgical procedure especially when based on frozen section diagnosis.
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Affiliation(s)
- Aya Harada
- Department of General Thoracic Surgery, Kagoshima University, Kagoshima, Japan
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25
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Kamimura G, Aoki M, Nakamura Y, Suenaga T, Sato M. [Esophageal Injury Treated with a Covered Expandable Metallic Stent]. Kyobu Geka 2016; 69:525-527. [PMID: 27365065] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/06/2023]
Abstract
We report a case of iatrogenic esophageal injury treated with a covered expandable metallic stent after thoracoscopic chest drainage. A 70-year-old man who had stricture of the esophagus after endoscopic submucosal dissection underwent balloon dilation. Chest computed tomography revealed esophageal rupture. Initially, continuous intra-esophageal drainage was carried out, however, due to the development of mediastinitis with enlarged abscess around the descending aorta and the left pneumothorax, thoracoscopic chest drainage was performed. Since direct closure was thought to be in appropriate, an intra-esophageal approach was chosen and a covered expandable metallic stent was mounted under fluorography on the next day. After the treatment, the patient was able to eat, and was able to discharge 42 days later. Intra-esophageal covered expandable metallic stent can be an alternative treatment for esophageal rupture.
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Affiliation(s)
- Go Kamimura
- Department of General Surgery and Gastrointestinal Surgery, Nanphu Hospital, Kagoshima, Japan
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26
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Wakida K, Watanabe Y, Kumasaka T, Seyama K, Mitani K, Hiraki T, Kamimura G, Nagata T, Nakamura Y, Sato M. Lymphangioleiomyomatosis in a Male. Ann Thorac Surg 2015; 100:1105-7. [PMID: 26354644 DOI: 10.1016/j.athoracsur.2014.11.069] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/20/2014] [Revised: 11/09/2014] [Accepted: 11/24/2014] [Indexed: 10/23/2022]
Abstract
We report a 17-year-old male with a histopathologic diagnosis of lymphangioleiomyomatosis after surgery for a pneumothorax. In general, lymphangioleiomyomatosis has been considered a female-specific disease. However, there are a few lymphangioleiomyomatosis cases reported in males, and our patient is the youngest case reported. Spontaneous pneumothorax occurs most commonly in males in their late teens and early twenties. Histopathologic diagnosis cannot always be performed in young males with pneumothorax. However, simple diagnosis should be avoided, and lymphangioleiomyomatosis should be considered as an underlying disease. This remarkable case provides new and valuable clinical insights into young male pneumothorax.
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Affiliation(s)
- Kazuhiro Wakida
- Department of General Thoracic Surgery, Graduate School of Medical and Dental Sciences, Kagoshima University, Kagoshima, Japan
| | - Yui Watanabe
- Department of General Thoracic Surgery, Graduate School of Medical and Dental Sciences, Kagoshima University, Kagoshima, Japan.
| | - Toshio Kumasaka
- Department of Pathology, Japanese Red Cross Medical Centre, Tokyo, Japan
| | - Kuniaki Seyama
- Division of Respiratory Medicine, Juntendo University Faculty of Medicine and Graduate School of Medicine, Tokyo, Japan
| | - Keiko Mitani
- Department of Human Pathology, Juntendo University Faculty of Medicine and Graduate School of Medicine, Tokyo, Japan
| | - Tsubasa Hiraki
- Department of Human Pathology, Graduate School of Medical and Dental Sciences, Kagoshima University, Kagoshima, Japan
| | - Go Kamimura
- Department of General Thoracic Surgery, Graduate School of Medical and Dental Sciences, Kagoshima University, Kagoshima, Japan
| | - Toshiyuki Nagata
- Department of General Thoracic Surgery, Graduate School of Medical and Dental Sciences, Kagoshima University, Kagoshima, Japan
| | - Yoshihiro Nakamura
- Department of General Thoracic Surgery, Graduate School of Medical and Dental Sciences, Kagoshima University, Kagoshima, Japan
| | - Masami Sato
- Department of General Thoracic Surgery, Graduate School of Medical and Dental Sciences, Kagoshima University, Kagoshima, Japan
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27
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Watanabe Y, Harada A, Aoki M, Kamimura G, Wakida K, Nagata T, Yokomakura N, Kariatsumari K, Nakamura Y, Sato M. Pulmonary Metastasectomy 31 Years After Surgery for Renal Cell Carcinoma. Ann Thorac Surg 2015; 99:2195-7. [DOI: 10.1016/j.athoracsur.2014.07.077] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/10/2014] [Revised: 07/23/2014] [Accepted: 07/30/2014] [Indexed: 10/23/2022]
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28
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Watanabe Y, Umehara T, Harada A, Aoki M, Tokunaga T, Suzuki S, Kamimura G, Wakida K, Nagata T, Otsuka T, Yokomakura N, Kariatsumari K, Nakamura Y, Watanabe Y, Sato M. Successful closure of a tracheocutaneous fistula after tracheostomy using two skin flaps: a case report. Surg Case Rep 2015; 1:43. [PMID: 26943408 PMCID: PMC4747946 DOI: 10.1186/s40792-015-0045-1] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/09/2015] [Accepted: 05/22/2015] [Indexed: 11/10/2022] Open
Abstract
A tracheocutaneous fistula may develop when a tracheostomy orifice epithelializes during a prolonged course of healing or undernutrition. Various techniques for closing such fistulae have been reported. However, a standard procedure has not yet been established. We, herein, present a case involving a 35-year-old woman who developed a tracheocutaneous fistula after tracheostomy. We closed the fistula using two skin flaps to cover the tracheal lumen and skin defect, respectively. The advantage of this technique is that it allows the tracheal lumen to be covered by inversed skin epithelium and ensures that the suture line of the skin does not match up with that of the subcutaneous tissue.
