[Case of scimitar syndrome with pulmonary sequestration].
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Biomedical subjects
Publications and source records attributed to Y Ohsaki.
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The manufacturing process of the chromate industry can be classified into five steps. The main hazardous pollutants of the first step are trivalent chromate compounds, and those of the second and third steps are hexavalent chromate compounds. Analysis of the detailed working history of chromate workers with bronchogenic carcinoma, yielded the following results: the work history of chromatic lung cancer patients in the first step, which produced mainly trivalent chromate dust, was rather short. Patients with small cell carcinoma were engaged mainly in the second step (98.1% of the total working months), where they were heavily exposed to hexavalent chromate dusts. Patients with squamous cell carcinoma were engaged rather evenly in the second and fourth steps, and somewhat longer in the third step. Comparisons of the exposure periods revealed that the working history of small cell carcinoma patients was significantly shorter than that of squamous cell carcinoma patients. There were many more heavy smokers among the squamous cell carcinoma group as compared to the small cell carcinoma patients. Based on these results, it is concluded that the cell type of occupational lung cancer was mainly small cell carcinoma when the exposure to carcinogenic agents was heavy, and that the carcinogenicity of chromate was derived mainly from hexavalent chromate rather than trivalent compounds.
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The genesis of unusual radiographic shadows by bronchi filled with tumor cells is reported. These shadows, similar to those caused by mucus or pus, are rod-like and indicate the replacement of air by water dense materials. The unifying term, "bronchial cast shadow" is proposed as the radiographic diagnostic sign.
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A case with huge cystic disease of the lung was reported. The plain chest X-P revealed several linear shadows in the left middle lung field. Bronchography disclosed multiple cystic lesions located mainly in the left lung. There were also several small cystic lesions in the right lung. No inflammatory findings of the bronchi were found. Difficult problem concerning differential diagnosis between acquired and congenital cystic disease of the lung was discussed.
The chromium content was measured in the lungs of chromate workers, obtained at necropsy in six patients and at surgery in two. The mean chromium content of peripheral lung tissue was 36.7 micrograms per gm wet weight (range 0.50 to 130.2 micrograms) and that of the large airways was 0.51 micrograms per gm wet weight (range 0.22 to 0.99 micrograms). These means values were high compared with those from control lungs of a non-chromate exposed lung cancer patients--respectively 0.21 micrograms per gm in lung tissue and 0.11 micrograms per gm in the large bronchi. The longer the exposure period, the higher was the chromium content in the lungs. The concentration of chromium in the upper lobes was significantly higher than that in the lower lobes, suggesting regional differences either in clearance from or deposition in the lung. Moreover, it was apparent that the metal remained in the lungs long after exposure to chromate had ceased
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