Ultra-thin endoscopic findings of bronchioloalveolar carcinoma

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210 Abstractdtung Gntcer 13 (1995) 185-232 An 8 mm peripheral luog adeoocarcinoma detected by routine sputum cytologic screening Suzuki N, Kitamura S. Department of Pulmonaty Medicine, Jichi Medical School, Tochigt. Jpn J Lung Cancer 1995;35:61-72. A 59-year-old man was admitted to our hospital for evaluation of atypical cells (group E: Class IV or V) found on routine spunmr cytologic screeningfor lung cancer. A chest radiograph showed hilar lymphadeno- pathy. Computed tomography (CT) of the chest showed a mass of 8 mm in diameter in the periphery of the right lung. However, repeated spubmr cytologic examinations and endoscopy found no evidence ofmalignancy. The tumor size increased over 4 months. Percutaneous ultrasonography- guided fine needle aspiration of the mass showed a cluster of atypical cells, suggesting adenocarcinoma. At surgery, the tumor was found to be accompanied by multiple disseminated nodules and a small amount of cancemus pleural fluid. Histologically, a diagnosis of welldiflbren- tiated papillary adenocarcinorna was established. The prognosis of sputum cytology-positive adenocarcinoma is poor, regardless of the tumor size. Immediate diagnostic and therapeutic work-ups are recommended. Ultra-thin eodoscopic findings of bronchioloalveolar carcinoma Tanaka M, Takl Y, Kohda E, Satoh M, Okada Y, Yamasawa F et al. Department of Diagnostic Radiology, School of Medicine. Keio University, Tokyo. Jpn J Lung Cancer 1995;35:29-34. We reviewed computed tomographic scans and ultra-thin bmncho- scopic findings of 5 cases of bmnchloloalveolar carcinoma, 1 with a solitary nodule (SN),, 1 with diffuse miliary nodules similar to metastatlc tumor @MN), and 3 with radiographic patterns suggestive of pneumonia (RPSP) rcentgenologically. Endoscepictindings showed abundant frothy secretions from respiratory bronchioles, sputum due to occlusion, and diffuse polypoid lesions in patients with RPSP Diffuse polypoid lesions may suggest the invasive pattern of bronchioloalveolar carcinoma. We observed a tumor in the SN patient, stenosis and paleness of the mucosal surface of the bronchioles in the DMN patient. Clinical study of adenosquamous carcinoma of the lung in 34 patients Mizushima Y, Fujishita T, Sugiyama S, Salto H, Kusajima Y, Noto H et al. IDepartment ofInternolMedicine. ToyamaA4edicaUPharmaceutical Univ., Toyama. Jpn J Lung Cancer 1995;35:23-8. Clinical features of adenosquamous carcinoma of the lung were studied in 34 cases who met the Japan Lung Cancer Society Classi- fication criteria. The male to female ratio was 3: 9, mean age was 63.0 years old, the ratio of peripheral to central type was 34:0, and the positive rate for CEA was 69%, which suggested adenocarcinoma rather than squamous cell carcinoma. The diagnostic accuracy prior to therapy was 6% (2/34). In all cases, adenosquamous carcinoma showed significantly poorer prognosis than $denocarcinoma. Clinical features of adeno- squamous carcinoma were reviewed with regard to previous reports. The relationship between the immunodetection of transforming growth factor-0 in lung adenocarcinoma and longer survival rates Inoue T, Ishida T, Takenoyama M, Sugio K, Sugimachi K. Department ojSwgery II, Faculty ofMedicine, Kpshu Universi@, Maidashi 3-1- 1, Higashi-ku, Fukuoka 812. Surg Oncol 1995;4:51-7. We immunohistochemically examined the expression of transforming growth factor-g (TGF-g) on tissue specimens fmm primary 124 human lung adenocarcinoma, using a pelyclonal antibody. The overall mean immunoreactivity of TGF-8 was 25.7 f 22.9, therefore we separated patients into two groups according to their mean immunoreactivity. There were 59 (48%) with a high TGF-0 and 65 (52%) with a low TGF-g. No correlation was observed between the expression of TGF-13 and clinicopathological factors except for degree of differentiation. The 5-year survival rates of patients with high and low TGF-g were 7l%and 37%, respectively (P < 0.05). A multivariate analysis using the C’ox life table regression model showed TGF-g to be a significantly independent factor. We thus concluded, based on our findings, that the expression of TGF-g was found to be related to a better prognosis. Therefore, estimating the negative cell proliferation activity induced by TGF-g on immunohistochemical technique is considered to he useful for determining the patients’ prognosis in cases of lung adenocarcinoma. Staining pattern of type IV collagen and prognosis in early stage adenocarcinoma of the lung Watanabe N, Nakajima I, Abe S, Ogura S, Iwbe H, Kawakami Y. First Department of Medicine. School of Medicine, Hokkaido CJniversi@, NIS, W7, Kttaku. Sappow 060. J Clin Pathol 1994;47:613-5. Aims - To examine the prognostic value of basement membrane expression in early stage adenocarcinoma of the lung. Methods -Using antibodies to type IV collagen, basement membrane expression at the tumour-stromal border was immunohistcchemically analysed in 30 patients with early stage adenocarcinoma of the lung @stage I and pstage II). lXv0 patterns of staining for type IV collagen were observed: in the first one the staining line was conserved or partially fragmented; in the second the staining Line was widely fragmented or absent in more than 10% of the tumour area. The first staining pattern was categorised as continuous and the second as discontinuous. Results - Ofthe 24 patients with pstage I adenocarcinoma, 12 (50%) cases showed acontinuous pattern. In only one (16.7%) of the six patients with pstage II adenocarcinoma was this pattern evident. Fii year survival was greater in pstage I adenocarcinoma (65%) than in pstage II adenocarcinoma (17%). but the difference was not significant. When the analysis was restricted to the 24 patients with pstage I adenocarcinoma, five year survival was better in continuous pattern cases (88%) than in discontinuous pattern cases (20.5%) @ < 0.05). The survival curve of 12 patients with pstage I adenocarcinoma and a discontinuous pattern resembled that of the six patients with pstage II adenocarcinoma. Conclusion - These findings suggest that patients with pstage I adenocarcinoma and a discontinuous pattern have histopathologially unrecognised micrometastasis when they come to surgery, The staining pattern of type IV collagen could help in the prognosis of pstage I adenocarcinoma of the lung alter surgery. Decline of posttreatmeot tumor marker levels tier therapy of noosmali cell lung cancer: A useful outcome predictor Spiridonidis CH, L&man LR, Stydnicki KA, Noltimier JW, Cho CC, Young DC et al. 8100 Ravines Edge Court, Columbus, OH 43235. Cancer 1995;75:1586-93. Background. The assessment of treatment efficacy in nonsmall cell lung cancer (NSCLC) is limited by the lack of a clear association between clinical response and survival. The prognostic usefulness of treatment- induced tumor- marker declines in NSCLC has not been established. The authors investigated the prognostic significance of treatment- induced declination in tumor marker levels ofcarcinoembryonic antigen, CA 19-9, and CA 125 in a group of patients with NSCLC treated with a brief course of cisplatin-based chemotherapy. Metho&. Eighty-three patients with NSCLC enrolled on 2 related treatment protocols had pretreatment tumor-marker determinations. Patients were restaged 10 to 12 weeks after study entry, and clinical and marker responses were determined. Results. Thirty-eight patients (46%) had elevated