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Affiliation(s)
- Yui Watanabe
- Department of General Thoracic Surgery, Graduate School of Medical and Dental Sciences, Kagoshima University, 8-35-1 Sakuragaoka, Kagoshima, 890-8570, Japan.
| | - Tadashi Umehara
- Department of General Thoracic Surgery, Graduate School of Medical and Dental Sciences, Kagoshima University, 8-35-1 Sakuragaoka, Kagoshima, 890-8570, Japan
| | - Aya Harada
- Department of General Thoracic Surgery, Graduate School of Medical and Dental Sciences, Kagoshima University, 8-35-1 Sakuragaoka, Kagoshima, 890-8570, Japan
| | - Masaya Aoki
- Department of General Thoracic Surgery, Graduate School of Medical and Dental Sciences, Kagoshima University, 8-35-1 Sakuragaoka, Kagoshima, 890-8570, Japan
| | - Takuya Tokunaga
- Department of General Thoracic Surgery, Graduate School of Medical and Dental Sciences, Kagoshima University, 8-35-1 Sakuragaoka, Kagoshima, 890-8570, Japan
| | - Soichi Suzuki
- Department of General Thoracic Surgery, Graduate School of Medical and Dental Sciences, Kagoshima University, 8-35-1 Sakuragaoka, Kagoshima, 890-8570, Japan
| | - Go Kamimura
- Department of General Thoracic Surgery, Graduate School of Medical and Dental Sciences, Kagoshima University, 8-35-1 Sakuragaoka, Kagoshima, 890-8570, Japan
| | - Kazuhiro Wakida
- Department of General Thoracic Surgery, Graduate School of Medical and Dental Sciences, Kagoshima University, 8-35-1 Sakuragaoka, Kagoshima, 890-8570, Japan
| | - Toshiyuki Nagata
- Department of General Thoracic Surgery, Graduate School of Medical and Dental Sciences, Kagoshima University, 8-35-1 Sakuragaoka, Kagoshima, 890-8570, Japan
| | - Tsunayuki Otsuka
- Department of General Thoracic Surgery, Graduate School of Medical and Dental Sciences, Kagoshima University, 8-35-1 Sakuragaoka, Kagoshima, 890-8570, Japan
| | - Naoya Yokomakura
- Department of General Thoracic Surgery, Graduate School of Medical and Dental Sciences, Kagoshima University, 8-35-1 Sakuragaoka, Kagoshima, 890-8570, Japan
| | - Kota Kariatsumari
- Department of General Thoracic Surgery, Graduate School of Medical and Dental Sciences, Kagoshima University, 8-35-1 Sakuragaoka, Kagoshima, 890-8570, Japan
| | - Yoshihiro Nakamura
- Department of General Thoracic Surgery, Graduate School of Medical and Dental Sciences, Kagoshima University, 8-35-1 Sakuragaoka, Kagoshima, 890-8570, Japan
| | - Yuko Watanabe
- Department of Anesthesiology and Critical Care Medicine, Graduate School of Medical and Dental Sciences, Kagoshima University, Kagoshima, Japan
| | - Masami Sato
- Department of General Thoracic Surgery, Graduate School of Medical and Dental Sciences, Kagoshima University, 8-35-1 Sakuragaoka, Kagoshima, 890-8570, Japan
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