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Sample records for abdominal lymph nodes

  1. CT diagnosis of abdominal lymph node metastases in hepatocellular carcinoma

    Tanaka, T.; Nakamura, H.; Choi, S.; Morimoto, K.; Kawamoto, S.; Hori, S.; Tokunaga, K.; Yoskioka, H.; Kuroda, C.

    1985-08-01

    CT scanning is useful for diagnosing abdominal lymph node metastasis. Using this technique, histologically confirmed abdominal lymph node metastases were detected in nine of 49 patients (33 autopsy cases and 16 laparotomy cases) with hepatocellular carcinoma (hepatoma). Among the 49 patients, three had periportal (6.1%), six peripancreatic (12.2.%) and six para-aortic adenopathies (12.2%). Two of the patients had adenopathy at all three sites. Retrospectively, CT detected two periportal, four peripancreatic and all six para-aortic adenopathies. Most of the hepatomas with adenopathy showed infiltrative growth; tumour thrombosis of the portal vein was a common complication.

  2. CT diagnosis of abdominal lymph node metastases in hepatocellular carcinoma

    CT scanning is useful for diagnosing abdominal lymph node metastasis. Using this technique, histologically confirmed abdominal lymph node metastases were detected in nine of 49 patients (33 autopsy cases and 16 laparotomy cases) with hepatocellular carcinoma (hepatoma). Among the 49 patients, three had periportal (6.1%), six peripancreatic (12.2.%) and six para-aortic adenopathies (12.2%). Two of the patients had adenopathy at all three sites. Retrospectively, CT detected two periportal, four peripancreatic and all six para-aortic adenopathies. Most of the hepatomas with adenopathy showed infiltrative growth; tumour thrombosis of the portal vein was a common complication. (orig.)

  3. Abdominal lymph node metastases of hepatocellular carcinoma diagnosed by computed tomography and angiography

    Nakamura, Hironobu; Oi, Hiromichi (Osaka Univ. (Japan). Research Inst. for Microbial Diseases); Tanaka, Takeshi; Sai, Soomi; Hori, Shinichi

    1984-04-01

    CT scans of 164 patients with hepatocellular carcinoma were studied, and abdominal lymph node metastases were detected in 13 cases. Most of these lymph node metastases occured in periportal, peripancreatic and paraaortic lymph nodes. Ten instances of each these metastases were identified by CT. Six of the patients had metastases in all three sites. In 9 of 13 cases, lymph node metastases were demonstrated by angiography and various degrees of contrast material stain were seen. Lymph node metastasis of hepatocellular carcinoma is apt to be hypervascular. Most of hepatocellular carcinoma with lymph node metastasis showed infiltrative growth, and tumor thrombosis in the portal vein was commonly complicated.

  4. Radiation therapy for abdominal lymph node metastasis from hepatocellular carcinoma

    We report the results of radiotherapy for abdominal lymph node metastasis from hepatocellular carcinoma (HCC). From 1998 to 2004, 45 cases were treated with radiotherapy (RT), with a dose between 30 and 55 Gy. The radiation response, overall survival, prognostic factors, and complications were evaluated. Thirty-nine cases were able to be evaluated for response: 10 cases showed complete response; 21 cases showed a partial response; and 8 cases showed stable disease. The overall response rate was 79.5%. The response rate was 87.5% for patients receiving ≥40 Gy10 (biologically effective dose, α/β=10) and 42.9% for patients receiving 10 (P=0.02). The median survival time was 10 months for responders and 6 months for nonresponders (P=0.01). The absence of other concurrent distant metastasis and controllable primary HCC were significant prognostic factors. RT induced gastric or duodenal ulcer development in nine patients. All of these patients had received more than 50 Gy10, and these complications were not detected among patients receiving 10 (0% vs 37.5%, P10 to 50 Gy10 might be the optimal RT dose. (author)

  5. Accuracy of abdominal lymph node scintigraphy in tumor diagnostics

    In view of the diagnostical correspondence between lymph node scintigraphy and X-ray lymphograpy, this dissertation, which is based on 110 systematic comparative evaluations, examines the diagnostical weight of the scintigraphic criteria for tumor growth, discusses diagnostical discrepancies and confirms the efficacy of lymph node scintigraphy in detecting malignomas. In discussing the diagnostical results in the light of previous experience, the shortcomings of the nuclear medical method in tumor diagnostics are shown to be attributable to the uncertainty of the individual scintigraphic criteria. Owing to the variability of the lymph node system as to topography, anatomy and retention rate and the fact that it cannot morphologically be well differentiated in the scintigram, X-ray lymphography to verify the scintigraphic result and preclude misinterpretation remains an indispensable measure. (orig.)

  6. Detection of abdominal lymph node metastases from esophageal and cardia cancer by computed tomography

    Shima, S.; Sugiura, Y.; Yonekawa, H.; Ogata, T. (National Defence Medical Coll., Tokorosawa, Saitama (Japan))

    1982-03-01

    In order to evaluate the sensitivity of computed tomography (CT) scan in detecting the abdominal lymph node metastases, preoperative CT scan was performed in 16 patients with carcinoma of the esophagus and gastric cardia. Ten patients (62.5%) had pathological evidence of lymph node metastases in the abdominal cavity and 4 of them were identified to involve the para-aortic nodes. CT scan correctly demonstrated the lymph node metastases in the para-aortic and celiac axisis areas, but failed to detect other abdominal lymph node involvements, which were small enough to be excised by operation. The para-aortic nodes on the CT scan showed the following two features; one was nodular mass in shape, which did not obscure the aorta or inferior vena cava, and the other was conglomerated mass, which was difficult to be distinguished from the aorta. The former was resectable and the latter was not.

  7. Tuberculosis versus lymphoma in the abdominal lymph nodes: A comparative study using contrast-enhanced MRI

    Purpose: The purpose of this study was to determine the differential characteristics on MRI between tuberculosis and lymphoma in abdominal lymph nodes. Materials and methods: We conducted a retrospective analysis for the counter, size, signal intensity, enhancement patterns, and anatomic distribution of lymph nodes in 57 consecutive patients with documented tuberculosis (28 patients; 49.1%) and newly diagnosed, untreated lymphoma (29 patients; 50.9%). Results: Twenty-four cases (85.7%) in the tuberculosis group were hyperintense on T2-weighted images and either hypointense or isointense on T1-weighted images with respect to the abdominal wall muscle. All cases in the lymphoma group were hyperintense on T2-weighted images and isointense on T1-weighted images with respect to the abdominal wall muscle. Concerning the main anatomic distribution of lymph nodes, the lymph nodes in the lower paraaortic region were more frequently involved in the lymphoma group (48.3%) than in tuberculosis (17.9%, p < 0.05). Moreover, mesenteric lymph nodes were more often involved in tuberculosis (32.1%) than in lymphoma (6.9%, p < 0.05). Tuberculous lymphadenopathy showed predominantly peripheral enhancement, frequently with a multilocular appearance; whereas lymphomatous adenopathy often demonstrated uniform homogeneous enhancement (all p < 0.001). Conclusion: Contrast-enhanced MRI can be useful in differentiation between these two entities

  8. CT diagnosis of 52 patients with lymphoma in abdominal lymph nodes

    Ri-Sheng Yu; Wei-Min Zhang; Yi-Qing Liu

    2006-01-01

    AIM: To assess CT manifestations and its diagnostic value for lymphoma in the abdominal lymph nodes (LALN).METHODS: CT findings in 52 cases of LALN proved by surgery or biopsy, including Hodgkin's disease (HD) in 16 cases and non-Hodgkin's lymphoma (NHL) in 36 cases,were retrospectively analyzed.RESULTS: (1) CT manifestations based on distribution of the lesions of LALN: Solitary mass type was found in 10 cases, including solitary, round, uniform-density,enlarged lymph nodes in 3 cases; and multiple, enlarged lymph nodes fusing into singular lobular mass in 7cases. Thirty-four cases of multiple-nodular type showed multiple, round, enlarged lymph nodes with uniform density and clear margins. Vessels-embedded signs,including mesenteric vessels, renal vessels, abdominal aorta or inferior vena cava, were seen in 6 cases, and duodenum-embedded signs were seen in 2 cases. Eight cases of diffuse type showed characteristic "cobblestone signs". (2) CT manifestations correlated with pathological type: CT manifestations of 12 cases of HD were different from those of 40 cases of NHL in distribution, size,quantity and fused lesion of enlarged lymph nodes. (3)Twenty-eight cases of 52 patients were accompanied with extra-nodal lymphoma in the abdomen, especially gastrointestinal lymphoma, which had characteristic CT findings. (4) In follow-up examinations, CT images showed uniform, heterogeneous or rim enhancement in 15 cases, and occasional calcifications accompanied with reduction of the lesion size and quantity in 12 cases, whereas the lesions disappeared in 3 cases after treatment.CONCLUSION: CT images show many characteristic manifestations valuable for qualitative diagnosis of LALN,and it is also helpful for pathological classification of LALN and therapeutic evaluation in follow-up of patients.

  9. Pathways of lymph node involvement in upper abdominal malignancies: evaluation with high-resolution CT

    Efremidis, S.C.; Vougiouklis, N.; Zafiriadou, E.; Sofianou, F. [Department of Diagnostic Radiology, Hippokration Hospital and Medical Center, GR-54642 Thessaloniki (Greece); Sbarounis, C.; Fardellas, Y. [Department of Surgery, Hippokration Hospital and Medical Center, GR-54642 Thessaloniki (Greece); Patsiaura, K.; Leontsini, M. [Department of Pathology, Hippokration Hospital and Medical Center, GR-54642 Thessaloniki (Greece)

    1999-06-01

    The aim of this study was to enhance our understanding of the pathways of lymphatic spread of primary carcinomas in the upper abdomen by recognizing the development, configuration, and frequency of nodal enlargement in discrete anatomic regions. The study included 417 patients with histologically confirmed carcinomas (CC) of the stomach (n = 267), liver (n = 98), gallbladder (n = 25), and bile ducts (n = 27). All patients were studied by high-resolution CT and tumor extension to the lymph nodes of the subperitoneal space was clearly identified in 59 patients [33 with CC of the stomach, 8 with CC of the gallbladder, 3 with CC of the bile ducts, and 15 with hepatocellular carcinoma (HCC)]. In 47 of 59 patients this extension was confirmed by surgery or aspiration biopsy. Three discrete anatomic groups of lymph nodes were recognized producing a relatively distinct CT configuration when involved: (a) the hepatoduodenal seen in 49 patients; (b) the peripancreatic demonstrated in 33 patients; and (c) the aortocaval recognized in 16 patients. These groups of lymph nodes can be seen individually involved or in combination. Recognition of involvement of these nodes is important for correct diagnosis and staging of upper abdominal malignancies. The development of this involvement follows the natural flow of lymph via the lesser omentum to the retroperitoneal space. (orig.) With 9 figs., 2 tabs., 15 refs.

  10. Sentinel Lymph Node Biopsy

    ... Ask about Your Diagnosis Research Sentinel Lymph Node Biopsy On This Page What are lymph nodes? What ... lymph node? What is a sentinel lymph node biopsy? What happens during an SLNB? What are the ...

  11. Lymph node biopsy

    Biopsy - lymph nodes; Open lymph node biopsy; Fine needle aspiration biopsy; Sentinel lymph node biopsy ... A lymph node biopsy is done in an operating room in a hospital. Or, it is done at an outpatient surgical center. The ...

  12. Malignant transformation of abdominal wall endometriosis with lymph node metastasis ☆

    Fargas Fàbregas, Francesc; Cusidó Guimferrer, Maite; Tresserra Casas, Francesc; Baulies Caballero, Sonia; Fábregas Xauradó, Rafael

    2014-01-01

    Highlights • A simple endometriosis can result in malignancy pathology, as a neoplasia. • Wall-abdominal tumors and soft tissue as a possible differential diagnosis of abdominal wall endometriosis • Preperitoneal node-metastasis as malignancy of endometriosis in previous cesarean scar

  13. Ultrasound detection of abdominal lymph nodes in chronic liver diseases. A retrospective analysis

    Soresi, M.; Bonfissuto, G.; Magliarisi, C.; Riili, A.; Terranova, A.; Di Giovanni, G.; Bascone, F.; Carroccio, A.; Tripi, S.; Montalto, G. E-mail: gmontal@unipa.it

    2003-05-01

    AIM: To retrospectively evaluate the prevalence of lymph nodes of the hepato-duodenal ligament in a group of patients with chronic liver disease of various aetiologies and to investigate what clinical, aetiological and laboratory data may lead to their appearance. MATERIALS AND METHODS: One thousand and three patients (554 men, 449 women) were studied, including 557 with chronic hepatitis and 446 with liver cirrhosis. The presence of lymph nodes near the trunk of the portal vein, hepatic artery, celiac axis, superior mesenteric vein and pancreas head was investigated using ultrasound. RESULTS: Lymph nodes were detected in 394 out of the 1003 study patients (39.3%); their number ranged from one to four, with a diameter ranging between 0.8 and 4 cm. The highest prevalence was in the subgroup of patients with primary biliary cirrhosis (87.5%), followed by patients with hepatitis C virus (HCV; 42%), patients with HCV and hepatitis B virus (HBV; 41.3%), autoimmune hepatitis (40%), and HBV alone (21.2%). In the alcoholic and idiopathic subgroups prevalence was 9.5%, while in the non-alcoholic steatohepatitis and haemochromatosis subgroups it was 0%. HCV RNA was present in 97 out of 103 lymph node-positive patients and in 141 out of 168 lymph node-negative HCV-negative patients (p<0.003). Lymphadenopathy frequency increased as the liver disease worsened ({chi}{sup 2} MH=74.3; p<0.0001). CONCLUSION: Despite the limitations of a retrospective study, our data indicate a high prevalence of lymphadenopathy in liver disease patients; ultrasound evidence of lymph nodes of the hepato-duodenal ligament in a given liver disease may most likely suggest a HCV or an autoimmune aetiology and a more severe histological picture.

  14. Leptin deficiency-induced obesity affects the density of mast cells in abdominal fat depots and lymph nodes in mice

    Altintas Mehmet M

    2012-02-01

    Full Text Available Abstract Background Mast cells are implicated in the pathogenesis of obesity and insulin resistance. Here, we explored the effects of leptin deficiency-induced obesity on the density of mast cells in metabolic (abdominal fat depots, skeletal muscle, and liver and lymphatic (abdominal lymph nodes, spleen, and thymus organs. Fourteen-week-old male leptin-deficient ob/ob mice and their controls fed a standard chow were studied. Tissue sections were stained with toluidine blue to determine the density of mast cells. CD117/c-kit protein expression analysis was also carried out. Furthermore, mast cells containing immunoreactive tumor necrosis factor-α (TNF-α, a proinflammatory cytokine involved in obesity-linked insulin resistance, were identified by immunostaining. Results ob/ob mice demonstrated adiposity and insulin resistance. In abdominal fat depots, mast cells were distributed differentially. While most prevalent in subcutaneous fat in controls, mast cells were most abundant in epididymal fat in ob/ob mice. Leptin deficiency-induced obesity was accompanied by a 20-fold increase in the density of mast cells in epididymal fat, but a 13-fold decrease in subcutaneous fat. This finding was confirmed by CD117/c-kit protein expression analysis. Furthermore, we found that a subset of mast cells in epididymal and subcutaneous fat were immunoreactive for TNF-α. The proportion of mast cells immunoreactive for TNF-α was higher in epididymal than in subcutaneous fat in both ob/ob and control mice. Mast cells were also distributed differentially in retroperitoneal, mesenteric, and inguinal lymph nodes. In both ob/ob mice and lean controls, mast cells were more prevalent in retroperitoneal than in mesenteric and inguinal lymph nodes. Leptin deficiency-induced obesity was accompanied by increased mast cell density in all lymph node stations examined. No significant difference in the density of mast cells in skeletal muscle, liver, spleen, and thymus was

  15. Prognostic indicators for radiotherapy of abdominal lymph node metastases from hepatocellular carcinoma

    Lee, Doo Yeul; Park, Joong-Won; Kim, Tae Hyun; Lee, Ju Hee; Kim, Bo Hyun; Woo, Sang Myung; Kim, Sang Soo; Lee, Woo Jin; Kim, Dae Yong; Kim, Chang-Min [National Cancer Center, Center for Liver Cancer, Research Institute and Hospital, Goyang (Korea, Republic of)

    2015-11-15

    To identify prognostic indicators in patients treated with radiotherapy (RT) for metastases from hepatocellular carcinoma (HCC) in abdominal lymph nodes (LNs). RT was used to treat 65 patients for metastases from HCC in abdominal LNs. Total radiation dose was 30-60 Gy (median 52.8 Gy), with fraction size 1.8-3 Gy. RT was administered five times per week to an equivalent dose in 2-Gy fractions (EQD2; Gy{sub 10}) of 32.5-65 Gy{sub 10} (median 54 Gy{sub 10}) and an α/β ratio for tumor and acute effects of normal tissue of 10. Median overall survival (OS) in all patients was 8.1 months. LN responders had significantly higher median OS than nonresponders (14.5 vs. 3.7 months, p < 0.05). Multivariate analysis showed that Child-Pugh classification, status of intrahepatic tumor, number of metastatic LNs, and LN response were independently predictive of OS (p < 0.05 each). Based on results of multivariate analysis, patients were prognostically stratified according to pretreatment risk factors, including Child-Pugh classification, intrahepatic tumor status, and number of metastatic LNs; with the expected median OS in patients with ≥ 2, 1, and 0 risk factors being 2.9, 9.8, and 27.6 months, respectively (p < 0.05). Our data showed that LN response to RT was an independent prognostic factor for OS in advanced HCC patients with abdominal LN metastases, and suggested that RT for metastatic LNs might improve OS in these patients. In addition, our data suggest that Child-Pugh classification, intrahepatic tumor status, and number of metastatic LNs may be useful prognostic and therapeutic indicators for selecting treatment strategies. (orig.) [German] Identifikation von Prognoseindikatoren fuer die Strahlentherapie (RT) von Metastasten in abdominalen Lymphknoten (LN) bei Patienten mit einem Leberzellkarzinom (HCC). Bei 65 Patienten wurden HCC-Metastasen in abdominalen LNs mit einer RT behandelt. Die Gesamtdosis betrug 30-60 Gy (Mittelwert 52,8 Gy), mit Einzeldosen zwischen 1

  16. Cervical lymph nodes

    Mack, Martin G. [Department of Diagnostic and Interventional Radiology, University Hospital Frankfurt, Johann Wolfgang Goethe-University, Theodor-Stern-Kai 7, 60590 Frankfurt/Main (Germany)], E-mail: martinmack@arcor.de; Rieger, Joerg [Department of Maxillo-Facial Surgery, University Hospital Frankfurt am Main, Theodor Stern Kai 7, 60590 Frankfurt/Main (Germany); Baghi, Mehran [Department of ENT Surgery, University Hospital Frankfurt am Main, Theodor Stern Kai 7, 60590 Frankfurt/Main (Germany); Bisdas, Sotirios; Vogl, Thomas J. [Department of Diagnostic and Interventional Radiology, University Hospital Frankfurt, Johann Wolfgang Goethe-University, Theodor-Stern-Kai 7, 60590 Frankfurt/Main (Germany)

    2008-06-15

    The lymph node staging is a very important prognostic parameter for patients with presenting with head neck cancer and is influencing the selection of the different therapeutic strategies including surgery, chemotherapy, radiotherapy or a combination of them. The accuracy of imaging techniques, such as US, MR imaging, and CT, depends on the appropriateness of radiological criteria used for diagnosing lymph node metastases. Size of nodes and evidence of necrosis are still the most important radiological criteria. However, the size shows great variability. A spherical lymph node larger than 10 mm is an indicator for a malignant node, whereas an oval shape and/or a fatty hilus are more benign signs. But there are many limitations and different cut offs published in the literature, indicating that the size of a lymph node is not a reliable criteria for the assessment of lymph nodes in the head and neck region. Today new high-resolution MRI sequences and the development of specific contrast agents are offering new possibilities in the diagnostic work-up of head and neck lymph nodes. Ultrasmall superparamagnetic iron oxide particles (USPIO's) are resulting after intravenous application in a reduction of the T2 relaxation time. This is causing a signal decrease on T2-weighted MR images in benign lymph nodes after administration of USPIO's, whereas malignant lymph nodes do not show a significant signal decrease. Some clinical studies presented already very promising results. Based on the fact, that the size evaluation of lymph nodes in the head and neck has not changed during the last decade, this paper will mainly focus on MRI with new contrast agents and new techniques as diffusion weighted imaging (DWI)

  17. Lymph node culture

    Culture - lymph node ... or viruses grow. This process is called a culture. Sometimes, special stains are also used to identify specific cells or microorganisms before culture results are available. If needle aspiration does not ...

  18. Clear cell carcinoma arising from abdominal wall endometriosis: a unique case with bladder and lymph node metastasis

    Liu, Haiyuan; Leng, Jinghua; Lang, Jinghe; Cui, Quancai

    2014-01-01

    The malignant transformation of abdominal wall endometriosis is a rare event and poorly understood. Less than 30 cases have been reported in the literature. Most of the reported cases have a solitary tumor in the abdominal scar. A few cases have metastasis. Here we report a case of clear cell carcinoma in abdominal wall endometriosis with bladder and lymph system metastasis. The patient had a history of abdominal wall endometriosis and recently developed symptoms of urgent urination and ingui...

  19. Stereotactic body radiation therapy for patients with recurrent pancreatic adenocarcinoma at the abdominal lymph nodes or postoperative stump including pancreatic stump and other stump

    Zeng, Xian-Liang; Wang, Huan-Huan; Meng, Mao-Bin; Wu, Zhi-Qiang; Song, Yong-Chun; Zhuang, Hong-Qing; Qian, Dong; Li, Feng-Tong; Zhao, Lu-Jun; Yuan, Zhi-Yong; Wang, Ping

    2016-01-01

    Background and aim The aim of this study is to evaluate the efficacy and safety of stereotactic body radiation therapy (SBRT) using CyberKnife in the treatment of patients with recurrent pancreatic adenocarcinoma at the abdominal lymph node or stump after surgery. Patients and methods Between October 1, 2006 and May 1, 2015, patients with recurrent pancreatic adenocarcinoma at the abdominal lymph node or stump after surgery were enrolled and treated with SBRT at our hospital. The primary end point was local control rate after SBRT. Secondary end points were overall survival, time to symptom alleviation, and toxicity, assessed using the Common Terminology Criteria for Adverse Events version 4.0. Results Twenty-four patients with 24 lesions (17 abdominal lymph nodes and seven stumps) were treated with SBRT, of which five patients presented with abdominal lymph nodes and synchronous metastases in the liver and lung. The 6-, 12-, and 24-month actuarial local control rates were 95.2%, 83.8%, and 62.1%, respectively. For the entire cohort, the median overall survival from diagnosis and SBRT was 28.9 and 12.2 months, respectively. Symptom alleviation was observed in eleven of 14 patients (78.6%) within a median of 8 days (range, 1–14 days) after SBRT. Nine patients (37.5%) experienced Common Terminology Criteria for Adverse Events version 4.0 grade 1–2 acute toxicities; one patient experienced grade 3 acute toxicity due to thrombocytopenia. Conclusion SBRT is a safe and effective treatment for patients with recurrent pancreatic adenocarcinoma at the abdominal lymph node or stump after surgery. Further studies are needed before SBRT can be recommended routinely. PMID:27418841

  20. Abdominal tuberculosis with periportal lymph node involvement mimicking pancreatic malignancy in an immunocompetent adolescent

    Lee, Yeoun Joo; Park, Su-Eun [Pusan National University, Department of Pediatrics, Pusan National University Children' s Hospital, School of Medicine, Yangsan (Korea, Republic of); Hwang, Jae-Yeon; Kim, Yong-Woo; Lee, Jun Woo [Pusan National University, Department of Radiology, Pusan National University Yangsan Hospital, School of Medicine, Yangsan (Korea, Republic of)

    2014-11-15

    Abdominal tuberculosis manifesting as isolated lymphadenopathy is rare, particularly in children. Tuberculous involvement of the pancreatic head and peripancreatic area can simulate a neoplasm of the pancreatic head. To our knowledge, obstructive jaundice caused by tuberculous lymphadenopathy has not been reported in children or adolescents. Here we present radiologic findings in a case of tuberculous lymphadenopathy that mimicked malignancy of the pancreatic head and caused obstructive jaundice in an immunocompetent adolescent. (orig.)

  1. Abdominal tuberculosis with periportal lymph node involvement mimicking pancreatic malignancy in an immunocompetent adolescent

    Abdominal tuberculosis manifesting as isolated lymphadenopathy is rare, particularly in children. Tuberculous involvement of the pancreatic head and peripancreatic area can simulate a neoplasm of the pancreatic head. To our knowledge, obstructive jaundice caused by tuberculous lymphadenopathy has not been reported in children or adolescents. Here we present radiologic findings in a case of tuberculous lymphadenopathy that mimicked malignancy of the pancreatic head and caused obstructive jaundice in an immunocompetent adolescent. (orig.)

  2. Critical Appraisal of Volumetric Modulated Arc Therapy in Stereotactic Body Radiation Therapy for Metastases to Abdominal Lymph Nodes

    Purpose: A planning study was performed comparing volumetric modulated arcs, RapidArc (RA), fixed beam IMRT (IM), and conformal radiotherapy (CRT) with multiple static fields or short conformal arcs in a series of patients treated with hypofractionated stereotactic body radiation therapy (SBRT) for solitary or oligo-metastases from different tumors to abdominal lymph nodes. Methods and Materials: Fourteen patients were included in the study. Dose prescription was set to 45 Gy (mean dose to clinical target volume [CTV]) in six fractions of 7.5 Gy. Objectives for CTV and planning target volume (PTV) were as follows: Dosemin >95%, Dosemax 15Gy 36Gy 36Gy 15Gy 3) for liver. Dose-volume histograms were evaluated to assess plan quality. Results: Planning objectives on CTV and PTV were achieved by all techniques. Use of RA improved PTV coverage (V95% = 90.2% ± 5.2% for RA compared with 82.5% ± 9.6% and 84.5% ± 8.2% for CRT and IM, respectively). Most planning objectives for organs at risk were met by all techniques except for the duodenum, small bowel, and stomach, in which the CRT plans exceeded the dose/volume constraints in some patients. The MU/fraction values were as follows: 2186 ± 211 for RA, 2583 ± 699 for IM, and 1554 ± 153 for CRT. Effective treatment time resulted as follows: 3.7 ± 0.4 min for RA, 10.6 ± 1.2 min for IM, and 6.3 ± 0.5 min for CRT. Conclusions: Delivery of SBRT by RA showed improvements in conformal avoidance with respect to standard conformal irradiation. Delivery parameters confirmed logistical advantages of RA, particularly compared with IM.

  3. Differentiation between tuberculosis and leukemia in abdominal and pelvic lymph nodes: evaluation with contrast-enhanced multidetector computed tomography

    Ge Zhang

    2015-03-01

    Full Text Available PURPOSE: To compare the characteristics of tubercular vs. leukemic involvement of abdominopelvic lymph nodes using multidetector computed tomography (CT. MATERIALS AND METHODS: We retrospectively reviewed multidetector computed tomography features including lymph node size, shape, enhancement patterns, and anatomical distribution, in 106 consecutive patients with newly diagnosed, untreated tuberculosis (55 patients; 52% or leukemia (51 patients; 48%. In patients with leukemia, 32 (62.7% had chronic lymphocytic leukemia, and 19 (37.3% had acute leukemias; of these, 10 (19.6% had acute myeloid leukemia, and 9 (17.6% had acute lymphocytic leukemia. RESULTS: The lower para-aortic (30.9% for tuberculosis, 63.2% for acute leukemias and 87.5% for chronic lymphocytic leukemia and inguinal (9.1% for tuberculosis, 57.9% for acute leukemias and 53.1% for chronic lymphocytic leukemia lymph nodes were involved more frequently in the three types of leukemia than in tuberculosis (both with p <0.017. Tuberculosis showed peripheral enhancement, frequently with a multilocular appearance, in 43 (78.2% patients, whereas patients with leukemia (78.9% for acute myeloid leukemia and acute lymphocytic leukemia, 87.5% for chronic lymphocytic leukemia demonstrated predominantly homogeneous enhancement (both with p <0.017. For the diagnosis of tuberculosis, the analysis showed that a peripheral enhancement pattern had a sensitivity of 78.2%, a specificity of 100%, and an accuracy of 88.7%. For the diagnosis of leukemia, the analysis showed that a homogeneous enhancement pattern was associated with a sensitivity of 84.3%, a specificity of 94.5%, and an accuracy of 89.6%. CONCLUSION: Our findings indicate that the anatomical distribution and enhancement patterns of lymphadenopathy seen on multidetector computed tomography are useful for differentiating between untreated tuberculosis and leukemia of the abdominopelvic lymph nodes.

  4. Lymph pathways of the medial retropharyngeal lymph node in dogs.

    Belz, G T; Heath, T J

    1995-01-01

    In dogs, lymph drains from tissues throughout the head, including the tonsils, along lymphatic vessels to the facial, parotid, lateral retropharyngeal and mandibular lymph nodes. From the mandibular lymph nodes, lymph may flow to the ipsilateral medial retropharyngeal lymph nodes, or along anastomotic connections to the contralateral node. Afferent lymphatics convey lymph from these nodes to defined areas in the medial retropharyngeal nodes. They divide over the surface of the node, and withi...

  5. Experimental studies of metastases of esophageal carcinoma to lymph nodes

    Marked progress has been made in surgery for esophageal carcinoma, however, when compared to results of surgery for other carcinomas of the digestive tract, much research remains to be done. The author transplanted VX2 carcinoma, a transplantable tumor of the rabbit, to the esophagus in attempt to determine the mode of metastases of esophageal carcinoma to lymph nodes and also to observe the effect of chemotherapy (Bleomycin) and radiotherapy (Betatron). Carcinoma of the cervical esophagus metastasized to the cervical lymph nodes and then to the paratracheal lymph nodes. Carcinoma of the upper thoracic esophagus metastasized to the paratracheal lymph nodes and then to the cervical lymph nodes. Carcinoma of the mid-thoracic esophagus metastasized to the intrathoracic lymph nodes and then to the intraperitoneal lymph nodes. Carcinoma of the abdominal esophagus metastasized to the intraperitoneal lymph nodes and then to the intrathoracic lymph nodes. Skipping metastasis was rarely observed. Carcinoma of the thoracic esophagus with metastases of lymph nodes in the cervical or abdominal portion was considerably advanced, therefore it is considered that cleaning of the intrathoracic lymph nodes and simultaneous chemotherapy are required when such cases are encountered clinically. Irradiation resulted in regression in the size of the tumor and metastases to lymph nodes and there was a decrease in metastases to the distant lymph nodes. Effects of irradiation were similar on tumors and lymph nodes with positive metastases located within the field of irradiation. Bleomycin medication resulted in regression in the size of tumor and metastases to lymph nodes. Effects of Bleomycin medication were similar on tumors and lymph nodes with positive metastases. (auth.)

  6. Volumetric modulated arc therapy with flattening filter free beams for isolated abdominal/pelvic lymph nodes: report of dosimetric and early clinical results in oligometastatic patients

    SBRT is a safe and efficient strategy to locally control multiple metastatic sites. While research in the physics domain for Flattening Filter Free Beams (FFF) beams is increasing, there are few clinical data of FFF beams in clinical practice. Here we reported dosimentric and early clinical data of SBRT and FFF delivery in isolated lymph node oligometastatic patients. Between October 2010 and March 2012, 34 patients were treated with SBRT for oligometastatic lymph node metastasis on a Varian TrueBeamTM treatment machine using Volumetric Modulated Arc Therapy (RapidArc). We retrospectively evaluated a total of 25 patients for isolated lymph node metastases in abdomen and/or pelvis treated with SBRT and FFF (28 treatments). Acute toxicity was recorded. Local control evaluation was scored by means of CT scan and/or PET scan. All dosimetric results are in line with what published for the same type of stereotactic abdominal lymph node metastases treatments and fractionation, using RapidArc. All 25 FFF SBRT patients completed the treatment. Acute gastrointestinal toxicity was minimal: one patient showed Grade 1 gastrointestinal toxicity. Three other patients presented Grade 2 toxicity. No Grade 3 or higher was recorded. All toxicities were recovered within one week. The preliminary clinical results at the median follow up of 195 days are: complete response in 12 cases, partial response in 11, stable disease in 5, with an overall response rate of 82%; no local progression was recorded. Data of dosimetrical findings and acute toxicity are excellent for patients treated with SBRT with VMAT using FFF beams. Preliminary clinical results showed a high rate of local control in irradiated lesion. Further data and longer follow up are needed to assess late toxicity and definitive clinical outcomes

  7. Volumetric modulated arc therapy with flattening filter free beams for isolated abdominal/pelvic lymph nodes: report of dosimetric and early clinical results in oligometastatic patients

    Alongi Filippo

    2012-12-01

    Full Text Available Abstract Background SBRT is a safe and efficient strategy to locally control multiple metastatic sites. While research in the physics domain for Flattening Filter Free Beams (FFF beams is increasing, there are few clinical data of FFF beams in clinical practice. Here we reported dosimentric and early clinical data of SBRT and FFF delivery in isolated lymph node oligometastatic patients. Methods Between October 2010 and March 2012, 34 patients were treated with SBRT for oligometastatic lymph node metastasis on a Varian TrueBeamTM treatment machine using Volumetric Modulated Arc Therapy (RapidArc. We retrospectively evaluated a total of 25 patients for isolated lymph node metastases in abdomen and/or pelvis treated with SBRT and FFF (28 treatments. Acute toxicity was recorded. Local control evaluation was scored by means of CT scan and/or PET scan. Results All dosimetric results are in line with what published for the same type of stereotactic abdominal lymph node metastases treatments and fractionation, using RapidArc. All 25 FFF SBRT patients completed the treatment. Acute gastrointestinal toxicity was minimal: one patient showed Grade 1 gastrointestinal toxicity. Three other patients presented Grade 2 toxicity. No Grade 3 or higher was recorded. All toxicities were recovered within one week. The preliminary clinical results at the median follow up of 195 days are: complete response in 12 cases, partial response in 11, stable disease in 5, with an overall response rate of 82%; no local progression was recorded. Conclusions Data of dosimetrical findings and acute toxicity are excellent for patients treated with SBRT with VMAT using FFF beams. Preliminary clinical results showed a high rate of local control in irradiated lesion. Further data and longer follow up are needed to assess late toxicity and definitive clinical outcomes.

