Distribution of Ectopic Germinal Centers in Thymic Epithelial Tumors and Their Relationship With Thymic Involution.

Ectopic germinal centers (GCs) are often formed in the thymus of patients with anti-acetylcholine receptor antibody (anti-AChR Ab)-positive thymic epithelial tumors (TETs) and are considered sites where B cells undergo affinity maturation to produce high-affinity anti-AChR Abs, contributing to the development of myasthenia gravis. To evaluate the clinical relevance of these ectopic GCs, we analyzed their distribution and associations with thymic involution and anti-AChR Ab titers using paraffin-embedded surgical specimens from 79 TET patients. Thymic involution was scored, and immunohistochemistry was performed to identify cells involved in GC formation.

Pleurodesis using 50% glucose solution for air leak after pulmonary resection: a multi-center retrospective study.

Purpose: To assess the usefulness of and predictive factors for pleurodesis using 50% glucose solution to treat air leak after pulmonary resection.

Methods: The subjects of this retrospective study were 70 patients from three Japanese institutions, who were treated with 50% glucose solution for postoperative air leak between April, 2015 and March, 2023. Air leak was monitored using a digital drainage system.

Proximal ligation of the pulmonary vein stump to prevent postoperative cerebral infarction after a lobectomy†.

Objectives: Our goal was to assess whether proximal ligation of the pulmonary vein stump (PVS) outside the pericardium reduces the incidence of postoperative cerebral infarction (PCI) after a lobectomy.

Methods: A single-institution retrospective review was conducted of 683 patients undergoing a lobectomy for lung cancer, metastatic lung tumours and benign diseases. Associations among PCI within 90 days, ligation of the PVS and clinicopathological features were analysed.

Rapid growth of a solitary fibrous tumor of the pleura after slow long-term progression: a case report.

Background: Solitary fibrous tumors (SFTs) of the pleura are usually benign. We present a case of SFT of the pleura which grew rapidly after slow long-term progression.

Case Presentation: A 78-year-old man was referred to our hospital for left-sided back pain and shortness of breath.

Intrapericardial Pulmonary Vein Ligation to Prevent Stump Thrombosis During Left Upper Lobectomy.

Background: Postoperative cerebral infarction, a serious complication of surgery, is occasionally experienced with pulmonary vein stump thrombosis (PVST), which is frequently observed after left upper lobectomy (LUL). Herein, we prospectively investigated whether PVST could be safely prevented by intrapericardial ligation of the superior pulmonary vein (SPV) to shorten the SPV stump during LUL.

Methods: In a consecutive 21 patients who underwent LUL, we ligated the proximal intrapericardial SPV with 1-0 silk suture and divided the distal hilar SPV by an automatic stapling device.

Non-stapling thoracoscopic surgery for spontaneous pneumothorax in young patients.

Objectives: Spontaneous pneumothorax in young patients has a high recurrence rate, even after surgical treatment, and bulla neogenesis around stapled lesions has been reported as a cause of postoperative recurrence. We investigate the clinical safety and long-term outcome of non-stapling thoracoscopic surgery for spontaneous pneumothorax in young patients.

Methods: Twenty-seven non-stapling thoracoscopic surgeries for pneumothorax in 24 patients younger than 25 years were retrospectively reviewed.

Mediastinal Yolk Sac Tumor With Solitary Adenocarcinoma in Subcarinal Nodal Metastases.

Germ cell tumors with somatic-type solid malignancy are mostly attributed to the malignant transformation of teratomas. Herein, we describe the case of a 41-year-old man with mediastinal yolk sac tumor who presented with adenocarcinoma in nodal metastases. Computed tomography revealed enlarged subcarinal lymph nodes and an anterior mediastinal tumor, which was diagnosed as a yolk sac tumor by percutaneous biopsy.

Characteristic differences in the abundance of tumor-infiltrating lymphocytes and intratumoral developing T cells in thymoma, with special reference to PD-1 expression.

Purpose: Though programmed cell death-1 (PD-1) inhibitors mainly target tumor-infiltrating lymphocytes (TILs) expressing PD-1, developing T cells in thymus also express PD-1 in their process of maturation. To predict the therapeutic effect of PD-1 inhibitors for thymoma, it is necessary to clarify the proportions of TILs and intratumoral developing T cells.

Methods: The expressions of CD4, CD8, and PD-1 on T cells were analyzed by flow cytometry in 31 thymomas.

[Robot-assisted Segmentectomy for Lung Cancer].

The role of segmentectomy for lung cancer is expected to increase owing to the results of Japan Clinical Oncology Group (JCOG) 0802. Moreover, the major advantage of robot-assisted thoracic surgery (RATS) is that it allows high precision of dissection. The surgical approach comprised the placement of four robotic ports on the lower intercostal space with an assistant hole.

