Guide sheath breakage during endobronchial ultrasonography.

This report describes a case of guide sheath breakage during endobronchial ultrasonography. While steering the guide sheath in the direction of a peripheral lung nodule using a guiding device/curette, the radiopaque band (RB) attached to the head of the guide sheath dislodged and remained in the peripheral bronchus near the tumour. The band could not be removed endoscopically.

Neo-generation of neogenetic bullae after surgery for spontaneous pneumothorax in young adults: a prospective study.

Background: To investigate the development of neogenetic bullae or blebs on 1-year postoperative chest computed tomography after video-assisted thoracic surgery (VATS) in young patients with primary spontaneous pneumothorax (PSP).

Methods: In this prospective study, 10- to 20-year-old patients with PSP were treated via VATS with additional procedures (bullectomy, cold coagulation, coverage, pleural abrasion, or chemical pleurodesis). All patients underwent the additional procedures and computed tomography of the chest 1 year postoperatively for the assessment of neogenetic bullae.

Thymectomy during Myasthenic Crisis under Artificial Respiration.

A 34-year-old man was diagnosed with thymoma, which was evaluated preoperatively as stage II or III, with myasthenia gravis (MG). The size of the tumor was 70 × 44 × 80 mm. No invasion to neighboring organs was observed.

[Surgical Treatment for Synchronous Double Cancer of the Thoracic Esophagus and Lung].

We herein report 2 cases of radical operation for synchronous double cancer of the thoracic esophagus and each side of the lung. Case 1:A 71-year-old woman with synchronous double cancer of the thoracic esophagus (Mt, T3N2M0, Stage III) and right lung (M, T2aN0M0, Stage I B) underwent esophagectomy concomitantly with right middle lobectomy through right thoracotomy (single-stage operation) after 2 courses of systemic chemotherapy with docetaxel, cisplatin and 5-fluorouracil( DCF regimen). Case 2:A 72-year-old man with synchronous double cancer of the thoracic esophagus( MtLt, T3N2M0, Stage III) and left lung( U, T1aN0M0, Stage I A) underwent 2-stage operation after 2 courses of the DCF therapy.

Primary and Secondary Spontaneous Pneumothorax: Prevalence, Clinical Features, and In-Hospital Mortality.

. Optimal treatment practices and factors associated with in-hospital mortality in spontaneous pneumothorax (SP) are not fully understood. We evaluated prevalence, clinical characteristics, and in-hospital mortality among Japanese patients with primary or secondary SP (PSP/SSP).

Invasive Thymoma with Pure Red Cell Aplasia and Amegakaryocytic Thrombocytopenia.

We here describe a case involving a 67-yearold female patient who was referred to our hospital due to severe anemia (hemoglobin, 5.0 g/dL), thrombocytopenia (platelet count, 0.6 × 10/μL), and a mediastinal shadow with calcification noted on X-ray.

[Displaced B1+2 Found at Video Assisted Thoracic Surgery for Lung Cancer of Left Upper Lobe].

We report the case of an 83-year-old woman who presented with an abnormal pulmonary nodule suspected to be lung cancer in the left S3 segment. Bronchoscopy showed that the left main bronchus branched off into the B1+2, B3 plus lingular bronchus, and lower bronchus. Video-assisted thoracic surgery was performed, and the nodule was pathologically diagnosed as a primary lung cancer.

Myasthenia gravis with thymic epithelial tumour: a retrospective analysis of a Japanese database.

Objectives: Myasthenia gravis (MG) has been reported to correlate with earlier stage and Type B thymomas by the World Health Organization classification. We analysed a large database of clinical characteristics of patients with MG and thymic epithelial tumours to elucidate whether the severity of MG affected postoperative survival of those with thymic epithelial neoplasms.

Methods: We conducted a multi-institutional study on the patients who had undergone surgical treatment for thymic epithelial tumours between 1991 and 2010.

[Independent Occurrence of a Mediastinal Bronchogenic Cyst and an Intralobar Pulmonary Sequestration].

Here we describe a case of an 18-year-old boy who exhibited abnormal pulmonary parenchyma supplied by an aberrant artery from the descending aorta in the right lower lobe of the lung and a cystic tumor measuring 34×26×54 mm in the right upper mediastinum. Video-assisted thoracic surgery for resection of the 2 lesions showed that they were independent of each other. Final diagnosis of an intralobar pulmonary sequestration in the right lower lobe and a bronchogenic cyst in the upper mediastinum was made.

Immunostaining for thyroid transcription factor 1, Napsin A, p40, and cytokeratin 5 aids in differential diagnosis of non-small cell lung carcinoma.

The present study aimed to examine the effectiveness of immunostaining of cytological specimens in discerning squamous from non-squamous cell carcinoma. Various combinations of six antibodies were examined in order to determine the optimal combination for use in differential diagnosis. Immunostaining was performed using tumor imprint smears obtained from 70 lung carcinoma cases.

Posterior mediastinal hematoma after a simple fall in a patient with normal coagulation.

Case: A 77-year-old woman presented with neck swelling and odynophagia following a fall from standing height. She had no history of antiplatelet or anticoagulant use. Computed tomography of the chest showed an isodense to hypodense soft tissue mass in the bilateral carotid space, retropharyngeal space, and posterior mediastinum.

Mediastinitis of bronchogenic cyst caused by endobronchial ultrasound-guided transbronchial needle aspiration.