  8. Sonographic Features of Lymphoma in the Abdominal Lymph Nodes%腹部结内淋巴瘤的超声诊断

    王亚红; 蔡胜; 王蕾; 张晓东; 齐振红; 徐钟慧; 李建初

    2013-01-01

    Objective To summarize the sonographic features of the lymphoma in the abdominal lymph nodes. Method The clinical data and sonographic findings of 41 lymphoma patients with original appearance of abdominal mass or lymphadenectasis were retrospectively analyzed. Results Among these 41 cases, the retro-peritoneal and mesenteric lymph nodes were most commonly involved. These patients were divided into two types according to sonographic appearances: solitary mass ( n = 14 ) and multiple nodules ( n = 27 ) . Solitary hypoe-choic mass in abdomen was found in the former type, mostly with irregular or lobular shape, and the inner echo was often heterogenous. The typical appearances of the latter type were multiple enlarged lymph nodes, mostly round or oval, with homogeneous inner echo and clear margins. Some other sonographic characteristics were also helpful for the diagnosis of lymphoma, such as cobblestone sign, intranodular reticulation, vessels-embedded sign, and hilar vascularity. Conclusion Ultrasonography can provide useful information in the diagnosis of the lymphoma in the abdominal lymph nodes.%目的 分析总结腹部结内淋巴瘤的超声图像特点,提高诊断准确率.方法 回顾性分析41例以腹部包块或腹部淋巴结肿大起病的淋巴瘤患者的临床及超声检查资料,总结其声像图特征.结果 受累淋巴结主要位于腹膜后及肠系膜区,其中单发包块型14例,超声表现为腹部单发低回声包块,多数形态不规则或呈分叶状,内部回声不均.多发结节型27例,超声典型表现为多个边界清晰的类圆形低回声,边界规整,内部回声均匀.特异性超声表现包括鹅卵石征、网状分隔、血管包绕征、门型血流等.结论 超声检查有助于腹部结内淋巴瘤的诊断,同时还可评估受累区域及病灶特征,为临床分期及治疗提供依据.

  9. Mesenteric lymph node cavitation syndrome

    Hugh; James; Freeman

    2010-01-01

    The mesenteric lymph node cavitation syndrome consists of central necrosis of mesenteric lymph nodes and may occur with either celiac disease or a sprue-like intestinal disease that fails to respond to a gluten-free diet. Splenic hypofunction may also be present. The cause is not known but its development during the clinical course of celiac disease is usually indicative of a poor prognosis for the intestinal disorder, a potential for signif icant compli-cations including sepsis and malignancy, particularly...

  10. Sonography of neck lymph nodes. Part II: abnormal lymph nodes

    Assessment of cervical lymph nodes is essential for patients with head and neck carcinomas, and ultrasound is a useful imaging technique. Sonographic features that help distinguish between the causes of neck lymphadenopathy, including grey scale and Doppler features, are discussed. In addition to the distribution and location of nodes, the useful grey-scale features are: size, shape, internal architecture, intranodal necrosis, absence of hilar structure and calcification. The useful Doppler features are: distribution of vascularity and intranodal resistance. Ancillary features such as oedema of soft tissue and nodal matting are particularly helpful to identify tuberculous nodes

  11. Lymph node imaging: Basic principles

    Lymph nodes are involved in a wide variety of diseases, particularly in cancer. In the latter, precise nodal staging is essential to guide therapeutic options and to determine prognosis. For long, imaging of the lymphatic system has been limited to lymph vessel,especially via the exclusive use of conventional lymphography, at the expense of invasive procedures and patient's discomfort. Three main technical advances, however, have recently completed the clinical armamentarium for lymph node imaging: first, the refinement of cross sectional imaging, i.e. CT and MRI, combined or not with dedicated contrast agents, has progressively replaced conventional lymphography in oncology situations; second, the development of intra-operative sentinel node mapping has profoundly modified the diagnostic and therapeutic procedures in several cancer situations, mostly melanoma and breast cancer; finally, the increased availability of functional imaging, especially through the use of FDG-PET, has greatly contributed to the accuracy improvement of nodal metastases identification. The aim of this review will thus be to briefly review the anatomy and physiology of the lymphatic systems and to overview the basic principles of up-to-date lymph node imaging

  12. Elective ilioingunial lymph node irradiation

    Henderson, R.H.; Parsons, J.T.; Morgan, L.; Million, R.R.

    1984-06-01

    Most radiologists accept that modest doses of irradiation (4500-5000 rad/4 1/2-5 weeks) can control subclinical regional lymph node metastases from squamous cell carcinomas of the head and neck and adenocarcinomas of the breast. There have been few reports concerning elective irradiation of the ilioinguinal region. Between October 1964 and March 1980, 91 patients whose primary cancers placed the ilioinguinal lymph nodes at risk received elective irradiation at the University of Florida. Included are patients with cancers of the vulva, penis, urethra, anus and lower anal canal, and cervix or vaginal cancers that involved the distal one-third of the vagina. In 81 patients, both inguinal areas were clinically negative; in 10 patients, one inguinal area was positive and the other negative by clinical examination. The single significant complication was a bilateral femoral neck fracture. The inguinal areas of four patients developed mild to moderate fibrosis. One patient with moderate fibrosis had bilateral mild leg edema that was questionably related to irradiation. Complications were dose-related. The advantages and dis-advantages of elective ilioinguinal node irradiation versus elective inguinal lymph node dissection or no elective treatment are discussed.

  13. Regional lymph nodes of liver and spleen: topographic evaluation based on CT examinations of Thorotrast patients

    The formerly used contrast medium Thorotrast is stored in liver (60 %), spleen (30 %) and their regional lymph nodes. CT scans of 22 Thorotrast patients were reviewed regarding the evaluation of the abdominal lymph nodes. Due to the high density of Thorotrast-accumulating lymph nodes (> 500 HU) and the excellent contrast sensitivity of CT, lymph nodes less than 0.4 cm in diameter can be imaged. In all more than 1300 lymph nodes could be detected (mean 63 ± 24 per patient). The goal of the study was to describe the normal topographic anatomy of the regional lymph nodes of liver and spleen, which can not be visualised by bipedal lymphography. (orig.)

  14. Sentinel lymph node biopsy in oral cancer

    Thomsen, Jørn Bo; Sørensen, Jens Ahm; Grupe, Peter;

    2005-01-01

    PURPOSE: To validate lymphatic mapping combined with sentinel lymph node biopsy as a staging procedure, and to evaluate the possible clinical implications of added oblique lymphoscintigraphy and/or tomography and test the intra- and interobserver reproducibility of lymphoscintigraphy. MATERIAL AND....... RESULTS: Eleven (28%) patients were upstaged. The sentinel lymph node identification rate was 97.5%. Sentinel lymph node biopsy significantly differentiated between patients with or without lymph node metastasis (P = 0.001). Lymphatic mapping revealed 124 hotspots and 144 hot lymph nodes were removed by...... sentinel lymph node biopsy. Three patients developed a lymph node recurrence close to the primary tumor site during follow-up. Added oblique lymphoscintigraphic images and/or tomography revealed extra hotspots in 15/40 (38%) patients. In 4/40 (10%), extra contralateral hotspots were detected. CONCLUSION...

  15. Targeted Delivery of Immunomodulators to Lymph Nodes

    Jamil Azzi; Qian Yin; Mayuko Uehara; Shunsuke Ohori; Li Tang; Kaimin Cai; Takaharu Ichimura; Martina McGrath; Omar Maarouf; Eirini Kefaloyianni; Scott Loughhead; Jarolim Petr; Qidi Sun; Mincheol Kwon; Stefan Tullius

    2016-01-01

    Active-targeted delivery to lymph nodes represents a major advance toward more effective treatment of immune-mediated disease. The MECA79 antibody recognizes peripheral node addressin molecules expressed by high endothelial venules of lymph nodes. By mimicking lymphocyte trafficking to the lymph nodes, we have engineered MECA79-coated microparticles containing an immunosuppressive medication, tacrolimus. Following intravenous administration, MECA79-bearing particles showed marked accumulation...

  16. Targeted Delivery of Immunomodulators to Lymph Nodes.

    Azzi, Jamil; Yin, Qian; Uehara, Mayuko; Ohori, Shunsuke; Tang, Li; Cai, Kaimin; Ichimura, Takaharu; McGrath, Martina; Maarouf, Omar; Kefaloyianni, Eirini; Loughhead, Scott; Petr, Jarolim; Sun, Qidi; Kwon, Mincheol; Tullius, Stefan; von Andrian, Ulrich H; Cheng, Jianjun; Abdi, Reza

    2016-05-10

    Active-targeted delivery to lymph nodes represents a major advance toward more effective treatment of immune-mediated disease. The MECA79 antibody recognizes peripheral node addressin molecules expressed by high endothelial venules of lymph nodes. By mimicking lymphocyte trafficking to the lymph nodes, we have engineered MECA79-coated microparticles containing an immunosuppressive medication, tacrolimus. Following intravenous administration, MECA79-bearing particles showed marked accumulation in the draining lymph nodes of transplanted animals. Using an allograft heart transplant model, we show that targeted lymph node delivery of microparticles containing tacrolimus can prolong heart allograft survival with negligible changes in tacrolimus serum level. Using MECA79 conjugation, we have demonstrated targeted delivery of tacrolimus to the lymph nodes following systemic administration, with the capacity for immune modulation in vivo. PMID:27134176

  17. Targeted Delivery of Immunomodulators to Lymph Nodes

    Jamil Azzi

    2016-05-01

    Full Text Available Active-targeted delivery to lymph nodes represents a major advance toward more effective treatment of immune-mediated disease. The MECA79 antibody recognizes peripheral node addressin molecules expressed by high endothelial venules of lymph nodes. By mimicking lymphocyte trafficking to the lymph nodes, we have engineered MECA79-coated microparticles containing an immunosuppressive medication, tacrolimus. Following intravenous administration, MECA79-bearing particles showed marked accumulation in the draining lymph nodes of transplanted animals. Using an allograft heart transplant model, we show that targeted lymph node delivery of microparticles containing tacrolimus can prolong heart allograft survival with negligible changes in tacrolimus serum level. Using MECA79 conjugation, we have demonstrated targeted delivery of tacrolimus to the lymph nodes following systemic administration, with the capacity for immune modulation in vivo.

  18. Lymph node metastases - diagnosis by lymphography and CT

    The value of lymphography and CT in the diagnosis of abdominal lymph node metastases was compared in 82 patients with various types of malignant disease. In the presence of systemic disease or testicular tumours, CT increased the recognition of lymph node metastases and their extent, particularly of high para-aortic deposits which were frequently underestimated by lymphography. Lymph nodes in the pelvis are more easily identified. CT is the first choice for the investigation of systemic disease and testicular tumours. This will, in addition, also demonstrate abnormalities of the organs and assist in radiation planning. CT is a simple procedure which is also very valuable in following the effect of treatment. For metastases from other origins, lymphography is often more valuable since CT is unable to identify metastases in lymph nodes if these are not enlarged. The two methods complement each other and their combination provides improved diagnostic information. (orig.)

  19. Localized Lymph Node Light Chain Amyloidosis

    Binod Dhakal

    2015-01-01

    Full Text Available Immunoglobulin-derived light chain amyloidosis can occasionally be associated with localized disease. We present a patient with localized lymph node light chain amyloidosis without an underlying monoclonal protein or lymphoproliferative disorder and review the literature of lymph node amyloidosis discussing work-up and risk factors for systemic progression.

  20. Anatomy and nomenclature of murine lymph nodes: Descriptive study and nomenclatory standardization in BALB/cAnNCrl mice.

    Van den Broeck, Wim; Derore, Annie; Simoens, Paul

    2006-05-30

    Murine lymph nodes are intensively studied but often assigned incorrectly in scientific papers. In BALB/cAnNCrl mice, we characterized a total of 22 different lymph nodes. Peripheral nodes were situated in the head and neck region (mandibular, accessory mandibular, superficial parotid, cranial deep cervical nodes), and at the forelimb (proper axillary, accessory axillary nodes) and hindlimb (subiliac, sciatic, popliteal nodes). Intrathoracic lymph nodes included the cranial mediastinal, tracheobronchal and caudal mediastinal nodes. Abdominal lymph nodes were associated with the gastrointestinal tract (gastric, pancreaticoduodenal, jejunal, colic, caudal mesenteric nodes) or were located along the major intra-abdominal blood vessels (renal, lumbar aortic, lateral iliac, medial iliac and external iliac nodes). Comparative and nomenclative aspects of murine lymph nodes are discussed. The position of the lymph nodes of BALB/cAnNCrl mice is summarized and illustrated in an anatomical chart containing proposals for both an official nomenclature according to the Nomina Anatomica Veterinaria and English terms. PMID:16624319

  1. Tattoo-pigmented cervical lymph node that masqueraded as the sentinel lymph node in oral squamous cell carcinoma.

    Pinto, Amith; Wieshmann, Hulya; Triantafyllou, Asterios; Shaw, Richard

    2015-11-01

    We describe a case of a pigmented cervical lymph node mimicking the sentinel node during sentinel lymph node biopsy (SLNB) on a patient with oral squamous cell carcinoma (OSCC). The patient had extensive tattoos on his neck. This pigmented lymph node was not identified to be the sentinel lymph node using static and dynamic lymphoscintigraphy. Subsequent histological analysis revealed tattoo pigment within this lymph node. It is important during cervical SLNB to be aware that cutaneous tattoos can pigment lymph nodes. PMID:26188933

  2. Retroperitoneal pleomorphic rhabdomyosarcoma metastasizing to inguinal lymph node

    Shagufta Qadri

    2015-01-01

    Full Text Available Rhabdomyosarcoma (RMS is a highly aggressive, malignant tumor of skeletal muscle cell, associated with an early and a wide spread metastasis. Although a commonly occurring soft tissue sarcoma in the pediatric population, it is seldom encountered in adults. Outcome for adult RMS is poorly documented due to its rarity. We report a case of pleomorphic RMS (PRMS in a 50 years male presenting with an intra-abdominal mass along with a swelling in the right inguinal region measuring 4 cm Χ 3 cm. Computed tomography revealed an ill-defined intra-abdominal mass arising from the peritoneum. Abdominal mass was resected along with the dissection of inguinal lymph node. Histopathological examination of these masses coupled with the immunohistochemistry, confirmed the diagnosis of PRMS metastasizing into inguinal lymph node. Despite of adjuvant radiotherapy and chemotherapy, the patient couldn′t survive >3 months and died of widespread lung metastasis.

  3. Mesothelial cell inclusions mimicking adenocarcinoma in cervical lymph nodes in association with chylous effusion

    Goyal Manu

    2010-01-01

    Full Text Available Mesothelial cell inclusions in lymph nodes are of rare occurrence and can be mistaken as metastatic adenocarcinomas, mesothelioma or sinus histiocytosis. These are usually found in mediastinal and abdominal lymph nodes and are associated with effusions. We report a case of benign mesothelial cell inclusions in cervical lymph nodes, which was associated with chylous effusion, and immunohistochemistry revealed unusual weak cytoplasmic epithelial membrane antigen positivity in the cells.

  4. Cervical lymph node diseases in children

    Lang, S.; Kansy, B

    2014-01-01

    The lymph nodes are an essential part of the body's immune system and as such are affected in many infectious, autoimmune, metabolic and malignant diseases. The cervical lymph nodes are particularly important because they are the first drainage stations for key points of contact with the outside world (mouth/throat/nose/eyes/ears/respiratory system) - a critical aspect especially among children - and can represent an early clinical sign in their exposed position on a child's slim neck.Involve...

  5. Intravital Microscopy of the Inguinal Lymph Node

    Sellers, Stephanie L.; Payne, Geoffrey W.

    2011-01-01

    Lymph nodes (LN's), located throughout the body, are an integral component of the immune system. They serve as a site for induction of adaptive immune response and therefore, the development of effector cells. As such, LNs are key to fighting invading pathogens and maintaining health. The choice of LN to study is dictated by accessibility and the desired model; the inguinal lymph node is well situated and easily supports studies of biologically relevant models of skin and genital mucosal infe...

  6. Enhancement characteristics of retroperitoneal lymphomatous lymph nodes

    Hagtvedt, Trond; Smith, Hans-Joergen; Kolbenstvedt, Alf [Dept. of Radiology and Nuclear Medicine, Oslo Univ. Hospital, Oslo (Norway); Faculty of Medicine, Univ. of Oslo, Oslo (Norway); Aaloekken, Trond Mogens [Dept. of Radiology and Nuclear Medicine, Oslo Univ. Hospital, Oslo (Norway)], e-mail: trond.mogens.aalokken@rikshospitalet.no; Graff, Bjoern Anton [Div. of Diagnostics, Vestre Viken Hospital Trust, Drammen (Norway); Kongsberg Hospital, Vestre Viken Hospital Trust, Drammen (Norway); Holte, Harald [Dept. of Oncology, Oslo Univ. Hospital, Oslo (Norway)

    2013-04-15

    Background: Previous studies of CT enhancement of lymphomatous lymph nodes (LLN) of the neck and the mediastinum showed that the LLN had lower enhancement values than normal lymph nodes. Purpose: To elucidate the contrast medium enhancement curves of LLN in the retroperitoneum by comparing the curves of LLN with those of normal lymph nodes, to test whether differences between these curves could be of diagnostic value, and to compare the present enhancement curves of LLN of the retroperitoneum with the curves of LLN of the neck and the mediastinum from previous similar investigations. Material and Methods: Twenty-eight consecutive patients with LLN of the retroperitoneum (three with Hodgkin's lymphoma [HL]) and 21 control patients with sarcomas and thus presumably normal retroperitoneal nodes underwent dynamic CT examinations. The previous, similar investigation of lymph nodes of the neck comprised 28 patients with LLN and the investigation of mediastinal lymph nodes comprised 24 patients with LLN. Results: The enhancement curves of the retroperitoneal LLN had significantly lower attenuation than those of the retroperitoneal control nodes. A combination of peak contrast value and time to peak adjusted to total body weight yielded a diagnostic accuracy which at the best showed a sensitivity of 90.5% with a specificity of 82.6%. The LLN of the retroperitoneum had higher attenuation values than corresponding nodes of the mediastinum but no significant difference was found between LLN of the retroperitoneum and LLN of the neck in previous similar investigations. Conclusion: The comparison of enhancement curves of retroperitoneal LLN with retroperitoneal control nodes showed a marked similarity with and substantiates our previous findings in lymph nodes of the neck and of the mediastinum. The best diagnostic accuracy was achieved by combining the parameters peak contrast value and time to peak and adjusting these values to the body weight. Peak enhancement of the

  7. Sentinel lymph node biopsy: clinical relevance

    Sentinel lymph node biopsy (SLNB) has become an important technique in the management of patients with intermediate level melanoma, clinical operable breast cancer and some other cancers. The technique relies on lymphatic mapping to define the lymph drainage from a primary tumour with the premise that the lymph nodes, which directly drain from that area, will reflect the tumour status of the remainder of the node field. Current techniques use lymphoscintigraphy where a radioactive labelled particle and / or blue dye are injected intradermally or intraparenchymally to map the lymph drainage, often in conjunction with a radioactive gamma probe at surgery. In patients with melanoma the SLNB has improved the staging and prognostic information by more accurate determination of whether regional lymph nodes have metastatic spread. This has a major impact on patient management as those patients with negative nodes do not require regional lymph node dissection and have a significantly better prognosis. In our experience of over 3000 patients the combined sentinel node biopsy technique localised accurately 98% of sentinel lymph nodes. Lymphoscintigraphy in patients with melanoma to locate the sentinel lymph nodes involves the intradermal injection of a radiocolloid around the melanoma site or the excision biopsy site. Injections of 5 -10 MBq in 0.05-0.1ml/inj are used and typically 4 injections are usually required. Following tracer injection dynamic imaging is performed to follow the lymphatic collecting vessels until they reach the draining sentinel nodes. An image should be acquired as the vessels reach the node field so that the sentinel nodes directly receiving the channels can be identified and distinguished from any second tier nodes which may sometimes be seen. Delayed scans are performed 2 hours later at which time all regions which can possible drain the primary melanoma site are examined with 5-10 minute static images. The surface location of all sentinel nodes is

  8. Mesenchymal cell differentiation during lymph node organogenesis

    Brendolan, Andrea; Caamaño, Jorge H.

    2012-01-01

    Secondary lymphoid tissues such as lymph nodes are essential for the interactions between antigen presenting cells and lymphocytes that result in adaptive immune responses that protect the host against invading pathogens. The specialized architecture of these organs facilitates the cognate interactions between antigen-loaded dendritic cells and lymphocytes expressing their specific receptor as well as B–T cell interactions that are at the core of long lasting adaptive immune responses. Lymph ...

  9. Lymph node enhancement at MRI with MnDPDP in primary hepatic carcinoma. Technical report

    AIMS: To report two cases of lymph node enhancement in primary hepatic carcinoma following the administration of Mangafodipir trisodium (MnDPDP, Teslascan[reg ], Nycomed Amersham U.K.), an hepatocyte specific magnetic resonance imaging (MRI) contrast agent. To review our experience with this contrast agent and the literature to establish if such enhancement occurs in normal lymph nodes or has been previously described in hepatocellular carcinoma (HCC) or other lesions. MATERIALS AND METHODS: The radiological reports of all MnDPDP enhanced abdominal MRI examinations were reviewed for lymph node enlargement. The MR images from examinations with reported nodal enlargement were re-evaluated for evidence of nodal enhancement and the hospital notes and histological reports were reviewed. Nodal enhancement was considered present if lymph node signal intensity was greater than that of the spleen following MnDPDP. Literature searches were performed on Medline and PubMed for previous descriptions of lymph node enhancement following MnDPDP. RESULTS: The reports of 90 MnDPDP abdominal MRI examinations were reviewed. Of 18 cases of lymph node enlargement, two had evidence of lymph node enhancement following MnDPDP. These two cases had hepatocellular carcinoma and fibrolamellar hepatocellular carcinoma, respectively, confirmed on liver biopsy. No reports of lymph node enhancement following MnDPDP were identified in the literature. CONCLUSION: Two cases of lymph node enhancement following MnDPDP have been presented. Although histological confirmation of the lymph nodes was not obtained, the authors propose that the lymph node enhancement was due to functioning hepatocytes in lymph node metastases from the patients' histologically confirmed hepatocellular carcinomas. Burkill, G.J.C., Mannion, E.M. and Healy, J.C. (2001)

  10. Lymph node enhancement at MRI with MnDPDP in primary hepatic carcinoma. Technical report

    Burkill, Guy J.C.; Mannion, Ethna M.; Healy, Jeremiah C

    2001-01-01

    AIMS: To report two cases of lymph node enhancement in primary hepatic carcinoma following the administration of Mangafodipir trisodium (MnDPDP, Teslascan[reg ], Nycomed Amersham U.K.), an hepatocyte specific magnetic resonance imaging (MRI) contrast agent. To review our experience with this contrast agent and the literature to establish if such enhancement occurs in normal lymph nodes or has been previously described in hepatocellular carcinoma (HCC) or other lesions. MATERIALS AND METHODS: The radiological reports of all MnDPDP enhanced abdominal MRI examinations were reviewed for lymph node enlargement. The MR images from examinations with reported nodal enlargement were re-evaluated for evidence of nodal enhancement and the hospital notes and histological reports were reviewed. Nodal enhancement was considered present if lymph node signal intensity was greater than that of the spleen following MnDPDP. Literature searches were performed on Medline and PubMed for previous descriptions of lymph node enhancement following MnDPDP. RESULTS: The reports of 90 MnDPDP abdominal MRI examinations were reviewed. Of 18 cases of lymph node enlargement, two had evidence of lymph node enhancement following MnDPDP. These two cases had hepatocellular carcinoma and fibrolamellar hepatocellular carcinoma, respectively, confirmed on liver biopsy. No reports of lymph node enhancement following MnDPDP were identified in the literature. CONCLUSION: Two cases of lymph node enhancement following MnDPDP have been presented. Although histological confirmation of the lymph nodes was not obtained, the authors propose that the lymph node enhancement was due to functioning hepatocytes in lymph node metastases from the patients' histologically confirmed hepatocellular carcinomas. Burkill, G.J.C., Mannion, E.M. and Healy, J.C. (2001)

  11. Cervical lymph node diseases in children

    Lang, Stephan; Kansy, Benjamin

    2014-01-01

    [english] The lymph nodes are an essential part of the body’s immune system and as such are affected in many infectious, autoimmune, metabolic and malignant diseases. The cervical lymph nodes are particularly important because they are the first drainage stations for key points of contact with the outside world (mouth/throat/nose/eyes/ears/respiratory system) – a critical aspect especially among children – and can represent an early clinical sign in their exposed position on a child’s slim ne...

  12. SOME ASPECTS OF THE ANATOMY OF AXILLARY LYMPH NODES

    A. I. Shvedavchenko; I. V. Vysotskaya; O. S. Mikhailenko; G. V. Martynova; Ye. A. Kim

    2014-01-01

    The paper concisely reviews the classifications of axillary lymph nodes (LN) and considers various approaches to their formation. The authors identify the axillary lymph chain consisting of lateral, central, and apical groups of nodes through which lymph outflows into the overlying lymph collectors, as well as of subscapular and medial groups of nodes from where lymph makes its way into the auxil- lary lymph chain.

  13. SOME ASPECTS OF THE ANATOMY OF AXILLARY LYMPH NODES

    A. I. Shvedavchenko

    2014-09-01

    Full Text Available The paper concisely reviews the classifications of axillary lymph nodes (LN and considers various approaches to their formation. The authors identify the axillary lymph chain consisting of lateral, central, and apical groups of nodes through which lymph outflows into the overlying lymph collectors, as well as of subscapular and medial groups of nodes from where lymph makes its way into the auxil- lary lymph chain.

  14. Clinical implications of metastatic lymph node ratio in gastric cancer

    Wang Shubao

    2007-10-01

    Full Text Available Abstract Background The 5-year survival rate in patients with gastric cancer is still poor, and lymph node metastasis is considered one of the most important prognostic factors. However, there are controversies in the classification of lymph node metastasis in gastric cancer. This study was carried out to investigate whether the metastatic lymph node ratio is a reliable classification of lymph node metastasis in gastric cancer in Chinese. Methods 224 cases with gastric cancer with more than D1 dissection were retrospectively reviewed. The association between the total number of resected lymph nodes and the number of metastatic lymph nodes was determined. The prognostic value of the metastastic node ratio, defined as the ratio of the number of metastatic lymph nodes over the total number of resected lymph nodes, and the pN classification was assessed. Results The number of metastatic lymph node increased with the number of total resected lymph nodes. A Cox regression revealed that the metastatic node ratio, the number of metastatic nodes, histological type, and histological growth pattern independently influenced prognosis. The 5-year survival rates were 78%, 61%, 25%, 0% in cases with a metastastic node ratio of 0%, > 0% but 80%, respectively (P P Conclusion The metastatic lymph node ratio is a simple and useful independent prognostic factor. It may obviate possible confounding factors that are related to stage migration, and should be considered as an important component in the lymph node category.

  15. Inguinal lymph node metastasis of colon cancer

    Sloane McGraw

    2011-01-01

    Full Text Available We present a case of adenocarcinoma of colon with unusual metastasis to inguinal lymph nodes. Our patient is a young male with bilateral inguinal lymphadenopathy, bone pains, and jaundice who presented as carcinoma of unknown primary. He was diagnosed as widely metastatic adenocarcinoma of colon for which he received chemotherapy and has had a good response to the treatment.

  16. Para-recurrent lymph node metastasis was a significant predictor for cervical lymph nodes metastasis in thoracic esophageal carcinoma

    Objective: To evaluate correlation factors of cervical lymph nodes metastasis in thoracic esophageal carcinoma. Methods: Local-regional metastasis of lymph node for 126 cases with esophageal squamous cell cancer after surgery from 2004 to 2009 were reviewed. Risk factors of cervical lymph nodes metastasis were examined by multiple Logistic regression analysis. Results: In 126 cases, supraclavicular lymph node metastasis rate was 43.7% (55/126). By logistic regression, none of the primary site, T stage, N stage, histological grade, lymph node metastasis rate, lymph node metastasis degree and number of lymph nodes metastatic field was not the high risk of cervical lymph nodes metastasis. In addition, multivariate analysis found that lymph node metastasis in mediastinum region 1 was high risk factor for lymph node metastasis of region 1 (χ2 =12.14, 9.27, P =0.000, 0.002), lymph node metastasis in region III and region 2 were high risk factors for lymph node metastasis of region IIa (χ2 =14.56, 8.27, 8.02, 3.93, P =0.000, 0.004, 0.005, 0.047). Conclusion: Mediastinal para-recurrent nerve lymph node metastasis is a significant predictor for cervical lymph nodes metastasis. (authors)

  17. Tumor cell entry into the lymph node is controlled by CCL1 chemokine expressed by lymph node lymphatic sinuses

    Das, Suvendu; Sarrou, Eliana; Podgrabinska, Simona; Cassella, Melanie; Mungamuri, Sathish Kumar; Feirt, Nikki; Gordon, Ronald; Nagi, Chandandeep S.; Wang, YaRong; Entenberg, David; Condeelis, John; Skobe, Mihaela

    2013-01-01

    Lymphatic vessels are thought to contribute to metastasis primarily by serving as a transportation system. It is widely believed that tumor cells enter lymph nodes passively by the flow of lymph. We demonstrate that lymph node lymphatic sinuses control tumor cell entry into the lymph node, which requires active tumor cell migration. In human and mouse tissues, CCL1 protein is detected in lymph node lymphatic sinuses but not in the peripheral lymphatics. CCR8, the receptor for CCL1, is strongl...

  18. Lymph Node Metastases and Prognosis in Penile Cancer

    Yao Zhu; Ding-wei Ye

    2012-01-01

    Lymph node status is a key prognostic factor in penile squamous cell carcinoma.Recently,growing evidence indicates a multimodality approach consisting of neoadjuvant chemotherapy followed by consolidation surgery improves the outcome of locally advanced penile cancer.Thus,accurate estimation of survival probability in node-positive penile cancer is critical for treatment decision making,counseling of patients and follow-up scheduling.This article reviewed evolving developments in assessing the risk for cancer progression based on lymph node related variables,such as the number of metastatic lymph nodes,bilateral lymph node metastases,the ratio of positive lymph nodes,extracapsular extension of metastatic lymph nodes,pelvic lymph node metastases,metastatic deposit in sentinel lymph nodes and N stage in TNM classification.Controversial issues surrounding the prognostic value of these nodal related predictors were also discussed.

  19. Early diagnosis of lymph node metastasis: Importance of intranodal pressures.

    Miura, Yoshinobu; Mikada, Mamoru; Ouchi, Tomoki; Horie, Sachiko; Takeda, Kazu; Yamaki, Teppei; Sakamoto, Maya; Mori, Shiro; Kodama, Tetsuya

    2016-03-01

    Regional lymph node status is an important prognostic indicator of tumor aggressiveness. However, early diagnosis of metastasis using intranodal pressure, at a stage when lymph node size has not changed significantly, has not been investigated. Here, we use an MXH10/Mo-lpr/lpr mouse model of lymph node metastasis to show that intranodal pressure increases in both the subiliac lymph node and proper axillary lymph node, which are connected by lymphatic vessels, when tumor cells are injected into the subiliac lymph node to induce metastasis to the proper axillary lymph node. We found that intranodal pressure in the subiliac lymph node increased at the stage when metastasis was detected by in vivo bioluminescence, but when proper axillary lymph node volume (measured by high-frequency ultrasound imaging) had not increased significantly. Intravenously injected liposomes, encapsulating indocyanine green, were detected in solid tumors by in vivo bioluminescence, but not in the proper axillary lymph node. Basic blood vessel and lymphatic channel structures were maintained in the proper axillary lymph node, although sinus histiocytosis was detected. These results show that intranodal pressure in the proper axillary lymph node increases at early stages when metastatic tumor cells have not fully proliferated. Intranodal pressure may be a useful parameter for facilitating early diagnosis of lymph node metastasis. PMID:26716604

  20. Popliteal lymph node metastasis of tibial osteoblastic osteosarcoma

    Yalın Dirik

    2014-01-01

    CONCLUSION: Lymph node metastasis of osteosarcoma is a rare entity and metastatic patterns could not be clearly explained. On the other hand, the effects of lymph node metastasis on prognosis are also not clearly defined and further studies are needed.

