Ryu Nakajima

A Phase III Randomized Trial of Lobectomy Versus Limited Resection for Small-sized Peripheral Non-small Cell Lung Cancer (JCOG0802/WJOG4607L)

A Phase III study was started in Japan to evaluate the non-inferiority in overall survival of segmentectomy compared with lobectomy in patients with small-sized (diameter </=2 cm) peripheral non-small cell lung cancer, excluding radiologically determined non-invasive cancer. This study began in August 2009, and a total of 1100 patients will be accrued from 71 institutions within 3 years. The primary endpoint is overall survival. The secondary endpoints are post-operative respiratory function, relapse-free survival, proportion of local recurrence, adverse events, proportion of patients who complete segmentectomy, duration of hospitalization, duration of chest tube placement, operation time, blood loss and number of auto-sutures used. This study is one of the first intergroup studies in Japan between the Japan Clinical Oncology Group and the West Japan Oncology Group.

Successful surgical treatment of pulmonary artery aneurysm in Behçet's syndrome

We report herein an uncommon clinical case of pulmonary artery aneurysm in Behçets syndrome, for which only a few reports have been published in the literature to date. A 68-year-old Japanese male, who was referred for recurrent fever of unknown origin, anemia and pulmonary nodular opacities, was treated by right lower lobectomy followed by postoperative oral administration of colchicine and corticosteroid. Postoperative pathological examination confirmed a diagnosis of pulmonary artery aneurysm accompanied by vasculitis and thrombi. Clinical and radiographic feature are presented herein.

Extrathoracic protrusion of a chronic expanding hematoma in the chest mimicking a soft tissue tumor

We report an uncommon clinical case of extrathoracic protrusion of a chronic expanding hematoma in the chest, mimicking a soft tissue sarcoma. A 77-year-old Japanese man was successfully treated by chest wall resection and partial decortication of the lung. The postoperative pathology examination confirmed a diagnosis of a granular cell reaction. Details of the clinical and radiographic features are presented.

Sclerosing Mediastinitis Mimicking Anterior Mediastinal Tumor

A 54-year-old asymptomatic man presented with an anterior mediastinal mass discovered on chest roentgenogram. Chest computed tomography revealed a noncalcified round mass in the mediastinum. A white solid mass, 5-cm in diameter, had arisen from the pericardial adipose tissue with multiple small nodular lesions mimicking mediastinal tumor with pleural dissemination. Postoperative pathologic examination confirmed a diagnosis of sclerosing mediastinitis. Details of the clinical and radiographic feature are presented.

Surgery for multiple and diffuse pulmonary arteriovenous fistulas during childhood.

We report an uncommon clinical case of multiple, diffuse pulmonary arteriovenous fistulas that occurred during childhood. A 15-year-old Japanese girl with multiple pulmonary arteriovenous fistulas presented with moderate hypoxemia and was treated by left lower lobectomy for complete resection of the arteriovenous fistulas. Clinical and radiographic features are presented.

Ectopic bone formation in a subsegmental bronchus

A 48-year-old man with fever and dry cough was admitted to our hospital. Imaging examinations revealed a mass lesion with calcification in the right B3b bronchus and atelectasis in the distal lung area. Subsequently, right S3 segmentectomy was performed. There was a hard polypoid mass completely obstructing the right B3b bronchus. Histopathological findings suggested a metaplastic bone formation with mature bone marrow tissue leading to the primary bronchial cartilage. A case of ectopic bone formation in subsegmental bronchus has never been reported thus far. The resident fibroblasts might transform into osteoblasts under appropriate environmental conditions and induce bone formation.