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Toyoshi S, Funaguchi N, Ishigaki H, Yanase K. Primary Squamous Cell Lung Cancer With Frequent Episodes of Sustained Ventricular Tachycardia due to Myocardial Metastasis. J Med Cases 2023; 14:111-117. [PMID: 37188297 PMCID: PMC10181293 DOI: 10.14740/jmc4066] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/23/2023] [Accepted: 04/08/2023] [Indexed: 05/17/2023] Open
Abstract
Myocardial metastasis from lung cancer rarely occurs. We encountered a patient with squamous cell lung cancer who was diagnosed with myocardial metastasis before death and sustained ventricular tachycardia during the course of the disease. The patient was a 56-year-old woman. A tumor was noted in the apex area of the left lung and was diagnosed as stage IVA of squamous cell lung cancer after a detailed examination. She underwent concurrent chemoradiotherapy with weekly treatment of carboplatin + paclitaxel. A 12-lead electrocardiogram performed upon admission for additional chemotherapy showed negative T waves in leads III, aVF, and V1-4. Transthoracic echocardiography and computed tomography showed a tumor lesion in the right ventricular wall, which was diagnosed as myocardial metastasis from lung cancer. During the course of the disease, the patient had frequent episodes of sustained ventricular tachycardia, which were refractory to treatment with antiarrhythmic drugs. However, the sinus rhythm was restored with cardioversion. Subsequently, the patient received palliative treatment and eventually died 4 months after the diagnosis of cardiac metastasis and 3 weeks after the diagnosis of ventricular tachycardia. Myocardial metastasis might reflect poor prognosis due to serious arrhythmia or some other complications. Therefore, the early diagnosis and appropriate treatment of cardiac metastasis by chemotherapy, cardiac radiotherapy, or surgery, are necessary prior to the development of symptoms in tolerant cases.
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Affiliation(s)
- Sayaka Toyoshi
- Department of Respiratory Medicine, Asahi University Hospital, Gifu 500-8523, Japan
| | - Norihiko Funaguchi
- Department of Respiratory Medicine, Asahi University Hospital, Gifu 500-8523, Japan
- Corresponding Author: Norihiko Funaguchi, Department of Respiratory Medicine, Asahi University Hospital, Gifu 500-8523, Japan.
| | - Hirotoshi Ishigaki
- Department of Respiratory Medicine, Asahi University Hospital, Gifu 500-8523, Japan
| | - Komei Yanase
- Department of Cardiology and Respiratory Medicine, Gifu University Graduate School of Medicine, Gifu 501-1194, Japan
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Tanaka O, Funaguchi N, Toyoshi S, Taniguchi T, Ono K, Kunishima Y, Masui Y, Matsuo M. EP1.17-24 Biologically Effective Dose Was Associated with Overall Survival in Stereotactic Body Radiotherapy for Lung Tumors. J Thorac Oncol 2019. [DOI: 10.1016/j.jtho.2019.08.2434] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
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Mori H, Sakai C, Iwai M, Sasaki Y, Gomyo T, Toyoshi S, Kaito D, Yanase K, Ito F, Endo J, Funaguchi N, Ohno Y, Minatoguchi S. Immune thrombocytopenia induced by nivolumab in a patient with non-small cell lung cancer. Respir Med Case Rep 2019; 28:100871. [PMID: 31198679 PMCID: PMC6557745 DOI: 10.1016/j.rmcr.2019.100871] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/24/2019] [Revised: 05/30/2019] [Accepted: 06/02/2019] [Indexed: 11/16/2022] Open
Abstract
Antibodies targeting the receptor programmed death 1 on T cells have been approved for the treatment of lung cancer. Immune checkpoint inhibitors (ICIs) induce various immune-related adverse events. Life-threatening hematotoxicity can be provoked by ICI therapy. Although ICI-related endocrinopathy and interstitial lung disease have been well documented, hematotoxicity requiring intensive treatment is relatively rare. We describe a case of nivolumab induced thrombocytopenia after transient mild fever. A 77-year-old man with non-small cell lung cancer was administered nivolumab (240 mg/body, every 2 weeks) as second line therapy. On the day 2 after the first nivolumab infusion, he had a fever and his C-reactive protein level was elevated. Thoracic computed tomography revealed no interstitial lung disease or pneumonia. The fever resolved on day 9 and was not seen thereafter. On day 15 after the first nivolumab infusion, severe thrombocytopenia suddenly emerged. A bone marrow examination revealed no dysplasia or invasion. Based on the presence of high platelet-associated IgG titer, normal bone marrow plasticity and a lack of effectiveness of platelet infusion, we diagnosed nivolumab-induced immune thrombocytopenia. Daily administration of 60 mg of prednisolone restored the patient's platelet count and platelet-associated IgG. We also found that there was significant shrinkage of the primary lesion and that stable disease was achieved. One must be aware of this relatively rare side effect and the unusual clinical findings that could be associated with immunoreaction.