Here, we describe the case of a 56-year-old female patient who was diagnosed with an anterior mediastinal cyst measuring 26 × 16 mm in size. An endobronchial ultrasound-guided transbronchial needle aspiration was performed, and punctures occurred three times. The patient was then prescribed cefditoren pivoxil.

Radiologically indeterminate pulmonary cysts in Birt-Hogg-Dubé syndrome.

Birt-Hogg-Dubé (BHD) syndrome is an inherited disease characterized by recurrent pneumothorax. We report some unusual clinicopathologic features of the lung in a Japanese family with this syndrome presenting with recurrent pneumothorax. Radiologic imaging did not show detectable lesions; however, at video-assisted thoracic surgery (VATS), multiple diffusely distributed microcysts were visible on the pleura.

Spontaneous hemopneumothorax: epidemiological details and clinical features.

Purposes: Spontaneous hemopneumothorax (SHP) may cause life-threatening blood loss. The objective of this study was to elucidate the epidemiological and clinical features of SHP.

Methods: We reviewed the records of 26 patients who underwent surgery for SHP between 1989 and 2010.

Acute onset of mediastinal cystic lymphangioma in the puerperium.

Lymphangioma is a benign congenital malformation developing from the prenatal lymphatic vessels. Lymphangiomas are typically slow-growing and asymptomatic, but can occur throughout the body; there are few documented cases of either mediastinal or rapid growing lymphangiomas. Here, we report a case of a 27-year-old female who experienced sudden-onset nocturnal dyspnea 1 month after delivery.

Preoperative symptoms and postoperative sequelae of intrathoracic neurogenic tumors: a single institution's experience.

Objective: Most intrathoracic neurogenic tumors are resected for therapeutic diagnosis; many adult tumors are benign. However, few studies have reported the preoperative symptoms, postoperative modalities, and sequelae of these tumors. We focused on and evaluated the diversity and postoperative prognosis of these tumors.

Early-stage thymic carcinoma: is adjuvant therapy required?

Although the prognosis of advanced thymic carconoma remains poor, previous reports have shown survival rates of 70% to 100% in patients with Masaoka stage I or stage II of the disease who were treated with surgery followed by adjuvant therapy. However, the role of adjuvant therapy in these stages is controversial. We retrospectively evaluated the outcome of 4 patients with Masaoka stage II thymic carcinoma who were treated with surgery alone between 1992 and 2008.

Intrapulmonary bronchogenic cyst in the thoracic cavity: a case report.

This case report presents an intrapulmonary bronchogenic cyst exhibiting a unique shape. The patient was a 19-year-old man who had been diagnosed with a posterior mediastinal tumor by computed tomography and magnetic resonance imaging, 2 years previously. The imaging revealed that the tumor was located on the left side of the posterior mediastinum and was 45 × 25 mm in size.

Dual-phase FDG-PET imaging shows suspected malignancy that histological examination later confirmed as sclerosing mediastinitis: report of a case.

Sclerosing mediastinitis is a rare, benign disorder that is often indistinguishable from malignancy by conventional imaging techniques. The value of fluorodeoxyglucose positron emission tomography (FDG-PET) imaging in the diagnosis of this disorder has not been elucidated. Recently, a few studies have reported the use of dual-phase FDG-PET imaging in the diagnosis of malignancies.

Possible delayed cut-end recurrence after limited resection for ground-glass opacity adenocarcinoma, intraoperatively diagnosed as Noguchi type B, in three patients.

Introduction: In our limited resection trial of pulmonary peripheral ground-glass opacity (GGO) lesions from 1998 to 2002, limited resection of Noguchi type A and B carcinomas seemed to have a positive outcome. However, recently three of the 24 patients, with mixed GGO lesions intraoperatively diagnosed as type B, developed a solid lesion at the cut-end scar.

Methods: Medical records and radiology and pathology findings of the three patients were reviewed.

[S-1 activity in non-small cell lung cancer in clinical practice].

Objective: We evaluated retrospectively single-agent S-1 chemotherapy in non-small cell lung cancer patients in clinical practice.

Methods: Sixteen consecutive patients treated with single-agent S-1 for NSCLC between July 2005 and June 2007 at the Department of Thoracic Surgery, Tsuchiura Kyodo General Hospital. The treatment schedule comprised oral administration of S-1 at 80-120 mg/day.

[Lipofibroadenoma of the thymus].

Here we report a case of a rare thymic tumors histologically diagnosed as lipofibroadenoma. The patient was a 32-year-old male who displayed an anterior mediastinal tumor on a chest computed tomography (CT) scan while being treated for pneumonia. The tumor was localized within the thymus, and the diameter was 3 cm.

Pathologic radioresponse of preoperatively irradiated invasive thymomas.

Background: We have been applying preoperative radiotherapy (RT) to Masaoka stage III thymomas intending to make surgical resection more complete by reducing mass volume, to prevent possible dissemination caused by surgical manipulation and to get better survival as a result. However, the radioresponses vary from tumor to tumor. We hypothesized that thymoma is a variable radioresponsive tumor depending on pretreatment histology.

[Bloody sputum caused by hemorrhage around staple-lines 5 years after surgery; report of a case].

23 year-old non-smoking male who had underwent bilateral video-assisted thoracoscopic surgery (VATS) bullectomy for spontaneous pneumothorax using surgical stapler (Endo GIA, Tyco Healthcare) 5 years before, referred to our hospital due to hemoptysis. Chest computed tomography (CT) revealed infiltrative shadow surrounding stapled-line at right pulmonary apex. Aspiration-shadows were scattered in right lung parenchyma.