Nihon Kyōbu Shikkan Gakkai zasshi
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Nihon Kyobu Shikkan Gakkai Zasshi · Jul 1993
Case Reports[A case of so-called benign metastasizing leiomyoma responsive to progesterone].
A 47-year-old female, who had undergone hysterectomy and unilateral oophorectomy in 1975, was admitted to our hospital in 1989 because chest X-ray films revealed an increase in size and number of pulmonary nodules for two years. On admission, a left inguinal tumor was found and histologically it consisted of smooth muscle cells with nuclear atypia arranged in interlacing fascicles. An open-lung biopsy was performed. ⋯ At two years the pulmonary lesions had regressed. BML is a rare condition, considered to be pulmonary metastasis from low-grade leiomyosarcoma of the uterus. Measuring estrogen and progesterone receptors in lung biopy material may help determine the most appropriate therapy.
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Nihon Kyobu Shikkan Gakkai Zasshi · Apr 1993
[Alveolar type II cells in centrilobular emphysema lesions of human lung--an ultrastructural study].
The lungs studied were surgically resected, mainly for lung cancer. All lungs had centrilobular emphysema. ⋯ In emphysematous lesions, transmission electron microscopic observation revealed that (1) the shape of type II cells was associated with the changes of alveoli, such as type II cells were flattened in flattened alveolar wall; (2) the cells were cuboidal in the alveolar corner; (3) the number of close contacts between type II cells and interstitial cells was significantly decreased; (4) osmiophilic lamellated bodies in type II cells were normal in number and shape, and that type II cell hyperplasia was observed in the overlapping alveolar walls. These findings suggest that both injury and repair may occur in the alveolar epithelium of emphysematous lesions, and tissue repair may be impaired.
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Nihon Kyobu Shikkan Gakkai Zasshi · Mar 1993
Review Case Reports[A case of endobronchial chondroma in a patient with atypical mycobacterial infection].
A case of endobronchial chondroma in a 74-year-old man with atypical mycobacterial infection is reported. Bronchoscopy was performed in order to exclude the possibility of malignancy. At bronchoscopic examination, a hemispherical polypoid tumor with smooth surface was found at the orifice of left B3 and was removed by transbronchial biopsy forceps. ⋯ About 1 year after forceps resection, no growth of the tumor was seen in the left upper lobe bronchus on bronchoscopic examination. Endobronchial chondroma is relatively rare. We discuss the clinical features of 19 cases of endobronchial chondroma so far reported in Japan, including our case.
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Nihon Kyobu Shikkan Gakkai Zasshi · Feb 1993
Case Reports[A case of rheumatoid arthritis accompanied by repeated pleural effusion associated with rapid tapering of steroid].
A 65-year-old woman was referred to our department because of general fatigue and anorexia for one month. The patient has received anti-rheumatoid therapy with aurothiomalate and bucillamine for the last two years for rheumatoid arthritis diagnosed 11 years earlier. Based on her systemic arthralgia, positive RA factor, and characteristic pleural effusion, the diagnosis of rheumatoid pleural effusion was made and prednisolone was administered. ⋯ Pleural effusion reappeared after similar rapid tapering of the drug. These results suggest that induction of pleural effusion may occur in rheumatoid arthritis patients as a result of rapid tapering of steroids. Tapering of steroids in rheumatoid patients should be performed with care.
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Nihon Kyobu Shikkan Gakkai Zasshi · Dec 1992
[Pulmonary arteriography and bronchial arteriography in pulmonary embolism].
Pulmonary arteriography is the most reliable technique for evaluation of pulmonary embolism and other vascular abnormalities. A definitive diagnosis of pulmonary embolism is made on the basis of direct angiographic signs of emboli of intravascular filling defect and vessel cut-off sign. To obtain these findings, pulmonary arteriography needs to be performed as soon as possible, and in acutely ill patients who are in shock and under consideration for thrombolytic therapy or emergency embolectomy, the study should be performed on an emergency basis. ⋯ Wedged pulmonary arteriography can demonstrate the direct signs of distal emboli, which are difficult to obtain by main pulmonary artery injection angiogram. In the chronic stage of pulmonary embolism, bronchial arteriogram shows collaterals to pulmonary arteries. This study may be useful in patients with chronic pulmonary embolism, especially when thromboembolectomy is planned.