Takaharu Yagi

Computed Tomography–Diagnosed Emphysema, Not Airway Obstruction, Is Associated with the Prognostic Outcome of Early-Stage Lung Cancer

Purpose: Because both emphysema and lung cancer can arise from biological damage caused by cigarette smoking, we investigated if the development of emphysema is associated with the clinical features of smokers lung cancer. Experimental Design: The subjects were a consecutive series of 100 smokers who underwent lobectomy with hilar and mediastinal dissection for clinical stage I non–small cell lung cancer. We studied the relationship between the presence or absence of emphysema at the onset of the lung cancer and clinicopathologic features. Emphysema was diagnosed by measuring the low-attenuation area using computed tomography densitometry. Results: There were no differences in clinicopathologic variables, including the degree of smoking exposure between the patients with (n = 58) and those without (n = 42) emphysema, although male gender and airflow limitation were predominant in the patients with emphysema. The presence of emphysema, but neither male gender nor airflow limitation, adversely affected both overall and disease-specific survival. According to Cox regression analysis, emphysema was an independent prognosticator among age, gender, degree of smoking exposure, tumor size, nodal status, histologic subtype, histologic grade, and microvessel invasion. These results were stabilized by a bootstrap sampling model. Conclusions: Computed tomography–diagnosed emphysema, but not airway obstruction, is associated with poor prognosis in smokers with early-stage lung cancer. Thus, routine computed tomography densitometry in smokers with lung cancer should be mandatory.

Retroperitoneal solitary fibrous tumor of the pelvis with pollakiuria: a case report

BackgroundSolitary fibrous tumor (SFT) is rare soft tissue tumor, and it occurs most commonly in the pleura. Retroperitoneal SFT is generally found by palpable mass or abdominal distention. Here we report a case of SFT presenting pollakiuria.Case presentationA 64-year-old man was referred to our hospital for pollakiuria. Contrasted-enhanced computed tomography revealed a heterogeneously enhanced pelvic tumor of approximately 10 × 8 × 7 cm. Invasion of the surrounding organs, distal metastasis, and lymph node swelling were absent. Therefore, surgical resection was performed. The resected specimen was a 13 × 8 × 5.5-cm encapsulated elastic hard tumor weighing 420 g. Histologically, the tumor consisted of oval or spindle cells growing in a random manner in a collagenous matrix. Immunohistochemically, the specimen was positive for CD34, bcl-2, as well as vimentin and negative for c-kit. On the basis of these findings, a retroperitoneal solitary fibrous tumor (SFT) of the pelvis was diagnosed.ConclusionSurgery is the primary treatment for SFT, and pathologically negative margins are important for good prognosis.