  1. The influence of ionizing beams on the barrier function of the lymph nodes

    60 female Wistar rats were given a 60Co gamma irradiation dose of 1,500 R in one go on a ventral pelvic field. The bilateral iliac and inguinal groups of lymph nodes were always within the penetrated region. 30 test animals each were investigated in a test series I (three months after irradiation) and a test series II (four months after irradiation). After three or four months, the barrier function of the abdominal lymph node groups was tested. Radioactively labelled erythrocytes were incorporated in the filtration system of the lymph apparatus as test particles. The comparison of the measured results with those of non-irradiated control animals showed a significant reduction of the barrier effectiveness in both test series. It can be concluded from the investigations that the radiogenic barrier reduction observed on the single lymph nodes is valid for the whole system consisting of several lymph nodes and also for physiological lymph transport. (BSC/LH)

  2. The lymph node in chronic lymphocytic leukemia.

    Dick, F R; Maca, R D

    1978-01-01

    Lymph nodes were examined from 41 cases of typical chronic lymphocytic leukemia (CLL). Degree of immaturity was graded as absent to minimal (Grade I), moderate (Grade II) and marked (Grade III). A moderate degree of immaturity was found in the lymph node in 14 of 41 cases even though the cells seen on the initial bone marrow and peripheral blood smears obtained from these patients were essentially all mature. The morphology of these nodes could be confused with poorly differentiated lymphocytic or mixed lymphocytic-histiocytic lymphoma in terms of the degree of immaturity present. A marked degree of immaturity present. A marked degree of immaturity was found in 5 cases; the morphology of these cases resembled histiocytic lymphoma. In the remaining 22 cases immaturity was essentially absent. The morphology of these cases was similar to that of diffuse well differentiated lymphocytic lymphoma. Our studies suggest that a moderate degree of immaturity in the lymph node of patients with CLL does not indicate that these patients will have a marked shortening of their survival. PMID:580071

  3. Topography of the major superficial lymph nodes and their efferent lymph pathways in the koala (Phascolarctos cinereus).

    Hanger, J J; Heath, T J

    1991-01-01

    The koala has an inguinoaxillary lymph trunk on either side of the ventral midline, and this carries efferent lymph from the superficial inguinal lymph node directly to the deep axillary lymph node. The superficial lymph nodes are large and soft compared with those of the domestic species, and each lymph centre usually contains only one or two large lymph nodes. Koalas have a rostral mandibular lymph node which has not been described in other species, but lack popliteal and subiliac lymph nod...

  4. Abnormal position of lymph nodes in a freemartin sheep

    Salazar PA

    2012-03-01

    Full Text Available Angela M Gonella-Diaza, Luz Zoraya Duarte, Sergio Dominguez, Pedro A SalazarClínica de Grandes Animales, Facultad de Medicina Veterinaria y de Zootecnia, Universidad Cooperativa de Colombia, Bucaramanga, Santander, ColombiaAbstract: In this freemartin case report the authors present the clinical and morphological findings of a freemartin ewe with an abnormal position of two lymph nodes. Freemartins, infertile females from mixed-sex twin pregnancies, are chimeras, having two cell populations: one of their own (XX DNA and one from their male twin (XY DNA. Freemartins can have varying degrees of phenotypic masculinization, including, in some cases, having active male gonads and exhibiting male behaviors such as heat detection and aggressiveness. During the clinical examination of the freemartin ewe, a morphological abnormality of the vulva, the presence of scrotal sacs, and a lack of mammary tissue development were noted. On inspection of the vaginal channel, an extremely enlarged clitoris, resembling a penis, was found. The clinical evidence suggested freemartinism. After the karyotyping diagnosis confirmation, a necropsy was performed and samples were taken for histology and immunohistochemistry. There were two structures found in the scrotal sacs; however, these were found to be lymph nodes, not testicles, and this was confirmed by CD3 lymph protein coloration. On histological study, the phallic structure showed corpus cavernosum and tunica albuginea. The testicles were found retained inside the abdominal cavity, with the presence of atrophic seminiferous tubules. Although the position of the testicles in freemartins has been reported as highly variable, this is the first time, to the best of the authors' knowledge, that a case has been reported where lymph nodes have been found inside the scrotal sacs. It is possible that these were the inguinal lymph nodes, trapped inside the scrotum during fetal growth and development.Keywords: freemartinism

  5. Sentinel lymph node concept in oral cancer

    The cervical lymph node (CLN) status is one of the most important prognostic factors in oral cancer. However, the main method of addressing the CLN depends on diagnostic imaging. Sentinel lymph node (SN) biopsy combined with lymphoscintigraphy may be a minimally invasive technique that samples first-echelon lymph node to predict the need for neck dissection. Focused analysis of the SN is highly accurate in identifying metastases. In this study, we investigate the possibility of identifying the SN in oral cancer and the detection of metastases in SN by HE stain, cytokeratin IHC and cytokeratin 17 reverse transcription polymerase chain reaction (RT-PCR). Twenty-four consecutive patients who had clinically negative CLN underwent SN biopsy, followed by elective neck dissection. SNs were detected by means of mapping with isotope labeling 99mTc-phytate. All lymph nodes were examined by conventional HE staining for evaluating metastasis. In addition, each SN was cut into multiple sections for cytokeratin IHC staining and for RT-PCR for cytokeratin 17. SNs were identified in 24 (100%) of 24 patients by lymphoscintigraphy and gamma probe. One to seven SNs were identified in each patient. Both HE and immunohistochemical staining of SN identified metastasis in 7 patients (29.2%), and the expression of cytokeratin 17 by RT-PCR of SN was positive in 8 patients (34.8%). No metastases were identified using HE, cytokeratin IHC staining in non-SNs. Neck failure has not developed in 23 (95.8%) of 24 patients. The results strongly suggest the usefulness of the SN concept in oral cancer and for better assessing the status of the CLN. (author)

  6. Generation of Lymph Node-fat Pad Chimeras for the Study of Lymph Node Stromal Cell Origin

    Benezech, Cecile; Caamano, Jorge H

    2013-01-01

    The stroma is a key component of the lymph node structure and function. However, little is known about its origin, exact cellular composition and the mechanisms governing its formation. Lymph nodes are always encapsulated in adipose tissue and we recently demonstrated the importance of this relation for the formation of lymph node stroma. Adipocyte precursor cells migrate into the lymph node during its development and upon engagement of the Lymphotoxin-b receptor switch off adipogenesis and d...

  7. CT on the distribution of peripancreatic lymph nodes

    Twelve patients, who were in the past injected thorotrast as the angiographic contrast medium, were examined on CT on the distribution of peripancreatic lymph nodes. Peripancreatic lymph nodes were demonstrated as high density dots on CT. Most peripancreatic lymph nodes were situated along the dorsal surface of the pancreas. Superior pancreatic nodes number 8.0 and splenic hilar nodes 2.4 on the average. These results were comparable with the data obtained from the postmortem examination previously reported. (author)

  8. CT on the distribution of peripancreatic lymph nodes

    Niwa, K.; Ishikawa, T.; Ishigaki, T. (Nagoya City Univ. (Japan). Faculty of Medicine); Endo, T.; Kido, C.

    1981-10-01

    Twelve patients, who were in the past injected with thorotrast as the angiographic contrast medium, were examined on CT on the distribution of peripancreatic lymph nodes. Peripancreatic lymph nodes were demonstrated as high density dots on CT. Most peripancreatic lymph nodes were situated along the dorsal surface of the pancreas. Superior pancreatic nodes number 8.0 and splenic hilar nodes 2.4 on the average. These results were comparable with the data obtained from the postmortem examination previously reported.

  9. Sentinel lymph node after intramammary injection of superparamagnetic iron oxide

    The purpose of this study was to evaluate enhancement (signal loss) of the axillary lymph nodes on MR lymphography after intramammary injection of superparamagnetic iron oxide (Ferumoxides) for detection of the sentinel lymph node. MR lymphography was performed in a total of 11 patients with breast cancer without palpable axillary lymph node swelling before operation. Coronal and axial images were obtained before and after intramammary injection of 1.5 ml Ferumoxides adjacent to the breast tumor. In all patients, decreased intensity was recognized in the axillary lymph nodes. MR lymphography could detect the sentinel lymph node with its decreased signal intensity 20 minutes after the intramammary injection of Ferumoxides. (author)

  10. High-frequency Ultrasound Imaging of Mouse Cervical Lymph Nodes.

    Walk, Elyse L; McLaughlin, Sarah L; Weed, Scott A

    2015-01-01

    High-frequency ultrasound (HFUS) is widely employed as a non-invasive method for imaging internal anatomic structures in experimental small animal systems. HFUS has the ability to detect structures as small as 30 µm, a property that has been utilized for visualizing superficial lymph nodes in rodents in brightness (B)-mode. Combining power Doppler with B-mode imaging allows for measuring circulatory blood flow within lymph nodes and other organs. While HFUS has been utilized for lymph node imaging in a number of mouse  model systems, a detailed protocol describing HFUS imaging and characterization of the cervical lymph nodes in mice has not been reported. Here, we show that HFUS can be adapted to detect and characterize cervical lymph nodes in mice. Combined B-mode and power Doppler imaging can be used to detect increases in blood flow in immunologically-enlarged cervical nodes. We also describe the use of B-mode imaging to conduct fine needle biopsies of cervical lymph nodes to retrieve lymph tissue for histological  analysis. Finally, software-aided steps are described to calculate changes in lymph node volume and to visualize changes in lymph node morphology following image reconstruction. The ability to visually monitor changes in cervical lymph node biology over time provides a simple and powerful technique for the non-invasive monitoring of cervical lymph node alterations in preclinical mouse models of oral cavity disease. PMID:26274059

  11. HISTOPATHOLOGICAL CHARACTERISTICS OF LYMPH NODE SINUS CONTAINING BLOOD

    YIN Tong; JI Xiao-long

    2001-01-01

    This study is to find out the histopathological characteristics of lymph node sinus containing blood. Routine autopsy was carried out in the randomly selected 102 patients(among them,100 patients died of various diseases, and 2 of non-diseased causes),their superficial lymph nodes locating in the bilateral neck, axilla, inguina, thorax and abdomen were sampled. Haematoxylin-eosin staining was performed on 10% formalin-fixed and paraffin-embedded lymph node tissue sections(5μm).The histological characteristics of the lymph node sinuses containing blood were observed under light microscope. Among the 1362 lymph nodes sampled from the 100 autopsies, lymph sinuses containing blood were found in 809 lymph nodes sampled from 91 cases, but couldn't be seen in the lymph nodes sampled from the non-diseased cases. According to histology, five kinds of lymph sinuses containing blood were found:vascular-opening sinus, blood-deficient sinus, erythrophago-sinus, blood-abundant sinus, and vascular-formative sinus. It is concluded that in the state of disease, the phenomenon of blood in the lymph sinus is not uncommon. Blood could possibly enter into lymph sinus through lymphatic-venous communications between the veins and sinuses in the node. Lymph circulation and blood circulation could communicate with each other in the lymph sinus.

  12. Lymph Node Metastases in Esophageal Carcinoma: An Endoscopist's View

    Cho, Jin Woong; Choi, Suck Chei; Jang, Jae Young; Shin, Sung Kwan; Choi, Kee Don; Lee, Jun Haeng; Kim, Sang Gyun; Sung, Jae Kyu; Jeon, Seong Woo; Choi, Il Ju; Kim, Gwang Ha; Jee, Sam Ryong; Lee, Wan Sik; Jung, Hwoon-Yong; ,

    2014-01-01

    One of the most important prognostic factors in esophageal carcinoma is lymph node metastasis, and in particular, the number of affected lymph nodes, which influences long-term outcomes. The esophageal lymphatic system is connected longitudinally and transversally; thus, the pattern of lymph node metastases is very complex. Early esophageal cancer frequently exhibits skipped metastasis, and minimal surgery using sentinel node navigation cannot be performed. In Korea, most esophageal cancer ca...

  13. Immunomorphologic lymph node changes in rats bearing experimental breast tumors.

    Ciocca, D. R.

    1980-01-01

    In this paper regional lymph nodes draining tumors and also nonregional lymph nodes have been studied at the light- and electron-microscopic levels. These nodes were obtained from rats bearing long-evolving autochthonous breast cancers. They were compared with a control group of the same age. A morphometric quantitative analysis was done to evaluate immunologically competent cell populations. In the experimental group there were no differences between regional and distal lymph nodes in the tu...

  14. Greater auricular nerve masquerading as lymph node.

    Saxena, Shilpi; Deb, Prabal; Nijhawan, Vijay Shrawan; Kharayat, Veena; Verma, Rajesh

    2015-01-01

    Hansen's disease is on the verge of being eliminated from India and often missed by clinicians due to low index of suspicion. We present an unusual case in which greater auricular nerve thickening masqueraded as enlarged lymph node in the neck. The patient was referred for fine needle aspiration cytology, which revealed epithelioid cell granulomas suggestive of Hansen's disease. Further clinical examination and investigations including the skin biopsy confirmed the disease, highlighting the role of pathologist in the management of such unusual presentation of a common disease. PMID:26229249

  15. Feasibility of Sentinel Lymph Node Detection in Nodular Thyroid Disease

    Background and purpose: Sentinel lymph node biopsy has been proven to be successful and accurate in predicting the nodal status in melanoma and breast cancer. Occult lymph node metastases are common in well differentiated thyroid cancer (WDTC). Although the prognostic significance of these occult lymph node metastases remains controversial, identifying these patients may help direct therapy. The purpose of the study was to assess the technical feasibility and the safety of the sentinel lymph node biopsy in uni-nodular thyroid disease. Methods: Patients of previously untreated benign solitary thyroid nodule, diagnosed preoperatively by fine needle aspiration cytology without any palpable cervical lymph node were prospectively studied. The nodule was injected with iso sulfan blue vital dye. Blue stained lymphatics were traced. Then, hemi thyroidectomy was per-formed. Results: A total of 30 patients underwent sentinel lymph node biopsy; lymph tics were observed in 23 patients and sentinel lymph nodes were found in 18. In 5 patients, blue stained lymphatics were traced to the outside of the central compartment but no sentinel lymph node was identified. Sentinel lymph nodes were located in the central compartment in 14 cases, in the lateral compartment in 3 cases and in one patient 2 sentinel lymph nodes were found in both the central and the lateral compartments. Overall detection of sentinel lymph nodes was possible in 60% of cases. There were no intra or postoperative complications. Conclusions: The role of sentinel lymph node biopsy has yet to be determined in the thyroid setting. Certainly the technique can be performed safely, but its accuracy needs further refinement and investigation on larger series of patients before it can be recommended in the routine management of thyroid neoplasia. Key Words: Sentinel node - Biopsy - Solitary thyroid nodule

  16. Preoperative diagnosis of lymph node metastasis in thoracic esophageal cancer

    From 1994 to 1995, to evaluate the utility of preoperative CT, EUS (endoscopic ultrasonography) and US in the diagnosis of lymph node metastasis in thoracic esophageal cancer, 94 patients with thoracic esophageal cancer who underwent esophagectomy were studied clinicopathologically. The sensitivity of EUS diagnosis of upper mediastinal lymph node metastasis (85%), left-sided paragastrin lymph node metastasis (73-77%), and especially lower paraesophageal lymph node metastasis (100%) were good. But due to their low-grade specificity in EUS diagnosis, their overall accuracy was not very good. On the other hand, the overall accuracy of the CT diagnosis of lymph node metastasis was fine. However, sensitivity, the most important clinical factor in the CT diagnosis of lymph node metastasis was considerably inferior to EUS. The assessment of the diagnosis of lymph node metastasis around the tracheal bifurcation and the pulmonary hilum and the left para-cardial lesion by CT or EUS was poor. It was concluded that lymph node metastasis of these area must be the pitfall in preoperative diagnosis. The average diameter of the lymph nodes and the proportion of cancerous tissue in the lymph nodes diagnosed as metastatic lymph nodes by CT was larger than that of the false negative lymph nodes. However, the lymph nodes diagnosed as true positives by EUS showed no such tendency. This must be the reason the sensitivity of the EUS diagnosis and specificity of the CT diagnosis were favorable, but the specificity of the EUS diagnosis and especially the sensitivity of the CT diagnosis were not as good. (author)

  17. Nomogram to Predict Risk of Lymph Node Metastases in Patients With Endometrioid Endometrial Cancer.

    Pollom, Erqi L; Conklin, Christopher M J; von Eyben, Rie; Folkins, Ann K; Kidd, Elizabeth A

    2016-09-01

    Pelvic lymphadenectomy in early-stage endometrial cancer is controversial, but the findings influence prognosis and treatment decisions. Noninvasive tools to identify women at high risk of lymph node metastasis can assist in determining the need for lymph node dissection and adjuvant treatment for patients who do not have a lymph node dissection performed initially. A retrospective review of surgical pathology was conducted for endometrioid endometrial adenocarcinoma at our institution. Univariate and multivariate logistic regression analysis of selected pathologic features were performed. A nomogram to predict for lymph node metastasis was constructed. From August 1996 to October 2013, 296 patients underwent total abdominal or laparoscopic hysterectomy, bilateral salpingo-oophorectomy, and selective lymphadenectomy for endometrioid endometrial adenocarcinoma. Median age at surgery was 62.7 yr (range, 24.9-93.6 yr). Median number of lymph nodes removed was 13 (range, 1-72). Of all patients, 38 (12.8%) had lymph node metastases. On univariate analysis, tumor size ≥4 cm, grade, lymphovascular space involvement, cervical stromal involvement, adnexal or serosal or parametrial involvement, positive pelvic washings, and deep (more than one half) myometrial invasion were all significantly associated with lymph node involvement. In a multivariate model, lymphovascular space involvement, deep myometrial invasion, and cervical stromal involvement remained significant predictors of nodal involvement, whereas tumor size of ≥4 cm was borderline significant. A lymph node predictive nomogram was constructed using these factors. Our nomogram can help estimate risk of nodal disease and aid in directing the need for additional surgery or adjuvant therapy in patients without lymph node surgery. Lymphovascular space involvement is the most important predictor for lymph node metastases, regardless of grade, and should be consistently assessed. PMID:26598977

  18. Recurrence patterns of thoracic esophageal cancer after two-field lymph node dissection

    Objective: To investigate the local-regional recurrence in thoracic esophageal cancer after radical surgery including two-field lymph node dissection and provide evidence for postoperative radiotherapy. Methods: We reviewed local-regional recurrence for 134 cases with esophageal squamous cell carcinoma after radical surgery from 2004 to 2009. Results: In 134 cases, lymph node metastasis rate,anastomosis recurrence rate and tumor bed recurrence rate was 94. 0%, 9. 7% and 3.7%, respectively. As to the 126 cases with lymph node metastasis, significant difference was detected between mediastinal metastasis, supraclavicular metastasis and abdominal lymph node metastasis (80.2%, 43.7% and 13.5%, respectively, χ2= 113.15, P = 0.000). Furthermore, the relative metastasis rate in upper mediastinum,middle mediastinum and the lower mediastinum was 73.8%, 39.7% and 1.6%, respectively, the difference was statistically significant (χ2 = 139.11, P = 0.000). Significant difference was identified between right and left supraclavicular lymph node metastasis (31.7% vs 16.7%, χ2= 7. 81, P = 0.005). To confirm the analysis above, lymph node metastasis rate of left recurrent laryngeal nerve nodes, (including region 1L, 2L, 4L and 5) ,right recurrent laryngeal nerve nodes, azygos nodes, subcarinal nodes, and 2R region was 38.9%, 43.7%, 15.1%, 34.1% and 25.4%, respectively. Conclusions: The main characteristics of local-regional recurrence may be lymph node metastasis for esophageal squamous cell carcinoma after radical surgery. On the contrary, tumor bed recurrence is rare. Dangerous regions include supraclavicular nodes, recurrent laryngeal nerve nodes, azygos nodes as well as subcarinal nodes. (authors)

  19. Lymph Node Metastasis of Gastric Cancer

    Akagi, Tomonori, E-mail: tomakagi@med.oita-u.ac.jp [Oita University Faculty of Medicine, Department of Gastroenterological Surgery, 1-1 Idaigaoka, Hasama-machi, Oita 879-5593 (Japan); Shiraishi, Norio [Surgical division, Center for community medicine, Oita University, 1-1 Idaigaoka, Hasama-machi, Oita 879-5593 (Japan); Kitano, Seigo [Oita University Faculty of Medicine, Department of Gastroenterological Surgery, 1-1 Idaigaoka, Hasama-machi, Oita 879-5593 (Japan)

    2011-04-26

    Despite a decrease in incidence in recent decades, gastric cancer is still one of the most common causes of cancer death worldwide [1]. In areas without screening for gastric cancer, it is diagnosed late and has a high frequency of nodal involvement [1]. Even in early gastric cancer (EGC), the incidence of lymph node (LN) metastasis exceeds 10%; it was reported to be 14.1% overall and was 4.8 to 23.6% depending on cancer depth [2]. It is important to evaluate LN status preoperatively for proper treatment strategy; however, sufficient results are not being obtained using various modalities. Surgery is the only effective intervention for cure or long-term survival. It is possible to cure local disease without distant metastasis by gastrectomy and LN dissection. However, there is no survival benefit from surgery for systemic disease with distant metastasis such as para-aortic lymph node metastasis [3]. Therefore, whether the disease is local or systemic is an important prognostic indicator for gastric cancer, and the debate continues over the importance of extended lymphadenectomy for gastric cancer. The concept of micro-metastasis has been described as a prognostic factor [4-9], and the biological mechanisms of LN metastasis are currently under study [10-12]. In this article, we review the status of LN metastasis including its molecular mechanisms and evaluate LN dissection for the treatment of gastric cancer.

  20. Lymph Node Metastasis of Gastric Cancer

    Despite a decrease in incidence in recent decades, gastric cancer is still one of the most common causes of cancer death worldwide [1]. In areas without screening for gastric cancer, it is diagnosed late and has a high frequency of nodal involvement [1]. Even in early gastric cancer (EGC), the incidence of lymph node (LN) metastasis exceeds 10%; it was reported to be 14.1% overall and was 4.8 to 23.6% depending on cancer depth [2]. It is important to evaluate LN status preoperatively for proper treatment strategy; however, sufficient results are not being obtained using various modalities. Surgery is the only effective intervention for cure or long-term survival. It is possible to cure local disease without distant metastasis by gastrectomy and LN dissection. However, there is no survival benefit from surgery for systemic disease with distant metastasis such as para-aortic lymph node metastasis [3]. Therefore, whether the disease is local or systemic is an important prognostic indicator for gastric cancer, and the debate continues over the importance of extended lymphadenectomy for gastric cancer. The concept of micro-metastasis has been described as a prognostic factor [4-9], and the biological mechanisms of LN metastasis are currently under study [10-12]. In this article, we review the status of LN metastasis including its molecular mechanisms and evaluate LN dissection for the treatment of gastric cancer

  1. Nanoparticle Transport from Mouse Vagina to Adjacent Lymph Nodes

    Byron Ballou; Andreko, Susan K.; Elvira Osuna-Highley; Michael McRaven; Tina Catalone; Bruchez, Marcel P.; Hope, Thomas J.; Labib, Mohamed E.

    2012-01-01

    To test the feasibility of localized intravaginal therapy directed to neighboring lymph nodes, the transport of quantum dots across the vaginal wall was investigated. Quantum dots instilled into the mouse vagina were transported across the vaginal mucosa into draining lymph nodes, but not into distant nodes. Most of the particles were transported to the lumbar nodes; far fewer were transported to the inguinal nodes. A low level of transport was evident at 4 hr after intravaginal instillation,...

  2. Observation of a Long Primo Vessel in a Lymph Vessel from the Inguinal Node of a Rabbit

    Young-Il Noh; Yeong-Min Yoo; Ran-Hyang Kim; Ye-Ji Hong; Hye-Rie Lee; Min-Suk Rho; Sang-Suk Lee

    2013-01-01

    Though primo vessels are frequently found in the lymph near the abdominal aorta of rabbit by Alcian blue dye, the reproductions are still difficult to require considerable skills and technical know-how at dissected tissue of animal species. However, in the inguinal lymph node of a rabbit we found a long-type primo vascular system (LTP) dyed with Alcian blue, from an abdominal lymph vessel to an inguinal lymph node. The length of LTP was over an average length of 9.1 cm. The average diameters ...

  3. Computed tomography of neck lymph nodes involved with malignant lymphoma

    CT images of 24 patients with head and neck lymphoma were retrospectively reviewed, compared with ultrasonograms, and compared with CT images of 13 patients with lymph node metastases. In nine (38%) of 24 patients, some lymph nodes with lymphomatous involvement showed a spotty or linear pattern of contrast enhancement. In two of these nine patients, a dendritic pattern of contrast enhancement between multiple enlarged lymph nodes was observed. The same pattern appeared as spotty, linear, or dendritic hyperechoic areas on the ultrasonogram. None of 13 patients with lymph node metastases showed a spotty, linear, or dendritic pattern of contrast enhancement. Ten of 13 (77%) showed ring-like contrast enhancement on CE-CT images. The spotty or linear contrast enhancement in enlarged lymph nodes and the dendritic contrast enhancement in confluent lymph nodes could be useful CT findings in diagnosing nodal involvement with malignant lymphoma. (author)

  4. Simultaneous occurrence of follicular lymphoma and mixed-cellularity Hodgkin's lymphoma: lymph node and extranodal involvement

    Grangeiro Maria do Patrocínio F.

    2004-01-01

    Full Text Available An unusual and well-characterised case of composite lymphoma in the spleen and lymph node is presented. The simultaneous occurrence of mixed-cellularity Hodgkin's lymphoma (HL and follicular non-Hodgkin's lymphoma (NHL was demonstrated in a 66-year-old man admitted in our Service with anaemia, hepatosplenomegaly and multiple abdominal lymph nodes. The morphological study of the spleen and lymph node of the splenic hilum showed an infiltrate composed of two distinct neoplasias. The liver was involved by NHL infiltrate and the peripancreatic lymph node exhibited HL. The Reed-Sternberg (RS cells expressed CD 15 and CD 30, whereas the NHL cells presented standard immunohistochemical features of follicular lymphoma. To our knowledge, this is the fifth case report of concurrent spleen involvement by composite lymphoma. The incidence, clinicopathological and immunohistochemical features of this rare association are discussed.

  5. Modeling lymphocyte homing and encounters in lymph nodes

    Bernaschi Massimo; Paci Paola; Baldazzi Valentina; Castiglione Filippo

    2009-01-01

    Abstract Background The efficiency of lymph nodes depends on tissue structure and organization, which allow the coordination of lymphocyte traffic. Despite their essential role, our understanding of lymph node specific mechanisms is still incomplete and currently a topic of intense research. Results In this paper, we present a hybrid discrete/continuous model of the lymph node, accounting for differences in cell velocity and chemotactic response, influenced by the spatial compartmentalization...

  6. Uncommon applications of sentinel lymph node mapping: urogenital cancers

    Beside the classical applications of sentinel lymph node mapping, some new procedures are emerging and showing feasibility and clinical utility. In this chapter, we will report on sentinel lymph node mapping in 1) malignancies of the female reproductive system (cervical cancer, endometrial cancer, vulvar cancer and ovarian cancer); 2) malignancies of the male reproductive system (prostate cancer, penile cancer and testicular cancer); 3) malignancies in kidney and bladder. This paper presents the uncommon applications of sentinel lymph node mapping in urogenital neoplasms.

  7. Sentinel lymph nodes in cancer of the oral cavity

    Thomsen, Jørn Bo; Sørensen, Jens Ahm; Krogdahl, Annelise

    2005-01-01

    with T1/T2 cN0 oral cancer were re-classified histologically to find possible ITC and to describe technical pitfalls. RESULTS: Primarily we found metastatic spread in 12 of 108 sentinel lymph nodes: five macrometastasis and seven micrometastasis. After re-classification, we found seven lymph nodes with......BACKGROUND: Sentinel lymph node biopsy, step sectioning and immunohistochemistry have changed detection of tumour deposits. Isolated tumour cells (ITC) are detected more frequently than earlier because of a changed level of detection. METHODS: A total of 108 sentinel lymph nodes from 30 patients...

  8. Right axillary lymph node metastasis of carcinoma of the cecum with histologically proven cutaneous lymphatic invasion by carcinoma cells: a case report

    Kawamura, Yutaka J.; Kohno, Michitaka; Shiga, Junji; Asakage, Naoki; Hatano, Minoru; Okame, Hirohisa; SASAKI, JUNICHI; Tobari, Shoichi; Nishida, Katsunori

    2015-01-01

    Axillary lymph node metastasis from colorectal carcinoma is extremely rare, and this scarcity hinders understanding of its pathogenesis and, thus, the application of appropriate management. Here, we present a case with axillary lymph node metastasis of cecal carcinoma associated with macroscopic invasion of the skin of the abdominal wall with histological evidence of such invasion, findings which support our hypothesis that the axillary lymph node metastasis developed via the lymph channels i...

  9. Lymphocyte migration into syngeneic implanted lymph nodes

    To judge the functional activity of lymphocytes of an implanted lymph node (LN), the proliferative response of lymphocytes of the implanted organ in the blast-transformation reaction in vitro and their ability to induce a local graft versus host reaction (GVHR) were determined. The lymphocyte suspension for labeling with 51Cr was obtained from peripheral LN in different situations from syngeneic mice. The resulting lymphocyte suspension was labeled with a solution of sodium chromate-51Cr in a concentration of 20-40 microCi/100.106 cells in 1 ml for 40 min at 370C. The proliferative activity of a suspension of lymphocytes was estimated as incorporation of 3H-thymidine into DNA during incubation of the cell suspension for 3 days. Data on migration of 51Cr-labeled cells and the results of the morphological observations revealed marked ability of lymphocytes of the peripheral pool to colonize the regenerating stroma

  10. Endoscopic ultrasound: Elastographic lymph node evaluation.

    Dietrich, Christoph F; Jenssen, Christian; Arcidiacono, Paolo G; Cui, Xin-Wu; Giovannini, Marc; Hocke, Michael; Iglesias-Garcia, Julio; Saftoiu, Adrian; Sun, Siyu; Chiorean, Liliana

    2015-01-01

    Different imaging techniques can bring different information which will contribute to the final diagnosis and further management of the patients. Even from the time of Hippocrates, palpation has been used in order to detect and characterize a body mass. The so-called virtual palpation has now become a reality due to elastography, which is a recently developed technique. Elastography has already been proving its added value as a complementary imaging method, helpful to better characterize and differentiate between benign and malignant masses. The current applications of elastography in lymph nodes (LNs) assessment by endoscopic ultrasonography will be further discussed in this paper, with a review of the literature and future perspectives. PMID:26374575

  11. Unusual metachronous isolated inguinal lymph node metastasis from adenocarcinoma of the sigmoid colon

    Parodo Giuseppina

    2011-10-01

    Full Text Available Abstract This study aimed to describe an unusual case of metachronous isolated inguinal lymph nodes metastasis from sigmoid carcinoma. A 62-year-old man was referred to our department because of an obstructing sigmoid carcinoma. Colonoscopy showed the obstructing lesion at 30 cm from the anal verge and abdominal CT revealed a sigmoid lesion infiltrating the left lateral abdominal wall. The patient underwent a colonic resection extended to the abdominal wall. Histology showed an adenocarcinoma of the colon infiltrating the abdominal wall with iuxtacolic nodal involvement. Thirty three months after surgery abdominal CT and PET scan revealed a metastatic left inguinal lymph node involvement. The metastatic lymph node was found strictly adherent to the left iliac-femoral artery and encompassing the origin of the left inferior epigastric artery. Histology showed a metachronous nodal metastasis from colonic adenocarcinoma. Despite metastastic involvement of inguinal lymph node from rectal cancer is a rare but well known clinical entity, to the best of our knowledge, this is the first report of inguinal metastasis from a carcinoma of the left colon. Literature review shows only three other similar reported cases: two cases of inguinal metastasis secondary to adenocarcinoma of the cecum and one case of axillary metastasis from left colonic carcinoma. A metastatic pathway through superficial abdominal wall lymphatic vessels could be possible through the route along the left inferior epigastric artery. The solitary inguinal nodal involvement from rectal carcinoma could have a more favorable prognosis. In the case of nodal metastasis to the body surface lymph nodes from colonic carcinoma, following the small number of such cases reported in the literature, no definitive conclusions can be drawn.

  12. Assessment of lymph node involvement in colorectal cancer

    Ong, Mark L H; Schofield, John B.

    2016-01-01

    Lymph node metastasis informs prognosis and is a key factor in deciding further management, particularly adjuvant chemotherapy. It is core to all contemporary staging systems, including the widely used tumor node metastasis staging system. Patients with node-negative disease have 5-year survival rates of 70%-80%, implying a significant minority of patients with occult lymph node metastases will succumb to disease recurrence. Enhanced staging techniques may help to identify this subset of pati...

