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A case of peripheral epidermoid carcinoma showing a fungus ball-like shadow
Abstracts NDPK/nm23 cxprcsdon in human lung cancer
and its comziatiou
/Lung
Cancer
with lymph node nMasta&
CYFBA21-1:Pmknkryexperiencesinbmnchialca&nomaandother tumors Hocfliger M, Monnt R, Ricsen W, Baumgartner G, Engler H. Insl. fur K/in. Chemie/Hamotologie. Kantonsspital, CH-9007 St. Gallen. Schweiz Med Wochcnschr 1994;124:1%6-70. CYFRA 21-I (CYFRA) is a new hmwr-associated marker wfiich appears to be useful in monitoring non-small ccl1 bronchial carcinoma. We examined I93 scra from tumor patients (92 of whom had bronchial carcinoma), and 62 patients with benign lung disease. Sensitivity and specificity of CYFRA was compared with that of CEA, TPA, TPS and SCC in squamous cell bronchial carcinoma and with that ofNSE in small cell bronchial carcinoma. The sensitivity of CYFRA in other hmwr localizations was also assessed. In squamous cell bronchial carcinoma CYFRA proved to be the best marker with respect to sensitivity (58%) and specificity (98%). In gastrointestinal tumors CYFRA bed a similar sensitivity to CEA. Since the two markers do not correlate their sensitivity is additive. In conclusion, CYFRA is continned as marker of first choice in squamous cell bronchial carcinoma. In other tumors CYFRA displayed a similar sensitivity ta CEA.
bypositmn
emi.udi~tomo-gmpby
Knapp Mv, Bischoff HG. Forschungsschwerpunkt, Radiologische DiagnostikI Therapie, Deutsches Krebsforschungszenbum, Im Neuenheimw Feld 280, D69120 Heidelberg. Radiologic 1994,34:588-91. Positron emission tomography (PET) with fluor-I8-labeled dcoxyglucose (FDG) enables metabolically oriented imaging of intrapulmonary lesions. PET is currently not used for the detection of lung me&stases, but for further diagnostic differentiation of nodulestbat haveaheady been det&ed. The diagnostic accuracy of FDG-PET is currently dependent on the size of the metestatic lesions and the uptake intensity. Significantly increased FDG uptake is strongly suggestive of malignant disease whatever the size of lesion concerned. Differentiation of a solitary metastasis fmm a primary lung tumor is not possible. Slightly elevated FDG uptakecan also be found in tuberculosis, sarcoidosis and other granulometous or inflammatory processes. Exclusion of metes&tic disease with PET is currently only reliably possible for lesions larger than 2.0 cm in diameter, owing to respiratory motion and effects of prtisl volume.
A cast of small cell lung cancer associated
with fulmioant
hepatitis
265-329
A cast of peripheral
Lci W, Zhang R, Yan S. Cancer Hospital, Chinese Academy ofMedica1Sciences. Beijing IOOOtl. Chin JOncal 1994;16:277-9. Using labcllcd strcptavidin-biotin (LSAB) method, we examined the expression of nucleosidc diphosphate kinwe (NDPK), the product of metastasis suppressor gene nm23, in human lung cancer. Of 88 patients tested, 48 (54.5%) showed positive staining. The positive staining rate was higher in adcnocarcinoma (28/42,66.7%) than in squamous cell carcinoma (20/46,43.5%, P < 0.05). Higher incidence of positive staining was also found in squamous cell carcinoma without hilar or mcdiastinal lymph node metastasis (16/27, 59.3%) than in that with hilar or mediastinal lymph node involvement (4119, 21.1%; P < 0.05). NDPK/nm23 was equally expressed in adcnocarcinoma irrespective of lymph node status. In both cell types of carcinoma, expression of NDPWnm23 was not correlated with tumor cell differentiation, nor we8 it correlated with the P-TNM staging. Our results suggest that NDPWnm23 may play different roles in the pathogcncsis and metastasis of human pulmonary squamous cell carcinoma and adenocaminoma. Its expression levels an inversely oorrcieted with lymph node metastasis in squamous cell carcinoma.