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Affiliation(s)
- Hidenori Mori
- Department of Respiratory Medicine, Hashima Community Medical Center, Gifu, Japan
- Second Department of Internal Medicine Gifu University Graduate School of Medicine, Gifu, Japan
- Corresponding author. Department of Respiratory Medicine, Hashima Community Medical Center, Shinsei-cho 3-246, Hashima-city, Gifu 501-6206, Japan
| | - Chizuru Sakai
- Second Department of Internal Medicine Gifu University Graduate School of Medicine, Gifu, Japan
| | - Masamichi Iwai
- Second Department of Internal Medicine Gifu University Graduate School of Medicine, Gifu, Japan
| | - Yuka Sasaki
- Second Department of Internal Medicine Gifu University Graduate School of Medicine, Gifu, Japan
| | - Takenobu Gomyo
- Second Department of Internal Medicine Gifu University Graduate School of Medicine, Gifu, Japan
| | - Sayaka Toyoshi
- Second Department of Internal Medicine Gifu University Graduate School of Medicine, Gifu, Japan
| | - Daizo Kaito
- Second Department of Internal Medicine Gifu University Graduate School of Medicine, Gifu, Japan
| | - Komei Yanase
- Second Department of Internal Medicine Gifu University Graduate School of Medicine, Gifu, Japan
| | - Fumitaka Ito
- Second Department of Internal Medicine Gifu University Graduate School of Medicine, Gifu, Japan
| | - Junki Endo
- Second Department of Internal Medicine Gifu University Graduate School of Medicine, Gifu, Japan
| | - Norihiko Funaguchi
- Second Department of Internal Medicine Gifu University Graduate School of Medicine, Gifu, Japan
| | - Yasushi Ohno
- Second Department of Internal Medicine Gifu University Graduate School of Medicine, Gifu, Japan
| | - Shinya Minatoguchi
- Second Department of Internal Medicine Gifu University Graduate School of Medicine, Gifu, Japan
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Kaito D, Iihara H, Funaguchi N, Endo J, Ito F, Yanase K, Toyoshi S, Sasaki Y, Hirose C, Arai N, Kitahora M, Ohno Y, Itoh Y, Minatoguchi S. Efficacy of Single-dose First-generation 5-HT 3 Receptor Antagonist and Dexamethasone for Preventing Nausea and Vomiting Induced by Low-dose Carboplatin-based Chemotherapy. Anticancer Res 2017; 37:1965-1970. [PMID: 28373467 DOI: 10.21873/anticanres.11537] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/20/2017] [Revised: 03/07/2017] [Accepted: 03/08/2017] [Indexed: 11/10/2022]
Abstract
BACKGROUND Carboplatin (CBDCA) is known to exhibit a high emetic risk among moderate-emetic risk anticancer drugs, and the dose of CBDCA varies in different therapies. In concurrent chemoradiotherapy (CCRT) for non-small cell lung cancer (NSCLC), the weekly administration of CBDCA (area under the curve (AUC) 2 mg/ml/min) and paclitaxel (PTX: 40 mg/m2) is frequently applied as standard therapy. However, the optimal antiemetic measures in the use of such low-dose CBDCA remain unclear. In this study, we retrospectively assessed the antiemetic effect of a single-dose of a first-generation 5-hydroxytryptamine-3 receptor antagonist (5-HT3RA) and dexamethasone in the weekly CBDCA+PTX therapy in CCRT. PATIENTS AND METHODS The subjects were patients with NSCLC who were administered weekly CBDCA+PTX therapy in CCRT between January 2011 and December 2016 at our Department. As an antiemetic measure, a first-generation 5-HT3RA, azasetron (10 mg, orally) or granisetron (3 mg, intravenously), and dexamethasone (9.9 mg, intravenously) were administered on day 1. The patients were evaluated for the following efficacy end-points for the first cycle: Complete response (CR; defined as no vomiting or retching episodes with no rescue medication) in the acute phase (0-24 hours), delayed phase (>24-120 hours), and overall phase (0-120 hours). Other efficacy endpoints evaluated were no vomiting or retching, and no nausea in all phases. RESULTS The subjects we assessed in this study were 46 patients who were administered weekly CBDCA+PTX therapy in CCRT. For the overall, acute, and delayed phases, the complete response rates were 89.1%, 100%, and 89.1%, respectively. The rate of no nausea in the overall, acute, and delayed phases was 78.3%, 100%, and 78.3%, respectively. The rate of no vomiting in the overall, acute, and delayed phases was 95.7%, 100%, and 95.7%, respectively. CONCLUSION A single dose of a first-generation 5-HT3RA and dexamethasone had a favorable suppressive effect on nausea and vomiting in weekly CBDCA+PTX therapy for NSCLC.
