肺癌第49巻第1号

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1 1 Department of Diagnostic Pathology, Graduate School of edicine, Chiba University, Japan; 2 Department of Thoracic Surgery, Chiba Rosai Hospital, Japan; 3 Work Environment Research Group, National Institute of Occupational Safety and Health, Japan. ABSTRACT Background. ethods. Results. Conclusion. JJLC. KEY WORDS Japanese Journal of Lung Cancer

2 µ Figure1. Sedimentofformalin-fixedlungtissuedigested with20% sodium hypochloritesolution.iron-containingsubstanceremainsinthetubeafterthedigestion(left).ixed celuloseestermembranefilter(ilipore)throughwhich thesedimentwasfiltered(right). Japanese Journal of Lung Cancer

3 Figure2. Case1.Autopsyoflungcarcinomacausedbyasbestosexposure.Plaqueisobserved ontheparietalpleuraanddiaphragm (left).smalcelcarcinomaispresentintherightlung.vis ceralpleuraandinterloberpleuraarethickened.thereisalsofibrosisofthelung(right). µ φ Japanese Journal of Lung Cancer

4 Figure3. HistologicalfindingsofthelungparenchymaofCase1.A largenumberofasbestos bodiesareobserved(left).highermagnificationofasbestosbodies.theyarephagocytosedbyal veolarmacrophages(right). Figure4. icroscopicfindingsofasbestosbodiescolectedwithdigestiontechnique(left),and thoseobservedwithphasecontrastmicroscope(right). Japanese Journal of Lung Cancer

5 Figure5. Case2.A caseoflungadenocarcinomaaccompaniedbypleuralplaque.groundglassopacity wasobservedintherightupperlobeonchestct (upperleft).thereisnoapparentfibrosisinthelung (right).asbestosbodieswereobservedinthelung(lowerleft). Japanese Journal of Lung Cancer

6 Figure6. Case3.A caseofmalignantpleuralmesotheliomacausedbyenvironmentalexposureto asbestos.pleuralthickeningwasobservedonchestct (upperleft).thoracoscopicfindingsofthetumor (lowerleft).icroscopicfindingsofthethoracoscopicbiopsysample.thetumorcelswerecuboidalor polygonalwith moderateamountsofeosinophiliccytoplasm and round nucleicontaining asingle nucleolus.theyproliferatedinsheets,however,glandularspaceswereobserved(right). Japanese Journal of Lung Cancer

7 Figure7. Case4.A caseofmalignantpleuralmesotheliomatreatedwithextrapleural pneumonectomy.anabnormalshadow waspointedoutonchestroentgenogram (up perleft).thepleurawasthickenedonchestct (lowerleft).rightlungresectedwith extrapleuralpneumonectomy.tumorencapsulatedtheentirelung.thetumorin vadedintointerlobarsepta.therewasfocalinvasionintothelung(right). Table1. Summary ofdataon 14Casesofalignant Pleuralesothelioma Treated with ExtrapleuralPneu monectomy Case Subtype Sex Hyaluronicacid Asbestos Age (ng/ml) bodycounts , ,000 3 Biphasic 58 54, ,000 2, Biphasic 48 94,200 10,000 7 Sarcomatoid ,000 8 Sarcomatoid 51 35,700 1,000 9 Sarcomatoid 59 3, , ,660,000 14, , , , Figure8. Relationshipofthenumbersofasbestosbodies oniron-stainedtissuesectionstothenumbermeasuredby atissuedigestiontechnique.thecorrelationcoeficientis significant(p<0.0001). Japanese Journal of Lung Cancer

8 Figure9. Pleuralplaques.Thoracoscopicfindings(left).icroscopicfindings.Theyareacelular,consistingofhyalinecolagenthathasa basket-weave patern(right). Table2. CriteriaforGradingAsbestosis 11) Severity Grade0 Grade1 Grade2 Grade3 Grade4 Extent GradeA GradeB GradeC None Fibrosisinvolveswalofatleastonerespiratory bronchiole Grade1+ involvementofalveolarductsortwoor morelayersofadjacentalveoli Grade2+ alalveolibetweenatleasttwoadjacent bronchioleshavethickened,fibroticsepta Grade3+ honeycombing Occasionalbronchioles Lessthanhalfofalbronchioles orethanhalfofalbronchioles µ µ Japanese Journal of Lung Cancer

9 Figure10. icroscopicfindingsofgrade1asbestosis.fibrosisisobservedinbronchiolarwal, butnofibrosisispresentindistalalveoli(left).anyasbestosbodiesarefoundinthefibrosisof bronchiolarwal(right). REFERENCES Am J Ind ed. JElectron icrosc. Ann N Y Acad Sci. Scand J Work Environ Health. Japanese Journal of Lung Cancer

10 Lancet. Chest. Am J Ind ed. Cancer. Hum Pathol. Arch Pathol Lab ed. Katzenstein and Askin s surgical pathology of non-neoplastic lung disease. Pathology of the lungs. Non-neoplastic disorders of the lower respiratory tract. Katzenstein and Askin s surgical pathology of non-neoplastic lung disease. Japanese Journal of Lung Cancer

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