Evahtationofintrapulmmaqnod~
I2 (1995)
B
Watanabe Y, Tanaka H, Ogewa M, Tanaka T, Tantiwe M. Deparbnenf ofInfernal Medicine. Kamo Hospital, 3-17, Moroshim, Toyota. Aichi. Jpn J Thorac Dis 1994;32:894-8. A 48-year-old man ~88 admitted to our hospital hecause of upper abdominal pain, and a cervical tumor, on Oct. 23, 1992. Chest X-ray, CT scan and MRI revealed a hrmor ~cf&SlO) and enlarged mediastinal lymph nodes. A pathological diagnosis of smell cell lung cancer was made by transbronchial biopsy. Ultrasonography showed liver metastases. He received four courses of chemotherapy (Carboplatin, Ifosfamidc, Etoposidc). Three days after the completion ofchemotherapy, his serum transaminasclcvel was markedly increased, and he was disorientated on March 4,1993. In spite of plasma exchange, the patient died due to hepatic failure on March 6, 1993. Fulminant hepatitis in a patient with lung cancer receiving chemotherapy is rarely reported.
epidennoid
carcinoma
showiag
a runguS ball-like
Komiye T, Matsushima T, Kimura M, Koyama I. Second Dept. oflnfernal Medicine. Kawasaki Medical School. Kawasaki Hospital, Kwoshiki 701-01. Lung Cancer (Japan) 1994;34:965-9. A 52-year-old female was admitted to our hospital because of hemoptysis. A chest X-ray showed a cavity in the left middle lung field in which a fungus bell-like material was recognized by tomography and CT. The nodule deaeased in size over several days, and the fungus ball-like material also disappeared. We diagnosed the lesion lls epidcrmoid carcinoma based on the microscopic tindings of biopsied material. Regarding the macroscopic and microscopic findings of surgical specimen, there was only a small amount of blood clot without any fungus in the cavity. From the patient’s histmy of hemoptysis and the blood clot found in the fungus bell-like shadow removed during the operation, we considered it to have been related to the blood clot and bleeding in the carcinomatous cavity.
Acasc
of synchronous
quadruple
lungcancer
Fu~kawa T, Koyanagi K. Soejima Y, Sugihara M, Yoshida T. Depotfment of Surgery, Koseikan Saga Prefectural Hospital, Saga Lung Cancer (Japan) 1994;34:95964. A SO-year-old male was admitted to our hospital with a complaint of hcmosputum. Bmnchoscopy revealed 4 independent lesions in right B,, right B’, the orifice of the right lower lobe bmnchus, and in letI B”‘. All four lesions showed squamous cell carcinoma by bronchoseopic biopsy. It seemed impossible that all four lesions could be reswted surgically. We selected a combination of laser therapy, radiation therapy end additional chemotherapy. The disappearance of all 4 lesions was demonstrated by bmnchoscopic biopsies at the time of discharge. Following-up every three months by bronchoscopy, we continued Law therapy only for the lesion at the orifice of the right lower lobe bronchus. The patient is alive for two years since the beginning of treatment without eny sign of recurrence.
A case of GCSF leucocytosis
producing
lung cancer detected
on examination
for
Kokuba M, Ishikawa K, Tateyama K, Sugiyama A, Katayama M, Takami T. Deporbnent of Surgery. National Tohsei Hospital, Giju UniversiQ School of Medicine. T~kosa-mochi 40. G~J~I500. LUng Cancer (Japan) 1994,34:955-8. A 52-year-old man wes admitted to our hospital because of leucocytosis (15000/mm’) detected by a medical check-up. Chest X-ray revealed a tumor shadow in the right upper lung field. Brushing cytology revealed class V Laboratory data showed increased CRP (6.4 mg/dl). Serum G-CSF was 60.4 pgiml (normal 4 30). Right upper lobectomy (pT2NOMO) was performed in June, 1993. Histological study revealed giant cell type large cell carcinoma. ImmunOhistochcmical study showed that tumor cells stained positively with antirecombinant human G-GSF monoclonal antibody. This finding indicated production of G-CSF by the hunor cells. Postoperative laboratory data showed e normal serum GCSF level and a normal CRP level.
A case of rapidly fetopmtein
growing
primary
lung cancer
producing
alpha-
Kubote M, Tsubota N. Yoshimura M, Murotani A, Sakamoto T. Department of Surges, Konan Hospiral, Hyogo Medical Cente,: Hyogo. Lung Cancer (Japan) 1994;34:923-9. A S3-year-old man had a rapidly growing hlmor in the right pleural cavity with positive Ga scintigraphy tindings and a serum alpha-fetoprotein level of 296 rig/ml. CT scan, echogrephy and scintigmphy showed no space-occupying lesions in the liver. Moreover there were giant bullae on the contralateral side. Right upper and middle lobcctomy with S6 scgmentectomy wes pcrfomcd in order to preserve lung function. This T2N2MO case was poorly differentiated adenocarcinoma postoperatively and the serum AFP level returned to the normal range. His perfomww status is good and there has been no recurrence 22 months after surgery. The immunocnzyme labeling technique using the peroxidaseantiperoxidase method confirmed AFP secretion by this tumor. E-PHA affmity electrophoresis of AFP from serum showed a different pattern from primary hepatocellular carcinoma. This rare case was diagnosed primary lung cancer producing AFP.
