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Biomedical subjects

Yoshiki Umemori

Publications and source records attributed to Yoshiki Umemori.

7 recordsLinked to original sources

[Complete resection of Pancoast tumor while receiving preoperative concurrent chemoradiotherapy (CCRT) as an induction therapy--report of a case].

A 60-year-old man complaining of right shoulder pain and numbness of right arm was diagnosed with Pancoast tumor (invasive right apical lung cancer). Chest CT scan showed a tumor, 5 cm in diameter, in the right apex invading the right posterior chest wall. The patient received preoperative CCRT (RT: 40 Gy/20 Fr, cisplatin: CDDP and etoposide: ETP), resulting in tumor regression (PR). The patient underwent right upper lobectomy (ND 2a), partial resection of the 1st-3rd ribs and Th 1 nerve. Pathological examination demonstrated no live cancer cells and organization of necrotic tissue in the lung and intercostal region (Ef. 3). The patient received postoperative chemotherapy (CDDP+ETP) and was discharged. He did well without any tumor recurrence for 1 year postoperatively. CCRT seems effective and is one of the standard treatments for Pancoast tumor.

Antineoplastic Combined Chemotherapy Protocols↗

Chronic lung abscess with Pasteurella multocida infection.

We report a patient with chronic lung abscess due to Pasteurella multocida infection that may be caused by the contact with cows in his workplace. Despite its apparent rarity, chronic abscess due to P. multocida should be considered in the differential diagnosis of solitary pulmonary masses. This case report suggests that P. multocida infection can be potentially caused from saliva of cows as well as dogs or cats.

Bronchoscopy↗

[A review and development of sentinel node navigation surgery for lung cancer].

Sentinel node navigation surgery (SNNS) for lung caner has not yet been established. Sentinel node (SN) identification using dye or radioisotope has been developed; however, the SN identification rate was less than 50% in the dye method and use of radioisotopes is strongly restricted in Japan. The novel method using a CT or MRI contrast medium are expected. A study of local immune reaction for lung cancer in SN is also a very interesting issue.

Contrast Media↗

Mediastinal parathyroid cyst with tracheal constriction.

A 63-year-old man visiting a physician for slight dyspnea, attributed to a lump on his neck, was found in ultrasonography and computed tomography to have a cyst extending from the left lobe of the thyroid gland to the superior mediastinum. Radiography showed right deviation of the trachea. The cyst disappeared after fine-needle aspiration, but cyst fluid subsequently reaccumulated and he was admitted to our hospital. No abnormalities were detected in tests of thyroid and parathyroid function or blood chemical analysis. The cyst was surgically removed and diagnosed as a nonfunctioning parathyroid cyst, based on the high-intact parathyroid hormone in cyst fluid. The patient recovered fully and has shown no recurrence in the 11 months to data since surgery.

Cysts↗

New method of visualizing lymphatics in lung cancer patients by multidetector computed tomography.

OBJECTIVE: The aim of the present study was to investigate the safety and acceptability of a new method of visualizing lymphatics, including sentinel lymph nodes (SNs), in lung cancer patients using multidetector computed tomography (MDCT). METHODS: Images were obtained using an MDCT scanner (Asteion Multi 4 Detector-Row; Toshiba) at 1, 2, and 3 minutes after percutaneous injection of 1 mL contrast medium (iohexol) near the tumor in 15 patients with small peripheral lung cancers (cT1N0M0). A lymph node was confirmed to be an SN if the attenuation was more than 30 Hounsfield units greater on postcontrast images than on precontrast images. All patients underwent surgery, and definitive lymph node staging was assessed. RESULTS: The procedure was performed safely in all patients without significant complications. Lymphatic ducts or lymph nodes were visualized in all 15 patients. The SN was identified in 14 of 15 patients (93.3%) at lymph node 14 in 4 patients, lymph node 13 in 7, lymph node 12 in 6, and lymph node 6 in 1. In 1 remaining patient, the lymphatic duct running from the tumor toward the pleura was visualized. CONCLUSIONS: Lymphatics were visualized by this method in all patients without significant complications. This method should be useful not only to detect the SNs but to visualize pathways other than through the hilar lymph nodes.

Aged↗

Primary choriocarcinoma of the lung.

Primary choriocarcinoma (PCC) of the lung is extremely rare, with about 25 cases previously reported. We describe here a patient with PCC of the lung and review previously described cases to establish the clinical characteristics and most appropriate management of this disease. Survival for patients treated with both surgery and chemotherapy was longer than for patients treated with surgery alone, chemotherapy alone, or optional supportive care. Multivariate analysis of prognostic factors revealed that treatment with both surgery and chemotherapy had independent prognostic significance. Our analysis including previous cases suggests that resection followed by adjuvant chemotherapy is the most effective treatment.

Adult↗

Sudden onset of interstitial lung disease induced by gefitinib in a lung cancer patient with multiple drug allergy.

Gefitinib is an oral selective inhibitor of the epidermal growth factor receptor tyrosine kinase which is effective for patients with advanced non-small cell lung cancer. A 75-year-old man with advanced adenocarcinoma of the lung was treated with gefitinib. He had a history of allergy to several antibiotics and Welder's lung. Two days after initiation, he developed acute interstitial lung disease (ILD) and died of respiratory failure due to progression of ILD. Critical assessment pointed to gefitinib as the likely cause of this complication. This is the first report of rapid gefitinib-induced ILD. This case should alert physicians to the potential for dangerous pulmonary side-effects of gefitinib therapy, especially in patients with drug allergy.

Adenocarcinoma↗