BACKGROUND Macrophage migration inhibitory factor (MIF) is known to be a proinflammatory cytokine and glucocorticoid‐induced immunomodulator as well as a regulator of tumor growth. Although positive and negative effects of MIF on tumor cell growth have been reported, to the authors' knowledge the precise role of MIF in tumorigenesis remains unclear. In the current study the authors assessed expression of MIF protein and mRNA in lung adenocarcinomas with regard to patient prognosis. METHODS Immunohistochemical analysis was performed on tissue specimens surgically obtained from 74 patients with primary lung adenocarcinoma (American Joint Committee on Cancer pathologic Stages I, II, and IIIa). In addition, expression of MIF mRNA in the cancerous tissue was investigated using in situ hybridization. Patient prognosis was evaluated with regard to MIF expression levels and its distribution was analyzed with the Kaplan–Meier method. RESULTS MIF mRNA and MIF protein were observed in the bronchial epithelium, alveolar epithelium, vascular smooth muscle, and alveolar macrophages in the normal lung tissue. In tumor tissue from lung adenocarcinoma specimens, both MIF mRNA and protein were observed at much higher levels than in the normal alveolar epithelium. MIF protein was observed diffusely in the cytoplasm of tumor cells in all tumor specimens examined. MIF protein also was observed in the nuclei of tumor cells from 59 patients (79.7%), whereas it was not observed in the nuclei of tumor cells from 15 patients (20.3%). The patients without nuclear MIF expression had a worse prognosis compared with those patients with MIF expression in the nuclei (P = 0.04). CONCLUSIONS The results of the current study suggest that intracellular MIF distribution predicts patient prognosis in individuals with adenocarcinoma of the lung. Cancer 2000;89:334–41. © 2000 American Cancer Society.

Wereport a case of mucousgland adenomaof the trachea in a 73-year-old male revealed by bronchoscopy. The tumor was resected with a contact neodymium:yttrium aluminum garnet (Nd-YAG)laser after five years of observation. The tumor was histologically peculiar because it presented numerous cystically dilated, or irregularly shaped mucus-filled glands lined with cuboidal or tall columnar cells. In some parts, the lining cells of the tumor showed papillary proliferation. Wediagnosed this tumor as a mucous gland adenomaof the trachea. Wereview the clinical features of this rare tumor and discuss the usefulness of the laser in the diagnosis and the therapy. (Internal Medicine 35: 890-893, 1996)

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After chemotherapy and radiotherapy for nonHodgkin's lymphoma during a one-year period, a 66-year-old mandeveloped synchronous triple lung cancers in both lungs. Of the three resected tumors, one was advanced large cell carcinoma with neuroendocrine morphology, and the other two were early squamouscell carcinoma without lymph node metastasis. Although he received repeated chemotherapy for lung cancer, the patient died of hepatic failure due to multiple liver metastases. Autopsy revealed disseminated metastasis of the large cell carcinoma with neuroendocrine morphology throughout the entire body, but no recurrence of malignant lymphoma or squamouscell carcinoma was found. To our knowledge, this is the first report of triple lung cancers occurring after treatment for malignant lymphoma.

Background: Since the prognosis of patients with stage IIIA N2 non-small cell lung cancer is poor, investigation of combined modality therapy is necessary. Case: The patient was a 53-year-old man. He was admitted because of an abnormal shadow on his chest X-ray film. He received a diagnosis of adenocarcinoma of the lung, T1N2M0, stage IIIA. Because of the bulky lymph node, neoadjuvant chemotherapy was performed. After chemotherapy (Cisplatin 25 mg/m2, day 1, 8, 15+Docetaxel 20 mg/m2,day 1, 8, 15) with concurrent radiotherapy (40Gy/16fr), # 2 lymph node was reduced and primary lesion was detected only as a scar. After chemoradiotherapy right upper lobectomy with regional lymph node dissection (ND2a) was performed. Microscopic findings of the resected specimen showed no tumor tissue. Conclusion : We describe our experience with an advanced non-small cell lung cancer which achieved complete response after chemoradiotherapy. This result indicates that neoadjuvant chemoradiotherapy before surgical resection might be useful.