Yusaku Matsui

Alpha‐fetoprotein and human chorionic gonadotropin‐producing lung cancer

A 73‐year‐old man had primary lung cancer that produced both alphafetoprotein (AFP) and human chorionic gonadotropin (HCG). The preoperative serum AFP level of 1039 ng/ml decreased to the normal range 8 weeks after surgery. The preoperative serum HCG level of 11 mIU/ml, which temporarily decreased to the normal range after operation, soon increased thereafter. The serum HCG level decreased, however, to the normal range after postoperative mediastinal radiation therapy. During relapse, only the serum HCG level increased gradually to 26,000 mIU/ml 7 weeks before his death. The lung cancer was classified histologically as poorly differentiated adenocarcinoma. Immunohistochemically, AFP was detected in the mononuclear tumor cells of the primary tumor in the lung, and HCG was found in the giant cells of the subcarinal metastatic lymph node. The concanavalin A non‐reactive fraction rate for AFP was 81.3%, and appeared to differ from those of hepatocellular carcinoma and yolk sac tumor. Cancer 59:227–232, 1987.

Oral administration of BOF-A2 to rats with lung transplanted tumors results in increased 5-fluorouracil levels

A new tumor model was developed in which solid Yoshida sarcoma tissue injected intravenously developed into tumors in the lungs of about 30% (13/42) of the inoculated rats. Histological examination revealed that alveoli were occupied with tumor cells and the tumors were similar to those obtained by subcutaneous inoculation. Using this model, the concentrations of 5‐fluorouracil (5‐FU) in tumor tissue 12 h after oral administration of 3‐[3‐(6‐benzoyloxy‐3‐cyano‐2‐pyridyloxycarbonyl)‐benzoyl]‐1‐ethoxymethyl‐5‐fluorouracil (BOF‐A2, 36 μmol/kg) or a combination of tegafur and uracil in a molar ratio 1 to 4 (UFT, 50 μmol/kg) were found to be 129.8 ng/g and 19.2 ng/g, respectively. Thus, compared to treatment with UFT, BOF‐A2 resulted in higher levels of 5‐FU in lung tumor tissues. Increased concentrations of 5‐FU should have a superior anti‐tumor effect and so BOF‐A2 merits clinical trial in the treatment of patients with lung cancer.

Necrobiosis-Lipoidica-Like Skin Manifestation in Lymphomatoid Granulomatosis (Liebow)

A 58-year-old man developed 3 indurative erythematous lesions like necrobiosis lipoidica on the right lower leg. He had had similar cutaneous lesions 1.5 years previously. These had been surgically excised, and a histologic diagnosis of necrobiosis lipoidica was made at another hospital. He was diagnosed as having lymphomatoid granulomatosis by lung biopsy in our hospital. Nasal involvement was confirmed in later examinations and the skin lesions were also considered to be the cutaneous manifestation of lymphomatoid granulomatosis. This outlines that cutaneous manifestations may allow early diagnosis of lymphomatoid granulomatosis.