  13. Vascularized Free Lymph Node Flap Transfer in Advanced Lymphedema Patient after Axillary Lymph Node Dissection.

    Cook, Kyung Hoon; Park, Myong Chul; Lee, Il Jae; Lim, Seong Yoon; Jung, Yong Sik

    2016-03-01

    Lymphedema is a condition characterized by tissue swelling caused by localized fluid retention. Advanced lymphedema is characterized by irreversible skin fibrosis (stage IIIb) and nonpitting edema, with leather-like skin, skin crypts, and ulcers with or without involvement of the toes (stage IVa and IVb, respectively). Recently, surgical treatment of advanced lymphedema has been a challenging reconstructive modality. Microvascular techniques such as lymphaticovenous anastomosis and vascularized lymph node flap transfer are effective for early stage lymphedema. In this study, we performed a two-stage operation in an advanced lymphedema patient. First, a debulking procedure was performed using liposuction. A vascularized free lymph node flap transfer was then conducted 10 weeks after the first operation. In this case, good results were obtained, with reduced circumferences in various parts of the upper extremity noted immediately postoperation. PMID:27064862

  14. Sentinel lymph node biopsy in breast cancer and melanoma

    Doting, Meintje Hylkje Edwina

    2007-01-01

    Summary and conclusions In the introduction, a short overview of the development of the sentinel lymph node biopsy concept is presented. In addition to melanoma and breast cancer, the usefulness of sentinel lymph node biopsy as a surgical assessment method for squamous cell carcinoma of penis and vu

  15. A case report of giant retroperitoneal lymph node hyperplasia

    Park, Hae Won [Korea General Hospital, Seoul (Korea, Republic of)

    1985-08-15

    Giant lymph node hyperplasias are an uncommon entity. They are difficult to image on plain film. The CT appearance of this condition has been described in recent radiologic literature. In this case report, combination of ultrasonogram and CT permitted differentiated of other space occupying lesions from giant retroperitoneal lymph node hyperplasia.

  16. A case report of giant retroperitoneal lymph node hyperplasia

    Giant lymph node hyperplasias are an uncommon entity. They are difficult to image on plain film. The CT appearance of this condition has been described in recent radiologic literature. In this case report, combination of ultrasonogram and CT permitted differentiated of other space occupying lesions from giant retroperitoneal lymph node hyperplasia

  17. Sentinel lymph nodes in cancer of the oral cavity

    Thomsen, Jørn Bo; Christensen, Rikke Kølby; Sørensen, Jens Ahm;

    2007-01-01

    when compared with (B) step-sectioning and immunostaining of the entire sentinel lymph node at 250 microM levels. METHODS: Forty patients with T1/T2 cN0 oral cancer were enrolled. Three patients were excluded. In one patient no sentinel lymph node was identified. The remaining two had unidentified...

  18. Process of distant lymph node metastasis in colorectal carcinoma: Implication of extracapsular invasion of lymph node metastasis

    Asao Takayuki; Tsutsumi Soichi; Yamaguchi Satoru; Yajima Reina; Tabe Yuichi; Fujii Takaaki; Kuwano Hiroyuki

    2011-01-01

    Abstract Background We previously demonstrated that extracapsular invasion (ECI) at a metastatic sentinel node was significantly associated with the presence of positive non-sentinel nodes in patients with breast cancer. However, the mechanism of metastatic spreading of tumor cells to distant lymph nodes in patients with colorectal carcinoma is not fully understood. In this study, we investigated the factors that may determine the likelihood of additional regional lymph node metastasis when m...

  19. Effects of transuranics on pulmonary lymph nodes of rodents

    Pulmonary lymph nodes have been suggested as the ''critical'' tissue for insoluble, inhaled transuranic compounds owing to the high concentration of transuranics in these lymph nodes. About 800 rats were given from 0.2 to 3600 nCi of 238PuO2 or 239PuO2 by inhalation, intratracheal instillation, intrapleural injection, or intraperitoneal injection. From about 1 to 10 percent of deposited plutonium was translocated to pulmonary lymph nodes, the amount depending on the time after deposition and the route of administration; 238PuO2 was cleared from pulmonary lymph nodes faster than 239PuO2 owing to the greater in vivo solubility of 238PuO2. No primary tumors of pulmonary lymph nodes were observed, indicating that this tissue was not the critical tissue for carcinogenic induction

  20. Nanoparticle transport from mouse vagina to adjacent lymph nodes.

    Byron Ballou

    Full Text Available To test the feasibility of localized intravaginal therapy directed to neighboring lymph nodes, the transport of quantum dots across the vaginal wall was investigated. Quantum dots instilled into the mouse vagina were transported across the vaginal mucosa into draining lymph nodes, but not into distant nodes. Most of the particles were transported to the lumbar nodes; far fewer were transported to the inguinal nodes. A low level of transport was evident at 4 hr after intravaginal instillation, and transport peaked at about 36 hr after instillation. Transport was greatly enhanced by prior vaginal instillation of Nonoxynol-9. Hundreds of micrograms of nanoparticles/kg tissue (ppb were found in the lumbar lymph nodes at 36 hr post-instillation. Our results imply that targeted transport of microbicides or immunogens from the vagina to local lymph organs is feasible. They also offer an in vivo model for assessing the toxicity of compounds intended for intravaginal use.

  1. Nanoparticle transport from mouse vagina to adjacent lymph nodes.

    Ballou, Byron; Andreko, Susan K; Osuna-Highley, Elvira; McRaven, Michael; Catalone, Tina; Bruchez, Marcel P; Hope, Thomas J; Labib, Mohamed E

    2012-01-01

    To test the feasibility of localized intravaginal therapy directed to neighboring lymph nodes, the transport of quantum dots across the vaginal wall was investigated. Quantum dots instilled into the mouse vagina were transported across the vaginal mucosa into draining lymph nodes, but not into distant nodes. Most of the particles were transported to the lumbar nodes; far fewer were transported to the inguinal nodes. A low level of transport was evident at 4 hr after intravaginal instillation, and transport peaked at about 36 hr after instillation. Transport was greatly enhanced by prior vaginal instillation of Nonoxynol-9. Hundreds of micrograms of nanoparticles/kg tissue (ppb) were found in the lumbar lymph nodes at 36 hr post-instillation. Our results imply that targeted transport of microbicides or immunogens from the vagina to local lymph organs is feasible. They also offer an in vivo model for assessing the toxicity of compounds intended for intravaginal use. PMID:23284844

  2. Axillary sentinel lymph node biopsy after mastectomy: a case report

    Hahm George; Henry Leonard R; Vicente Diego A; Soballe Peter W; Smart DeeDee

    2010-01-01

    Abstract Background Sentinel lymph node biopsy has been established as the preferred method for staging early breast cancer. A prior history of mastectomy is felt to be a contraindication. Case presentation A patient with recurrent breast cancer in her skin flap was discovered to have positive axillary sentinel nodes by sentinel lymph node biopsy five years after mastectomy for ductal carcinoma in situ. Conclusion A prior history of mastectomy may not be an absolute contraindication to sentin...

  3. Differentiation of hyperplastic from metastatic lymph nodes using a lymph node specific MR contrast agent gadofluorine M

    Cha, Joo Hee; Cheon, Jung Eun [Seoul Municipal Boramae Hospital, Seoul (Korea, Republic of); Moon, Woo Kyung [Seoul National University College of Medicine and the Institute of Radiation Medicine, SNUMRC, Seoul (Korea, Republic of)] (and others)

    2006-08-15

    We wanted to evaluate the value of a lymph node specific MR contrast agent, Gadofluorine M, for the differentiation of hyperplastic and metastatic lymph nodes. This study included thirty-one rabbits. In ten rabbits, an injection of egg yolk or feces of rat into the calf muscles induced hyperplasia of the lymph node. In sixteen rabbits, metastasis of the lymph node was induced by implantation of VX2 tumor. Five rabbits were normal control models. We acquired the T1-, T2-weighted and SPGR coronal imaging before enhancement with 1.5 T MR. After injection of Gadofluorine M (5 {mu}mol/mL, total amount: 4 mL) interstitially into the interdigital skin fold of the hind limb, we acquired the SPGR coronal imaging at 15, 30, 60 and 90 minutes. We calculated the signal-to-noise ratios on the sequential images, and we recorded the number, size and location of the popliteal and iliac lymph nodes. Three readers assessed the state of the lymph nodes according to the pattern of enhancement: they were deemed hyperplastic nodes when totally enhanced and as metastatic nodes when there was no or partial enhancement. We also compared the imaging patterns with the histopathological results. Among the 26 hyperplasia- or metastasis-induced rabbits, two rabbits were excluded because of failure to be enhanced. Histopathologic evaluation of the 24 rabbits detected one hundred seventeen lymph nodes: forty-six lymph nodes in nine hyperplasia-induced rabbits and seventy-one (metastasis in twenty-eight) lymph nodes in fifteen metastasis-induced rabbits. Out of one hundred two lymph nodes that were larger than 5 mm in size, MR enabled us to detect one hundred one lymph nodes (99.1%). The means of sensitivity, specificity, and the positive and negative predictive values for the diagnosis of lymph node metastasis by three readers were 97.6% (82/84), 98.2% (215/219), and 95.3% (82/86), and 99.1% (215/217), respectively ({rho} < 0.05). Interstitial MR lymphography using Gadofluorine M showed excellent

  4. [Intraoperative detection of the sentinel lymph nodes in lung cancer].

    Akopov, A L; Papayan, G V; Chistyakov, I V

    2015-01-01

    An analysis of the scientific data was made. It was used the literature devoted to the intraoperative visualization of the sentinel lymph nodes in patients with lung cancer. Correct detection of such lymph nodes with following pathologic investigation allowed limiting the volume of lympho-dissection in a number of patients. There is the possibility of maximal in-depth study of the sentinel lymph nodes by purposeful application of most sensible pathologic and molecular methods for detection their micrometastatic lesions. At the same time the treatment strategy and prognosis could be determined. The authors present the results of an application of dye techniques, radioactive preparation and fluorescence imaging for sentinel lymph node detection. Advantages and disadvantages of the methods are shown in the article. There are validated the prospects of technical development, study of information value of new applications and the most perspective method of fluorescence indocyanine green visualization by lymph outflow. PMID:25962306

  5. Assessment of lymph node involvement in colorectal cancer.

    Ong, Mark L H; Schofield, John B

    2016-03-27

    Lymph node metastasis informs prognosis and is a key factor in deciding further management, particularly adjuvant chemotherapy. It is core to all contemporary staging systems, including the widely used tumor node metastasis staging system. Patients with node-negative disease have 5-year survival rates of 70%-80%, implying a significant minority of patients with occult lymph node metastases will succumb to disease recurrence. Enhanced staging techniques may help to identify this subset of patients, who might benefit from further treatment. Obtaining adequate numbers of lymph nodes is essential for accurate staging. Lymph node yields are affected by numerous factors, many inherent to the patient and the tumour, but others related to surgical and histopathological practice. Good lymph node recovery relies on close collaboration between surgeon and pathologist. The optimal extent of surgical resection remains a subject of debate. Extended lymphadenectomy, extra-mesenteric lymph node dissection, high arterial ligation and complete mesocolic excision are amongst the surgical techniques with plausible oncological bases, but which are not supported by the highest levels of evidence. With further development and refinement, intra-operative lymphatic mapping and sentinel lymph node biopsy may provide a guide to the optimum extent of lymphadenectomy, but in its present form, it is beset by false negatives, skip lesions and failures to identify a sentinel node. Once resected, histopathological assessment of the surgical specimen can be improved by thorough dissection techniques, step-sectioning of tissue blocks and immunohistochemistry. More recently, molecular methods have been employed. In this review, we consider the numerous factors that affect lymph node yields, including the impact of the surgical and histopathological techniques. Potential future strategies, including the use of evolving technologies, are also discussed. PMID:27022445

  6. Effects of concurrent chemoradiotherapy on cervical lymph node metastases

    We report an investigation into the effects of concurrent chemoradiotherapy (CCRT) on cervical lymph node metastases in cases of head and neck squamous cell carcinoma occurring with cervical lymph node metastasis. The subjects were 32 patients receiving CCRT simultaneously for both the primary tumor and cervical lymph node metastases over a five-year period, from January 2005 to December 2009. A complete response (CR) was observed in 71.9% of cases, increasing to 87.5% when cases with no residual viable tumor cells in excised specimens of radical neck dissection were included. Although no relationship existed between primary tumor location, N classification, and the therapeutic effect on cervical lymph node, the actual ratio of CR for cervical lymph node metastases tended to decrease with advanced stages of T classification. Considering that positive results are obtained without planned neck dissection, recurrence occurs only in a few cases, and there are no serious complications of radical neck dissection after CCRT, we believe that a planned neck dissection procedure is not necessarily required in all cases. However, evaluation is difficult with regard to cervical lymph nodes subsequent to CCRT, and therefore, future studies are needed to investigate a test method or a combination of test methods that provide a definite assessment of the presence or absence of residual cervical lymph node metastasis. (author)

  7. Histopathological Evaluation of Lymph Node Biopsies: A Hospital Based Study

    Syeda Tasfia Siddika

    2012-07-01

    Full Text Available Background: Lymphadenopathy is a common manifestation of a large variety of disorders,both benign and malignant. It is essential to define the pattern of disorders presenting primarily as lymph node enlargement in a particular environment. Histopathological examination of the lymph node biopsies is a gold standard test in the distinction between reactive and malignant lymphoid proliferations as well as for detailed subtyping oflymphomas. We designed this study in our population for histopathological evaluation of lymph nodes that might be helpful for clinical management of these lesions. Objective: Histopathological evaluation of lymphadenopathy from excised specimen, in relation to ageand sex of the patients, and distribution of the lymph nodes. Materials and Methods: It was a retrospective cross sectional study conducted in the department of Pathology, Enam Medical College & Hospital, Savar, Dhaka during the period from January 2006 to December 2010. Lymph node biopsies of all patients of both sexes and all age groups were included.Metastatic lymph nodes associated with evidence of primaries elsewhere in the body were excluded from the study. Total 191 lymph node biopsies were selected for histopathological evaluation. Among these 90 (47.12% were from males and 101 (52.88% were from females with male to female ratio being 1:2.1. The age of the patients ranged from 2 to 85 years with a mean age of 35.73 ± 18 years. Results: Cervical lymph nodes were the most common (56% biopsied group. Of the 191 cases 59 cases (30.89% were reactive lymphadenitis, 64 cases (33.5% were tuberculosis, 2 cases (1.05% were non-caseous granuloma, 11 cases (5.76% were Hodgkin lymphoma, 22 cases (11.52% were non-Hodgkin lymphoma, 24 cases (12.57% were metastatic neoplasm and 9 cases (4.7% were other lesions. Conclusion: Tuberculosis was the most common cause of lymphadenopathy, followed by reactive lymphadenitis and the cervical group of lymph nodes was most

  8. Lymph sacs are not required for the initiation of lymph node formation

    Vondenhoff, Mark F.; : Serge A. van de Pavert; Dillard, Miriam E.; Greuter, Mascha; Goverse, Gera; Oliver, Guillermo; Mebius, Reina E.

    2008-01-01

    The lymphatic vasculature drains lymph fluid from the tissue spaces of most organs and returns it to the blood vasculature for recirculation. Before reaching the circulatory system, antigens and pathogens transported by the lymph are trapped by the lymph nodes. As proposed by Florence Sabin more than a century ago and recently validated, the mammalian lymphatic vasculature has a venous origin and is derived from primitive lymph sacs scattered along the embryonic body axis. Also as proposed by...

  9. Evaluation of sentinel lymph node biopsy in clinically node-negative breast cancer

    In patients with clinically node-negative breast cancer, diagnosed with palpation and several types of imaging examination, sentinel lymph nodes accurately predict the status of the other axillary nodes, which determine the nature of subsequent adjuvant treatment. In addition, compared with axillary lymph node dissection, sentinel-node biopsy results in less postoperative morbidity, including pain, numbness, swelling, and reduced mobility in the ipsilateral arm. We analyzed the validity of the sentinel node biopsy procedure using dual-agent injection of blue dye and radioactive colloid performed in our hospital from May 2006 through March 2010. A total of 258 breasts of 253 patients were studied. Simultaneous axillary lymph node dissection was performed only if rapid intraoperative diagnosis identified metastasis in sentinel lymph nodes. The identification rate, accuracy, provisional false-negative rate, which was calculated with data from all 65 patients whose sentinel lymph nodes had metastasis, and axillary recurrence rate of sentinel node biopsy were calculated. The sentinel node identification rate was 99.2%, and the accuracy of sentinel lymph node status was 98.0%. The provisional false-negative rate was 7.7%. During an observation period averaging 24 months, axillary recurrence was observed in only 1 of 256 cases (0.4%), and there were no cases of parasternal recurrence. In patients who underwent sentinel-node biopsy without axillary lymph node dissection, there was no obvious morbidity. Our sentinel-node biopsy procedure yielded satisfactory results, which were not inferior to the results of previous clinical trials. Thus, we conclude our sentinel-node biopsy procedure is feasible. If the efficacy and safety of sentinel-node biopsy are confirmed in several large-scale randomized controlled trials in Europe and the United States, sentinel-node biopsy will become a standard surgical technique in the management of clinically node-negative breast cancer

  10. Dynamic dose-shaping by gravity-oriented absorbers for total lymph node irradiation

    Rotational therapy with gravity-oriented absorbers is proposed for better total lymph node irradiation (TLI). Two metal semicylinders are joined coaxially (face to face) to form a radiation absorber that is centrally suspended in the beam. During rotation this absorber is kept parallel to itself by gravity, like the riders of a Ferris wheel. The vertebrae remain continuously protected under the absorber's shadow. The circular full-dose region, achieved by ordinary rotation, is now transformed into a horse-shoe region embracing the spine anteriorly. The abdominal lymph nodes are thus irradiated while the spine and most of the normal tissue around the spine are protected. A similar technique is applied for the selective irradiation of the pelvic lymph nodes, which are confined in the two legs of an inverted V region

  11. CT manifestations of lymph node metastasis of thyroid carcinoma

    Objective: to study the CT manifestations of metastatic lymph node of thyroid carcinoma. Methods: CT appearances of metastatic lymph node of thyroid carcinoma proved by surgery and pathology in 108 patients were reviewed. Results: Of these 108 cases, metastatic lymph node were located at superior and middle internal jugular chain (n = 76), inferior internal jugular chain and super clavicular region (n = 86), tracheoesophageal groove (n = 52), and superior mediastinum (n = 17). Of 84 thyroid papillary carcinoma patients, the attenuation of metastatic lymph nodes were similar to that of normal thyroid gland (n = 16), with cystic formations, (n = 24), intra-cystic high attenuation papillary-like nodules (n = 18), and fine granular calcifications (n = 11). Of 24 follicular carcinoma, medullary carcinoma, and clear cell carcinoma patients, 17 cases had significant homogeneous or heterogeneous enhanced nodes, and the attenuation was the same as primary or recurrent thyroid tumors. Conclusion: For thyroid carcinoma, the most common locations of metastatic lymph nodes were internal jugular chain, tracheoesophageal groove, and superior mediastinum regions. Marked enhancement similar to normal thyroid gland, cystic formations with intra-cystic high attenuation papillary-like nodules, and fine discrete granular calcifications were the characteristic manifestations of metastatic lymph node of papillary carcinoma. Marked homogeneous or heterogeneous enhancement after contrast administration and the same attenuation as the primary or recurrent thyroid tumor were found in follicular carcinoma, medullary carcinoma, and clear cell carcinoma metastases

  12. Sentinel lymph node biopsy in local recurrence of cutaneous melanoma

    Full text: Locally recurrent disease in patients with melanoma is usually defined as cutaneous or subcutaneous arising within 5 cm of the primary site after complete excision of the primary lesion. It may represent residual disease not excised with the primary tumor or the outgrowth of the satellite lesions, which are common with melanoma. Lymphatic mapping and sentinel lymph node (SLN) biopsy is highly accurate in staging nodal basins at risk of regional metastases in primary melanoma patients and identifies those who may benefit from earlier lymphadenectomy. Our purpose was to evaluate the efficacy of sentinel lymph node mapping and biopsy in local recurrence of cutaneous melanoma when the primary lesion was less than 1.0mm thick. Three patients with local recurrence of cutaneous melanoma underwent sentinel lymph node mapping and biopsy. All patients underwent preoperative lymphoscintigraphy to identify the lymphatic basin and the site of the sentinel node. All patients subsequently underwent intra-operative lymphatic mapping and selective lymph node biopsy with vital blue dye and hand-held gamma probe. Excised SLN were analysed by conventional histological staining (H and E) and immunohistochemical staining. In all patients the lymphatic mapping and sentinel lymph node biopsy was successful. The SLN biopsy was negative in two patients and positive in one who underwent therapeutic lymph node dissection. Our results indicate that the SLN mapping and biopsy is also possible in patients having local recurrence of cutaneous melanoma. Although long-term results are not available, early results are promising. (author)

  13. Pyoderma Gangrenosum and lymph nodes tuberculosis disease: unusual association

    Ines Zaraa; Abdulmohti Hawilo; Slim Ben Hassine; Inès Chelly; Slim Haouet; Mokni Mourad; Amel Ben Osman

    2011-01-01

    Pyoderma gangrenosum (PG) is a rare neutrophilic dermatosis with unknown etiology. PG associated with infectious disease is very unsual. We report a singular case of PG with lymph nodes tuberculosis disease.

  14. Pyoderma Gangrenosum and lymph nodes tuberculosis disease: unusual association

    Ines Zaraa

    2011-06-01

    Full Text Available Pyoderma gangrenosum (PG is a rare neutrophilic dermatosis with unknown etiology. PG associated with infectious disease is very unsual. We report a singular case of PG with lymph nodes tuberculosis disease.

  15. Ultrasound elastography for evaluation of cervical lymph nodes

    Young Jun Choi

    2015-07-01

    Full Text Available Ultrasound (US elastography has been introduced as a noninvasive imaging technique for evaluating cervical lymph nodes. US elastography techniques include strain elastography and shear wave-based elastography. The application of this technique is based on the fact that stiff tissues tend to deform less and show less strain than compliant tissues when the same force is applied. In general, metastatic lymph nodes demonstrate higher stiffness than benign lymph nodes. Overall, preliminary studies suggest that US elastography may be useful in differentiating benign and malignant cervical lymph nodes, thereby informing decisions to perform a biopsy and facilitating follow-up. For US elastography to be accepted into clinical practice, however, its techniques, associated diagnostic criteria, and reliability need to be further refined.

  16. Computed tomography (CT) of cervical lymph nodes in patients with oral cancer. Comparison of low-attenuation areas in lymph nodes on CT images with pathological findings

    The objective of this study was to clarify the histopathological features of low-attenuation areas in computed tomography (CT) images of cervical metastatic and benign lymph nodes in patients with oral squamous cell carcinoma (SCC). CT images of 230 lymph nodes from 37 patients with oral SCC were classified into four categories and compared with histopathological findings. Metastatic lymph nodes were evaluated in terms of focal necrosis, keratinization, fibrous tissue, and the proportion of the lymph node showing focal necrosis. Benign lymph nodes were evaluated in terms of adipose tissue, follicular hyperplasia, sinus histiocytosis, hyperemia, focal hemorrhaging, and the amount of adipose tissue. Histopathologically, all 13 metastatic lymph nodes with rim enhancement on CT images included focal necrosis. However, most of the lymph nodes showed no focal necrosis. In addition, tumor cells, keratinization, and fibrous tissue were observed in the lymph nodes. Of the 26 metastatic lymph nodes with a heterogeneous appearance on CT images, four did not show focal necrosis. These lymph nodes showed keratinization or accumulation of lymph fluid. Histopathologically, 20 of 24 benign lymph nodes with a heterogeneous appearance on CT images (83.3%) had accompanying adipose tissue. Focal necrosis was the most important factor contributing to low attenuation in metastatic lymph nodes. However, other factors, such as tumor cells, keratinization, fibrous tissue, and accumulation of lymph fluid, also contributed. In benign lymph nodes, the presence of adipose tissue was a contributing factor in low-attenuation areas, as was focal hemorrhaging. (author)

  17. A level III sentinel lymph node in breast cancer

    Ghesani Nasrin

    2006-06-01

    Full Text Available Abstract Background For accurate nodal staging, all blue and radioactive lymph nodes should be sampled during the sentinel lymph node biopsy for breast cancer. We report a case of anomalous drainage in which one of the sentinel lymph nodes was unexpectedly found in the level III axillary space. Case presentation A 40-year-old female underwent mastectomy for extensive high-grade ductal carcinoma in-situ (DCIS with micro-invasion. The index lesion was located in the right upper inner quadrant. Lymphoscintigraphy was performed on the morning of surgery. Two sentinel lymph nodes were identified. At operation, 5 mls of isosulfan blue dye was injected at the same site of the radio-colloid injection. The first sentinel lymph node was found at level I and was blue and radioactive. The second sentinel node was detected in an unexpected anomalous location at level III, medial to the pectoralis minor. Both sentinel nodes were negative. Conclusion Sentinel node staging can lead to unexpected patterns of lymphatic drainage. For accurate staging, it is important to survey all potential sites of nodal metastasis either with preoperative lymphoscintigraphy and/or rigorous examination of regional nodal basins with the intra-operative gamma probe.

  18. Predictive factors for lymph node metastasis in early gastric cancer

    Chang-Mu; Sung; Chen-Ming; Hsu; Jun-Te; Hsu; Ta-Sen; Yeh; Chun-Jung; Lin; Tse-Ching; Chen; Cheng-Tang; Chiu

    2010-01-01

    AIM: To analyze the predictive factors for lymph node metastasis (LNM) in early gastric cancer (EGC). METHODS: Data from patients surgically treated for gastric cancers between January 1994 and December 2007 were retrospectively collected. Clinicopathological factors were analyzed to identify predictive factors for LNM. RESULTS: Of the 2936 patients who underwent gas-trectomy and lymph node dissection, 556 were diag-nosed with EGC and included in this study. Among these, 4.1% of patients had mucosal tumors ...

  19. What next? Managing lymph nodes in men with penile cancer

    Leveridge, Michael; Siemens, D. Robert; Morash, Christopher

    2008-01-01

    The management of patients with squamous cell carcinoma of the penis is often daunting given its rarity and subsequent lack of high-level evidence to support our decision-making. This culminates in the complex surgical issues involving the management of the regional lymph nodes, which is of critical importance to both quantity and quality of life for these patients. This review aims to highlight the decisive issues surrounding the management of the pelvic and inguinal lymph nodes in the setti...

  20. Prostanoid induces premetastatic niche in regional lymph nodes

    Ogawa, Fumihiro; AMANO, HIDEKI; Eshima, Koji; Ito, Yoshiya; Matsui, Yoshio; Hosono, Kanako; Kitasato, Hidero; Iyoda, Akira; Iwabuchi, Kazuya; Kumagai, Yuji; Satoh, Yukitoshi; Narumiya, Shuh; Majima, Masataka

    2014-01-01

    The lymphatic system is an important route for cancer dissemination, and lymph node metastasis (LNM) serves as a critical prognostic determinant in cancer patients. We investigated the contribution of COX-2–derived prostaglandin E2 (PGE2) in the formation of a premetastatic niche and LNM. A murine model of Lewis lung carcinoma (LLC) cell metastasis revealed that COX-2 is expressed in DCs from the early stage in the lymph node subcapsular regions, and COX-2 inhibition markedly suppressed media...

  1. Dynamics of neutrophil migration in lymph nodes during infection

    Chtanova, Tatyana; Schaeffer, Marie; Han, Seong-Ji; van Dooren, Giel G.; Nollmann, Marcelo; Herzmark, Paul; Chan, Shiao Wei; Satija, Harshita; Camfield, Kristin; Aaron, Holly; Striepen, Boris; Robey, Ellen A.

    2008-01-01

    While the signals that control neutrophil migration from the blood to sites of infection have been well characterized, little is known about their migration patterns within lymph nodes, or the strategies that neutrophils use to find their local sites of action. To address these questions, we used two-photon scanning laser microscopy (TPSLM) to examine neutrophil migration in intact lymph nodes during infection with an intracellular parasite, Toxoplasma gondii. We find that neutrophils form bo...

  2. Internal mammary lymph node biopsy guided by computed tomography

    Irving, Henry C; Hardy, Graham J.

    1982-01-01

    Internal mammary lymph node enlargement may be demonstrated using computed tomography (CT), and a confirmatory tissue diagnosis of metastatic involvement may be obtained using fine needle aspiration biopsy with needle tip placement guided by the CT scanner. A case history is described to illustrate how a patient presented 9 years after mastectomy with an internal mammary lymph node metastasis and how cytopathological diagnosis of this metastasis was achieved by CT guided biopsy.

  3. Lymph node imaging by ultrarapid 3D angiography

    Purpose: A report on observations of lymph node images obtained by gadolinium-enhanced 3D MR angiography (MRA). Methods: Ultrarapid MRA (TR, TE, FA - 5 or 6.4 ms, 1.9 or 2.8 ms, 30-40 degrees) with 0.2 mmol/kg BW Gd-DTPA and 20 ml physiological saline. Start after completion of injection. Single series of the pelvis-thigh as well as head-neck regions by use of a phased array coil with a 1.5 T Magnetom Vision or a 1.0 T Magnetom Harmony (Siemens, Erlangen). We report on lymph node imaging in 4 patients, 2 of whom exhibited benign changes and 2 further metastases. In 1 patient with extensive lymph node metastases of a malignant melanoma, color-Doppler sonography as color-flow angiography (CFA) was used as a comparative method. Results: Lymph node imaging by contrast medium-enhanced ultrarapid 3D MRA apparently resulted from their vessels. Thus, arterially-supplied metastases and inflammatory enlarged lymph nodes were well visualized while those with a.v. shunts or poor vascular supply in tumor necroses were poorly imaged. Conclusions: Further investigations are required with regard to the visualization of lymph nodes in other parts of the body as well as a possible differentiation between benign and malignant lesions. (orig.)

  4. Process of distant lymph node metastasis in colorectal carcinoma: Implication of extracapsular invasion of lymph node metastasis

    We previously demonstrated that extracapsular invasion (ECI) at a metastatic sentinel node was significantly associated with the presence of positive non-sentinel nodes in patients with breast cancer. However, the mechanism of metastatic spreading of tumor cells to distant lymph nodes in patients with colorectal carcinoma is not fully understood. In this study, we investigated the factors that may determine the likelihood of additional regional lymph node metastasis when metastasis is found in nodes at the N1 site in colorectal cancer, especially focusing on the presence of ECI. Two hundred and twenty-eight consecutive patients who underwent colorectal resection were identified for inclusion in this study, of which 37 (16.2%) had positive lymph nodes at the N1 site. Six of these 37 cases had additional metastasis in N2 site lymph nodes. We reviewed the clinicopathological features of these cases and performed statistical analysis of the data. In the univariate analysis ECI at the N1 site was the only factor significantly associated with the presence of cancer cells in the N2 site. Other factors, including number of positive lymph nodes, lymphovascular invasion of the primary tumor, tumor size and tumor depth of invasion, were not associated with metastatic involvement at the N2 site. Our results suggest that the presence of ECI at metastatic lymph nodes at the N1 site is correlated with further metastasis at the N2 site. These findings imply the possibility that ECI might indicate the ability of colorectal tumor cells to disseminate to distant lymph nodes

  5. Pre-prostatic tissue removed in robotic assisted lymph node dissection for prostate cancer contains lymph nodes

    J Blarer

    2013-01-01

    Conclusions: Pre-prostatic tissue might contain lymph nodes that potentially harbour metastases. In the intention to perform the most accurate staging this tissue should be considered for histopathological evaluation.

  6. Predicting sentinel lymph node metastasis in breast cancer with lymphoscintigraphy

    Lymphoscintigraphy is an effective method for detecting sentinel lymph nodes (SLNs). However, the rate and degree of SLN detection is not uniform. We quantified SLNs detected with lymphoscintigraphy, and investigated correlations with factors that may influence detection. We then attempted to predict SLN metastasis from lymph node counts, comparing the predictions to subsequent biopsy results. We assessed lymph node counts in 100 breast cancer patients in whom a single SLN was detected with a fixed lymphoscintigraphy procedure. We examined correlations between the counts and factors known to influence lymphoscintigraphic SLN detection (age, body mass index, tumor size, and presence or absence of metastasis), and determined reference values (lymph node counts of 10.0, 19.4 and 53.0) which were used to predict SLN metastasis in 100 subsequent patients. The predictions were then compared with the SLN biopsy findings. SLN counts correlated strongly with the presence or absence of metastasis, with metastasis-positive lymph nodes showing significantly lower counts than negative nodes (p<0.001). Prediction of SLN metastasis achieved a 100% positive predictive value at a reference value of 10.0, and a 100% negative predictive value at a reference value of 53.0. At a reference value of 19.4, the sensitivity, specificity, and diagnostic accuracy were 77.8, 73.2, and 74.0%, respectively. The SLN counts detected with lymphoscintigraphy were significantly lower in metastasis-positive lymph nodes than in metastasis-negative lymph nodes. This suggests that prediction of SLN metastasis in breast cancer is possible using lymphoscintigraphy. (author)

  7. CT-guide coaxial 125I seeds implantation for the treatment of retroperitoneal lymph node metastasis: analysis of 21 cases

    Objective: To investigate the method, safety and clinical value of CT-guided coaxial percutaneous 125I seed implantation in treating retroperitoneal metastatic lymph nodes. Methods: CT-guided coaxial percutaneous 125II seed implantation, as interstitial brachytherapy, was carried out in 21 patients with retroperitoneal lymph node metastasis. Before operation therapeutic plan system (TPS) was used in all patients to design the distribution of radioactive particles, and after the procedure CT scanning was performed to verify the distribution of radioactive particles. After the treatment, the abdominal pain, abdominal distension, serum tumor marker levels and local reaction of the target lymph nodes were evaluated. Results: The technical success rate was 100%, and after the operation no serious complications such as gastrointestinal perforation, radiation enteritis, vascular injury, bleeding, etc. occurred. Follow-up CT scanning was conducted once every 1-2 months. Six months after the treatment, complete remission (CR) was obtained in 13 cases, partial remission (PR) in 6 cases, stable disease (SD) in 2 cases, and progression disease (PD) in none. The overall response (CR + PR) rate was 90.5%. The abdominal pain and abdominal distension were relieved in different degrees in 16 patients, and the serum tumor marker levels were decreased in different degrees in 14 patients. Conclusion: For the treatment of retroperitoneal lymph node metastasis, CT-guided coaxial percutaneous l25I seed implantation is effective, safe and reliable. This technique provides a new minimally-invasive treatment for retroperitoneal lymph node metastasis. (authors)

  8. Histological step sectioning of pelvic lymph nodes increases the number of identified lymph node metastases

    Engvad, Birte; Poulsen, Mads H; Staun, Pia W;

    2014-01-01

    Pathological examinations of lymph nodes (LN) in prostate cancer patients are handled differently at various institutions. The objective of this study is to provide means to improve the guidelines by examining the impact of step sectioning on LN status in patients with intermediate and high...... examination included a 100-μm-deep haematoxylin and eosin (HE) section followed by a slide stained with cytokeratin AE1/AE3 and then by four HE sections at 0.5-mm intervals.The standard pathological examination detected 41 patients with LN metastasis. The remaining 169 patients had 1,185 HE sections made at...... the standard examination, whereas the extended examination gave additional 7,110 slides and detected 5 additional patients with LN metastasis. In all, 1,158 LN were removed. The additional LN metastases were smaller than the LN metastases found at the standard examination, mean 1.2 mm vs. 7.8 mm...