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210 Abstractdtung Gntcer 13 (1995) 185-232

An 8 mm peripheral luog adeoocarcinoma detected by routine sputum cytologic screening Suzuki N, Kitamura S. Department of Pulmonaty Medicine, Jichi Medical School, Tochigt. Jpn J Lung Cancer 1995;35:61-72.

A 59-year-old man was admitted to our hospital for evaluation of atypical cells (group E: Class IV or V) found on routine spunmr cytologic screeningfor lung cancer. A chest radiograph showed hilar lymphadeno- pathy. Computed tomography (CT) of the chest showed a mass of 8 mm in diameter in the periphery of the right lung. However, repeated spubmr cytologic examinations and endoscopy found no evidence ofmalignancy. The tumor size increased over 4 months. Percutaneous ultrasonography- guided fine needle aspiration of the mass showed a cluster of atypical cells, suggesting adenocarcinoma. At surgery, the tumor was found to be accompanied by multiple disseminated nodules and a small amount of cancemus pleural fluid. Histologically, a diagnosis of welldiflbren- tiated papillary adenocarcinorna was established. The prognosis of sputum cytology-positive adenocarcinoma is poor, regardless of the tumor size. Immediate diagnostic and therapeutic work-ups are recommended.

Ultra-thin eodoscopic findings of bronchioloalveolar carcinoma Tanaka M, Takl Y, Kohda E, Satoh M, Okada Y, Yamasawa F et al. Department of Diagnostic Radiology, School of Medicine. Keio University, Tokyo. Jpn J Lung Cancer 1995;35:29-34.

We reviewed computed tomographic scans and ultra-thin bmncho- scopic findings of 5 cases of bmnchloloalveolar carcinoma, 1 with a solitary nodule (SN),, 1 with diffuse miliary nodules similar to metastatlc tumor @MN), and 3 with radiographic patterns suggestive of pneumonia (RPSP) rcentgenologically. Endoscepictindings showed abundant frothy secretions from respiratory bronchioles, sputum due to occlusion, and diffuse polypoid lesions in patients with RPSP Diffuse polypoid lesions may suggest the invasive pattern of bronchioloalveolar carcinoma. We observed a tumor in the SN patient, stenosis and paleness of the mucosal surface of the bronchioles in the DMN patient.

Clinical study of adenosquamous carcinoma of the lung in 34 patients Mizushima Y, Fujishita T, Sugiyama S, Salto H, Kusajima Y, Noto H et al. IDepartment ofInternolMedicine. ToyamaA4edicaUPharmaceutical Univ., Toyama. Jpn J Lung Cancer 1995;35:23-8.

