[Primary varicella pneumonia with respiratory failure].

Varicella pneumonia is a rare but serious and occasionally fatal complication of infection with varicellazoster. A 40-year-old man was admitted to our hospital with fever, eruptions, dyspnea, and severe hypoxemia. A chest X-ray film showed diffuse nodular infiltrative shadows in both lung fields. Transbronchial lung biopsy was done, and examination of the specimen revealed an organizing exudative reaction in the alveolar spaces, as well as interstitial inflammation. Primary varicella pneumonia was diagnosed on the basis of family history, typical eruptions, high titer of antibody against varicellazoster virus, and pathological findings. The patient was treated with methylprednisolone, antibiotics, acyclovir, and immunoglobulin. The skin eruptions and disturbances of gas exchange and diffusion resolved in about one week, but the infiltrative shadows on chest X-ray films remained for more than eight weeks.

[Primary lung cancer of the right middle lobe].

During the period from 1973 to 1986, 230 patients with lung cancer were operated on at our Surgical Clinic of Kagoshima University Hospital. There were fourteen patients (6.1%) with lung cancer in the right middle lobe. There were 13 male and 1 female patients. The histological types were adenocarcinoma (10), squamous cell carcinoma (4). Five-year survival rate of 14 patients was 34.9%. Statistically, it was similar to that of the patients with lung cancer in the other lobes. As concerns with the histological type of lung cancer in the right middle lobe, the case of squamous cell carcinoma revealed poorer prognosis than those of adenocarcinoma, because there were many cases of advanced cancer in the former case.