and its comziatiou
/Lung
Cancer
with lymph node nMasta&
CYFBA21-1:Pmknkryexperiencesinbmnchialca&nomaandother tumors Hocfliger M, Monnt R, Ricsen W, Baumgartner G, Engler H. Insl. fur K/in. Chemie/Hamotologie. Kantonsspital, CH-9007 St. Gallen. Schweiz Med Wochcnschr 1994;124:1%6-70. CYFRA 21-I (CYFRA) is a new hmwr-associated marker wfiich appears to be useful in monitoring non-small ccl1 bronchial carcinoma. We examined I93 scra from tumor patients (92 of whom had bronchial carcinoma), and 62 patients with benign lung disease. Sensitivity and specificity of CYFRA was compared with that of CEA, TPA, TPS and SCC in squamous cell bronchial carcinoma and with that ofNSE in small cell bronchial carcinoma. The sensitivity of CYFRA in other hmwr localizations was also assessed. In squamous cell bronchial carcinoma CYFRA proved to be the best marker with respect to sensitivity (58%) and specificity (98%). In gastrointestinal tumors CYFRA bed a similar sensitivity to CEA. Since the two markers do not correlate their sensitivity is additive. In conclusion, CYFRA is continned as marker of first choice in squamous cell bronchial carcinoma. In other tumors CYFRA displayed a similar sensitivity ta CEA.
bypositmn
emi.udi~tomo-gmpby
Knapp Mv, Bischoff HG. Forschungsschwerpunkt, Radiologische DiagnostikI Therapie, Deutsches Krebsforschungszenbum, Im Neuenheimw Feld 280, D69120 Heidelberg. Radiologic 1994,34:588-91. Positron emission tomography (PET) with fluor-I8-labeled dcoxyglucose (FDG) enables metabolically oriented imaging of intrapulmonary lesions. PET is currently not used for the detection of lung me&stases, but for further diagnostic differentiation of nodulestbat haveaheady been det&ed. The diagnostic accuracy of FDG-PET is currently dependent on the size of the metestatic lesions and the uptake intensity. Significantly increased FDG uptake is strongly suggestive of malignant disease whatever the size of lesion concerned. Differentiation of a solitary metastasis fmm a primary lung tumor is not possible. Slightly elevated FDG uptakecan also be found in tuberculosis, sarcoidosis and other granulometous or inflammatory processes. Exclusion of metes&tic disease with PET is currently only reliably possible for lesions larger than 2.0 cm in diameter, owing to respiratory motion and effects of prtisl volume.
A cast of small cell lung cancer associated
with fulmioant
hepatitis
265-329
A cast of peripheral
Lci W, Zhang R, Yan S. Cancer Hospital, Chinese Academy ofMedica1Sciences. Beijing IOOOtl. Chin JOncal 1994;16:277-9. Using labcllcd strcptavidin-biotin (LSAB) method, we examined the expression of nucleosidc diphosphate kinwe (NDPK), the product of metastasis suppressor gene nm23, in human lung cancer. Of 88 patients tested, 48 (54.5%) showed positive staining. The positive staining rate was higher in adcnocarcinoma (28/42,66.7%) than in squamous cell carcinoma (20/46,43.5%, P < 0.05). Higher incidence of positive staining was also found in squamous cell carcinoma without hilar or mcdiastinal lymph node metastasis (16/27, 59.3%) than in that with hilar or mediastinal lymph node involvement (4119, 21.1%; P < 0.05). NDPK/nm23 was equally expressed in adcnocarcinoma irrespective of lymph node status. In both cell types of carcinoma, expression of NDPWnm23 was not correlated with tumor cell differentiation, nor we8 it correlated with the P-TNM staging. Our results suggest that NDPWnm23 may play different roles in the pathogcncsis and metastasis of human pulmonary squamous cell carcinoma and adenocaminoma. Its expression levels an inversely oorrcieted with lymph node metastasis in squamous cell carcinoma.
