著者

岡村 明治

出版者

The Japanese Respiratory Society

雑誌

日本胸部疾患学会雑誌 (ISSN:03011542)

巻号頁・発行日

vol.11, no.6, pp.325-346, 1973-06-25 (Released:2010-02-23)

参考文献数

67

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Fourty autopsy cases of malignant tumors treated with Bleomycin were studied histopathologically on the serious side effects of the lung, and the following conclusions were obtained:1) Pulmonary changes induced by Bleomycin treatment were observed in 29 (75.5%) among 40 autopsy cases including the case of slight changes, and Bleomycin pneumonitis showing moderate degree worthy of it's name was found in 21 cases (52.5%), and pulmonary fibrosis in 14 cases (35%). There were 15 cases (37.5%) died mainly of this pneumonitis.2) From macroscopical findings, Bleomycin pneumonitis was classified into three types; 1) diffuse type, 2) nodular type and 3) peripheral type. Among them, the diffuse type was the cases which were treated by the largest amount of the dosage, and the nodular type was given the smallest amount.3) Histological features of Bleomycin pneumonitis was interstitial pneumonitis involving alveoli, alveolar duct and bronchioli; at first edema appeared in alveolar walls and spaces with desquamation and bizarre change of proliferated alveolar lining cells. Hyaline membranes and large mononuclear cells were also seen in alveolar spaces. And then, these exudates and proliferated cells fell into degeneration and necrosis, and they rapidly changed into organization tissue in alveolar spaces. Finally, characteristics of this pneumonitis were the intraalveolar loose fibrosis mainly composed of reticular fibers and marked proliferation and squamous metaplasia of epithelia in many respiratory bronchioli and in allied alveolar sacs which occasionally resembled to squamous cell carcinoma.4) Pulmonary changes induced by Bleomycin are chemical pneumonitis, i. e. Bleomycin damages directly the alveolar walls involving alveolar lining cells and bronchiolar epithelia through blood vessels, and gives rise to serous exudation and regeneration, proliferation as well as bizarre change of alveolar lining cells, leading lastly to pulmonary fibrosis. On that occasion, Bleomycin pneumonitis has a tendency to occur in the aged men over than 55-60 years old, and it was produced by a very small amout of dosage with intrapleural administration. Careful application is needed as intramuscular injection of the drug produces the pneumonitis more easy than intravenous injection.5) Histological differentiation between Bleomycin-pneumonitis and allied interstitial pneumonitides were described.

著者

高橋 英幸 金田 邦彦 酒井 哲也 原田 直樹 堀井 進一 岡村 明治 土師 守

出版者

Japan Surgical Association

雑誌

日本臨床外科学会雑誌 (ISSN:13452843)

巻号頁・発行日

vol.75, no.5, pp.1423-1427, 2014

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症例は68歳,男性.平成24年12月に骨盤内を占める大きな腫瘍(φ90mm×140mm×100mm)に対し,腫瘍摘出術を施行.病理組織学的にperivascular epithelioid cell tumor (以下PEComa)でS状結腸に癒着があったため,一部S状結腸も合併切除した.粘膜面は正常であり,病理学的にS状結腸間膜から発生したものと診断した.核分裂像は1/10HPF以下であったが,腫瘍径は5cm以上で,腫瘍の中心部は広汎な壊死に陥っていたことより,悪性のポテンシャルを持った腫瘍の可能性を否定できないと考え,定期的に当院外来にて経過観察を行っていた.平成25年10月に約1年ぶりのfollow upの腹部CTで,下腹部に約55mm大の腫瘤を認めた.また,骨盤腔内右前部の腫瘍に一致してFDGの集積を認めた.(SUVmax 5.828)以上より,PEComaの腹膜再発と考え,摘出術を施行した.病理学的にも基本的に前回と同様の所見を認めた.術後の経過は良好であり,第7病日に軽快退院した.再々発の危険性があるため,今後,3~4カ月ごとの腹部PET-CT検査を予定している.

著者

飯山 仁 中根 恭司 井上 健太郎 佐藤 睦哉 明平 圭司 岡村 成雄 日置 紘士郎 坂井田 紀子 岡村 明治

出版者

一般社団法人日本消化器外科学会

雑誌

日本消化器外科学会雑誌 (ISSN:03869768)

巻号頁・発行日

vol.31, no.12, pp.2350-2353, 1998-12-01

参考文献数

21

被引用文献数

2