  9. Virtual lymph node analysis to evaluate axillary lymph node coverage provided by tangential breast irradiation

    Park, Shin Hyung; Kim, Jae Chul; Lee, Jeong Eun; Park, In Kyu [Dept.of Radiation Oncology, Kyungpook National University Hospital, Daegu(Korea, Republic of)

    2015-03-15

    To investigate the coverage of axillary lymph node with tangential breast irradiation fields by using virtual lymph node (LN) analysis. Forty-eight women who were treated with whole breast irradiation after breast-conserving surgery were analyzed. The axillary and breast volumes were delineated according to the Radiation Therapy Oncology Group (RTOG) contouring atlas. To generate virtual LN contours, preoperative fluorodeoxyglucose positron emission tomography/computed tomography (FDG-PET/CT) scans with identifiable LN were fused with the CT scans, and the virtual LN contour were delineated on the CT. The median level I and II axillary volume coverage percentages at the VD95% line were 33.5% (range, 5.3% to 90.4%) and 0.6% (range, 0.0% to 14.6%), respectively. Thirty-one LNs in 18 patients were delineated (26 in level I and 5 in level II). In the level I axilla, 84.6% of virtual LNs were encompassed by the 95% isodose line. In the level II axilla, by contrast, none of the virtual LNs were encompassed by the 95% isodose volumes. There was a substantial discrepancy between the RTOG contouring atlas-based axillary volume analysis and the virtual LN analysis, especially for the level I axillary coverage. The axillary volume coverage was associated with the body mass index (BMI) and breast volume. The tangential breast irradiation did not deliver adequate therapeutic doses to the axillary region, particularly those in the level II axilla. Patients with small breast volumes or lower BMI showed reduced axillary coverage from the tangential breast fields. For axillary LN irradiation, individualized anatomy-based radiation fields for patients would be necessary.

  10. Management of Regional Lymph Nodes in Localized Vulvar Carcinoma

    To evaluate the impact of postoperative radiotherapy on loco-regional failure in patients with vulvar carcinoma and to determine the treatment strategy for inguinal lymph nodes. Sixty-six patients who received treatment for primary vulvar carcinoma at Seoul National University Hospital, from October 1979 through June 2004, were retrospectively analyzed. Sixteen patients were excluded from the analysis due to the following reasons: distant metastases in two patients; palliative intent for six patients; previous radiotherapy given to the pelvis in three patients; follow-up loss after surgery for four patient; insufficient medical records for one patient. Of 50 eligible patients, 35 were treated with surgery alone (S), ten were treated with surgery followed by radiotherapy (S+RT), and five were treated with radiotherapy alone. The 5-year overall survival (OS) and disease-free survival (DFS) rates of all patients were 91% and 78%, respectively. Twelve patients (26%) experienced treatment failures and the sites of initial failure were as follows: a primary site in eight patients; regional lymph nodes in three patients; the lung in one patient. Although risk factors for failure were more common in the S+RT group than the S group of patients (p pound1/40.05), the DFS rates were similar for the two groups (5-year DFS rates, 78% vs. 83%, p=0.66). The incidences of occult lymph node metastases was 10%. Ten of 31 patients with clinically negative lymph nodes did not received inguinal lymph node dissection, but no patient experienced regional failure. Postoperative radiotherapy may have a potential benefit for patients with risk factors for failure. The omission of inguinal dissection or elective radiotherapy to the inguinal lymph nodes may be considered in low-risk patients with clinically negative lymph nodes

  11. Sentinel lymph node biopsy in breast cancer: the node to recovery

    Goyal, Amit

    2010-01-01

    The widespread adoption of sentinel lymph node biopsy to stage the axilla has led to decrease in arm and shoulder morbidity. Sentinel lymph node biopsy is suitable for patients with clinically/radiologically node negative invasive breast cancer and selected patients with DCIS (those with clinical/radiological mass or extensive lesions requiring mastectomy). The combined isotope-blue dye injection technique gives the best results. We inject the isotope intra-dermally preoperatively and blue dy...

  12. Enhancing regional lymph nodes from endoscopic ultrasound images

    Nwogu, Ifeoma; Chaudhary, Vipin

    2008-03-01

    Esophageal ultrasound (EUS) is particularly useful for isolating lymph nodes in the N-staging of esophageal cancer, a disease with very poor overall prognosis. Although EUS is relatively low-cost and real time, and it provides valuable information to the clinician, its usefulness to less trained "users" including opportunities for computer-aided diagnosis is still limited due to the strong presence of spatially correlated interference noise called speckles. To this end, in this paper, we present a technique for enhancing lymph nodes in EUS images by first reducing the spatial correlation of the specular noise and then using a modified structured tensor-based anisotropic filter to complete the speckle reduction process. We report on a measure of the enhancement and also on the extent of automatic processing possible, after the speckle reduction process has taken place. Also, we show the limitations of the enhancement process by extracting relevant lymph node features from the despeckled images. When tested on five representative classes of esophageal lymph nodes, we found the despeckling process to greatly reduce the specularity of the original EUS images, therefore proving very useful for visualization purposes. But it still requires additional work for the complete automation of the lymph node characterizing process.

  13. Ex vivo MRI of axillary lymph nodes in breast cancer

    Luciani, Alain [Department of Radiology, AP-HP, Groupe Henri Mondor-Albert Chenevier, 94010 Creteil (France)], E-mail: luciani@hmn.ap-hop-paris.fr; Pigneur, Frederic [Department of Radiology, AP-HP, Groupe Henri Mondor-Albert Chenevier, 94010 Creteil (France); Ghozali, Faridah [Department of Pathology, AP-HP, Groupe Henri Mondor-Albert Chenevier, 94010 Creteil (France); Dao, Thu-Ha [Department of Radiology, AP-HP, Groupe Henri Mondor-Albert Chenevier, 94010 Creteil (France); Cunin, Patrick [Unite de Recherche Clinique, AP-HP, Groupe Henri Mondor-Albert Chenevier, 94010 Creteil (France); Meyblum, Evelyne [Department of Radiology, AP-HP, Groupe Henri Mondor-Albert Chenevier, 94010 Creteil (France); De Baecque-Fontaine, Cecile [Department of Pathology, AP-HP, Groupe Henri Mondor-Albert Chenevier, 94010 Creteil (France); Alamdari, Ali [Department of Plastic Surgery, AP-HP, Groupe Henri Mondor-Albert Chenevier, 94010 Creteil (France); Maison, Patrick [Unite de Recherche Clinique, AP-HP, Groupe Henri Mondor-Albert Chenevier, 94010 Creteil (France); Deux, Jean Francois [Department of Radiology, AP-HP, Groupe Henri Mondor-Albert Chenevier, 94010 Creteil (France); Lagrange, Jean Leon [Department of Radiotherapy, AP-HP, Groupe Henri Mondor-Albert Chenevier, 94010 Creteil (France); Lantieri, Laurent [Department of Plastic Surgery, AP-HP, Groupe Henri Mondor-Albert Chenevier, 94010 Creteil (France); Rahmouni, Alain [Department of Radiology, AP-HP, Groupe Henri Mondor-Albert Chenevier, 94010 Creteil (France)

    2009-01-15

    Purpose: To provide a strategy for precise co-localization of lymph nodes on axillary lymph-node dissection (ALND) specimens both on pathology and MR. To identify nodal features suggestive of metastatic involvement on a node-to-node basis. Materials and methods: National Institutional review-board approved this prospective study of 18 patients with breast cancer referred for ALND. Ex vivo T1 and inversion recovery (IR) T2 WI of ALND specimens tightly positioned within scaled plastic cranes was performed immediately after surgery. The correspondence of MR-based or pathologically based nodes location was assessed. The MR size and morphological presentation of metastatic and normal nodes were compared (Student's t-test or Mann-Whitney test). Quantitative variables were compared using Pearson coefficient. Results: 207 nodes were retrieved on pathology and 165 on MR. MR-pathological correlation of nodes location was high regarding MR-identified nodes (r = 0.755). An MR short axis threshold of 4 mm yielded the best predictive value for metastatic nodal involvement (Se = 78.6%; Sp = 62.3%). Irregular contours (Se = 35.7%; Sp = 96.7%), central nodal hyper-intensity on IR T2 WI (Se = 57.1%; Sp = 91.4%), and a cortical thickness above 3 mm (Se = 63.6%; Sp = 83.2%) were significantly associated with metastatic involvement. Conclusion: Ex vivo MR allows node-to-node correlation with pathology. Morphological MR criteria can suggest metastatic involvement.

  14. Ex vivo MRI of axillary lymph nodes in breast cancer

    Purpose: To provide a strategy for precise co-localization of lymph nodes on axillary lymph-node dissection (ALND) specimens both on pathology and MR. To identify nodal features suggestive of metastatic involvement on a node-to-node basis. Materials and methods: National Institutional review-board approved this prospective study of 18 patients with breast cancer referred for ALND. Ex vivo T1 and inversion recovery (IR) T2 WI of ALND specimens tightly positioned within scaled plastic cranes was performed immediately after surgery. The correspondence of MR-based or pathologically based nodes location was assessed. The MR size and morphological presentation of metastatic and normal nodes were compared (Student's t-test or Mann-Whitney test). Quantitative variables were compared using Pearson coefficient. Results: 207 nodes were retrieved on pathology and 165 on MR. MR-pathological correlation of nodes location was high regarding MR-identified nodes (r = 0.755). An MR short axis threshold of 4 mm yielded the best predictive value for metastatic nodal involvement (Se = 78.6%; Sp = 62.3%). Irregular contours (Se = 35.7%; Sp = 96.7%), central nodal hyper-intensity on IR T2 WI (Se = 57.1%; Sp = 91.4%), and a cortical thickness above 3 mm (Se = 63.6%; Sp = 83.2%) were significantly associated with metastatic involvement. Conclusion: Ex vivo MR allows node-to-node correlation with pathology. Morphological MR criteria can suggest metastatic involvement

  15. Pathological axillary lymph nodes detected at mammographic screening

    AIM: To investigate the significance of abnormal axillary lymph nodes detected at mammographic screening in the absence of a concomitant breast lesion. METHODS: Twenty-three thousand, seven hundred and seven women were screened at the Merrion Unit as part of the Irish National Breast Screening Programme ('BreastCheck') in the period June 2000 to July 2002. Nine women (0.4 per 1000 women screened) were found to have an abnormal axillary lymph node(s) in the absence of a mammographic breast lesion and were recalled for assessment. The radiological criteria for recall included: size greater than or equal to 15 mm, round or irregular shape, increased node density and absence of hilar lucency. Each woman underwent further mammographic views, ultrasound examination of axilla and breast, clinical examination and lymph node biopsy either by 14 G needle core biopsy (NCB) or open excision. RESULTS: The final pathological diagnoses in the nine patients were oestrogen receptor (OR) positive metastatic breast carcinoma (two patients), metastatic malignant melanoma (one patient), malignant lymphoma (two patients), caseating granulomatous lymphadenitis suggestive of tuberculosis (one patient), and other benign conditions (three patients). CONCLUSION: Abnormal axillary lymph nodes, in the absence of an accompanying breast lesion, are rarely identified on screening mammogram, but may harbour significant pathology and their presence on screening mammogram merits further investigation including biopsy

  16. Axillary lymph nodes in breast cancer patients: sonographic evaluation*

    Pinheiro, Denise Joffily Pereira da Costa; Elias, Simone; Nazário, Afonso Celso Pinto

    2014-01-01

    Axillary staging of patients with early-stage breast cancer is essential in the treatment planning. Currently such staging is intraoperatively performed, but there is a tendency to seek a preoperative and less invasive technique to detect lymph node metastasis. Ultrasonography is widely utilized for this purpose, many times in association with fine-needle aspiration biopsy or core needle biopsy. However, the sonographic criteria for determining malignancy in axillary lymph nodes do not present significant predictive values, producing discrepant results in studies evaluating the sensitivity and specificity of this method. The present study was aimed at reviewing the literature approaching the utilization of ultrasonography in the axillary staging as well as the main morphological features of metastatic lymph nodes. PMID:25741091

  17. Angiosarcoma of the Thyroid and Regional Lymph Node Metastasis

    Lutfi Dogan

    2013-10-01

    Full Text Available Thyroid angiosarcomas are typically infiltrative and large tumors with very similar clinical findings of anaplastic carcinoma of thyroid. Early hematogenous metastasis is very frequent, but regional lymph node metastasis is quite rare. We present a case of angiosarcoma of the thyroid gland in a 68 years old man with regional lymph node metastasis. Total thyroidectomy with right modified radical neck dissection was applied. Four out of 19 lymph nodes dissected were seen to contain metastasis. Metastatic tumor was composed of sarcomatous areas containing large numbers of blood filled clefts. There after the surgery PET-CT was performed and multiple metastatic involvements were reported. Thyroid angiosarcomas are completely different tumors from angiomatoid anaplastic carcinomas. Longer survival with these tumors is only possible with agressive surgery and in case of regional LN metastasis, neck dissection should be done.

  18. DETECTION OF SENTINEL LYMPH NODE IN EARLY CERVICAL CANCER

    刘琳; 李斌; 章文华

    2004-01-01

    Objective: To assess the value of sentinel lymph node (SLN) localization by lymphoscintigraphy and gamma probe detection in early cervical cancer. Methods: A total of 27 patients with operable invasive early cervical cancer and clinically proved negative pelvic lymph nodes were included in this study. The 99Tcm-dextran of 74 MBq (2 mCi) was injected around the cervix at 2( and 10(. Lymphoscintigraphy and gamma probe detection were used to find the SLN. Results: The SLN was identified in 27 patients. The sensitivity and specificity of the SLN detection to predict the metastasis of the pelvic lymph node were 100% and 100% respectively. Conclusion: Identification of the SLN using radionuclide is feasible and possible in women with early cervical cancer.

  19. Robotic Salvage Lymph Node Dissection After Radical Prostatectomy

    Fabio C. M. Torricelli

    2015-08-01

    Full Text Available ABSTRACTIntroduction and objective:Radical prostatectomy is a first-line treatment for localized prostate cancer. However, in some cases, biochemical recurrence associated with imaging-detected nodal metastases may happen. Herein, we aim to present the surgical technique for salvage lymph node dissection after radical prostatectomy.Materials and Methods:A 70 year-old asymptomatic man presented with a prostate-specific antigen (PSA of 7.45ng/ mL. Digital rectal examination was normal and trans-rectal prostate biopsy revealed a prostate adenocarcinoma Gleason 7 (3+4. Pre-operative computed tomography scan and bone scintigraphy showed no metastatic disease. In other service, the patient underwent a robotic-assisted radical prostatectomy plus obturador lymphadenectomy. Pathologic examination showed a pT3aN0 tumor. After 6 months of follow-up, serum PSA was 1.45ng/mL. Further investigation with 11C–Choline PET/CT revealed only a 2-cm lymph node close to the left internal iliac artery. The patient was counseled for salvage lymph node dissection.Results:Salvage lymph node dissection was uneventfully performed. Operative time was 1.5 hour, blood loss was minimal, and there were no intra- or postoperative complications. The patient was discharged from hospital in the 1st postoperative day. After 12 months of follow-up, his PSA was undetectable with no other adjuvant therapy.Conclusion:Robotic salvage pelvic lymph node dissection is an effective option for treatment of patients with biochemical recurrence after radical prostatectomy and only pelvic lymph node metastasis detected by C11-Choline PET/CT.

  20. Sentinel Lymph Node Biopsy in Pure DCIS: Is It Necessary?

    Uras, C; G. Esen; Ince, U.; N. Cabioglu; Boler, D. E.

    2012-01-01

    Introduction. Sentinel lymph node biopsy (SLNB) in patients with pure ductal carcinoma in situ (DCIS) has been a matter of debate due to very low rate of axillary metastases. We therefore aimed to identify factors in a single institutional series to select patients who may benefit from SLNB. Material and Methods. Patients, diagnosed with pure DCIS ( = 6 3 ) between July 2000 and March 2011, were reviewed. All the sentinel lymph nodes were examined by serial sectioning (50 μm) of the entire ...

  1. Does extended lymph node dissection affect the lymph node density and survival after radical cystectomy?

    A Dharaskar

    2011-01-01

    Full Text Available Background : Diagnostic and therapeutic importance of pelvic lymph node (LN dissection (PLND in radical cystectomy (RC has gained recent attention. A method of pathological analysis of LN affects total number of LN removed, number of LN involved, and LN density. Objective : To compare extended lymphadenectomy to standard lymphadenectomy in terms of LN yield, density, and effect on survival. Materials and Methods : From Jan 2004 - July 2009, 78 patients underwent RC whose complete histopathological report was available for analysis. All were transitional cell carcinoma. From July 2007 onward extended LN dissection was started and LNs were sent in six packets. Twenty-eight patients of standard PLND kept in group I. Group II had 23 patients of standard PLND (LN sent in four packets, and group III had 23 patients of extended PLND (LN sent in six packets. SPSS 15 software used for statistical calculation. Results : Distribution of T-stage among three groups is not statistically significant. Median number of LN harvested were 5 (range, 1-25 in group I, 9 (range, 3-28 in group II, and 16 (range, 1-25 in group III. Although this is significant, we did not find significant difference in number of positive LN harvested. We did not find any patient with skip metastasis to common iliac LN in group 3. Conclusions : Separate package LN evaluation significantly increased the total number of LN harvested without increasing the number of positive LN and survival.

  2. Involvement of both Cervical Lymph Nodes and Retropharyngeal Lymph Nodes has prognostic value for N1 patients with Nasopharyngeal Carcinoma

    The N1 definition of 2010 UICC/AJCC staging system for nasopharyngeal carcinoma (NPC) covers quite a large range of nodal pattern. The objective of this research is to investigate prognostic value of lymph nodes related factors including involvement of both cervical lymph nodes (CLNs) and retropharyngeal lymph nodes (RLNs) or not, size and number of cervical lymph nodes (CLNs) in N1 patients with NPC. 142 newly diagnosed non-metastatic N1 patients with NPC, staged according to the 2010 AJCC staging system for NPC were retrospectively enrolled. All patients had undergone contrast-enhanced magnetic resonance imaging (MRI), and received radiotherapy, with or without chemotherapy as their primary treatment. The median follow-up was 48 months. The 5-year local recurrence-free survival (LFS), nodal recurrence-free survival (NFS), local-regional recurrence-free survival (LRFS), distant metastasis-free survival (DMFS), progression-free survival (PFS), and overall survival (OS) of the whole group were 82.3%, 83.0%, 81.0%, 82.1%, 75.3% and 89.8%, respectively. In univariate analysis, patients with both CLNs and RLNs involvement showed a significant lower DMFS, PFS and LRFS than the rest patients (p = 0.004 p = 0.003 and p = 0.034, respectively). Neither size nor number of CLNs affected the survival. In multivariate analysis, involvement of both CLNs and RLNs was an independent prognostic factor for DMFS and PFS (p = 0.019, p = 0.019), but there was no enough evidence confirming its prognostic value for LRFS (p = 0.051). For N1 patients with NPC, involvement of both RLNs and CLNs may be a potentially prognostic factor for distant metastasis and disease progression. The N stage for N1 patients with involvement of both cervical lymph nodes and retropharyngeal lymph nodes might need to be deliberated

  3. Risk factors for metastasis to No.14v lymph node and prognostic value of positive 14v lymph node for gastric cancer patients after surgery

    2015-01-01

    Objective:Lymphadenectomy has been increasingly regarded as standard surgical procedure for advanced gastric cancer (GC), while necessity No.14v lymph node dissection for lower GC is still controversial.Methods: A total of 311 GC patients receiving D1+ (D1+7, 8a, 9) or D2 plus No.14v lymph node dissection in our center were enrolled. Patients were categorized into two groups based on No.14v lymph node status: positive group (PG) and negative group (NG).Results:Fifty patients (16.1%) had No.14v lymph node metastasis. Metastasis to No.4d, No.6 lymph node and distant metastasis were independent variables affecting No.14v lymph node metastasis. Patients with positive No.14v lymph node had a significant lower overall survival (OS) rate than those without (3-year OS, 34.0% vs. 67.0%,P<0.001).Conclusion:GC patients with positive No.4d and No.6 lymph node often metastasis to No.14v lymph node. Status of No.14v lymph node was an independent prognostic factor for GC staged TNM III. Patients with positive No.14v lymph node usually have a poor prognosis, while such patients without distant metastasis may beneift from a curative surgery.

  4. Follicular dendritic cells in lymph nodes after X-irradiation

    Follicular dendritic cells (FDC), non lymphoid cells present in lymph follicles, are characterized by numerous cytoplasmic processes retaining antigen-antibody complexes. Their origin, nature and function are unknown. Mice inguinal lymph nodes after 4.5 or 7.5 Gy X-irradiation were depleted of lymphoid cells. Ultrastructural observations during the first few days post-irradiation show that FDC are unaltered and possess dendritic processes enveloping dense material. Furthermore, they show intense metabolic activity. A lamina densa, never observed so well-developed in other lymph node cells, was detected around the nuclear envelope. The localization of junctions between FDC was analysed. FDC preserve their typical cytoplasmic processes even if lymphoid cells are rare. The latter thus seem not to be responsible for the maintenance of FDC integrity or their development. The possible role of this for antibody production is discussed. Irradiated lymph nodes of lymphoid cells are highly convenient for studying FDC. Isolation of FDC from irradiated lymph organs would seem to be possible. (author)

  5. Lymph node mapping using quantum dot-labeled polymersomes.

    Bakalova, Rumiana; Zhelev, Zhivko; Nikolova, Biliana; Murayama, Shuhei; Lazarova, Desislava; Tsoneva, Iana; Aoki, Ichio

    2015-10-01

    The present study was designed to investigate whether poly-ion complex hollow vesicles (polymersomes), based on chemically-modified chitosan, are appropriate for lymph node mapping in the context of their application in the development of theranostic nanosized drug delivery systems (nano-DDS). The experiments were performed on Balb/c nude mice (colon cancer-grafted). The mice were subjected to anesthesia and quantum dot (QD(705))-labeled polymersomes (d-120 nm) were injected intravenously via the tail vein. The optical imaging was carried out on Maestro EX Imaging System (excitation filter: 435-480 nm; emission filter: 700 nm). A strong fluorescent signal, corresponding to QD(705) fluorescence, was detected in the lymph nodes, as well as in the tumor. A very weak fluorescent signal was found in the liver area. The half-life of QD(705)-labelled polymersomes was 6 ± 2 hours in the bloodstream and 11 ± 3 hours in the lymph nodes. The data suggest that polymersomes are very promising carriers for lymph node mapping using QD as a contrast agent. They are useful matrix for development of nano-formulations with theranostic capabilities. PMID:26221745

  6. LCP nanoparticle for tumor and lymph node metastasis imaging

    Tseng, Yu-Cheng

    A lipid/calcium/phosphate (LCP) nanoparticle formulation (particle diameter ˜25 nm) has previously been developed to delivery siRNA with superior efficiency. In this work, 111In was formulated into LCP nanoparticles to form 111In-LCP for SPECT/CT imaging. With necessary modifications and improvements of the LCP core-washing and surface-coating methods, 111In-LCP grafted with polyethylene glycol exhibited reduced uptake by the mononuclear phagocytic system. SPECT/CT imaging supported performed biodistribution studies, showing clear tumor images with accumulation of 8% or higher injected dose per gram tissue (ID/g) in subcutaneous, human-H460, lung-cancer xenograft and mouse-4T1, breast cancer metastasis models. Both the liver and the spleen accumulated ˜20% ID/g. Accumulation in the tumor was limited by the enhanced permeation and retention effect and was independent of the presence of a targeting ligand. A surprisingly high accumulation in the lymph nodes (˜70% ID/g) was observed. In the 4T1 lymph node metastasis model, the capability of intravenously injected 111In-LCP to visualize the size-enlarged and tumor-loaded sentinel lymph node was demonstrated. By analyzing the SPECT/CT images taken at different time points, the PK profiles of 111In-LCP in the blood and major organs were determined. The results indicated that the decrement of 111In-LCP blood concentration was not due to excretion, but to tissue penetration, leading to lymphatic accumulation. Larger LCP (diameter ˜65 nm) nanoparticles were also prepared for the purpose of comparison. Results indicated that larger LCP achieved slightly lower accumulation in the tumor and lymph nodes, but much higher accumulation in the liver and spleen; thus, larger nanoparticles might not be favorable for imaging purposes. We also demonstrated that LCP with a diameter of ˜25 nm were better able to penetrate into tissues, travel in the lymphatic system and preferentially accumulate in the lymph nodes due to 1) small

  7. Lymph Node Assessment in Endometrial Cancer: Towards Personalized Medicine

    Fabien Vidal

    2013-01-01

    Full Text Available Endometrial cancer (EC is the most common malignancy of the female reproductive tract and is increasing in incidence. Lymphovascular invasion and lymph node (LN status are strong predictive factors of recurrence. Therefore, the determination of the nodal status of patients is mandatory to optimally tailor adjuvant therapies and reduce local and distant recurrences. Imaging modalities do not yet allow accurate lymph node staging; thus pelvic and aortic lymphadenectomies remain standard staging procedures. The clinical data accumulated recently allow us to define low- and high-risk patients based on pre- or peroperative findings that will allow the clinician to stratify the patients for their need of lymphadenectomies. More recently, several groups have been introducing sentinel node mapping with promising results as an alternative to complete lymphadenectomy. Finally, the use of peroperative algorithm for risk determination could improve patient's staging with a reduction of lymphadenectomy-related morbidity.

  8. Sentinel lymph node (Sln) detection in vulvar cancer

    Full text: The purpose of the study is to verify the feasibility of the sentinel lymph node (SLN) procedure in patients with evidence of vulva cancer. We studied 13 women with early stage (T1/T2) carcinoma of the vulva. One day before surgery a lymphoscintigraphy was done. We injected intradermally an average 76 MBq of 99mTc-labelled human colloides (Albu-Res(r) in 0.4-0.6 ml NaCI at 4 locations round the tumor regarding the midline. Because of the large particles the colloid was filtered before to obtain the small particle fraction between 200-450 nm. Immediately alter injection a dynamic scintigraphy was performed with 28 images, 1 minute per frame. Additional we made static images, 5 minutes per image, 30 and 120 minutes after injection. The location of the SLN was marked on the skin. The SLN was intraoperatively identified using a hand-held gamma probe. In every case a complete inguino-femoral lymph node dissection was done. In all cases we could show one or more (on average 3) SLN by means of lymphoscintigraphy and in 11/13 cases we could detect SLN by using the gamma probe. Lymph channels were seen in 7/13 dynamic studies. 4/13 patients had lymph node metastasis in the SLN (3/4 cases only the SLN and in 1/4 cases the SLN and one additional lymph node were positive). We did not found any tumor-positive non-sentinel lymph node in case of tumor-negative SLN. The morbidity after operation of patients with vulva cancer is considerable and related to the groin dissection. The selective SLN-biopsy instead of radical groin dissection is feasible to reduce the morbidity without a loss of staging and prognostic factors. This method should be restricted to patients with early stage vulva cancer with clinically uninvolved lymph nodes. Further studies are needed to evaluate the accuracy and clinical validity of this procedure. (author)

  9. Sparing sentinel node biopsy through axillary lymph node fine needle aspiration in primary breast cancers

    Cheng, Yu-Shu; Kuo, Shou-Jen; Chen, Dar-Ren

    2013-01-01

    Background Axillary lymph node status is an important staging and prognostic factor in breast cancer. This study aimed to evaluate the efficacy of axilla fine needle aspiration cytology (FNAC) in primary breast cancer without a palpable node and even without image characteristics of a metastatic node. Methods From June 2008 to January 2012, 77 patients met the inclusion criteria of having received a FNAC procedure during the diagnostic protocol of primary breast cancer with the characteristic...

  10. Chest CT findings in EBUS-TBNA-proven anthracosis in enlarged mediastinal lymph nodes

    Kirchner, J. [Allgemeines Krankenhaus Hagen (Germany). Dept. of Interventional and Diagnostic Radiology; Mueller, P. [Allgemeines Krankenhaus Hagen (Germany). Dept. of Medicine; Broll, M.; Kirchner, E.M. [Sana Klinikum Duisburg (Germany). Dept. of Medicine; Pomjanski, N.; Biesterfeld, S. [University Hospital Duesseldorf (Germany). Dept. of Pathology; Liermann, D. [Marien Hospital, Herne (Germany). Dept. of Diagnostic and Interventional Radiology and Nuclear Medicine; Kickuth, R. [University Hospital Wuerzburg (Germany). Dept. of Radiology

    2014-12-15

    We demonstrate the multislice computed tomography (MSCT) findings of endobronchial ultrasound-guided transbronchial needle aspiration (EBUS-TBNA)-proven hilar and mediastinal lymph node enlargement with signs of anthracosis. 53 enlarged lymph nodes in 39 patients (28 male, 11 female) with EBUS-TBNA-confirmed anthracosis were analyzed retrospectively. The mean short axis diameter of the enlarged lymph nodes with signs of anthracosis was 13.7 mm. Lymph nodes most often showed an oval shape (84%) and were well defined in 66% of cases. Lymph node confluence was observed in 32% of cases. Calcifications were documented in 24.5% of cases. Contrast enhancement and fatty involution were seen seldom (3.8%). Lymph node necrosis was not seen. Lymph node anthracosis may be found most often in enlarged, well defined lymph nodes with an oval shape, frequently associated with confluence and calcifications.

  11. Chest CT findings in EBUS-TBNA-proven anthracosis in enlarged mediastinal lymph nodes

    We demonstrate the multislice computed tomography (MSCT) findings of endobronchial ultrasound-guided transbronchial needle aspiration (EBUS-TBNA)-proven hilar and mediastinal lymph node enlargement with signs of anthracosis. 53 enlarged lymph nodes in 39 patients (28 male, 11 female) with EBUS-TBNA-confirmed anthracosis were analyzed retrospectively. The mean short axis diameter of the enlarged lymph nodes with signs of anthracosis was 13.7 mm. Lymph nodes most often showed an oval shape (84%) and were well defined in 66% of cases. Lymph node confluence was observed in 32% of cases. Calcifications were documented in 24.5% of cases. Contrast enhancement and fatty involution were seen seldom (3.8%). Lymph node necrosis was not seen. Lymph node anthracosis may be found most often in enlarged, well defined lymph nodes with an oval shape, frequently associated with confluence and calcifications.

  12. Endoscopic ultrasound, endoscopic sonoelastography, and strain ratio evaluation of lymph nodes with histology as gold standard

    Larsen, Michael Hareskov; Fristrup, Claus Wilki; Hansen, Tine Plato; Hovendal, Claus; Mortensen, Michael Bau

    2012-01-01

    . Endoscopic sonoelastography (ESE) assesses the elasticity of lymph nodes and has been used to differentiate lymph nodes with promising results. The aim of this study was to evaluate the use of EUS, EUS - FNA, ESE, and ESE-strain ratio using histology as the gold standard. PATIENTS AND METHODS: Patients with......, EUS - FNA and EUS - FNM were performed. The marked lymph node was isolated during surgery for histological examination. RESULTS: The marked lymph node was isolated for separate histological examination in 56 patients, of whom 22 (39 %) had malignant lymph nodes and 34 (61 %) had benign lymph nodes...... EUS - FNM technique enabled the identification of a specific lymph node and thereby the use of histology as gold standard. ESE and ESE-strain ratio were no better than standard EUS in differentiating between malignant and benign lymph nodes in patients with resectable upper gastrointestinal cancer....

  13. Differential Gene Expression in Primary Breast Tumors Associated with Lymph Node Metastasis

    Ellsworth, Rachel E; Field, Lori A.; Brad Love; Kane, Jennifer L.; Hooke, Jeffrey A.; Craig D. Shriver

    2011-01-01

    Lymph node status remains one of the most useful prognostic indicators in breast cancer; however, current methods to assess nodal status disrupt the lymphatic system and may lead to secondary complications. Identification of molecular signatures discriminating lymph node-positive from lymph node-negative primary tumors would allow for stratification of patients requiring surgical assesment of lymph nodes. Primary breast tumors from women with negative ( = 4 1 ) and positive ( = 3 5 ) lymp...