Evahtationofintrapulmmaqnod~
I2 (1995)
B
Watanabe Y, Tanaka H, Ogewa M, Tanaka T, Tantiwe M. Deparbnenf ofInfernal Medicine. Kamo Hospital, 3-17, Moroshim, Toyota. Aichi. Jpn J Thorac Dis 1994;32:894-8. A 48-year-old man ~88 admitted to our hospital hecause of upper abdominal pain, and a cervical tumor, on Oct. 23, 1992. Chest X-ray, CT scan and MRI revealed a hrmor ~cf&SlO) and enlarged mediastinal lymph nodes. A pathological diagnosis of smell cell lung cancer was made by transbronchial biopsy. Ultrasonography showed liver metastases. He received four courses of chemotherapy (Carboplatin, Ifosfamidc, Etoposidc). Three days after the completion ofchemotherapy, his serum transaminasclcvel was markedly increased, and he was disorientated on March 4,1993. In spite of plasma exchange, the patient died due to hepatic failure on March 6, 1993. Fulminant hepatitis in a patient with lung cancer receiving chemotherapy is rarely reported.
epidennoid
carcinoma
showiag
a runguS ball-like
Komiye T, Matsushima T, Kimura M, Koyama I. Second Dept. oflnfernal Medicine. Kawasaki Medical School. Kawasaki Hospital, Kwoshiki 701-01. Lung Cancer (Japan) 1994;34:965-9. A 52-year-old female was admitted to our hospital because of hemoptysis. A chest X-ray showed a cavity in the left middle lung field in which a fungus bell-like material was recognized by tomography and CT. The nodule deaeased in size over several days, and the fungus ball-like material also disappeared. We diagnosed the lesion lls epidcrmoid carcinoma based on the microscopic tindings of biopsied material. Regarding the macroscopic and microscopic findings of surgical specimen, there was only a small amount of blood clot without any fungus in the cavity. From the patient’s histmy of hemoptysis and the blood clot found in the fungus bell-like shadow removed during the operation, we considered it to have been related to the blood clot and bleeding in the carcinomatous cavity.
Acasc
of synchronous
quadruple
lungcancer
Fu~kawa T, Koyanagi K. Soejima Y, Sugihara M, Yoshida T. Depotfment of Surgery, Koseikan Saga Prefectural Hospital, Saga Lung Cancer (Japan) 1994;34:95964. A SO-year-old male was admitted to our hospital with a complaint of hcmosputum. Bmnchoscopy revealed 4 independent lesions in right B,, right B’, the orifice of the right lower lobe bmnchus, and in letI B”‘. All four lesions showed squamous cell carcinoma by bronchoseopic biopsy. It seemed impossible that all four lesions could be reswted surgically. We selected a combination of laser therapy, radiation therapy end additional chemotherapy. The disappearance of all 4 lesions was demonstrated by bmnchoscopic biopsies at the time of discharge. Following-up every three months by bronchoscopy, we continued Law therapy only for the lesion at the orifice of the right lower lobe bronchus. The patient is alive for two years since the beginning of treatment without eny sign of recurrence.
A case of GCSF leucocytosis
producing
lung cancer detected
on examination
for
Kokuba M, Ishikawa K, Tateyama K, Sugiyama A, Katayama M, Takami T. Deporbnent of Surgery. National Tohsei Hospital, Giju UniversiQ School of Medicine. T~kosa-mochi 40. G~J~I500. LUng Cancer (Japan) 1994,34:955-8. A 52-year-old man wes admitted to our hospital because of leucocytosis (15000/mm’) detected by a medical check-up. Chest X-ray revealed a tumor shadow in the right upper lung field. Brushing cytology revealed class V Laboratory data showed increased CRP (6.4 mg/dl). Serum G-CSF was 60.4 pgiml (normal 4 30). Right upper lobectomy (pT2NOMO) was performed in June, 1993. Histological study revealed giant cell type large cell carcinoma. ImmunOhistochcmical study showed that tumor cells stained positively with antirecombinant human G-GSF monoclonal antibody. This finding indicated production of G-CSF by the hunor cells. Postoperative laboratory data showed e normal serum GCSF level and a normal CRP level.
A case of rapidly fetopmtein
growing
primary
lung cancer
producing
alpha-
Kubote M, Tsubota N. Yoshimura M, Murotani A, Sakamoto T. Department of Surges, Konan Hospiral, Hyogo Medical Cente,: Hyogo. Lung Cancer (Japan) 1994;34:923-9. A S3-year-old man had a rapidly growing hlmor in the right pleural cavity with positive Ga scintigraphy tindings and a serum alpha-fetoprotein level of 296 rig/ml. CT scan, echogrephy and scintigmphy showed no space-occupying lesions in the liver. Moreover there were giant bullae on the contralateral side. Right upper and middle lobcctomy with S6 scgmentectomy wes pcrfomcd in order to preserve lung function. This T2N2MO case was poorly differentiated adenocarcinoma postoperatively and the serum AFP level returned to the normal range. His perfomww status is good and there has been no recurrence 22 months after surgery. The immunocnzyme labeling technique using the peroxidaseantiperoxidase method confirmed AFP secretion by this tumor. E-PHA affmity electrophoresis of AFP from serum showed a different pattern from primary hepatocellular carcinoma. This rare case was diagnosed primary lung cancer producing AFP.