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Affiliation(s)
- Daizo Kaito
- Department of Cardiology and Respirology, Gifu University Graduate School of Medicine, Gifu, Japan
| | | | - Norihiko Funaguchi
- Department of Cardiology and Respirology, Gifu University Graduate School of Medicine, Gifu, Japan.,Department of Respiratory Medicine, Murakami Memorial Hospital, Asahi University, Gifu, Japan
| | - Junki Endo
- Department of Cardiology and Respirology, Gifu University Graduate School of Medicine, Gifu, Japan
| | - Fumitaka Ito
- Department of Cardiology and Respirology, Gifu University Graduate School of Medicine, Gifu, Japan
| | - Komei Yanase
- Department of Cardiology and Respirology, Gifu University Graduate School of Medicine, Gifu, Japan
| | - Sayaka Toyoshi
- Department of Cardiology and Respirology, Gifu University Graduate School of Medicine, Gifu, Japan
| | - Yuka Sasaki
- Department of Cardiology and Respirology, Gifu University Graduate School of Medicine, Gifu, Japan
| | - Chiemi Hirose
- Department of Pharmacy, Gifu University Hospital, Gifu, Japan
| | - Natsumi Arai
- Department of Pharmacy, Gifu University Hospital, Gifu, Japan
| | - Mika Kitahora
- Department of Pharmacy, Gifu University Hospital, Gifu, Japan
| | - Yasushi Ohno
- Department of Cardiology and Respirology, Gifu University Graduate School of Medicine, Gifu, Japan
| | - Yoshinori Itoh
- Department of Pharmacy, Gifu University Hospital, Gifu, Japan
| | - Shinya Minatoguchi
- Department of Cardiology and Respirology, Gifu University Graduate School of Medicine, Gifu, Japan
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Ito F, Ohno Y, Toyoshi S, Kaito D, Koumei Y, Endo J, Kamamiya F, Mori H, Mori M, Morishita M, Funaguchi N, Minatoguchi S. Pharmacokinetics of consecutive oral moxifloxacin (400 mg/day) in patients with respiratory tract infection. Ther Adv Respir Dis 2015; 10:34-42. [PMID: 26660898 DOI: 10.1177/1753465815620338] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
A population pharmacokinetic analysis was performed to investigate the pharmacokinetics of moxifloxacin (400 mg) following a once-daily oral administration in 28 patients with respiratory tract infection disease. The maximum plasma concentration and the area under the plasma concentration-time curve were 3.97 µg/ml and 51.74 µg·h/ml, respectively; these values were nearly equivalent to those of healthy adult men. Two adverse drug reactions (nausea, vomiting) occurred, but both reactions were mild and nonserious and the patients recovered without treatment. The pharmacokinetic profile of moxifloxacin in Japanese patients with respiratory tract infection and an underlying disease should thus be considered safe and comparable with that in healthy adult men, and adjustment of dose may do not need for age, sex, body weight, or renal function.
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Affiliation(s)
- Fumitaka Ito
- Second Department of Internal Medicine, Gifu University Graduate School of Medicine, Gifu, Japan
| | - Yasushi Ohno
- Second Department of Internal Medicine, Gifu University Graduate School of Medicine, 1-1 Yanagido, Gifu 501-1194, Japan
| | - Sayaka Toyoshi
- Second Department of Internal Medicine, Gifu University Graduate School of Medicine, Gifu, Japan
| | - Daizo Kaito
- Second Department of Internal Medicine, Gifu University Graduate School of Medicine, Gifu, Japan
| | - Yanase Koumei
- Second Department of Internal Medicine, Gifu University Graduate School of Medicine, Gifu, Japan
| | - Junki Endo
- Second Department of Internal Medicine, Gifu University Graduate School of Medicine, Gifu, Japan
| | - Fumihiko Kamamiya
- Second Department of Internal Medicine, Gifu University Graduate School of Medicine, Gifu, Japan
| | - Hidenori Mori
- Second Department of Internal Medicine, Gifu University Graduate School of Medicine, Gifu, Japan
| | - Masahiro Mori
- Second Department of Internal Medicine, Gifu University Graduate School of Medicine, Gifu, Japan
| | - Megumi Morishita
- Second Department of Internal Medicine, Gifu University Graduate School of Medicine, Gifu, Japan
| | - Norihiko Funaguchi
- Second Department of Internal Medicine, Gifu University Graduate School of Medicine, Gifu, Japan
| | - Shinya Minatoguchi
- Second Department of Internal Medicine, Gifu University Graduate School of Medicine, Gifu, Japan