  14. Reply to ‘Pancreatic Adenocarcinoma with Supraclavicular Lymph Node Metastasis: Is This the Virchows Node?

    Arundhati D Soman

    2011-01-01

    Full Text Available Saif et al. [1] astutely point out that left sided supraclavicular lymph node involvement has been described in other malignancies, most notably gastric cancer, where it was first described by Rudolf Virchow, a German pathologist, in 1848 [2]. Troisier, a French pathologist, also noted association of left sided supraclavicular lymphadenopathy with abdominal malignancies [3]. The clinical significance of metastasis in pancreatic cancer involving Virchow’s node with regards to staging assessment, change in treatment course and prognosis has only recently been appreciated after so many years [4]. The advent and increased use of positron emission tomography (PET has helped in detection of asymptomatic cases, particularly given that CT scans of the head and neck region are not utilized in routine staging and re-staging of patients with pancreatic cancer. The cumulative knowledge garnered through compiling individual cases and case series and reporting them in the literature has help confirm that this is a matter of clinical importance that has been appreciated by multiple groups. Given the prohibitive costs of PET scans, there currently exists a debate involving the cost effectiveness of finding a few patients within a larger group who exhibit this clinical presentation. With the wider use of PET in cancer diagnosis and treatment response monitoring the cost of this imaging modality should become more equivalent to more well established modalities such as CT scan and barriers such as economic feasibility will be less of a concern in using PET as a tool to help diagnose supraclavicular metastases in pancreatic cancer, particularly isolated ones.

  15. Prognostic significance of metastatic lymph nodes ratio in patients with gastric adenocarcinoma after curative gastrectomy

    Zhang Meiling; Wang Jian; Shi Wei; Chen Wenjiao; Li Wei; Shu Yongqian; Liu Ping

    2014-01-01

    Background We evaluated the impact of the number of metastatic lymph nodes and the metastatic lymph nodes ratio (the ratio between metastatic lymph nodes and total dissected lymph nodes,MLNR) in patients with gastric adenocaminoma following curative gastrectomy and also analyzed the relationship between the number of removed lymph nodes and prognosis in node-negative gastric cancer.Methods From January 2005 to December 2010,1 390 patients who were diagnosed with gastric adenocarcinoma and underwent curative gastrectomy were included.In particular,lymph node metastasis was not present in 515 patients.The number of metastatic lymph nodes and the metastatic lymph nodes ratio were selected for univariate and multivariate analyses to evaluate their influences on the disease outcome.The survival curve was presented according to the number of removed lymph nodes in node-negative gastric cancer using Kaplan-Meier plots.Results The overall 5-year survival rate was 54% in this group.Univariate analysis revealed that age category,macroscopic appearance,histological grade,tumor size,depth of primary tumor invasion,number of metastatic lymph nodes,metastatic lymph nodes ratio,tumor,nodes,metastasis-classification (TNM) stage and status of lymphovascular,and vessel invasion have significant impact on survival.The number of metastatic lymph nodes and the metastatic lymph nodes ratio both have significant impact on survival (P <0.001).However,in multivariate analyses,only the metastatic lymph nodes ratio was identified to be an independent prognostic factor (P <0.001).The number of removed lymph nodes in node-negative was a strong prognostic factor of survival,the more lymph nodes dissected,the better the survival.Conclusions The metastatic lymph nodes ratio has more significant prognostic value for survival in patients with gastric cancer following curative gastrectomy than the number of metastatic lymph nodes.The number of removed lymph nodes miaht be an important

  16. Risk factors for non-sentionel lymph node metastases in brdeast cancer patients with positive sentionel lymph ondes

    ZHANG Tao; WANG Hong; CHEN Bao-ping; ZHANG Hai-song; WEI Xi-liang; FU Ying; LI Zhong; HU Geng-kun

    2008-01-01

    @@ The presence or absence of metastases in the axillary lymph nodes has remained the most powerful prognostic factor in breast carcinoma. Axillary lymph node dissection (ALND) is the standard procedure for obtaining this information. However, postoperative complications are common. Sentinel lymph node (SLN) biopsy has been proposed as a potential alternative to ALND for staging breast carcinoma. This technique has been shown to be sensitive and specific for predicting the status of the axillary lymph nodes.1 Furthermore, it has the potential advantage of decreasing the morbidity associated with ALND.

  17. Occipital lymph node metastasis from nasopharyngeal carcinoma:a special case report and literature review

    Jing Yang; Wei-Xiong Xia; Yan-Qun Xiang; Xing Lv; Liang-Ru Ke; Ya-Hui Yu; Xiang Guo

    2016-01-01

    Cervical lymph node metastasis is common in patients with nasopharyngeal carcinoma (NPC), but occipital lymph node metastasis in NPC patients has not yet been reported. In this case report, we describe an NPC patient with occipital lymph node metastasis. The clinical presentation, diagnostic procedure, treatment, and outcome of this case were presented, with a review of the related literature.

  18. Immune thrombocytopenia (ITP): a rare association of lymph node tuberculosis.

    Surana, Anuj P; Shelgikar, Kishor M; Melinkeri, Sameer; Phadke, Arvind

    2014-01-01

    Although various haematologic abnormalities are known to occur with tuberculosis, association of immune thrombocytopenia with tuberculosis is uncommon. We report a case of retroperitoneal lymph node tuberculosis who presented with ITP. A 76 year old female was admitted to our hospital with oral mucosal bleed and petechial lesions over extremities and abdomen. A diagnosis of immune thrombocytopenia (ITP) was established. Intravenous Anti-D immunoglobulin and Dexamethasone therapy was started, but failed to elicit any sustained platelet response. CT abdomen revealed multiple retroperitoneal lymph nodes with central necrosis. Histopathology (HPE) of these revealed caseating lymphadenitis suggestive of tuberculosis. After 2 months of anti-tuberculous therapy, the platelet counts returned to normal and patient was off all therapy for ITP thereby suggesting likely association between tuberculosis and immune thrombocytopenia. PMID:25327103

  19. RECURRENT MARJOLIN’S ULCER WITH REGIONAL LYMPH NODE METASTASIS

    Anjali

    2012-11-01

    Full Text Available ABSTRACT: Marjolin’s ulcer is a malignant tumour developing in a chronic skin lesion (burn scar, vaccination scar, non-healing wound etc.. Th e majority of cases reported are squamous cell carcinoma. Surgery remains the first treatment of choice (resection with 2cms. safety margin of healthy skin for primary squamous cell car cinoma Marjolin ulcers and 2.5cms. safety margin for recurrent cases. Recurrence after surge ry and regional lymph node metastasis are not uncommon (17% & 30% respectively.We presents a c ase report and literature review of Recurrent Marjolin’s Ulcer with regional Lymph Node Metastasis. Marjolin's ulcer should be considered as a significant post-burn complication; i t should be treated with full emphasis on adequate local clearance and regular follow up for m any years; if not treated adequately, it may lead to complicated recurrence.

  20. Two cases of giant lymph node hyperplasia (Castleman's lymphoma)

    Giant lymph node hyperplasia (Castleman's lymphoma) is a rare disease. Only 86 cases habe been reported in Japan. Among these 86 cases, only four have included the results of scintigrams taken using 67Ga-citrate. In the present study, our experience of two cases showing positively integrated images on scintigrams using 67Ga-citrate is reported. Case 1 was a 61-year-old man who visited our hospital with a complaint of a tumor in the left groin, and Case 2 was a 60-year-old woman who visited our hospital with a complaint of a left cervical tumor. In these two cases, positively integrated images on scintigrams using 67Ga-citrate were recognized and giant lymph node hyperplasia was diagnosed upon histopathological examination. (author)

  1. The Prognostic Value of Harvested Lymph Nodes and the Metastatic Lymph Node Ratio for Gastric Cancer Patients: Results of a Study of 1,101 Patients

    Chen, Shi; Zhao, Bai-wei; Li, Yuan-Fang; Feng, Xing-Yu; Sun, Xiao-wei; Li, Wei; Zhou, Zhi-Wei; Zhan, You-Qing; Qian, Chao-Nan; Chen, Ying-Bo

    2012-01-01

    Aim To investigate whether the recommendation to remove 15 lymph nodes that is used in the staging system is necessary to assess gastric cancer progression and to evaluate whether our metastatic lymph node ratio dividing method, adapted from the AJCC’s (American Joint Committee on Cancer) 7th TNM staging system, is helpful for the patients with fewer than 15 harvested lymph nodes. Methods We performed a retrospective study of 1101 patients with histologically diagnosed gastric cancer who unde...

  2. Staging of Cervical Lymph Nodes in Oral Squamous Cell Carcinoma

    Norling, Rikke; Buron, Birgitte Marie Due; Therkildsen, Marianne Hamilton;

    2014-01-01

    INTRODUCTION: Clinical staging of patients with oral squamous cell carcinoma (OSCC) is crucial for the choice of treatment. Computed tomography (CT) and/or magnetic resonance imaging (MRI) are typically recommended and used for staging of the cervical lymph nodes (LNs). Although ultrasonography (US...... patients (6%) were over-staged by US. CONCLUSION: The addition of US to the clinical work-up of patients with cN0 OSCC increases the detection of metastases, thus US potentially reduces the number of patients requiring a secondary neck surgery after sentinel node biopsy....

  3. Lymph node metastasis in the biliary tract carcinoma: CT evaluation

    Lee, Byung Hee; Lee, Ah Ra; Kim, Kie Hwan; Do, Young Soo; Chin, Soo Yil [Korea Cancer Center Hospital, Seoul (Korea, Republic of)

    1994-07-15

    The primary biliary carcinoma is usually unresectable at presentation, because of early lymphatic spread. To determine the incidence and the spread pattern of lymph node metastases according to the location of the primary tumor, we analyzed the CT scans of the patients with primary biliary adenocarcinoma. We reviewed the CT scans of 92 patients with pathologically proven primary biliary adenocacinima, including 45 peripheral cholangiocarcinomas, 22 hilar cholangiocarcinomas, 18 gallbladder carcinomas, and 7 common bile duct carcinomas. Positive adenopathy was diagnosed when the node exceeded 10 mm in short axis. The overall incidence of nodal metastases was 59.8% (55/92); 66.7% in peripheral cholangiocarcinoma, 54.5% in hilar cholangiocarcinoma, 55.6% in gallbladder carcinoma, and 42.9% in common bile duct carcinoma. The most commonly involved nodal group was the lesser omentum, followed by the celiac, periaortic, and peripancreatic group. The phrenic node group was only involved in the cases with the peripheral or hilar cholangiocarcinoma. The primary biliary carcinoma has a high incidence of lymph node metastases at the time of diagnosis, and shows different nodal spread pattern according to the location of the primary tumor. Involvement of the phrenic node was limited to the peripheral and hilar cholangiocarcinoma.

  4. Ultrasonography for diagnostic evaluation of the skin and lymph nodes

    The textbook presents: A comprehensive survey of all aspects and capabilities of ultrasonography applied as a diagnostic tool in dermatology; practical guidance on the various established applications for diagnostic evaluation of the skin and subcutaneous lymph nodes; interpretation of findings, enhanced by a large number of images; the information and knowledge required to pass examinations for qualification as an expert in 'ultrasonic diagnosis of skin lesions'. (orig./CB)

  5. Endobronchial Ultrasound Elastography for Diagnosing Mediastinal and Hilar Lymph Nodes

    Hai-Yan He; Mao Huang; Jie Zhu; Hang Ma; Xue-Dong Lyu

    2015-01-01

    Background: Pathophysiological processes, such as malignancy, can lead to the formation of stiffer tissue in lung cancers. Endobronchial ultrasound (EBUS) elastography is a novel technique for measuring tissue stiffness during EBUS-guided transbronchial needle aspiration (EBUS-TBNA). The current study was conducted to investigate the diagnostic value of EBUS elastography for mediastinal and hilar lymph node metastasis in lung cancers. Methods: From January 2014 to January 2015, 40 patient...

  6. Lymph nodes cytology in HIV seropositive cases with haematological alterations

    Neelima Tirumalasetti; Prema Latha, P.

    2014-01-01

    Background & objectives: Lymphadenopathy and haematological alterations are the earliest manifestations with other associated opportunistic infections and malignancies. Hence, there is a need for simple investigations like fine needle aspiration cytology (FNAC) for evaluation of HIV lymphadenopathy and a haemogram to interpret the haematological alterations. This study was undertaken to analyze the cytological patterns of lymph node lesions in HIV/AIDS patients, to compare with available clin...

  7. SENTINEL LYMPH NODE CONCEPT IN DIFFERENTIATED THYROID CANCER

    Markovic Ivan

    2014-12-01

    Full Text Available Introduction: Differentiated thyroid carcinoma (DTC account up to 90% of all thyroid malignacies, and represents the most common malignant tumors of endocrine system. The incidence of papillary thyroid carcinoma (PTC, especially small tumors is rapidly increasing during past three decades. At the time of diagnosis, the incidence of lymph node metastases (LNM ranges from 80 to 90%. During the last 15 years, LNM were recognized as bad prognostic factor for both local-regional relapse (LRR and cancer specific survival. There is general agreement that neck dissections are indicated in cases of clinically apparent LNM. The subject of the current controversy is the surgical treatment of occult LNM that remain unrecognized on preoperative diagnosis (cN0. The extent of operations of the lymph nodes ranges from “wait and see” so-called “Western school” principle substantiated the role of applying ablative I131therapy and frequency peroperative complications (recurrent laryngeal nerve injury and hypoparathyroidism, especially for less experienced teams to mutual prophylactic dissection of the central and lateral compartments so-called “Japanese school” due to the limited use of radioactive iodine therapy and significantly lower operating morbidity if dissetion was done during primary operation. Despite high prevalence of occult LNM, existing controversies regarding diagnosis, longterm prognostic impact and extent of lymph node surgery, motivated some authors to apply consept of sentinel lymph node biopsy (SLNb in DTC, taking into account excellent results of SLN concept in breast cancer and skin melanoma. This review presents the summarized results of relevant studies and three meta-analysis of accuracy and applicability of SLN concept in patients with differentiated thyroid carcinoma.

  8. Peripheral blood and mesenteric lymph node lymphocytes in Crohn's disease.

    Richens, E R; Thorp, C M; Bland, P W; Gough, K R

    1980-01-01

    Analysis of peripheral blood lymphocytes from 44 patients with Crohn's disease showed no difference in the proportions of T- and B-cells from those in 38 healthy controls. Analysis revealed no disturbances in relation to duration or to activity of disease or to drug treatment. Lymphocytes from 18 patients with rheumatoid arthritis also showed normal proportions of T- and B-cells. Lymphocytes taken from gut lymph nodes were studied in five patients with Crohn's disease. On comparison with peri...

  9. The importance of lymph node biopsy in diagnosis on lymphadenopathy

    A study of 826 consecutive lymph node biopsies received during the period of four year from 1993-1996 was conducted to determine its role in arriving at a diagnosis and to see the pattern of diseases with which patient presented. These biopsies was interpreted. In the Department of Pathology, PNS Shifa Naval Hospital, a tertiary care center for the armed forces personnel in the southern part of Pakistan. The age of the patients varied from 10 months to 88 years. The commonest pathology encountered was tuberculosis (50.9%), followed by reactive hyperplasia (33.2%), malignant lymphomas (5.8%) and metastatic tumors (4.9%). Miscellaneous conditions like necrotizing lymphadenitis, infections mononucleosis, sarcoidosis, castle man's disease and lepromatous leprosy comprised 0.3% each. Cases of lymphadenopathy can now be diagnosed by other means such as fine needle aspiration cytology (FNAC) of the palpable lymph node but still lymph node biopsy plays an important role in typing of lymphomas and helps in those cases which cannot be diagnosed definitely by fine needle aspiration cytology. (author)

  10. Fluorescence spectroscopy using indocyanine green for lymph node mapping

    Haj-Hosseini, Neda; Behm, Pascal; Shabo, Ivan; Wârdell, Karin

    2014-02-01

    The principles of cancer treatment has for years been radical resection of the primary tumor. In the oncologic surgeries where the affected cancer site is close to the lymphatic system, it is as important to detect the draining lymph nodes for metastasis (lymph node mapping). As a replacement for conventional radioactive labeling, indocyanine green (ICG) has shown successful results in lymph node mapping; however, most of the ICG fluorescence detection techniques developed are based on camera imaging. In this work, fluorescence spectroscopy using a fiber-optical probe was evaluated on a tissue-like ICG phantom with ICG concentrations of 6-64 μM and on breast tissue from five patients. Fiber-optical based spectroscopy was able to detect ICG fluorescence at low intensities; therefore, it is expected to increase the detection threshold of the conventional imaging systems when used intraoperatively. The probe allows spectral characterization of the fluorescence and navigation in the tissue as opposed to camera imaging which is limited to the view on the surface of the tissue.

  11. Simultaneous Mapping of Pan and Sentinel Lymph Nodes for Real-Time Image-Guided Surgery

    Ashitate, Yoshitomo; Hyun, Hoon; Kim, Soon Hee; Lee, Jeong Heon; Henary, Maged; Frangioni, John V.; Choi, Hak Soo

    2014-01-01

    The resection of regional lymph nodes in the basin of a primary tumor is of paramount importance in surgical oncology. Although sentinel lymph node mapping is now the standard of care in breast cancer and melanoma, over 20% of patients require a completion lymphadenectomy. Yet, there is currently no technology available that can image all lymph nodes in the body in real time, or assess both the sentinel node and all nodes simultaneously. In this study, we report an optical fluorescence techno...

  12. Fatal extraintestinal toxoplasmosis in a young male cat with enlarged mesenteric lymph nodes.

    Cohen, Tamara M; Blois, Shauna; Vince, Andrew R

    2016-05-01

    A 22-month-old indoor/outdoor neutered male domestic short-haired cat had a history of progressive lethargy, vomiting, and decreased appetite. Abdominal ultrasound revealed an irregular hyperechoic mass in the mid-abdomen. He was unresponsive to symptomatic medical management and was euthanized after 3 days of hospitalization. A diagnosis of disseminated extraintestinal toxoplasmosis was made based on the finding of intracytoplasmic protozoan parasites on histopathological examination of mesenteric lymph nodes, hepatic and intestinal samples, and on immunohistochemistry. PMID:27152033

  13. Needle Fracture during Endoscopic Ultrasound-Guided Fine-Needle Aspiration of Suspicious Thoracic Lymph Nodes

    Bartosz Adamowicz

    2016-01-01

    Full Text Available Endoscopic ultrasound fine-needle aspiration (EUS-FNA is used to make a cytopathologic diagnosis of suspicious lesions located around the gastrointestinal tract. It is a safe technique with few complications. The most common complications of EUS-FNA are related to pancreatic lesions (pancreatitis, bleeding, and abdominal pain. Rare complications have been noted such as stent malfunction, air embolism, infection, neural and vascular injuries, and tumor cell seeding. There are very few studies examining equipment malfunctions. We report a case of needle fracture during the EUS-FNA of suspicious thoracic lymph nodes in a 79-year-old man investigated for unexplained weight loss.

  14. DWI in diagnosis of regional lymph node metastasis of colorectal cancer

    Objective: To evaluate the efficacy of diffusion-weighted imaging (DWI) for diagnosing regional lymph nodes metastasis in patients with colorectal cancer. Methods: 75 patients with colorectal cancer underwent preoperative routine MRI and DWI examination, and tumor dissection. Metastatic and non-metastatic lymph nodes were confirmed by pathology after operation. ADC values of lymph nodes and primary tumor were measured and statistically analyzed. Diagnostic efficacies of ADC values and rADC (lymph node/tumor) values in differentiating metastatic lymph nodes from non-metastatic lymph nodes were assessed by comparing area under curve (AUC) of receiver operating characteristic-curve. Results: Metastatic lymph nodes and non-metastatic lymph nodes were identified. The ADC value of metastatic lymph nodes and non-metastatic lymph nodes were (0.79±0.12) x10-3 mm2/s vs. (0.98±0.23) x 10-3 mm2/s, and showed significant difference (P<0.01). The rADC values of metastatic lymph nodes are significantly lower than that of non-metastatic lymph nodes (P<0.01). AUC of ADC and rADC were 0.776 vs. 0.883. The threshold, sensitivity, and specificity for differentiating metastatic lymph nodes from non-metastatic lymph nodes were 1.11x10-3 mm2/s vs. 1.03x10-3 mm2/s, 61.9% vs. 78.6%, and 88% vs.90% respectively. Conclusion: DWI has distinct advantages in detecting metastatic lymph nodes of colorectal cancer. rADC value is more accurate than ADC value. (authors)

  15. Prognostic value of lymph node ratio in node-positive breast cancer in Egyptian patients

    Background: Breast cancer in Egypt is the most common cancer among women and is the leading cause of cancer mortality. Traditionally, axillary lymph node involvement is considered among the most important prognostic factors in breast cancer. Nonetheless, accumulating evidence suggests that axillary lymph node ratio should be considered as an alternative to classical pN classification. Materials and methods: We performed a retrospective analysis of patients with operable node positive breast cancer, to investigate the prognostic significance of axillary lymph node ratio. Results: Five-hundred patients were considered eligible for the analysis. Median follow-up was 35 months (95% Cl 32-37 months), the median disease-free survival (DFS) was 49 months (95% Cl, 46.4-52.2 months). The classification of patients based on pN staging system failed to prognosticate DFS in the multivariate analysis. Conversely, grade 3 tumors, and the intermediate (> 0.20 to <0.65) and high (>0.65) LNR were the only variables that were independently associated with adverse DFS. The overall survival (OS) in this series was 69 months (95% Cl 60-77). Conclusion: The analysis of outcome of patients with early breast cancer in Egypt identified the adverse prognostic effects of high tumor grade, ER negativity and intermediate and high LNR on DFS. If the utility of the LNR is validated in other studies, it may replace the use of absolute number of axillary lymph nodes.

  16. Long-term clinical impact of sentinel lymph node biopsy in breast cancer and cutaneous melanoma

    Sentinel lymph node biopsy (SLNB) is based on the hypothesis that the sentinel lymph node (SLN) reflects the lymph-node status and a negative SLN might allow complete axillary lymph node dissection (ALND) to be avoided. Past and current sentinel lymph node clinical trials for breast carcinoma and melanoma address the prognostic and therapeutic utility of SLN dissection (SLND). This technique has already become a standard of care for breast cancer patients and select patients with melanoma. However, it is still important to discuss current techniques and some controversies. This article reviews these issues as well as current guidelines for treatment and management of patients with various findings on SLNB

  17. Lymphoscintigraphy and intraoperative gamma probe guided biopsy of the sentinel lymph node in breast cancer

    Objective: To evaluate the role of lymphoscintigraphy and intraoperative gamma probe in sentinel lymph node identification and biopsy for breast cancer. Methods: 99Tcm labelled dextran (Dx) was injected intra-dermis at the skin surface center of breast tumor before mastectomy. The sentinel lymph nodes identified by lymphoscintigraphy and intraoperative gamma probe were dissected out from the axillary tissue. All sentinel and non-sentinel lymph nodes were sent to a pathologist for histological examination. The specimens were examined with hematoxylin and eosin (H and E) staining. Results: In 31 cases studied, sentinel lymph nodes were all identified by lymphoscintigraphy and intraoperative gamma probe, with a detection rate of 100%. Metastases were detected in sentinel lymph nodes in 10 patients, however, 12 cases showed positive axillary lymph nodes but for 3 cases, sentinel lymph nodes were negative. The sensitivity of the sentinel lymph node biopsy in the study was 83.33%, the accuracy was 87.09%, the false positive rate was 0, and the false negative rate was 25%. Conclusions: Intraoperative gamma probe detection is the best approach to identify sentinel lymph nodes in breast cancer. The attempt that substitution of sentinel lymph node biopsy for routine axillary lymph node dissection in breast cancer deserves further study

  18. Management of the lymph nodes in penile cancer.

    Heyns, Chris F; Fleshner, Neil; Sangar, Vijay; Schlenker, Boris; Yuvaraja, Thyavihally B; van Poppel, Hendrik

    2010-08-01

    A comprehensive literature study was conducted to evaluate the levels of evidence (LEs) in publications on the diagnosis and staging of penile cancer. Recommendations from the available evidence were formulated and discussed by the full panel of the International Consultation on Penile Cancer in November 2008. The final grades of recommendation (GRs) were assigned according to the LE of the relevant publications. The following consensus recommendations were accepted. Fine needle aspiration cytology should be performed in all patients (with ultrasound guidance in those with nonpalpable nodes). If the findings are positive, therapeutic, rather than diagnostic, inguinal lymph node dissection (ILND) can be performed (GR B). Antibiotic treatment for 3-6 weeks before ILND in patients with palpable inguinal nodes is not recommended (GR B). Abdominopelvic computed tomography (CT) and magnetic resonance imaging (MRI) are not useful in patients with nonpalpable nodes. However, they can be used in those with large, palpable inguinal nodes (GR B). The statistical probability of inguinal micrometastases can be estimated using risk group stratification or a risk calculation nomogram (GR B). Surveillance is recommended if the nomogram probability of positive nodes is .5 [50%] or primary tumor grade 2-3 or T2-T4 or cN1-N2, or with lymphovascular invasion), bilateral ILND should be performed (GR B). ILND can be performed at the same time as penectomy, instead of 2-6 weeks later (GR C). SNB based on the anatomic position can be performed, provided the patient is willing to accept the potential false-negative rate of /=2 nodes on one side, contralateral limited ILND with frozen section analysis can be performed, with complete ILND if the frozen section analysis findings are positive (GR B). If clinically suspicious inguinal metastases develop during surveillance, complete ILND should be performed on that side only (GR B), and SNB or limited ILND with frozen section analysis on the

  19. Liver hilar tuberculous lymphadenitis successfully diagnosed by laparoscopic lymph node biopsy

    Masaki Wakasugi; Masahiro Tanemura; Tsubasa Mikami; Kenta Furukawa; Masahiko Tsujimoto; Hiroki Akamatsu

    2015-01-01

    Introduction: Liver hilar tuberculous lymphadenitis is extremely rare. A case of liver hilar tuberculous lymphadenitis mimicking lymph node metastasis of anal canal cancer that was successfully diagnosed by laparoscopic lymph node biopsy is reported. Presentation of case: A 49-year-old man with a past medical history of pulmonary tuberculosis suffering from anal canal cancer with left inguinal lymph node metastasis underwent laparoscopic anterior perineal resection and left inguinal lymph ...

  20. The role of sentinel lymph-node biopsy (SLNB) in the treatment of breast cancer.

    Marrazzo, Antonio; Taormina, Pietra; David, Massimo; Casà, Luigi; Lo Gerfo, Domenico; Noto, Antonio; Riili, Ignazio; Ficola, Umberto; Russo, Leila

    2006-01-01

    Sentinel lymph-node biopsy is an innovative method for axillary staging in breast cancer patients, based on the concept that information about the status of the entire lymphatic drainage from a tumour site could be obtained by identification and sampling of a "sentinel node". The aim of the study was to evaluate the impact of sentinel lymph-node biopsy in the management of patients with early invasive breast carcinoma. Three hundred and forty-one patients with primary invasive breast carcinoma measuring less than 2 cm (less than 3 cm from January 2001) and clinically negative axillary nodes were recruited into the study. Sentinel lymph-nodes were positive for metastases in 108/341 cases (31.7%). Micrometastases were found in 22 patients and isolated tumour cells in 1 case. The mean number of sentinel lymph-nodes removed was 1.8 per patient. The sentinel lymph-node was the only positive node in 57 of 108 patients (52.8%). The percentage of axillary recurrence in sentinel lymph-node-negative patients was 0%. The accuracy of sentinel lymph-node biopsy for axillary staging has been confirmed in many studies. Axillary recurrences after sentinel lymph-node biopsy range from 0 to 1.6% in many series, while axillary recurrence after axillary lymph-node dissection is about 0-3%. In our experience we observed no axillary recurrences in 233 patients with sentinel lymph-node biopsy alone, with a median follow-up of 33 months, confirming the accuracy of the procedure, and sentinel lymph-node-negative patients with sentinel lymph-node biopsy alone are no more at risk for axillary recurrences than those undergoing axillary lymph-node dissection. PMID:16845865

  1. Non-sentinel lymph node metastasis prediction in breast cancer with metastatic sentinel lymph node: impact of molecular subtypes classification.

    Fabien Reyal

    Full Text Available INTRODUCTION: To decipher the interaction between the molecular subtype classification and the probability of a non-sentinel node metastasis in breast cancer patients with a metastatic sentinel lymph-node, we applied two validated predictors (Tenon Score and MSKCC Nomogram on two large independent datasets. MATERIALS AND METHODS: Our datasets consisted of 656 and 574 early-stage breast cancer patients with a metastatic sentinel lymph-node biopsy treated at first by surgery. We applied both predictors on the whole dataset and on each molecular immune-phenotype subgroups. The performances of the two predictors were analyzed in terms of discrimination and calibration. Probability of non-sentinel lymph node metastasis was detailed for each molecular subtype. RESULTS: Similar results were obtained with both predictors. We showed that the performance in terms of discrimination was as expected in ER Positive HER2 negative subgroup in both datasets (MSKCC AUC Dataset 1 = 0.73 [0.69-0.78], MSKCC AUC Dataset 2 = 0.71 (0.65-0.76, Tenon Score AUC Dataset 1 = 0.7 (0.65-0.75, Tenon Score AUC Dataset 2 = 0.72 (0.66-0.76. Probability of non-sentinel node metastatic involvement was slightly under-estimated. Contradictory results were obtained in other subgroups (ER negative HER2 negative, HER2 positive subgroups in both datasets probably due to a small sample size issue. We showed that merging the two datasets shifted the performance close to the ER positive HER2 negative subgroup. DISCUSSION: We showed that validated predictors like the Tenon Score or the MSKCC nomogram built on heterogeneous population of breast cancer performed equally on the different subgroups analyzed. Our present study re-enforce the idea that performing subgroup analysis of such predictors within less than 200 samples subgroup is at major risk of misleading conclusions.

  2. Head and neck lymph node region delineation with image registration

    Shapiro Linda G

    2010-06-01

    Full Text Available Abstract Background The success of radiation therapy depends critically on accurately delineating the target volume, which is the region of known or suspected disease in a patient. Methods that can compute a contour set defining a target volume on a set of patient images will contribute greatly to the success of radiation therapy and dramatically reduce the workload of radiation oncologists, who currently draw the target by hand on the images using simple computer drawing tools. The most challenging part of this process is to estimate where there is microscopic spread of disease. Methods Given a set of reference CT images with "gold standard" lymph node regions drawn by the experts, we are proposing an image registration based method that could automatically contour the cervical lymph code levels for patients receiving radiation therapy. We are also proposing a method that could help us identify the reference models which could potentially produce the best results. Results The computer generated lymph node regions are evaluated quantitatively and qualitatively. Conclusions Although not conforming to clinical criteria, the results suggest the technique has promise.

  3. Ontogeny of the antigen-reactive lymph follicle-forming capacity of the popliteal lymph node in neonatal mice

    Hiramoto, M; Aizawa, S; Horie, K; Nagata, H; Hoshi, H

    2005-01-01

    The ontogenetic development of the reactive lymph follicle-forming capacity of the popliteal lymph node was investigated immunohistochemically in young mice which had received a single injection of hemocyanin (KLH) in a rear footpad at a predetermined age (between 1 and 21 days). The mice were sacrificed at various intervals after injection. In non-stimulated young mice, primary lymph follicles first appeared in the popliteal node at 11 days of age. When KLH wa...

  4. Recent Advance in Lymph Dynamic Analysis in Lymphatics and Lymph Nodes

    Ikomi, Fumitaka; Kawai, Yoshiko; Ohhashi, Toshio

    2012-01-01

    Lymphatics are a unidirectional transport system that carries fluid from the interstitial space and back into the blood stream. Initial lymphatics take up not only fluid but also high-molecular-weight substances, such as plasma proteins and hyaluronan; immune cells, such as lymphocytes, macrophages, and dendritic cells; and colloidal particles, such as carbon particles, bacteria, and tattoo dye. Interstitially injected colloidal particles are known to accumulate in the regional lymph nodes. T...

  5. Studies of plutonium in human tracheobronchial lymph nodes

    Since 1959, tissues from 70 occupationally exposed former employees of the Los Alamos Scientific Laboratory have been examined following autopsy. Exposure in most cases was to inhaled plutonium oxide aerosols. Chemical analyses of selected tissues were performed to determine the amount of plutonium retained in the body at the time of death. On the basis of the measured tissue concentrations of plutonium, extrapolations of total-body burdens were made. Thirty-three of the measured cases had plutonium depositions in the tracheobronchial lymph nodes ranging from 0.1 to 4000 dpm per gram of tissue (0.05 to 1800 pCi/g). The duration of exposures ranged from 4 to 30 years. Microscopic examination of representative sections of these lymph nodes revealed no abnormalities other than those which were directly attributable to the basic disease that caused the demise of the various persons in this study. The size distribution of plutonium particles in nodes from one individual was determined by exposing tissue sections to nuclear track film. The estimated mass median diameter of the particles was 0.3 μm, and the distribution had a geometric standard deviation of 1.6. It is estimated that 95 percent of the individual particles had corresponding plutonium concentrations between 0.001 and 0.22 pCi

  6. Metastatic lymph node ratio, 6th or 7th AJCC edition: witch is the best lymph node classification for esophageal cancer? Prognosis factor analysis in 487 patients

    CORAL, Roberto V.; BIGOLIN, André V.; CORAL, Roberto P.; Hartmann, Antonio; DRANKA, Carolina; ROEHE, Adriana V.

