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Few reports are currently available on the surgical management of bronchiectasis. We report our experience with 8 cases of bronchiectasis. The indications of pulmonary resection were recurrent pneumonia and/or hemoptysis in spite of medical treatment and the extent mainly limited to the unilateral lung. With the exception of one patient, who died from postoperative pneumonia, all patients showed improvement in symptoms. However, in two cases, hemoptysis recurred; these patients had cystic bronchiectasis, Pseudomonas aeruginosa infections and minimal disease in the contralateral lung, which accounted for the recurrence of hemoptysis. A few reports indicated that cystic bronchiectasis and incomplete resection were adverse prognostic factors and that Pseudomonas aeruginosa infections were related to the development of new bronchiectasis. However, according to some other reports, these factors were not adverse prognostic factors. It is thought that the analysis of many cases is required to determine the indication of lung resection and the appropriate type of resection for bronchiectasis; however, it is difficult to conduct randomized control studies. Since the accumulation of case reports is also considered to be important, we report our series of cases.

A 75-year-old woman with Mycobacterium avium complex (MAC) pulmonary disease who had been treated by drug therapy for 7 years was admitted on an emergency basis for hemoptysis. Through the previous 7 years, her sputum cultures had been positive for MAC, and her clinical symptoms and examinations, such as chest X-ray and computed tomography, revealed that her condition had worsened. The lesions spread over the right middle lobe, segment 3 (S3) in the right upper lobe, and segment 6 (S6) in the right lower lobe, however, no lesions were present in the left lung. Since we believed that the disease was localized unilaterally, surgical treatment was selected. The surgical procedures that were employed included right middle lobectomy, right S3 segmentectomy and partial resection of right S6 by thoracoscopy. Sixteen months postoperatively, the sputum culture is negative for MAC. Our procedure enabled the preservation of effective lung function and was successful in controlling MAC pulmonary disease. It is believed that surgery for MAC pulmonary disease should be evaluated in more patients to decide the appropriate surgical indication and procedure.

We report a case of lung adenocarcinoma with stromal bone formation. A 73-year-old woman was incidentally found to have a coin lesion in the left lower lung field on a chest roentgenogram and computed tomography showed a nodular lesion containing a few coarse high density areas in the left lower lobe. Since transbronchial cytology revealed adenocarcinoma, left lower lobectomy was performed. Histologically, the tumor was a papillary-tubular adenocarcinoma, and fragments of osseous tissue were found within abundant fibrous stroma. Bone formation in primary lung adenocarcinoma is a very rare condition, and only 7 other cases have been reported in the literature.