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Ito F, Kawasaki M, Ohno Y, Toyoshi S, Morishita M, Kaito D, Yanase K, Funaguchi N, Asano M, Endo J, Mori H, Kobayashi K, Nishigaki K, Miyazaki T, Takemura G, Minatoguchi S. Noninvasive Tissue Characterization of Lung Tumors Using Integrated Backscatter Intravascular Ultrasound: An Ex Vivo Comparative Study With Pathological Diagnosis. Chest 2015; 149:1276-84. [PMID: 26513315 DOI: 10.1378/chest.14-3042] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/05/2014] [Revised: 08/07/2015] [Accepted: 09/22/2015] [Indexed: 11/01/2022] Open
Abstract
BACKGROUND Endobronchial ultrasonography (EBUS) facilitates a lung cancer diagnosis. However, qualitative tissue characterization of lung tumors is difficult using EBUS. Integrated backscatter (IBS) is an ultrasound technique that calculates the power of the ultrasound signal to characterize tissue components in coronary arteries. We hypothesized that qualitative diagnosis of lung tumors is possible using the IBS technique. The aim of the present study was to elucidate whether the IBS technique can be used in lung tissue diagnoses. METHODS Thirty-five consecutive patients who underwent surgery for lung cancer were prospectively enrolled. Surgical specimens of the lung and the tumor tissue were obtained, and the IBS values were measured within 48 h after surgery. Histologic images of lung and tumor tissues were compared with IBS values, and the relative interstitial area according to results of Masson's trichrome staining were determined by using an imaging processor. RESULTS The IBS values in tumor tissue were significantly lower than those in normal lung tissue (-50.9 ± 2.6 dB and -47.6 ± 2.6 dB, respectively; P < .001). The IBS values of adenocarcinomas associated with a good 5-year survival rate were higher than those of non-adenocarcinomas (-48.1 ± 1.6 dB and -52.6 ± 1.4 dB; P < .001). There were significant correlations between the IBS values and the relative interstitial area or micro air area in tumor (r = 0.53 and r = 0.67; P < .01). After combining normal lung tissue and adenocarcinomas with a good prognosis, the sensitivity and specificity for establishing the presence of lung tumors were 84% and 85%. CONCLUSIONS Qualitative diagnosis of lung tumors was possible, with a sensitivity of 84% and a specificity of 85%, using the ultrasound IBS technique.
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Affiliation(s)
- Fumitaka Ito
- Department of Respirology, Gifu University Graduate School of Medicine, Gifu, Japan
| | - Masanori Kawasaki
- Department of Cardiology, Gifu University Graduate School of Medicine, Gifu, Japan.
| | - Yasushi Ohno
- Department of Respirology, Gifu University Graduate School of Medicine, Gifu, Japan
| | - Sayaka Toyoshi
- Department of Respirology, Gifu University Graduate School of Medicine, Gifu, Japan
| | - Megumi Morishita
- Department of Respirology, Gifu University Graduate School of Medicine, Gifu, Japan
| | - Daizo Kaito
- Department of Respirology, Gifu University Graduate School of Medicine, Gifu, Japan
| | - Komei Yanase
- Department of Respirology, Gifu University Graduate School of Medicine, Gifu, Japan
| | - Norihiko Funaguchi
- Department of Respirology, Gifu University Graduate School of Medicine, Gifu, Japan
| | - Masahiro Asano
- Department of Respirology, Gifu University Graduate School of Medicine, Gifu, Japan
| | - Junki Endo
- Department of Respirology, Gifu University Graduate School of Medicine, Gifu, Japan
| | - Hidenori Mori
- Department of Respirology, Gifu University Graduate School of Medicine, Gifu, Japan
| | - Kazuhiro Kobayashi
- Pathology Division, Gifu University Graduate School of Medicine, Gifu, Japan
| | - Kazuhiko Nishigaki
- Department of Cardiology, Gifu University Graduate School of Medicine, Gifu, Japan
| | - Tatsuhiko Miyazaki
- Pathology Division, Gifu University Graduate School of Medicine, Gifu, Japan
| | - Genzou Takemura
- Department of Cardiology, Gifu University Graduate School of Medicine, Gifu, Japan
| | - Shinya Minatoguchi
- Department of Cardiology, Gifu University Graduate School of Medicine, Gifu, Japan
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Fujimoto K, Toyoshi S. Reverse Spillover of Hydrogen on Carbon and its Participation in Catalytic Dehydrogenation. ACTA ACUST UNITED AC 1981. [DOI: 10.1016/s0167-2991(09)60274-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/08/2023]
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