{"title":"Retroperitoneal leiomyosarcoma with pulmonary metastasis: A case report","authors":"Ryusei Yoshino, Nana Yoshida, Yuki Kamikokura, Sayaka Yuzawa, Mishie Tanino, Masahiro Kitada","doi":"10.2995/jacsurg.37.527","DOIUrl":"https://doi.org/10.2995/jacsurg.37.527","url":null,"abstract":"症例は52歳,女性.42歳時に左乳癌に対し,術前薬物療法後に乳房温存手術を施行しypT1aN0M0(ypStageIA)であった.術後補助療法としてホルモン療法+抗HER2療法を施行後,経過観察中であった.10年目検査のCTで右肺上葉に10 mm大の小結節が出現し乳癌転移と考え,確定診断のため胸腔鏡補助下に肺部分切除を施行し平滑筋肉腫の診断であった.その後のPET検査で右後腹膜,骨盤上部にSUV max 4.6の腫瘤性病変を認め,後腹膜腫瘍疑いで後腹膜腫瘍・右腎尿管切除術を施行し,肺と同様の病理診断であった.以上より後腹膜平滑筋肉腫原発転移性肺腫瘍の診断となった.本症例より,転移性の孤立性肺結節を疑った際に,想定外の腫瘍からの転移も念頭におくべきである.","PeriodicalId":498875,"journal":{"name":"The Journal of The Japanese Association for Chest Surgery","volume":"43 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-09-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135354799","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"右上葉切除後に生じた中葉静脈還流障害に起因する中葉壊死の診断に難渋した1例","authors":"Takuya Iwamoto, Yusuke Muranishi, Tomoya Kono, Ryo Miyahara","doi":"10.2995/jacsurg.37.558","DOIUrl":"https://doi.org/10.2995/jacsurg.37.558","url":null,"abstract":"54歳女性.肺癌に対するロボット支援胸腔鏡下右上葉切除後1日目のX線で右上肺野縦郭側の透過性低下を認めた.術後2日目に施行した造影CTで中葉の無気肺が疑われた.血液検査,全身状態に問題なく慎重に経過観察したが透過性の改善を認めず術後5日目に再手術を行った.術中所見では中葉うっ血壊死を生じていた.下葉の拡張により中葉静脈が頭側へ牽引されたために静脈還流障害を生じていた可能性があると考えられた.極めて稀な合併症と考えられ,その機序について若干の文献的考察を加えて報告する.","PeriodicalId":498875,"journal":{"name":"The Journal of The Japanese Association for Chest Surgery","volume":"42 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-09-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135354802","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Thoracic tracheal injuries secondary to knife penetration: A case report","authors":"Yuka Takakuwa, Rei Inoue, Yasuaki Iimura","doi":"10.2995/jacsurg.37.521","DOIUrl":"https://doi.org/10.2995/jacsurg.37.521","url":null,"abstract":"胸部外傷の中でも鋭的外傷による気管・気管支損傷は稀であり,周囲臓器損傷の合併により死亡率の高い外傷である.今回我々は鋭的胸部外傷による気管損傷に対して緊急手術を行い救命し得た1例を経験した.症例は59歳,女性.右鎖骨上より尾側方向に包丁の刺入を認め緊急手術となった.包丁が刺入したままだったため体位変換が困難であり,仰臥位・胸骨正中切開で手術を開始した.気管右壁に損傷を認めたが,周囲臓器損傷は認めなかった.途中で肋間開胸を追加することで良好な視野を確保することができ,肺動脈・肺静脈を確保した上で安全に包丁を抜去,気管の修復が可能であった.術後重篤な合併症はなく経過良好であった.気管損傷の基本は外科的修復だが,気管損傷部位によってアプローチは異なり,症例ごとにアプローチ方法を検討する必要がある.また大血管や心臓などの周囲臓器損傷の合併を常に考慮して手術を行う必要がある.","PeriodicalId":498875,"journal":{"name":"The Journal of The Japanese Association for Chest Surgery","volume":"14 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-09-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135354541","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Madoka Goto, Yasuhisa Ichikawa, Hideki Tsubouchi, Yuta Kawasumi, Mika Uchiyama, Shoichi Mori
{"title":"A case of primary pulmonary plasmacytoma","authors":"Madoka Goto, Yasuhisa Ichikawa, Hideki Tsubouchi, Yuta Kawasumi, Mika Uchiyama, Shoichi Mori","doi":"10.2995/jacsurg.37.563","DOIUrl":"https://doi.org/10.2995/jacsurg.37.563","url":null,"abstract":"形質細胞腫には種々の病型があり,その多くは多発性骨髄腫である.多発性骨髄腫は骨髄での形質細胞増殖と全身の臓器障害を特徴とし,骨髄外に腫瘍を形成することもある.骨髄に形質細胞増殖を認めず,髄外に孤立性増殖を認める疾患が孤立性形質細胞腫である.肺原発は稀で,非特異的な所見を呈し他疾患との鑑別が困難である.症例は72歳,女性.肝細胞癌の経過観察中に右上葉に腫瘤を指摘され,X年に右上葉部分切除術を施行し,病理所見で形質細胞の増殖を認めた.骨髄検査で形質細胞増殖を認めず,血清M蛋白や尿蛋白・Bence-Jones蛋白も検出されなかったため,肺孤立性形質細胞腫と診断した.肺形質細胞腫を認めた場合,多発性骨髄腫の髄外病変である可能性があるため,それを除外する必要がある.孤立性形質細胞腫では30%程度で多発性骨髄腫への進展が見られ,血清蛋白を含む生化学検査による経過観察が必要である.","PeriodicalId":498875,"journal":{"name":"The Journal of The Japanese Association for Chest Surgery","volume":"53 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-09-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135354796","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Two cases of robot-assisted repair of bronchial injury caused during robot-assisted lobectomy","authors":"Takeshi Ohyu, Yuki Takahashi, Yoshiaki Takase, Masahiro Miyajima, Atsushi Watanabe","doi":"10.2995/jacsurg.37.580","DOIUrl":"https://doi.org/10.2995/jacsurg.37.580","url":null,"abstract":"気道損傷はロボット支援下(RATS)肺葉切除の術中合併症の約0.2%と報告されている.RATS肺葉切除術中気道損傷に対してRATSで修復を行った2例を経験したので文献的考察を加えて報告する.