Lung transplantation for secondary interstitial pneumonitis caused by treatment for primary mediastinal diffuse large B-cell lymphoma

A 34-year-old woman was diagnosed as primary mediastinal diffuse large B-cell lymphoma, treated by cyclophosphamide, doxorubicin, vincrisitne, prednisolone (CHOP) chemotherapy and radiation therapy, and received high-dose ranimustine, cytarabine, etoposide, cyclophosphamide (MCVAC) chemotherapy with autologous peripheral blood stem cell transplantation. Seven years after complete remission was achieved, she recognized dyspnea and was diagnosed secondary interstitial pneumonitis caused by chemotherapy and/or radiotherapy. Because her symptoms and pulmonary function got worsen gradually, she underwent lung transplantation from a brain death donor when she was 47-year-old. She has successfully rehabilitated and returned to her life without oxygen inhalation therapy.     

A case of multiple atypical adenomatous hyperplasia of the lung detected by computed tomography.

Multiple atypical adenomatous hyperplasia (AAH) of both lungs in a 72-year-old male, detected by computed tomography, is reported. The lesions of the right lung were resected for diagnosis via video-assisted thoracoscopic surgery (VATS). The resected specimen had 22 AAH lesions up to 10 mm in size. For nine of these lesions, the expressions of carcinoembryonic antigen (CEA), c-erbB-2 oncoprotein and p53 gene product were examined by immunohistochemistry and the loss of heterozygosity (LOH) on chromosomes was investigated by polymerase chain reaction analysis. These lesions showed a variety of expressions for CEA, c-erbB-2 and p53 oncoprotein. Three of the nine lesions showed LOH on chromosome 13q, although this was not exhibited in the largest one. These results indicate that each AAH in this case has independent genetic abnormalities and is multicentric.     

A case of multiple thymoma: the possibility of intra-thymic metastasis

A case of multiple thymoma is reported. The patient was a 28-year-old woman who came to us with myasthenia gravis. There were two separate thymoma in the anterior mediastinum: one measured 70 x 30 x 30 mm, while the other was 1.5 mm in diameter and situated in the surrounding thymic tissue. A histological study revealed that both thymoma consisted of epithelial cells with abundant cytoplasm, round-to-oval nuclei and inconspicuous nucleoli. Morphometric analysis showed the nuclear size of the epithelial cells to be similar in both tumors. The likelihood of positive Leu7 and keratin immunohistochemical staining was also similar for the two tumors. The two thymoma had similar histological, morphometric and immunohistochemical characteristics. These findings suggest the possibility of intra-thymic metastasis rather than a multicentric thymoma development. Extended thymectomy should be performed for thymoma to prevent postoperative tumor recurrence.     

Nasopharyngeal carcinoma: immunohistochemical study for keratin, secretory component and leukocyte common antigen

Immunohistochemical studies using antisera to keratin and secretory component (SC) and monoclonal antibody against leukocyte common antigen (LCA) were performed on 92 biopsy and autopsy specimens taken from 65 patients with nasopharyngeal carcinoma. Five biopsy specimens from malignant lymphoma of the nasopharynx and tonsil, and 20 biopsy specimens of nasopharyngeal epithelium were also included in the study. Keratin was positively stained in all squamous cell carcinomas and nonkeratinizing carcinomas, and 38 of 46 undifferentiated carcinomas (82.6%), but in no malignant lymphomas. LCA was intensely stained in all malignant lymphoma, but in no nasopharyngeal carcinomas. SC was positively stained in two of the 46 undifferentiated carcinomas (4.3%). Nasopharyngeal carcinoma is a definite malignant epithelial neoplasm and can be distinguished from malignant lymphoma by immunostaining for keratin and LCA. Some undifferentiated carcinoma may show cellular differentiation toward ciliated epithelium.     

Detection of NK activity and antibody-dependent cellular cytotoxicity of lymphocytes by human tumor clonogenic assay--its correlation with the 51Cr-release assay

NK activity of human peripheral blood lymphocytes (PBL) for cells of the human myeloid line K562, and antibody-dependent cellular cytotoxicity (ADCC) of PBL for cells of human lung adenocarcinoma line PC-9 were determined by the human tumor clonogenic assay (HTCA). Incubation of K562 cells or anti-PC-9 serum treated PC-9 cells with PBL before plating inhibited the formation of colonies of these tumor cells. The percent inhibition of tumor cell colony formation was dependent on the effector/target ratio, the incubation time before plating and, in the case of PC-9 cells, on the dilution of anti-PC-9 serum. PBL activated with human T-cell growth factor (TCGF), lymphokine-activated killer (LAK) cells, significantly augmented the inhibition of colony formation of K562 cells, compared to the control lymphocytes. The increase in colony inhibition was dependent on the concentration of TCGF and the time of incubation of PBL with TCGF. The HTCA determining the colony inhibition of K562 cells incubated with LAK or PBL correlated with the 51Cr-release assay (p less than 0.001). The HTCA determining the colony inhibition of anti-PC-9 serum-treated PC-9 cells incubated with PBL also correlated with the 51Cr-release assay (p less than 0.001). We found that the NK activity and ADCC of lymphocytes on K562 and PC9 tumor lines could be detected with HTCA.     

Serum clara cell protein levels in lung cancer patients: An assessment of preoperative values and postoperative changes

Serum levels of protein 1 (P1), a Clara cell protein known to have an antiinflammatory effect, were studied in 33 patients with lung cancer before surgery, and 3, 7, 14, 21 days, and 2 months after surgery. The preoperativeP1 values of the lung cancer patients were compared with those of 66 healthy controls matched by sex and age. The postoperative changes in P1 which occurred in the lung cancer patients were compared with those in 16 patients who underwent laparotomy for gastric or colon cancer. There was no significant difference in the P1 values between the lung cancer patients and the healthy controls; however, the postoperativeP1 values showed a significant decrease 3, 7, (P<0.001), and 14 days (P <0.05) postoperatively, recovering to normal within 2 months after surgery. One patient who died of postoperative pneumonia showed decreasing serum P1 levels until death. None of the laparotomy patients showed any decrease inP1 serum levels. Thus, we conclude that: (a) serumP1 levels do not differ between lung cancer patients and healthy individuals; (b) serumP1 levels significantly decrease in the early postoperative period, but recover within 2 months after lung resection; and (c) the postoperative changes that occur in serumP1 levels could provide important information about recovery from intraoperative lung damage.