Clinical features of adenosquamous carcinoma of the lung were studied in 34 cases who met the Japan Lung Cancer Society Classi- fication criteria. The male to female ratio was 3: 9, mean age was 63.0 years old, the ratio of peripheral to central type was 34:0, and the positive rate for CEA was 69%, which suggested adenocarcinoma rather than squamous cell carcinoma. The diagnostic accuracy prior to therapy was 6% (2/34). In all cases, adenosquamous carcinoma showed significantly poorer prognosis than $denocarcinoma. Clinical features of adeno- squamous carcinoma were reviewed with regard to previous reports.

The relationship between the immunodetection of transforming growth factor-0 in lung adenocarcinoma and longer survival rates Inoue T, Ishida T, Takenoyama M, Sugio K, Sugimachi K. Department ojSwgery II, Faculty ofMedicine, Kpshu Universi@, Maidashi 3-1- 1, Higashi-ku, Fukuoka 812. Surg Oncol 1995;4:51-7.

We immunohistochemically examined the expression of transforming growth factor-g (TGF-g) on tissue specimens fmm primary 124 human lung adenocarcinoma, using a pelyclonal antibody. The overall mean immunoreactivity of TGF-8 was 25.7 f 22.9, therefore we

separated patients into two groups according to their mean immunoreactivity. There were 59 (48%) with a high TGF-0 and 65 (52%) with a low TGF-g. No correlation was observed between the expression of TGF-13 and clinicopathological factors except for degree of differentiation. The 5-year survival rates of patients with high and low TGF-g were 7l%and 37%, respectively (P < 0.05). A multivariate analysis using the C’ox life table regression model showed TGF-g to be a significantly independent factor. We thus concluded, based on our findings, that the expression of TGF-g was found to be related to a better prognosis. Therefore, estimating the negative cell proliferation activity induced by TGF-g on immunohistochemical technique is considered to he useful for determining the patients’ prognosis in cases of lung adenocarcinoma.

Staining pattern of type IV collagen and prognosis in early stage adenocarcinoma of the lung Watanabe N, Nakajima I, Abe S, Ogura S, Iwbe H, Kawakami Y. First Department of Medicine. School of Medicine, Hokkaido CJniversi@, NIS, W7, Kttaku. Sappow 060. J Clin Pathol 1994;47:613-5.

Aims - To examine the prognostic value of basement membrane expression in early stage adenocarcinoma of the lung. Methods -Using antibodies to type IV collagen, basement membrane expression at the tumour-stromal border was immunohistcchemically analysed in 30 patients with early stage adenocarcinoma of the lung @stage I and pstage II). lXv0 patterns of staining for type IV collagen were observed: in the first one the staining line was conserved or partially fragmented; in the second the staining Line was widely fragmented or absent in more than 10% of the tumour area. The first staining pattern was categorised as continuous and the second as discontinuous. Results - Ofthe 24 patients with pstage I adenocarcinoma, 12 (50%) cases showed acontinuous pattern. In only one (16.7%) of the six patients with pstage II adenocarcinoma was this pattern evident. Fii year survival was greater in pstage I adenocarcinoma (65%) than in pstage II adenocarcinoma (17%). but the difference was not significant. When the analysis was restricted to the 24 patients with pstage I adenocarcinoma, five year survival was better in continuous pattern cases (88%) than in discontinuous pattern cases (20.5%) @ < 0.05). The survival curve of 12 patients with pstage I adenocarcinoma and a discontinuous pattern resembled that of the six patients with pstage II adenocarcinoma. Conclusion - These findings suggest that patients with pstage I adenocarcinoma and a discontinuous pattern have histopathologially unrecognised micrometastasis when they come to surgery, The staining pattern of type IV collagen could help in the prognosis of pstage I adenocarcinoma of the lung alter surgery.

Decline of posttreatmeot tumor marker levels tier therapy of noosmali cell lung cancer: A useful outcome predictor Spiridonidis CH, L&man LR, Stydnicki KA, Noltimier JW, Cho CC, Young DC et al. 8100 Ravines Edge Court, Columbus, OH 43235. Cancer 1995;75:1586-93.

Background. The assessment of treatment efficacy in nonsmall cell lung cancer (NSCLC) is limited by the lack of a clear association between clinical response and survival. The prognostic usefulness of treatment- induced tumor- marker declines in NSCLC has not been established. The authors investigated the prognostic significance of treatment- induced declination in tumor marker levels ofcarcinoembryonic antigen, CA 19-9, and CA 125 in a group of patients with NSCLC treated with a brief course of cisplatin-based chemotherapy. Metho&. Eighty-three patients with NSCLC enrolled on 2 related treatment protocols had pretreatment tumor-marker determinations. Patients were restaged 10 to 12 weeks after study entry, and clinical and marker responses were determined. Results. Thirty-eight patients (46%) had elevated