症例1は71歳,女性.右上葉肺腺癌に対してRATS右上葉切除+2a-1リンパ節郭清(ND)を施行し,上下葉間剥離の際右主気管支膜様部を損傷した.症例2は68歳,女性.左上葉肺腺癌に対してRATS左上葉切除+ND2a-1を施行し,リンパ節剥離や気管支切離の際に気管支断端近位膜様部を損傷した.ともに初期の症例で,1例目は気管支周囲組織の剥離の際に展開不良と解剖学的誤認が,2例目は鉗子の通電およびStapler挿入が原因と考えられた.ともにRATS下で瘻孔を縫合閉鎖した.RATS肺葉切除においては気道損傷を回避すべく注意が必要である.RATS施行中の気道損傷に対してのRATS下修復は,安全に施行可能である.","PeriodicalId":498875,"journal":{"name":"The Journal of The Japanese Association for Chest Surgery","volume":"40 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-09-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135354798","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"東京都立駒込病院で教えてもらったこと","authors":"嘉裕 西村","doi":"10.2995/jacsurg.37.501","DOIUrl":"https://doi.org/10.2995/jacsurg.37.501","url":null,"abstract":"","PeriodicalId":498875,"journal":{"name":"The Journal of The Japanese Association for Chest Surgery","volume":"202 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-09-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135354803","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"A case of methotrexate-related lymphoproliferative disorder in the right lung with lung metastasis after left breast cancer surgery","authors":"Shoji Nakata, Hiroki Dohsaka, Takumu Uryuu, Tatsuya Shinguu, Tatsuya Ishii, Yuka Idei","doi":"10.2995/jacsurg.37.515","DOIUrl":"https://doi.org/10.2995/jacsurg.37.515","url":null,"abstract":"関節リウマチに対してメトトレキサートは重要な治療薬であるが,稀にメトトレキサート関連リンパ増殖性疾患(methotrexate-associated lymphoproliferative disorder,以下MTX-LPD)を起こすことがある.79歳の女性.関節リウマチに対してメトトレキサートを内服中であった.200X年に左乳癌に対し乳房温存手術を行い,200X+11年に左腋窩リンパ節腫大を認めた.リンパ節生検の結果,明らかな悪性所見を認めず.200X+12年にCTで右肺下葉に2個の腫瘍(29 mm,9 mm)と右肺上葉の陰影が指摘された.経気管支肺生検では確定的な病理診断が得られず,右肺下葉切除を施行した.病理でMTX-LPDと乳癌肺転移の合併と診断された.メトトレキサート中止後に右肺上葉の陰影は消失した.メトトレキサート内服の患者ではMTX-LPDを発症する可能性があり注意を要する.","PeriodicalId":498875,"journal":{"name":"The Journal of The Japanese Association for Chest Surgery","volume":"133 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-09-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135354540","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"A case of postmenopausal benign metastasizing leiomyoma presenting with bilateral multiple pulmonary nodules","authors":"Shogo Ide, Takayuki Shiina, Keiichiro Takasuna","doi":"10.2995/jacsurg.37.551","DOIUrl":"https://doi.org/10.2995/jacsurg.37.551","url":null,"abstract":"子宮筋腫組織が転移する良性転移性平滑筋腫が閉経後の経過で増大するのは稀である.閉経後の経過で増大する両側多発肺結節を呈した良性転移性平滑筋腫の一例を報告する.","PeriodicalId":498875,"journal":{"name":"The Journal of The Japanese Association for Chest Surgery","volume":"2 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-09-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135354789","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"若手呼吸器外科医 Case presentation award","authors":"","doi":"10.2995/jacsurg.37.s14","DOIUrl":"https://doi.org/10.2995/jacsurg.37.s14","url":null,"abstract":"","PeriodicalId":498875,"journal":{"name":"The Journal of The Japanese Association for Chest Surgery","volume":"29 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135703727","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"会長講演","authors":"","doi":"10.2995/jacsurg.37.s2","DOIUrl":"https://doi.org/10.2995/jacsurg.37.s2","url":null,"abstract":"","PeriodicalId":498875,"journal":{"name":"The Journal of The Japanese Association for Chest Surgery","volume":"39 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135703736","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}