Spread through air spaces is a powerful prognostic predictor in patients with completely resected pathological stage I lung adenocarcinoma.

Purpose: To evaluate the frequency of spread through air spaces (STAS) in patients with early-stage primary lung cancer and to elucidate the association between STAS and various clinicopathological factors.

Methods: We retrospectively reviewed data from a total of 265 consecutive patients who underwent lobectomy and mediastinal lymph node dissection (172 patients) or sublobar resection (93 patients) for completely resected pathological stage I lung adenocarcinoma. We evaluated clinical variables, including the preoperative serum carcinoembryonic antigen (CEA) level, tumour size, consolidation tumour ratio (CTR), maximum standardized uptake value (SUVmax) on FDG-PET, histological results, presence of STAS and vascular and lymphatic invasion.

Robot-assisted thoracoscopic surgery for large apical schwannoma in an obese patient.

Background: Neural tumors at the thoracic apex require a careful surgical technique because of the presence of vascular and neural structures and minimally invasive surgery can be challenging for these tumors, especially large tumor in obese patients. We report a case of a large apical schwannoma that treated with RATS in an obese patient.

Case Presentation: An obese, diabetic, 36-year-old obese man with a body mass index of 34.

Clinical significance of postoperative pulmonary complications in elderly patients with lung cancer.

Objectives: An increasing number of elderly patients with impaired immunity, malnutrition and comorbidities are considered surgical candidates. This study aimed to clarify the predictive factors and prognostic impact of postoperative pulmonary complications in elderly patients with lung cancer.

Methods: This retrospective study included 188 patients (≥75 years) who underwent complete anatomical lung resection for non-small cell lung cancer between 2005 and 2019.

Robotic subxiphoid-optical thymectomy.

Robot-assisted thymectomy through a subxiphoid scopic approach can provide a good surgical view, similar to that of median sternotomy. We originally used the subxiphoid port only for the robotic scope to avoid instrument collision with the assistant device. This approach, robotic subxiphoid-optical thymectomy, is advantageous for the safe and accurate dissection of the bilateral phrenic nerves and the left brachiocephalic vein, which are especially needed in extended thymectomy for patients with myasthenia gravis.

Prognostic significance of spread through air spaces in pulmonary metastases from colorectal cancer.

Objectives: Surgical resection for pulmonary metastases from colorectal cancer could provide long-term survival in selected patients, and it is commonly performed in practice. However, surgical margin relapse sometimes occurs and is a problematic issue to resolve. Spread through air spaces (STAS) is one of the invasion forms in primary lung cancer and is associated with local recurrence and a poor prognosis.

One-stage closure of large bronchopleural fistula with pedicled latissimus dorsi muscle flap after preemptive antibiotics: A case report.

Introduction: Bronchopleural fistula (BPF) after lung cancer surgery is a life-threatening complication and often needs two-stage closure after fenestration. Although one-stage closure of BPF is challenging, it would provide shorter treatment time and lower patient physical burden than two-stage closure. However, there have been few reports of one-stage closure of a large BPF.

Prognostic Significance of Perioperative C-Reactive Protein in Resected Non-Small Cell Lung Cancer.

Inflammation is reportedly associated with the development and progression of various malignancies. However, the clinical significance of preoperative and postoperative inflammation in lung cancer patients undergoing surgery is unknown. The relationship between preoperative and postoperative C-reactive protein (CRP), an indicator of inflammation, and survival was retrospectively analyzed in 356 patients who underwent complete resection of pathologic Stage I and II non-small cell lung cancers.

Programmed death-ligand 1 expression profiling in thymic epithelial cell tumors: Clinicopathological features and quantitative digital image analyses.

Objectives: Whether the extent of expression of programmed death-ligand 1 (PD-L1) is clinically significant remains uncertain, although immuno-oncological features have been studied in thymic epithelial cell tumors (TETs). We investigated the histological features of PD-L1 expression in TETs, and assessed PD-L1 expression using digital image analysis.

Materials And Methods: Participants comprised 66 patients with TET who underwent surgical resection between 2001 and 2016.

High Neutrophil Count as a Negative Prognostic Factor for Relapse in Patients with Thymic Epithelial Tumor.

Purpose: Preoperative neutrophil count is reportedly associated with poor prognosis in cancer patients. This study aimed to investigate the clinical significance of pre-treatment peripheral blood cell counts in patients with thymic epithelial tumors (TETs).

Methods: A retrospective review of 71 patients with completely resected TETs [64 thymoma, 6 thymic carcinoma, and 1 thymic neuroendocrine tumor] between 2000 and 2018 was conducted.