    2015-01-01

    Background The esophageal cancer is one of the most common and aggressive worldwide. Recently, the AJCC changed the staging system, considering, among others, the important role of the lymph node metastasis on the prognosis. Aim To discuss the applicability of different forms of lymph node staging in a western surgical center. Methods Four hundred eighty seven patients with esophageal cancer were enrolled. Three staging systems were evaluated, the 6th and the 7th AJCC editions and the Lymph N...

  7. Sentinel lymph node biopsy for conjunctival malignant melanoma: surgical techniques

    Wainstein AJA

    2014-12-01

    Full Text Available Alberto JA Wainstein,1,2 Ana P Drummond-Lage,1 Milhem JM Kansaon,2 Gustavo O Bretas,2 Rodrigo F Almeida,3 Ana LF Gloria,3 Ana RP Figueiredo3 1Faculty of Medical Sciences of Minas Gerais, 2Oncad Surgical Oncology, 3Ophthalmology Department, Federal University of Minas Gerais, Belo Horizonte, Brazil Background: The purpose of this report is to examine the viability and safety of preoperative lymphoscintigraphy and radio guided sentinel lymph node (SLN biopsy for conjunctival melanoma, and to identify the best technique to perform this procedure.Methods: Three patients diagnosed with malignant melanoma of the conjunctiva underwent lymphoscintigraphy and SLN biopsy using a dual technique comprising isosulfan blue dye and technetium Tc 99m sulfur colloid. Each patient was anesthetized and the conjunctival melanoma was excised. SLNs were localized by a gamma probe, identified according to radioactivity and sentinel blue printing, and dissected, along with drainage of the associated lymphatic basins. The SLNs were evaluated by a pathologist using hematoxylin-eosin staining following serial sectioning and immunohistochemistry using a triple melanoma cocktail (S-100, Melan-A, and HMB-45 antigens.Results: Two SLNs were stained in the jugular chain during preoperative lymphoscintigraphy in the first patient, two SLNs were identified in the preauricular and submandibular areas in the second patient, and two SLNs were identified in the submandibular and parotid areas in the third patient. All lymph nodes identified by lymphoscintigraphy were dissected and identified at surgery with 100% accuracy in all three patients. All SLNs were histologically and immunohistochemically negative. Patients had good cosmetic and functional results, and maintained their visual acuity and ocular motility.Conclusion: Patients with conjunctival melanoma can undergo preoperative lymphoscintigraphy and SLN biopsy safely using radioactive technetium and isosulfan blue dye. Keywords

  8. Methylation signature of lymph node metastases in breast cancer patients

    Invasion and metastasis are two important hallmarks of malignant tumors caused by complex genetic and epigenetic alterations. The present study investigated the contribution of aberrant methylation profiles of cancer related genes, APC, BIN1, BMP6, BRCA1, CST6, ESR-b, GSTP1, P14 (ARF), P16 (CDKN2A), P21 (CDKN1A), PTEN, and TIMP3, in the matched axillary lymph node metastasis in comparison to the primary tumor tissue and the adjacent normal tissue from the same breast cancer patients to identify the potential of candidate genes methylation as metastatic markers. The quantitative methylation analysis was performed using the SEQUENOM’s EpiTYPER™ assay which relies on matrix-assisted laser desorption/ionization time-of-flight mass spectrometry (MALDI-TOF MS). The quantitative DNA methylation analysis of the candidate genes showed higher methylation proportion in the primary tumor tissue than that of the matched normal tissue and the differences were significant for the APC, BIN1, BMP6, BRCA1, CST6, ESR-b, P16, PTEN and TIMP3 promoter regions (P<0.05). Among those candidate methylated genes, APC, BMP6, BRCA1 and P16 displayed higher methylation proportion in the matched lymph node metastasis than that found in the normal tissue (P<0.05). The pathway analysis revealed that BMP6, BRCA1 and P16 have a role in prevention of neoplasm metastasis. The results of the present study showed methylation heterogeneity between primary tumors and metastatic lesion. The contribution of aberrant methylation alterations of BMP6, BRCA1 and P16 genes in lymph node metastasis might provide a further clue to establish useful biomarkers for screening metastasis

  9. The number of tumor-free axillary lymph nodes removed as a prognostic parameter for node-negative breast cancer

    Fei Gao; Ni He; Pei-Hong Wu

    2014-01-01

    Recently, there has been controversy about the relationship between the number of lymph nodes removed and survival of patients diagnosed with lymph node-negative breast cancer. To assess this relationship, 603 cases of lymph node-negative breast cancer with a median of 126 months of follow-up data were studied. Patients were stratified into two groups (Group A, 10 or fewer tumor-free lymph nodes removed; Group B, more than 10 tumor-free lymph nodes removed). The number of tumor-free lymph nodes in ipsilateral axilary resections as wel as 5 other disease parameters were analyzed for prognostic value. Our results revealed that the risk of death from breast cancer was significantly associated with patient age, marital status, histologic grade, tumor size, and adjuvant therapy. The 5- and 10-year survival rates for patients with 10 or fewer tumor-free lymph nodes removed was 88.0% and 66.4%, respectively, compared with 69.2% and 51.1%, respectively, for patients with more than 10 tumor-free lymph nodes removed. For patients with 10 or fewer tumor-free lymph nodes removed, the adjusted hazard ratio (HR) for risk of death from breast cancer was 0.579 (95% confidence interval, 0.492-0.687,P < 0.001), independent of patient age, marital status, histologic grade, tumor size, and adjuvant therapy. Our study suggests that the number of tumor-free lymph nodes removed is an independent predictor in cases of lymph node-negative breast cancer.

  10. Lymph nodes cytology in HIV seropositive cases with haematological alterations

    Neelima Tirumalasetti

    2014-01-01

    Full Text Available Background & objectives: Lymphadenopathy and haematological alterations are the earliest manifestations with other associated opportunistic infections and malignancies. Hence, there is a need for simple investigations like fine needle aspiration cytology (FNAC for evaluation of HIV lymphadenopathy and a haemogram to interpret the haematological alterations. This study was undertaken to analyze the cytological patterns of lymph node lesions in HIV/AIDS patients, to compare with available clinico-pathological and haematological parameters to segregate lymphadenopathy cases for further evaluation. Methods: In the present study, 129 HIV seropositive patients were included. Lymph node aspirates were stained routinely with hematoxylin and eosin and Ziehl-Neelsen (Z-N stains. Special stains and cultures were done in selected patients. Peripheral smears were taken from all the patients and CD4 counts were recorded. Tuberculous lymphadenitis was further categorized. Acid fast bacilli (AFB grading was done on Z-N positive smears. Each lesion was compared with CD4 counts, WHO clinical staging and haematological picture. Results: Cytological diagnosis in 129 patients included tuberculous (n=54, 41.9%, reactive lymphadenopathy (n=46, 35.6%, suppurative (n=16, 12.4% lymphadenitis, non-Hodgkin′s lymphoma (n=4, 3.1%, and Hodgkin′s lymphoma, secondary deposits, other granulomatous lesions, and cryptoccocal lymphadenitis in one patient each. The predominant cytomorphological pattern in tuberculous lymphadenitis was caseous necrosis + epithelioid granuloma formation (51.85%. Grade 2+ Z-N grading was noted in 62.96 per cent of AFB positive smears. CD4 counts showed a descending pattern with progression of WHO clinical staging. Cytopenia was more common in WHO clinical stage IV disease. Interpretation & conclusions: Lymph node cytology was found to be a useful tool for segregating lymphadenopathy cases for further evaluation and for identification of

  11. Lymph-scintigraphic identification of sentinel lymph nodes in breast carcinoma and malignant melanoma patients

    It is the purpose of the study to assay the possibilities of lymphoscintigraphy (LS) in evaluating local lymphatic drainage and sentinel lymph nodes (SLNs) location in patients presenting breast carcinoma and malignant melanoma. Twenty-nine women with breast carcinoma (TI-IIa clinical stage, age range 31 to 74 y) and 7 patients with malignant melanoma (Clark III-V) are scanned in the period 1997 through 1998. 99mTc-sulphur colloid (Solco Lymphoscint, SORIN) with mean size of particles 50 nm is used. Planar images are obtained at 20 and 120-180 min after sc injection in the region of primary tumor, at mean radioactivity 20 MBq per injection site in a volume 0.2-0.3 ml. In the breast cancer patients Patent Blue V or Mitoxantrone is injected around the tumor twice - 20 and 3 to 1/2 hours prior to surgery. In malignant melanoma patients immunoscintigraphy using 740 MBq 99mTc-anti-melanoma monoclonal antibodies (Technemab-K-1) is carried out before lymph node dissection. SLNs are visualized in 25 patients (86.2%) with breast cancer. In 21 (72%) patients to 4 SLNs are scanned in level I of the local axillary region, in 4 cases (14%) - in the region of axillary level II, in one female patient (3%) - at axillary level III, and in 3 patients (10%) i psilateral internal mammary lymph nodes are scanned. Two patients are suspected for the so-called skiptype of tumor lymphatic dissemination. In 4 patients no SLN images are visible. In breast carcinoma patients SLN are additionally stained blue and following intraoperative revision, evidence of metastatic involvement is established in 12 instances (41.3%). In 3 patients with melanoma in the abdomen and back SLNs are located in the region of inguinal and axillary lymph node groups, while in 3 patients presenting lesions to the surface of extremities only local lymph nodes draining the melanoma are visualized. Immunoscintigraphy shows enhanced uptake in the region of SLNs in 3 cases with the metastatic changes in them confirmed

  12. CT and MRI manifestations of metastatic lymph nodes of salivary carcinoma

    Objective: To study the CT and MRI manifestations of metastatic lymph nodes of salivary carcinoma. Methods: The CT and MRI images of 31 patients with pathologically confirmed large salivary carcinoma were retrospectively analyzed, in which 25 underwent CT scanning (21 with enhanced CT scanning) and 6 underwent MR scanning (5 with enhanced MRI scanning). The short diameters of the largest metastatic lymph nodes in the specific area were measured on PACS. Of the 111 metastatic lymph nodes, 14 were located in area Ⅰ, 28 in area Ⅱ, 26 in area Ⅲ, 20 in area Ⅳ, 9 in areaⅤ, and 14 were within the parotid. Results: Of these 31 cases, all metastatic lymph nodes were located unilaterally to the same side as the primary tumor. Of the 111 metastatic lymph nodes, there were 6, 52, 53 lymph nodes with short diameter (SD) < 5 mm, 8 mm > SD ≥5 mm, and SD ≥ 8 mm respectively. On the CT images, there were 75 lymph nodes with internal patchy low-density areas and 12 lymph nodes with homogenous density. On MR images, all of the 24 lymph nodes showed mixed iso-hypointensity on T1WI, mixed iso-hyperintensity on T2WI. The 21 cases with enhanced CT scans revealed 70 lymph nodes, in which 52 showed mild enhancement, 16 showed moderate enhancement and 2 showed marked enhancement. Twenty-three of them exhibited ring-like enhancement. The 5 cases with enhanced MRI scans revealed 21 lymph nodes, in which 9 had mild enhancement, 9 had moderate enhancement, and 3 showed marked enhancement. Three of them showed ring-like enhancement. Conclusions: For salivary carcinoma, the most common sites of metastatic lymph nodes were area Ⅰ-Ⅴ and the parotid, especially area Ⅱ and Ⅲ. Irregular boundary, mild to moderate heterogeneous enhancement, ring-like enhancement, with internal low attenuation were imaging features of metastatic lymph nodes in salivary carcinoma. (authors)

  13. Insight into the differences in classification of mediastinal and hilar lymph nodes between Wang’s lymph node map and the International Association for the Study of Lung Cancer lymph node map

    Li, Ya-qing; Wang, Ko-Pen; Ben, Su-Qin

    2015-01-01

    Lung cancer is the leading cause of malignant-tumor-related morbidity and mortality worldwide. Transbronchial needle aspiration (TBNA) has for the past 30 years been an effective technique for the diagnosis and staging of lung cancer. Understanding the anatomy of mediastinal and hilar lymph nodes is essential to improve the yield of TBNA. Wang’s lymph node map is based on the lymph node map of the American Thoracic Society (ATS), and on the TBNA technique; it was published in 1994, and has pr...

  14. The Nodal Location of Metastases in Melanoma Sentinel Lymph Nodes

    Riber-Hansen, Rikke; Nyengaard, Jens; Hamilton-Dutoit, Stephen;

    2009-01-01

    BACKGROUND: The design of melanoma sentinel lymph node (SLN) histologic protocols is based on the premise that most metastases are found in the central parts of the nodes, but the evidence for this belief has never been thoroughly tested. METHODS: The nodal location of melanoma metastases in 149...... SLNs. In addition, the size of the metastases located exclusively outside the 2 regional protocols (ie, 3 central sections, and 3 peripheral sections) were measured and compared with each other. RESULTS: The metastasis detection rates of the central, the peripheral, and the evenly distributed protocols...... were 77%, 79%, and 78%, respectively. No difference in either the mean volume or the maximum diameter of the metastases located exclusively outside the central and the peripheral protocols was found (volume: 0.036 vs. 0.031 mm and diameter: 0.320 vs. 0.332 mm). CONCLUSIONS: In SLNs, melanoma metastases...

  15. Factors related to lymph node metastasis and surgical strategy used to treat early gastric carcinoma

    Dong Yi Kim; Jae Kyoon Joo; Seong Yeob Ryu; Young Jin Kim; Shin Kon Kim

    2004-01-01

    AIM: The prognosis of early gastric carcinoma (EGC) is generally excellent after surgery. The presence or absence of lymph node metastasis in EGC is an important prognostic factor. The survival and recurrence rates of node-negative EGC are much better than those of node-positive EGC. This study examined the factors related to lymph node metastasis in EGC to determine the appropriate treatment for EGC.METHODS: We investigated 748 patients with EGC who underwent surgery between January 1985 and December 1999 at the Division of Gastroenterologic Surgery, Department of Surgery, Chonnam National University Hospital. Several clinicopathologic factors were investigated to analyze their relationship to lymph node metastasis: age, sex, tumor location, tumor size, gross type, histologic type, depth of invasion, extent of lymph node dissection, type of operation,and DNA ploidy.RESULTS: Lymph node metastases were found in 75 patients (10.0%). Univariate analysis showed that male sex, tumor size larger than 2.0 cm, submucosal invasion of tumor, histologic differentiation, and DNA ploidy pattern were risk factors for regional lymph node metastasis in EGC patients. However, a multivariate analysis showed that three risk factors were associated with lymph node metastasis:large tumor size, undifferentiated histologic type and submucosal invasion. No statistical relationship was found for age, sex, tumor location, gross type, or DNA ploidy in multivariate analysis. The 5-year survival rate was 94.2% for those without lymph node metastasis and 87.3% for those with lymph node metastasis, and the difference was significant (P<0.05).CONCLUSION: In patients with EGC, the survival rate of patients with positive lymph nodes is significantly worse than that of patients with no lymph node metastasis. Therefore,a standard D2 lymphadenectomy should be performed in patients at high risk of lymph node metastasis: large tumor size, undifferentiated histologic type and submucosal invasion.

  16. Sentinel lymph node detection with large human serum albumin colloid particles in breast cancer

    Detection of metastatic involvement of lymph nodes is essential for management and prognostic evaluation in breast cancer patients. The success of lymphatic mapping depends on identifying the sentinel lymph node(s) draining the primary tumour. However, when mapping is performed with a radiocolloidal agent, the number of hot lymph nodes varies with the agent and its size, among other factors. In this study, we evaluated prospectively the detection rate of sentinel lymph nodes in breast cancer when injecting large particles (100-600 nm) of human serum albumin colloids (Senti-Scint). In 128 consecutive breast cancer patients without palpable lymph nodes, pre-operative static lymphoscintigraphic mapping of the breast was performed after subcutaneous injection of 15 MBq of the radiocolloid. Lymphoscintigrahic results were compared with intra-operative surgical gamma detection probe and blue dye mapping data. Pre-operative lymphoscintigraphy and surgical gamma detection probe both correctly detected 203 sentinel lymph nodes in 122/128 patients (95%), while blue dye mapping showed only 183 sentinel lymph nodes in 82% of the patients. Only one or two sentinel lymph nodes were identified in each patient, which allowed the surgeon easily to find the sentinel lymph node(s) intra-operatively. In conclusion, lymphoscintigraphy with large particles of human serum albumin colloids is a helpful and reliable procedure for the surgical management of breast cancer. (orig.)

  17. Quantitative analysis of the central-chest lymph nodes based on 3D MDCT image data

    Lu, Kongkuo; Bascom, Rebecca; Mahraj, Rickhesvar P. M.; Higgins, William E.

    2009-02-01

    Lung cancer is the leading cause of cancer death in the United States. In lung-cancer staging, central-chest lymph nodes and associated nodal stations, as observed in three-dimensional (3D) multidetector CT (MDCT) scans, play a vital role. However, little work has been done in relation to lymph nodes, based on MDCT data, due to the complicated phenomena that give rise to them. Using our custom computer-based system for 3D MDCT-based pulmonary lymph-node analysis, we conduct a detailed study of lymph nodes as depicted in 3D MDCT scans. In this work, the Mountain lymph-node stations are automatically defined by the system. These defined stations, in conjunction with our system's image processing and visualization tools, facilitate lymph-node detection, classification, and segmentation. An expert pulmonologist, chest radiologist, and trained technician verified the accuracy of the automatically defined stations and indicated observable lymph nodes. Next, using semi-automatic tools in our system, we defined all indicated nodes. Finally, we performed a global quantitative analysis of the characteristics of the observed nodes and stations. This study drew upon a database of 32 human MDCT chest scans. 320 Mountain-based stations (10 per scan) and 852 pulmonary lymph nodes were defined overall from this database. Based on the numerical results, over 90% of the automatically defined stations were deemed accurate. This paper also presents a detailed summary of central-chest lymph-node characteristics for the first time.

  18. Tolerance and efficiency of radiation therapy treatment of the pelvic lymph nodes in patients with prostate cancer

    Tolerance and efficiency of radiation therapy treatment of the pelvic lymph nodes were assessed in 122 patients with prostate cancer. With no severe observed late toxicity the incidence for lymph node metastases was between 3,0% (primarily irradiated patients without lymph node or distant metastases) and 100% (primarily irradiated patients with lymph node and distant metastases) after 3 years. As it seems, the following subgroups might possibly profit the most from a dose escalation in the pelvic lymph nodes: primarily irradiated patients with positive lymph nodes and postoperatively irradiated patients in adjuvant/additive situation, with a biochemical or a local/lymph node recurrence.

  19. Sentinel lymph node detection in oropharynx and oral cavity

    The sentinel lymph node (SLN) is the first lymph node draining the tumour. Aim of the study: To determine the negative predictive value of the SLN in the NO or NI squamous cell carcinomas (SCC) of the oral cavity or the oropharynx. Materials and method: SLN localization firstly requires a lymphoscintigraphy which is realised after four injections of radiolabelled colloids around the tumour. This scintigraphy allows a cutaneous marking of the SLN. Per operative detection of the SLN is performed with a detection probe. Results: One or more SLN have been localized in 20 of the 21 patients. No SLN was found in one patient whose tumour was a recurrence. (T2 NO MO) of a SCC of the oropharynx irradiated 3 years before. The failure rate of the method is 4,8% (1 false negative in 21 patients) and the false negative rate is 12,5% (1 false negative in 8 positive patients). This false negative patient had a T3 NO MO SCC of the oropharynx with a SLN found in level III, deep lateral cervical group. The neck dissection revealed one positive node in level lb, submandibular group, and 27 other nodes, all negative. The probability for the whole neck dissection to be negative when the SLN is negative (negative predictive value), is 92,3% (12/13) in our study. Conclusion: Our patient population is too small to obtain statistically significant conclusions. A maximum of 2 % of false negative patients is necessary to apply this method and avoid complete neck dissection in NO and NI tumours of the the oral cavity and the oropharynx with a negative SLN. (author)

  20. Clinical outcomes after sentinel lymph node biopsy in clinically node-negative breast cancer patients

    Han, Hee Ji; Keun Ki Chang; Suh, Chang Ok; Kim, Yong Bae [Dept.of Radiation Oncology, Yonsei Cancer Center, Yonsei University College of Medicine, Seoul (Korea, Republic of); Kim, Ju Ree [Dept.of Radiation Oncology, Cheil General Hospital, Seoul (Korea, Republic of); Nam, Hee Rim [Dept.of Radiation Oncology, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul (Korea, Republic of)

    2014-09-15

    To evaluate non-sentinel lymph node (LN) status after sentinel lymph node biopsy (SNB) in patients with breast cancer and to identify the predictive factors for disease failure. From January 2006 to December 2007, axillary lymph node (ALN) dissection after SNB was performed for patients with primary invasive breast cancer who had no clinical evidence of LN metastasis. A total of 320 patients were treated with breast-conserving surgery and radiotherapy. The median age of patients was 48 years, and the median follow-up time was 72.8 months. Close resection margin (RM) was observed in 13 patients. The median number of dissected SNB was two, and that of total retrieved ALNs was 11. Sentinel node accuracy was 94.7%, and the overall false negative rate (FNR) was 5.3%. Eleven patients experienced treatment failure. Local recurrence, regional LN recurrence, and distant metastasis were identified in 0.9%, 1.9%, and 2.8% of these patients, respectively. Sentinel LN status were not associated with locoregional recurrence (p > 0.05). Close RM was the only significant factor for disease-free survival (DFS) in univariate and multivariate analysis. The 5-year overall survival, DFS, and locoregional DFS were 100%, 96.8%, and 98.1%, respectively. In this study, SNB was performed with high accuracy and low FNR and high locoregional control was achieved.

  1. Morphological analysis of lymph nodes in Odontocetes from north and northeast coast of Brazil.

    De Oliveira e Silva, Fernanda Menezes; Guimarães, Juliana Plácido; Vergara-Parente, Jociery Einhardt; Carvalho, Vitor Luz; De Meirelles, Ana Carolina Oliveira; Marmontel, Miriam; Ferrão, Juliana Shimara Pires; Miglino, Maria Angelica

    2014-05-01

    The morphology and location of lymph nodes from seven species of Odontocetes, of both sexes and different age groups, were described. All animals were derived from stranding events along the North and Northeastern coasts of Brazil. After the identification of lymph nodes in situ, tissue samples were analyzed for light and electron microscopy. Vascular volume density (VVD) and vascular length density (VLD) were evaluated in the mesenteric lymph nodes. Lymph nodes occurred as solitary nodules or in groups, varying in shape and size. In addition to using the nomenclature recommended by Nomina Anatomica Veterinaria, new nomenclatures were suggested based on the lymph nodes topography. Lymph nodes were covered by a highly vascularized and innervated capsule of dense connective tissue, below which muscle fibers were observed, inconsistently, in all studied species. There was no difference in VLD among different age groups. However, VVD was higher in adults. Lymph nodes parenchyma was divided into an outer cortex, containing lymph nodules and germinal centers; a paracortical region, transition zone with dense lymphoid tissue; and an inner medulla, composed of small irregular cords of lymphatic tissue, blood vessels, and diffuse lymphoid tissue. Abundant collagen fibers were observed around arteries and arterioles. Germinal centers were more evident and developed in calves and young animals, being more discrete and sparse in adults. The morphology of lymph nodes in Odontocetes was typical of that observed in other terrestrial mammals. However, new groups of lymph nodes were described for seven species occurring in the Brazilian coast. PMID:24449600

  2. Clinical significance of lymph node micrometastasis in gastric cancer.

    Arigami, Takaaki; Uenosono, Yoshikazu; Yanagita, Shigehiro; Nakajo, Akihiro; Ishigami, Sumiya; Okumura, Hiroshi; Kijima, Yuko; Ueno, Shinichi; Natsugoe, Shoji

    2013-02-01

    Recently, the existence of lymph node micrometastasis (LNM), including isolated tumor cells, has been focused on during the development of molecular diagnostic tools for lymph node metastasis in various malignant neoplasms. In particular, immunohistochemistry and reverse transcription-polymerase chain reaction have been reported to be available for the detection of LNM in gastric cancer. However, at present, the clinical significance of LNM remains unclear in patients with gastric cancer. Therefore, we cannot strategically make light of this issue in clinical management. Currently, minimally invasive treatments, such as endoscopic submucosal dissection and laparoscopic surgery with personalized lymphadenectomy, are widely performed in consideration of postsurgical quality of life (QOL). However, it is important to maintain the balance between QOL and curability when selecting surgical treatments for patients with gastric cancer. If minimally invasive surgery based on LNM status was established for patients with early gastric cancer, it could be performed safely. We reviewed the clinical significance of LNM as an important strategic target in patients with gastric cancer. PMID:22546997

  3. Impact of sentinel lymph node management in malignant melanoma

    Malignant melanoma initially metastasises to regional lymph nodes and belongs to the ''leading candidates'' for sentinel lymph node (SLN) management. In newly diagnosed melanoma stage Ib to IIIa, today the SLN diagnostics is classified as the staging method of first choice. The technique of the SLN diagnostics is described thoroughly, including multimodal imaging if this is required for selective SLN biopsy. The evaluation of the diagnostic results, documentation and classification encompasses an important part. In approximately 2/3 of the melanoma patients there is no presence of metastases in SLN and non-SLN, one of five patients has metastases in SLN with negative non-SLN, every sixth to tenth patient has positive SLN and non SLN. Every thirtieth patient with tumour free SLN exhibits pathological findings in the non-SLN by using conventional examination methods only, every fifteenth if using molecular-genetic methods in addition. Among the prognostic parameters the SLN status has the most significant impact on disease-free and disease-specific survival. (orig.)

  4. Sentinel lymph node biopsy in pregnant patients with breast cancer

    Gentilini, Oreste; Toesca, Antonio; Sangalli, Claudia; Veronesi, Paolo; Galimberti, Viviana [European Institute of Oncology, Division of Senology, Milan (Italy); Cremonesi, Marta; Pedroli, Guido [European Institute of Oncology, Unit of Medical Physics, Milan (Italy); Colombo, Nicola [European Institute of Oncology, Unit of Cardiology, Milan (Italy); Peccatori, Fedro [European Institute of Oncology, Division of Haematology-Oncology, Milan (Italy); Sironi, Roberto [S. Pio X Hospital, Unit of Obstetrics and Gynecology, Milan (Italy); Rotmensz, Nicole [European Institute of Oncology, Division of Epidemiology and Biostatistics, Milan (Italy); Viale, Giuseppe [European Institute of Oncology, Division of Pathology, Milan (Italy); University of Milan School of Medicine, Milan (Italy); Goldhirsch, Aron [European Institute of Oncology, Department of Medicine, Milan (Italy); Veronesi, Umberto [European Institute of Oncology, Division of Senology, Milan (Italy); European Institute of Oncology, Milan (Italy); Paganelli, Giovanni [European Institute of Oncology, Division of Nuclear Medicine, Milano (Italy)

    2010-01-15

    Sentinel lymph node biopsy (SLNB) is currently not recommended in pregnant patients with breast cancer due to radiation concerns. Twelve pregnant patients with breast cancer received low-dose (10 MBq on average) lymphoscintigraphy using {sup 99m}Tc human serum albumin nanocolloids. The sentinel lymph node (SLN) was identified in all patients. Of the 12 patients, 10 had pathologically negative SLN. One patient had micrometastasis in one of four SLN. One patient had metastasis in the SLN and underwent axillary clearance. From the 12 pregnancies, 11 healthy babies were born with no malformations and normal weight. One baby, whose mother underwent lymphatic mapping during the 26th week of gestation, was operated on at the age of 3 months for a ventricular septal defect and at 43 months was in good health. This malformation was suspected at the morphological US examination during week 21, well before lymphoscintigraphy, and was confirmed a posteriori by a different observer based on videotaped material. No overt axillary recurrence appeared in the patients with negative SLNs after a median follow-up of 32 months. Our experience supports the safety of SLNB in pregnant patients with breast cancer, when performed with a low-dose lymphoscintigraphic technique. (orig.)

  5. Fine-needle aspiration cytology of superficial lymph nodes.

    Cardillo, M R

    1989-01-01

    A series of 244 enlarged superficial lymph nodes was examined by fine-needle aspiration cytology. Twenty-nine smears (11.9%) were inadequate for study. Of the remaining 215, 108 were negative, 13 suspicious for malignancy, and 94 positive. Forty-five excisional biopsies were performed correlating the cytologic and histologic findings. There were two cytologic false-negative results; both were patients who had been treated for carcinoma and whose aspirates were cytologically negative. Of the 13 samples reported as suspicious for malignancy, there were three epidermoid carcinomas, nine reactive hyperplasias, and one non-Hodgkin's lymphocytic lymphoma. Of the positive cases, 83 were metastatic tumors, and 11 were malignant lymphomas (two non-Hodgkin's lymphomas and nine Hodgkin's lymphomas). The criteria used in the interpretation of these aspirates and the problems of differential cytological diagnosis are discussed. In spite of the drawbacks of inadequate and false-negative smears, fine-needle aspiration cytology is valuable in preliminary diagnosis of diseased lymph nodes and subsequent management. PMID:2776599

  6. Increased B Regulatory Phenotype in Non-Metastatic Lymph Nodes of Node-Positive Breast Cancer Patients.

    Mehdipour, F; Razmkhah, M; Hosseini, A; Bagheri, M; Safaei, A; Talei, A-R; Ghaderi, A

    2016-03-01

    Tumour-draining lymph nodes (TDLNs) are centre in orchestrating the immune responses against cancer. The cellularity and lymphocyte subpopulations change in the process of cancer progression and lymph node involvement. B lymphocyte subsets and their function in breast cancer-draining lymph nodes have not been well elucidated. Here, we studied the influence of tumour metastasis on the frequencies of different B cell subsets including naïve and memory B cells as well as those which are known to be enriched in the regulatory pool in TDLNs of 30 patients with breast cancer. Lymphocytes were obtained from a fresh piece of each lymph node and stained for CD19 and other B cell-associated markers and subjected to flow cytometry. Our investigation revealed that metastatic TDLN showed a significant decrease in active, memory and class-switched B cells while the frequencies of B cells with regulatory phenotypes were not changed. However, CD27(hi) CD25(+) and CD1d(hi) CD5(+) B regulatory subsets significantly increased in non-metastatic lymph nodes (nMLNs) of node-positive patients compared with node-negative patients. Our data provided evidence that in breast cancer, metastasis of tumour to axillary lymph nodes altered B cell populations in favour of resting, inactive and unswitched phenotypes. We assume that the lymphatic involvement may cause an increase in a subset of regulatory B cells in non-metastatic lymph nodes. PMID:26708831

  7. Dual-Modality Photoacoustic and Ultrasound Imaging System for Noninvasive Sentinel Lymph Node Detection in Patients with Breast Cancer

    Alejandro Garcia-Uribe; Todd N. Erpelding; Arie Krumholz; Haixin Ke; Konstantin Maslov; Catherine Appleton; Margenthaler, Julie A.; Wang, Lihong V.

    2015-01-01

    The detection of regional lymph node metastases is important in cancer staging as it guides the prognosis of the patient and the strategy for treatment. Sentinel lymph node biopsy (SLNB) is an accurate, less invasive alternative to axillary lymph node dissection. The sentinel lymph node hypothesis states that the pathological status of the axilla can be accurately predicted by determining the status of the first lymph nodes that drain from the primary tumor. Physicians use radio-labeled sulfu...

  8. Isolation of Escherichia coli from lymph nodes of bovine carcasses and detection of hlyA gene with PCR

    P. Sechi; V. Cambiotti; S. Parmegiani; C. Baldinelli; M.F. Iulietto; B. Cenci Goga

    2012-01-01

    A potential source of pathogenic bacteria in ground beef is the lymphatic system, specifically the lymph nodes. The objective of the current study was to determine the prevalence of Escherichia coli in bovine lymph nodes. Bovine lymph nodes (n = 200) were collected from 100 carcasses at a commercial slaugh-terhouse. 192 lymph nodes sampled were obtained from 96 regular slaughter, and the remainder 8 were obtained from 4 emergency slaughter. Subiliaci lymph nodes were collected for this study....

  9. Prognosis of patients with esophageal squamous cell carcinoma after esophagectomy using the log odds of positive lymph nodes

    Wu, San-Gang; Sun, Jia-Yuan; Yang, Li-Chao; Zhou, Juan; Li, Feng-Yan; Li, Qun; Lin, Huan-xin; Lin, Qin; He, Zhen-Yu

    2015-01-01

    To compare the log odds of positive lymph nodes (LODDS) with the number of positive lymph nodes (pN), lymph node ratio (LNR), removed lymph node (RLN) count, and negative lymph node (NLN) count in determining the prognosis of patients with esophageal squamous cell carcinoma (ESCC) after esophagectomy. The records of patients with ESCC who received esophagectomy were retrospectively reviewed. The log-rank test was used to compare curves for overall survival (OS), and Cox regression analysis wa...

  10. Lipoxygenase mediates invasion of intrametastatic lymphatic vessels and propagates lymph node metastasis of human mammary carcinoma xenografts in mouse

    Kerjaschki, Dontscho; Bago-Horvath, Zsuzsanna; Rudas, Margaretha; Sexl, Veronika; Schneckenleithner, Christine; Wolbank, Susanne; Bartel, Gregor; Krieger, Sigurd; Kalt, Romana; Hantusch, Brigitte; Keller, Thomas; Nagy-Bojarszky, Katalin; Huttary, Nicole; Raab, Ingrid; Lackner, Karin

    2011-01-01

    In individuals with mammary carcinoma, the most relevant prognostic predictor of distant organ metastasis and clinical outcome is the status of axillary lymph node metastasis. Metastases form initially in axillary sentinel lymph nodes and progress via connecting lymphatic vessels into postsentinel lymph nodes. However, the mechanisms of consecutive lymph node colonization are unknown. Through the analysis of human mammary carcinomas and their matching axillary lymph nodes, we show here that i...

