特発性間質性肺炎合併肺癌における術後急性増悪の臨床病理学的検討

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  • Clinicopathologic Considerations of Postoperative Acute Exacerbation in Patients With Idiopathic Interstitial Pneumonia Combined With Lung Cancer.

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Objective. In 9 patients operated on for idiopathic interstitial pneumonia (IIP) associated with primary lung cancer, we clinicopathologically examined the predictive factors of postoperative acute exacerbation of IIP. Methods. We collected 9 patients who had been operated on for lung cancer and in whom a pathological diagnosis of usual interstitial pneumonia (UIP) pattern had been made based on resected tissues. We studied some predictive factors related to the acute exacerbation of IIP preoperatively and during operation, and analyzed the pathological findings of UIP. Results. The incidence of postoperative acute exacerbation of IIP was 22%(2 of 9 patients). No correlation between the two patients who developed acute exacerbation of IIP and the seven patients who did not was observed, in terms of CRP, LDH, WBC, PaO2 and %VC of preoperation, blood loss, operation time and postoperative maximum CPK. Pathologically, abundant fibroblastic foci were observed in 4 patients and a half of them developed acute exacerbation of IIP at 7 and 9 days postoperatively. Conclusion. It was difficult to predict the development of acute exacerbation of HP because most patients were in a controlled stable state of IIP preoperatively. However, we considered that abundant fibroblastic foci in the tissue specimens known as pathologically active lesions of UIP were possibly one of the predictive factors in the acute exacerbation of IIP.

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  • 肺癌

    肺癌 42 (6), 567-572, 2002

    特定非営利活動法人 日本肺癌学会

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