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一家系 (兄弟といとこ) に, ほぼ同時期に発生した扁平上皮癌の3症例につき, その経過を報告する. 1例目は63才男子で手術により, 2例目は62才男子で気管支鏡生検により確定診断を得ており, 3例目は60才男子で頸部リンパ腺転移巣の生検にて判明した. 1例と2例は兄弟であり, 3例は1, 2例の父方のいとこで, 40年以上同一生活をしており, いずれの発症も昭和45年3月から8月までで, 胸部レ線で無気肺を呈していた.

Summary A case is reported in which a patient with complete heart block and an internal pacemaker underwent successful lobectomy for a squamous cell carcinoma of the lung. The significance of maintaining a normal blood volume during the operative and postoperative period is stressed. Serial blood volume deteminations are recommended as part of the routine management of such cases. The insertion of new myocardial leads during the thoracotomy anticipated future electronic failure and averted subsequent major surgery.

SUMMARY.— A case of systemic sclerosis associated with squamous cell carcinoma of the lung is presented. The relationship between malignant disease and systemic sclerosis is briefly discussed. Haemoptysis occurilng in a patient with systemic sclerosis may not be caused by the disease but be due to neoplastic change in the lung, and therefore merits full investigation.

A simple method of inducing carcinomas of the lung in rats has been employed to examine the mechanism of pulmonary carcinogenesis by cigarette smoke condensate (CSC). The method consists of injecting directly into the surgically exposed lung a heated mixture of beeswax and tricaprylin to which CSC or its components has been added. During the subsequent 2 years, a progressive series of metaplastic and neoplastic epithelial changes occur at the surface of the solidified pellet which, because of their focal nature, can be examined in detail and compared quantitatively. Final crude incidence rates for squamous cell carcinoma of the lung ranged from 14% to 34% when doses of a refined heptane soluble fraction were employed at levels of 12 mg to 72 mg. Preliminary response to the neutral fraction of CSC and a primary subfraction indicate that the highest carcinogenic potential resides with the neutral polynuclear aromatic hydrocarbons. Both the highly polar subfraction of the neutrals and the weak acid fraction are also active at proportions compatible with response on mouse skin painting experiments.

Mediastinal lymph node dissection in conjunction with pulmonary resection was performed on 231 patients with bronchogenic carcinoma. Mediastinal metastases were found in 48 patients. Thirty-six of these 48 patients underwent mediastinal irradiation in the immediate postoperative period. Seven of the 36 patients receiving postoperative irradiation lived five years (an absolute five-year survival rate of 19.5%). Of 17 patients with squamous cell carcinoma and mediastinal metastases, 5 lived five years (a five-year survival rate of 29.5%); only 1 of the 17 patients with adenocarcinoma and mediastinal metastases lived five years (an absolute survival rate of 5.9%). No patient who did not receive mediastinal irradiation postoperatively survived five years. The presence of mediastinal lymph node involvement in patients with squamous cell carcinoma of the lung is not a contraindication to resection because long-term survival can be achieved in a significant percentage of these patients.

Metastases are not uncommon in patients with carcinoma of the lung, but it is sometimes difficult to distinguish local metastases from direct spread. The mediastinal tissues may be extensively involved by direct infiltration from a hilar growth and the vertebrae, ribs, or sternum may be eroded by direct extension. Metastasis to mediastinal nodes, upwards to the supraclavicular and cervical nodes and downwards to abdominal nodes commonly occurs. Widespread visceral metastases may be seen especially in the liver, brain, and adrenals, and occasionally secondaries are found in the skin and other organs. Remote metastases in bone are also fairly frequently found. Harnett (1943) reviewed the cases of cancer recorded by the British Empire Cancer Campaign from April 1938 to September 1939 in hospitals in the administrative county of London; out of 15, 197 cases of cancer, 1,023 arose in the bronchi, lungs or pleura; of these 361 (35·2 per cent.) showed metastases. The site of metastasis detected clinically or radi...

CYTOLOGICAL EXAMINATION of the aqueous humor established the presence of an ocular malignancy in a 64-year-old man who presented with "uveitis." The tumor was a mucoepidermoid carcinoma of the ciliary body considered to be metastatic from a squamous cell carcinoma of the lung. The part played by cytopathologic examination and the unusual nature of the ocular tumor are the principal features of the case report. Report of a Case For five months prior to admission, this 64-year-old white steel worker (06-65-93) was under ophthalmological care for chronic iridocyclitis of undetermined origin and secondary glaucoma. The condition was refractory to all treatment including topical and systemic corticosteroids, corticotropin, systemic antibiotics, and antituberculous therapy. The patient had a long history of cigarette smoking, morning cough, and an unexplained 4.5 kg (10 lb) weight loss during the course of the present illness. At the time of admission to the Ophthalmology Branch (March 23