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Biomedical subjects

K Shigehara

Publications and source records attributed to K Shigehara.

21 records · Page 2Linked to original sources

[A case of pulmonary sarcoidosis with B lymphocytosis in peripheral blood].

A 24-year-old man was admitted on October 14, 1988, with bilateral cotton-like shadows on chest X-ray film. Chest CT demonstrated multiple nodular shadows in bilateral lung fields. Laboratory data on admission showed peripheral blood lymphocytosis and slight decrease of serum IgG and IgA. ACE was within normal limits, and BALF findings showed no increase of lymphocytes. Surface marker analysis of peripheral blood lymphocytes showed an increase of B lymphocytes of antibody independent stage (B1, B4, J5, OKB7, sIgM, and sIgD positive cells were increased). Southern blot analysis of peripheral blood showed no rearrangement of immunoglobulin chains (H chain and L chain). In order to differentiate sarcoidosis from lymphoproliferative disorder, open lung biopsy was performed. Pathologic study revealed multiple epithelial granulomas without caseation. Immunohistochemical study demonstrated no accumulation of B cells of the lung. This patient was pathologically diagnosed as having pulmonary sarcoidosis. The abnormal chest shadows gradually improved without therapy; however, B cell lymphocytosis and slight decrease of serum IgG and IgA persisted. In general, lymphocytopenia of peripheral blood is usual in sarcoidosis. We report a rare case of pulmonary sarcoidosis with polyclonal B lymphocytosis of antibody independent stage in peripheral blood.

Adult↗

[A case of the management of developed collateral vessels through left thoracotomy of recurrence of right bronchiectasia with hemoptysis].

A 40-year-old woman, with a previous history of right S1, S2 segmentectomy and right middle lobectomy for bronchiectasis with hemoptysis at the age of 24, was admitted for frequent hemoptysis. As a result of a chest roentgenogram, a CT scan and bronchographic examination, a recurrence of bronchiectasis in the right ventral segment of the upper lobe (S3) and the right superior segment of the lower lobe (S6) was diagnosed. The bronchial arteriogram and aortogram showed four vessels going into this region and a shunt lesion was located on located on the proximal side of the pulmonary artery. If a right pneumonectomy had been done, pulmonary function would have gotten worse. If a right thoracotomy had been performed, there would have been much bleeding from the entering vessels. Therefore, a left thoracotomy was preformed and those vessels ligated. The patient is doing well one year after the operation without hemoptysis.

Adult↗

A case of Trichosporon pullulans infection of the lung with adult T-cell leukemia.

Fungal infections are often reported, but Trichosporon infection is very rare. A 78-year-old man with adult T-cell leukemia complicated with pulmonary infections is presented. Bronchial exudate culture revealed many yeast-like colonies, which were morphologically and biochemically identified as Trichosporon pullulans.

Aged↗