  11. Normal mediastinal and hilar lymph nodes in children on multi-detector row chest computed tomography

    To study normal mediastinal and hilar lymph nodes on multi-detector chest computed tomography (CT). A cohort of 120 children aged 1-17 years underwent emergency CT, including the chest, after high-energy trauma. Axial 5-mm reconstructions were evaluated for lymph nodes at hilar and various mediastinal levels and the short-axis diameters were measured. At least one lymph node was found in 115 (96%) children, with subcarinal (69%), lower paratracheal (64%) and hilar (60%) nodes being most common. Up to 10 years of age most lymph nodes were smaller than or equal to 7 mm. In older children lymph nodes measuring up to 10-mm-short-axis diameter were found. Lymph nodes were rare along the mammary vessels, at lower oesophageal and at prevascular and posterior mediastinal levels in children. Mediastinal and hilar lymph nodes are more common than previously thought, probably because of increased detection by modern multi-detector CT. Lymph node location and age have to be taken into account when evaluating lymph nodes in the paediatric chest. (orig.)

  12. Computed tomographic evaluation of mediastinal lymph node metastases from bronchogenic carcinoma

    CT images of mediastinal lymph node metastases in resected primary lung cancers were studied. Enlargement of metastatic lymph nodes differed in extent in each region. Diagnosing accuracy of the metastatic group based on diameters depended on region; the region of bronchial bifurcation being difficult to diagnose. The extent of enlargement due to metastatic was different for each histological type of lung cancer, and lymph nodes did not enlarge in many cases of adenocarcinoma. By contrast enhancement, enlarged lymph nodes with a large cold area were highly probable for metastasis. The distribution pattern of enlarged lymph nodes was important for the diagnosis of presence or absence of metastasis, the enlarged lymph nodes showing no laterality in cases of nonspecific enlargement. (Chiba, N.)

  13. Lymph node metastases in the gastrocolic ligament in patients with colon cancer

    Bertelsen, Claus A; Bols, Birgitte; Ingeholm, Peter;

    2014-01-01

    in the proximity of the flexures or in the transverse colon. OBJECTIVE: The purpose of this work was to present our findings of metastases in the gastrocolic ligament in a consecutive series of patients. DESIGN: This was a single-center retrospective study. SETTINGS: The study was conducted in a...... colorectal cancer center. PATIENTS: All of the colon adenocarcinoma resections with relevant tumor location from June 1, 2008, to December 31, 2012 were included in this study. MAIN OUTCOME MEASURES: The presence of lymph node metastases in the gastrocolic ligament in colon adenocarcinomas located in the...... years (range, 30-90 years), and 57% were men. Gastrocolic lymph nodes were found in 86 specimens (88%) with a median number of 4 lymph nodes (range, 0-16 lymph nodes). Thirty-four patients (35%) had mesocolic lymph node metastases. Gastrocolic lymph node metastases were found in 4 (12%) of these 34...

  14. Computed tomography of neck lymph nodes involved with malignant lymphoma; Comparison with ultrasound

    Sakai, Fumikazu; Sone, Shusuke; Kiyono, Kunihiro (Shinshu Univ., Matsumoto, Nagano (Japan). Faculty of Medicine) (and others)

    CT images of 24 patients with head and neck lymphoma were retrospectively reviewed, compared with ultrasonograms, and compared with CT images of 13 patients with lymph node metastases. In nine (38%) of 24 patients, some lymph nodes with lymphomatous involvement showed a spotty or linear pattern of contrast enhancement. In two of these nine patients, a dendritic pattern of contrast enhancement between multiple enlarged lymph nodes was observed. The same pattern appeared as spotty, linear, or dendritic hyperechoic areas on the ultrasonogram. None of 13 patients with lymph node metastases showed a spotty, linear, or dendritic pattern of contrast enhancement. Ten of 13 (77%) showed ring-like contrast enhancement on CE-CT images. The spotty or linear contrast enhancement in enlarged lymph nodes and the dendritic contrast enhancement in confluent lymph nodes could be useful CT findings in diagnosing nodal involvement with malignant lymphoma. (author).

  15. Use of High Frequency Ultrasound to Monitor Cervical Lymph Node Alterations in Mice

    Walk, Elyse L.; McLaughlin, Sarah; Coad, James; Weed, Scott A.

    2014-01-01

    Cervical lymph node evaluation by clinical ultrasound is a non-invasive procedure used in diagnosing nodal status, and when combined with fine-needle aspiration cytology (FNAC), provides an effective method to assess nodal pathologies. Development of high-frequency ultrasound (HF US) allows real-time monitoring of lymph node alterations in animal models. While HF US is frequently used in animal models of tumor biology, use of HF US for studying cervical lymph nodes alterations associated with...

  16. Farnesoid X receptor, overexpressed in pancreatic cancer with lymph node metastasis promotes cell migration and invasion

    Lee, J Y; Lee, K. T.; Lee, J. K.; Lee, K. H.; Jang, K-T; Heo, J S; Choi, S. H.; Kim, YIl; Rhee, J. C.

    2011-01-01

    Background: Lymph node metastasis is one of the most important adverse prognostic factors for pancreatic cancer. The aim of this study was to identify novel lymphatic metastasis-associated markers and therapeutic targets for pancreatic cancer. Methods: DNA microarray study was carried out to identify genes differentially expressed between 17 pancreatic cancer tissues with lymph node metastasis and 17 pancreatic cancer tissues without lymph node metastasis. The microarray results were validate...

  17. Prophylactic central lymph nodes dissection (VI level in papillary thyroid cancer

    Pavel Olegovich Rumiantsev

    2015-05-01

    Full Text Available Metastatic involvement of central lymph nodes in patients with papillary thyroid cancer (PTC is very common. However, prophylactic central lymph nodes dissection additionally to thyroidectomy does not significantly affect disease-free and overall survival of PTC patients. Meanwhile its routine conduction is tangibly increase postsurgical complications. From efficacy/safety point of view prophylactic central lymph nodes dissection couldn't be recommended as substantiated in all PTC patients.

  18. Effect of Tumor Deposits on Overall Survival in Colorectal Cancer Patients with Regional Lymph Node Metastases

    Yabata, Eiichi; Udagawa, Masaru; Okamoto, Hiroyuki

    2014-01-01

    Objectives: The staging system of the International Union Against Cancer considers tumor deposits to be N1c in patients with no regional lymph node metastasis, but the significance of tumor deposits in patients with regional lymph node metastases is unclear. We investigated the effect of tumor deposits on overall survival in colorectal cancer patients with regional lymph node metastases. Patients and Methods: From 2000 to 2008, 551 patients underwent resections for colorectal cancer at our me...

  19. Ex vivo Imaging of T Cells in Murine Lymph Node Slices with Widefield and Confocal Microscopes

    Salmon, Hélène; Rivas-Caicedo, Ana; Asperti-Boursin, François; Lebugle, Camille; Bourdoncle, Pierre; Donnadieu, Emmanuel

    2011-01-01

    Naïve T cells continuously traffic to secondary lymphoid organs, including peripheral lymph nodes, to detect rare expressed antigens. The migration of T cells into lymph nodes is a complex process which involves both cellular and chemical factors including chemokines. Recently, the use of two-photon microscopy has permitted to track T cells in intact lymph nodes and to derive some quantitative information on their behavior and their interactions with other cells. While there are obvious advan...

  20. Cervical Lymph Node Metastases fromMeningioma: Report of Two Cases andTreatment Outcome

    Yahya Daneshbod; Ahmad Mosalaei; Mansoor Ansari; Niloofar Ahmadloo; Mohammad Mohammadianpanah; Hamid Nasrolahi; Shapour Omidvari; Neda Bagheri; Shahrzad Negahban

    2010-01-01

    Meningioma is usually a benign central nervous system (CNS) tumor. Metastasisis rare; however if it does occur the most metastatic sites are the liver and lungs. Here,two cases of CNS meningioma with metastasis to cervical lymph nodes are reported.The first case, a 48 year-old man developed cervical lymph node metastasis nine yearsafter primary tumor diagnosis. The second case, a 23 year-old woman with parietallobe meningioma, developed lymph node metastasis in the neck nine months afterth...

  1. Creating a risk model to determine paraaortic lymph node involvement in endometrial carcinoma

    Turan, Ahmet Taner; YILDIRIM, Burcu AYKAN; Üreyen, Işın; Hizli, Deniz; KARALÖK, Mustafa Alper; Ömer Lütfi TAPISIZ; TULUNAY, Hakkı Gökhan; Boran, Nurettin; Özgül, Nejat; Köse, Mehmet Faruk

    2011-01-01

    To define a high-risk group for paraaortic (PA) lymph node metastasis among endometrial carcinoma patients. Materials and methods: Prognostic factors determining PA lymph node metastasis were defined. Using these factors in different combinations, 14 risk groups were formed. A patient with at least one of these factors was considered as high-risk for PA lymph node metastasis. Results: This study included 152 patients. Of these patients, 18 had tumors in the PA region. Lymphovascular space ...

  2. Binding of Candida albicans yeast cells to mouse popliteal lymph node tissue is mediated by macrophages.

    Han, Y.; Van Rooijen, N.; Cutler, J E

    1993-01-01

    We previously reported that Candida albicans yeast cells adhere to the macrophage-rich medullary and subcapsular sinus areas of mouse lymph node tissue. To determine whether the yeast cell-lymph node interaction is mediated by macrophages, the effect of specific elimination of macrophages on yeast cell binding was studied, and yeast cell adherence was correlated with the ingestion of India ink by lymph node cells. Macrophage elimination was done by use of liposome-containing dichloromethylene...

  3. The mouse lymph node as an ectopic transplantation site for multiple tissues

    Komori, Junji; Boone, Lindsey; DeWard, Aaron; Hoppo, Toshitaka; Lagasse, Eric

    2012-01-01

    Cell-based therapy has been viewed as a promising alternative to organ transplantation, but cell transplantation aimed at organ repair is not always possible. Here, we show that the mouse lymph node can support the engraftment and growth of healthy cells from multiple tissues. Direct injection of hepatocytes into a single mouse lymph node generated enough ectopic liver mass to rescue survival of mice with lethal metabolic disease. Furthermore, thymuses transplanted into a lymph node of athymi...

  4. Development of a 3D coculture system to study adipocyte and lymph node cell interactions

    Daya, S.; Loughlin, J.; MacQueen, H.

    2006-01-01

    We have developed a long term 3-dimensional coculture system with adipocytes and lymph node cells for the purpose of investigating interactions between these cells in vitro. Present experimental work with the culture system is aimed at introducing lymph node cells, in proportions similar to those found in intact lymph nodes, among differentiated adipocytes and observing interactions and the establishment of a spatial relationship between them. Co-cultures will be used to investigate the ly...

  5. Distribution of Mast Cells in Mediastinal Lymph Nodes from Lung Cancer Patients

    Shimizu Tetsuya; Edagawa Masao; Matsuzaki Yasunori; Tomita Masaki; Hara Masaki; Onitsuka Toshio

    2003-01-01

    Abstract Background Mast cells have been documented to have several key functions with regards to malignant neoplasms. However, the functional significance of their accumulation is largely unknown. An analysis of the mast cell profile in mediastinal lymph nodes from lung cancer patients is reported here. Methods One hundred thirty-four, randomly selected lymph nodes (63 with positive pathological lymph node status) from 39 surgically treated lung cancer patients were examined. All cancer nega...

  6. Melanocytic cutaneous lesions and melanotic regional lymph nodes in slaughter swine.

    Bundza, A.; Feltmate, T E

    1990-01-01

    During a five month period, 220 slaughter swine (at two abattoirs) had gross cutaneous and lymph node lesions suggestive of melanoma. Lymph nodes from 214 and cutaneous lesions from 176 of these pigs were submitted for histological examination. Of the cutaneous lesions, 174 were spontaneously regressing melanomas, and two were nonregressing. Regression usually commenced by infiltration of the lesion by lymphocytes, plasma cells and the formation of giant cells. Of the melanotic lymph nodes, 1...

  7. Inefficient Lymph Node Sensitization during Respiratory Viral Infection Promotes IL-17–Mediated Lung Pathology

    Kallal, Lara E.; Hartigan, Adam J.; Hogaboam, Cory M.; Schaller, Matthew A.; Lukacs, Nicholas W.

    2010-01-01

    Development of bronchus-associated lymphoid tissue has been suggested to enhance local antiviral immune responses; however, ectopic lymph node formation often corresponds to chronic inflammatory diseases. These studies investigated the role of ectopic pulmonary lymph nodes upon respiratory syncytial virus (RSV) infection using CCR7-deficient mice, which develop bronchus-associated lymphoid tissue early in life. CCR7−/− mice exhibited impaired secondary lymph node formation, enhanced effector ...

  8. Human lymph node morphology as a function of age and site.

    Luscieti, P; Hubschmid, T; Cottier, H.; Hess, M W; Sobin, L H

    1980-01-01

    Cervical, axillary, cubital, inguinal, popliteal, and mesenteric lymph nodes from subjects of various ages who had died a sudden death were examined histologically. Care was taken to establish by morphometry the proportional distribution in lymph node cross-sections of cortical, paracortical, and medullary areas. In addition, numbers and surface areas of cross-sectioned germinal centres were registered. Important differences related to age and anatomical site of lymph nodes were established b...

  9. Ultrasonography of the supramammary lymph nodes for diagnosis of bovine chronic subclinical mastitis

    Khoramian, B.; Vajhi, A.; Ghasemzadeh-Nava, H.; Ahrari-Khafi, M. S; Bahonar, A

    2015-01-01

    Currently, somatic cell count (SCC) and bacterial culture are considered as the gold standard of detecting subclinical Mastitis. Mastitis leads to proliferation of lymphocytes in the supramammary lymph nodes and subsequent enlargement of ipsilateral lymph node. Ultrasonography can be used to survey these changes. A portable ultrasound machine with a 2-5 MHz convex transducer was used to identify the supramammary lymph node size in 35 cows in a herd with chronic Staphylococcus aureus mastit...

  10. FOXP3+ Lymphocyte Density in Pancreatic Cancer Correlates with Lymph Node Metastasis

    Jiang, Yongjian; Du, Zunguo; YANG, FENG; Di, Yang; Li, Ji; ZHOU, ZHONGWEN; Pillarisetty, Venu G.; Fu, Deliang

    2014-01-01

    Objective To determine if the density of FOXP3+ lymphocytes in primary tumors and lymph nodes in pancreatic cancer correlates with the presence of lymph node metastases. Methods FOXP3+ lymphocyte density in primary pancreatic cancer tissue and draining lymph nodes was measured using immunohistochemistry. We analyzed the clinical and pathological aspects associated with the accumulation of FOXP3+ lymphocytes in pancreatic cancer. We also analyzed the correlation of density of FOXP3+ lymphocyte...

  11. Tuberculosis and metastatic carcinoma coexistence in axillary lymph node: A case report

    K Chandramohan

    2003-04-01

    Full Text Available Abstract Background Coexistence of cancer and tuberculosis in axillary lymph nodes is rare. Only seven cases have been reported in the literature. Case Report We report here a case of infiltrating ductal carcinoma breast metastasizing to the axillary lymph node along with tubercular granuloma in the same lymph node without primary mammary or pulmonary tuberculosis. Conclusion Primary tuberculosis coexisting with carcinoma is of rare occurrence. A possibility should always be borne in mind especially in patients from endemic areas.

  12. CT appearance of hilar and mediastinal enlarged lymph nodes of coal worker's pneumoconiosis

    Objective: To study the CT appearance of the hilar and mediastinal enlarged lymph nodes in coal worker's pneumoconiosis (CWP), its pathological basis and diagnostic value for CWR complicated with lung cancer. Methods: (1) Twelve isolated lungs with CWP obtained at autopsy were inflated and fixed. CT scan was performed. The pathologic findings of enlarged lymph nodes were identified. (2) CT findings of hilar and mediastinal enlarged lymph nodes of 71 cases with CWP and 22 cases of CWP complicated with lung cancer were analyzed. Results: (1) Most of the enlarged hilar and mediastinal lymph nodes in simple CWR was in third stage of fibrosis. The fourth stage of fibrosis was only seen in lymph nodes of a case with complicated CWP. In this case the necrotic materials of lymph nodes eroded adjacent bronchi and vessels, and coalesced with progressive massive fibrosis (PMF). (2) The average number of lymph nodes in cases of complicated CWP was more than that of simple CWP (P 2 cm was 7.4%. (3) The prevalence of lymph nodes calcification in CWP was 61.1%, but egg shell calcification was only 14.7%. (4) In the cases of CWP complicated with lung cancer, lymph node > 2 cm was 20.8%, that was more than CWP (P3 cm was 7.6%. Conclusion: Lymph nodes up to 1 cm may have dust fibrosis and coal silicosis nodules. The lymph nodes >2 cm is more common in CWP complicated with lung cancer than in simple CWP. The lymph nodes > 3 cm indicates higher probability of CWP with lung cancer than PMF

  13. Pulmonary sclerosing hemangioma with lymph node metastasis: A case report and literature review

    Adachi, Yasushi; Tsuta, Koji; HIRANO, RYUJI; TANAKA, JIN; Minamino, Keizo; Shimo, Tomohiko; Ikehara, Susumu

    2014-01-01

    Pulmonary sclerosing hemangioma (SH) is an uncommon benign or low-grade malignant tumor. Multicentric SH and SH with lymph node metastasis have rarely been reported. The present report describes a case of pulmonary SH with lymph node metastasis in a middle-aged female. A nodule was found incidentally in the lower left lung. The patient underwent left lower pulmonary lobectomy and lymph node dissection. Histologically, the nodule demonstrated the characteristic features of SH and one of the re...

  14. Imaging of human lymph nodes using optical coherence tomography: potential for staging cancer.

    McLaughlin, Robert A; Scolaro, Loretta; Robbins, Peter; Hamza, Saud; Saunders, Christobel; Sampson, David D

    2010-04-01

    Histologic assessment is the gold standard technique for the identification of metastatic involvement of lymph nodes in malignant disease, but can only be performed ex vivo and often results in the unnecessary excision of healthy lymph nodes, leading to complications such as lymphedema. Optical coherence tomography (OCT) is a high-resolution, near-IR imaging modality capable of visualizing microscopic features within tissue. OCT has the potential to provide in vivo assessment of tissue involvement by cancer. In this morphologic study, we show the capability of OCT to image nodal microarchitecture through an assessment of fresh, unstained ex vivo lymph node samples. Examples include both benign human axillary lymph nodes and nodes containing metastatic breast carcinoma. Through accurate correlation with the histologic gold standard, OCT is shown to enable differentiation of lymph node tissue from surrounding adipose tissue, reveal nodal structures such as germinal centers and intranodal vessels, and show both diffuse and well circumscribed patterns of metastatic node involvement. PMID:20233873

  15. Mulig forbedret behandling af kolorektal cancer med sentinel lymph node-diagnostik

    Burgdorf, Stefan K; Eriksen, Jens Ravn; Gögenür, Ismail

    2014-01-01

    Possibly improved treatment of colorectal cancer by sentinel lymph node mapping Prognosis for colorectal cancer is dependent on radical surgical intervention. Chemotherapy in patients with advanced disease has improved the survival. A considerable proportion of the patients going through radical...... surgery will subsequently relapse. Adjuvant chemotherapy is reserved for patients with lymph node metastases, why undetected malignant lymph nodes will result in understaging and exclusion from the possible benefit of adjuvant chemotherapy. With sentinel lymph node mapping it may be possible to detect and...

  16. A qualitative synthesis of the evidence behind elective lymph node irradiation in oesophageal cancer

    Background and purpose: Oesophageal cancer is the sixth leading cause of cancer death worldwide and radiotherapy plays a prominent role in its treatment. The presence of lymph node (LN) metastasis has been demonstrated to be one of the most significant prognostic factors related to oesophageal cancer. The use of elective lymph node irradiation (ENI) is still a topic of persistent controversy. The conservative school is to irradiate positive lymph nodes only; the other school is to prophylactically irradiate the regional lymph node area according to different tumour sites. This review investigated the justification for including ENI in the treatment of patients with oesophageal cancer. Material and methods: We performed a systematic literature search to find surgical data about lymph node distribution depending on different tumour subgroups: early, cervical, thoracic and gastroesophageal junction cancer. Furthermore, we performed a qualitative assessment of recurrence patterns in patients treated with or without ENI to derive estimates of the potential area at risk for lymph node harvest. Results: We identified and reviewed 49 studies: 10 in early, 8 in cervical, 10 in thoracic and the remaining 21 in gastroesophageal junction cancer. In general, these studies were conclusive in incidence and location of pathologic lymph nodes for different subgroups. Data for lymph node recurrence patterns are scarce and contributed little to our review. Conclusions: This review resulted in five recommendations for radiation oncologists in daily practice. We used the available evidence about metastatic lymph node distribution to develop a careful reasonable radiation protocol for the corresponding tumour subgroups

  17. Accuracy of multidetector-row CT in diagnosing lymph node metastasis in patients with gastric cancer

    The purpose of this study was to determine the optimal cut-off value of lymph node size for diagnosing metastasis in gastric cancer with multidetector-row computed tomography (MDCT) after categorizing perigastric lymph nodes into three regions. The study included 90 gastric cancer patients who underwent gastrectomy. The long-axis diameter (LAD) and short-axis diameter (SAD) of all visualized lymph nodes were measured with transverse MDCT images. The locations of lymph nodes were categorized into three regions: lesser curvature, greater curvature, and suprapancreatic. The diagnostic value of lymph node metastasis was assessed with receiver operating characteristic (ROC) analysis. The area under the curve was larger for SAD than LAD in all groups. The optimal cut-off values of SAD were determined as follows: overall, 9 mm; differentiated type, 9 mm; undifferentiated type, 8 mm; lesser curvature region, 7 mm; greater curvature region, 6 mm; and suprapancreatic region, 9 mm. The diagnostic accuracies for lymph node metastasis using individual cut-off values were 71.1 % based on histological type and 76.6 % based on region of lymph node location. The diagnostic accuracy of lymph node metastasis in gastric cancer was improved by using individual cut-off values for each lymph node region. (orig.)

  18. Axillary lymph node metastases in breast cancer: preoperative detection with dynamic contrast-enhanced MRI

    Metastatic involvement of axillary lymph nodes is one of the most important prognostic variables in breast cancer. The aim of our work was to study the value of dynamic contrast-enhanced MR imaging in revealing axillary lymph node metastases from breast cancer. A total of 65 patients with invasive breast cancer treated with axillary lymph node dissection were preoperatively evaluated by MRI. T1-weighted dynamic contrast-enhanced 3D images were acquired using a coil covering the breast and the axilla. The dynamic contrast enhancement, size, and morphology of the axillary lymph nodes were registered. Histopathological examination revealed axillary lymph node metastases in 24 patients. When using a signal intensity increase in the lymph nodes of > 100 % during the first postcontrast image as a threshold for malignancy, 57 of 65 patients were correctly classified (sensitivity 83 %, specificity 90 %, accuracy 88 %). These results were not improved when lymph node size and morphology were used as additional criteria. Axillary lymph nodes can be evaluated as a part of an MR-mammography study without substantial increase in examination time, and provide the surgeon with knowledge about the localization of possible metastatic lymph nodes. (orig.)

  19. Accuracy of multidetector-row CT in diagnosing lymph node metastasis in patients with gastric cancer

    Saito, Takuro; Kurokawa, Yukinori; Takiguchi, Shuji; Miyazaki, Yasuhiro; Takahashi, Tsuyoshi; Yamasaki, Makoto; Miyata, Hiroshi; Nakajima, Kiyokazu; Mori, Masaki; Doki, Yuichiro [Osaka University, Graduate School of Medicine, Department of Gastroenterological Surgery, Suita, Osaka (Japan)

    2014-08-06

    The purpose of this study was to determine the optimal cut-off value of lymph node size for diagnosing metastasis in gastric cancer with multidetector-row computed tomography (MDCT) after categorizing perigastric lymph nodes into three regions. The study included 90 gastric cancer patients who underwent gastrectomy. The long-axis diameter (LAD) and short-axis diameter (SAD) of all visualized lymph nodes were measured with transverse MDCT images. The locations of lymph nodes were categorized into three regions: lesser curvature, greater curvature, and suprapancreatic. The diagnostic value of lymph node metastasis was assessed with receiver operating characteristic (ROC) analysis. The area under the curve was larger for SAD than LAD in all groups. The optimal cut-off values of SAD were determined as follows: overall, 9 mm; differentiated type, 9 mm; undifferentiated type, 8 mm; lesser curvature region, 7 mm; greater curvature region, 6 mm; and suprapancreatic region, 9 mm. The diagnostic accuracies for lymph node metastasis using individual cut-off values were 71.1 % based on histological type and 76.6 % based on region of lymph node location. The diagnostic accuracy of lymph node metastasis in gastric cancer was improved by using individual cut-off values for each lymph node region. (orig.)

  20. Pulmonary sclerosing hemangioma with lymph node metastasis: A case report and literature review.

    Adachi, Yasushi; Tsuta, Koji; Hirano, Ryuji; Tanaka, Jin; Minamino, Keizo; Shimo, Tomohiko; Ikehara, Susumu

    2014-04-01

    Pulmonary sclerosing hemangioma (SH) is an uncommon benign or low-grade malignant tumor. Multicentric SH and SH with lymph node metastasis have rarely been reported. The present report describes a case of pulmonary SH with lymph node metastasis in a middle-aged female. A nodule was found incidentally in the lower left lung. The patient underwent left lower pulmonary lobectomy and lymph node dissection. Histologically, the nodule demonstrated the characteristic features of SH and one of the resected lymph nodes contained a metastasis of this tumor. Thus, pulmonary SH has the potential to metastasize, a potential not suggested by histological features. PMID:24944657

  1. Contribution of minute axillary lymph nodes to accurate staging for patients with breast cancer

    JIANG Jun; HE Qing-qing; YANG Xin-hua; LIANG Yan; FAN Lin-jun; ZHANG Yi; GUO Mei-qin

    2007-01-01

    Background Axillary lymph node metastasis is a very important metastatic pathway in breast cancer and its accurate detection is important for staging tumour and guiding therapy. However, neither the accuracy of routine detection of lymph node in surgical specimens nor the significance of minute lymph node with metastases in breast cancer is clear. A modified method for conveniently detecting minute lymph node in specimens of axillary dissections in patients with breast cancer was used to analyze their influence on staging breast cancer.Methods Lymph nodes in fresh, unfixed, specimens of axillary dissections from 127 cases of breast cancer were detected routinely. Then the axillary fatty tissues were cut into 1 cm thick pieces, soaked in Carnoy's solution for 6 to 12 hours, taken out and put on a glass plate. Minute lymph nodes were detected by light of bottom lamp and examined by routine pathology.Results Lymph nodes (n= 2483, 19.6±8.0 per case) were found by routine method. A further 879 lymph nodes up to 6 mm (781 < 3 mm, 6.9±5.3 per case, increasing mean to 26.5±9.7) were found from the axillary tissues after soaking in Carnoy's solution. By detection of minute lymph nodes, the stages of lymph node metastasis in 7 cases were changed from pathological node (pN) stage pN0 to pN1 in 4 cases, from pN1 to pN2 in 2 and from pN2 to pN3 in 1.Conclusions The accurate staging of axillary lymph node metastasis can be obtained routinely with number of axillary lymph nodes in most cases of breast cancer. To avoid neglecting minute lymph nodes with metastases, small axillary nodes should be searched carefully in the cases of earlier breast cancer with no swollen axillary nodes. Treatment with Carnoy's solution can expediently detect minute axillary nodes and improve the accurate staging of lymph nodes in breast cancer.

  2. Sites of lymph follicle formation in the draining popliteal lymph nodes of mice locally injected with antigenic and mitogenic substances

    Hee Kyung Ahnl; Hajime Hoshi; Kaeko Horie; Hidetsugu Nagata

    1990-01-01

    Our previous studies showed that some antigenic and mitogenic substances, when locally injected into mice, efficiently produced new lymph follicles outside pre-exisiting follicles in draining lymph nodes, whereas others had virtually no effect. In the present experiments, young adult male mice were injected with several antigens and mitogens in the rear footpad, and the number and development sites of newly produced lymph follicles in the draining popliteal nod...

  3. CT guided radioactive seed 125I implantation in treating hilar hepatic tumor and metastatic lymph nodes

    Objective: To investigate the clinical value of CT guided radioactive seed 125I implantation in treating hilar hepatic tumor and metastatic lymph nodes. Methods: 32 patients with pancreatic cancer accepted CT guided radioactive seeds 125I implantation were enrolled in this study. The average tumor dimension was 4.2 cm. In this series, there were 8 cases of hepatocellular carcinoma, 12 cases of hilar cholangio carcinoma, 6 cases of hepatic metastasis and 6 of hepatic hilar tumor and metastatic lymph nodes. Among these patients, 14 cases had cholangiectasis and 22 cases had cirrhosis. Under CT guidance, 125I seeds of 0.6-0.9 mCi were implanted into the pancreatic cancer at a distance of 1.0-1.5 cm according to TPS. Results: Two cases died on account of metastasis and three died through liver function failure. Among CT followed-up of 32 patients in 2 months, 2 obtained CR, 20 obtained PR, 5 NC and 5 PD. The responsive rate was 68.8%. The side effects occurred during the procedure including pneumothorax in 1 case with lung compression less than 30%; 7 seeds migration in liver and 3 seeds in lung. WBC decreased slightly in 1 cases during 2 months follow up. No massive bleeding, biliary fistula, intestinal fistula, intestinal hemorrhage, acute pancreatitis, enterorrhagia and intra-abdominal abscess were encountered. Conclusions: CT guided radioactive seed 125I implantation procedure is a safe and effective method in treating hilar hepatic tumor and metastatic lymph nodes with good clinical effects of minimal damage and few complications. (authors)

  4. Relationship between lymph node sinuses with blood and lymphatic metastasis of gastric cancer

    Tong Yin; Xiao-Long Ji; Min-Shi Shen

    2003-01-01

    AIM: To elucidate the relationship between lymph nodesinuses with blood and lymphatic metastasis of gastric cancer.METHODS: Routine autopsy was carried out in the randomlyselected 102 patients (among them 100 patients died ofvarious diseases, and 2 patients died of non-diseasedreasons), their superficial lymph nodes locating in bilateralnecks (include supraclavicle), axilla, inguina, thorax, andabdomen were sampled. Haematoxylin-Eosin staining wasperformed on 10 % formalin-fixed and paraffin-embeddedlymph node tissue sections (Sum). The histological pattemsof the lymph sinuses containing blood were observed underlight microscope. The expression of CD31, a marker forendothelial cell, was detected both in blood and non-bloodcontaining lymph node sinuses with the method ofimmunohistochemistry.RESULTS: Among the 1322 lymph nodes sampled fromthe autopsies of 100 diseased cases, lymph node sinusescontaining blood were found in 809 lymph nodes sampledfrom 91 cases, but couldn't be seen in the lymph nodessampled from the non-diseased cases. According to histology,we divided the blood containing lymph node sinuses intofive categories: vascular-opening sinus, blood-deficient sinus,erythrophago-sinus, blood-abundant sinus, vascular-formative sinus. Immunohistochemical findings showed thatthe expression of CD31 was strongly positive in vascular-formative sinuses and some vascular-opening sinuses whileit was faint in blood-deficient sinuses, erythrophago-sinusesand some vascular-opening sinuses. It was almost negativein blood-abundant sinus and non-blood containing sinus.CONCLUSION: In the state of disease, the phenomenonof blood present in the lymph sinus is not uncommon. Bloodcould possibly enter into the lymph sinuses through thelymphaticovenous communications between the veins andthe sinuses in the node. Lymph circulation and the bloodcirculation could communicate with each other in the lymphnode sinuses. The skipping and distal lymphatic metastasisof gastric cancer may

  5. Nanoparticles in Sentinel Lymph Node Assessment in Breast Cancer

    Michael Douek

    2010-11-01

    Full Text Available The modern management of the axilla in breast cancer relies on surgery for accurate staging of disease and identifying those patients at risk who would benefit from adjuvant chemotherapy. The introduction of sentinel lymph node biopsy has revolutionized axillary surgery, but still involves a surgical procedure with associated morbidity in many patients with no axillary involvement. Nanotechnology encompasses a broad spectrum of scientific specialities, of which nanomedicine is one. The potential use of dual-purpose nanoprobes could enable imaging the axilla simultaneous identification and treatment of metastatic disease. Whilst most applications of nanomedicine are still largely in the laboratory phase, some potential applications are currently undergoing clinical evaluation for translation from the bench to the bedside. This is an exciting new area of research where scientific research may become a reality.

  6. Inflammation and Tumor Microenvironment in Lymph Node Metastasis

    In nearly all human cancers, the presence of lymph node (LN) metastasis increases clinical staging and portends worse prognosis (compared to patients without LN metastasis). Herein, principally reviewing experimental and clinical data related to malignant melanoma, we discuss diverse factors that are mechanistically involved in LN metastasis. We highlight recent data that link tumor microenvironment, including inflammation (at the cellular and cytokine levels) and tumor-induced lymphangiogenesis, with nodal metastasis. Many of the newly identified genes that appear to influence LN metastasis facilitate general motility, chemotactic, or invasive properties that also increase the ability of cancer cells to disseminate and survive at distant organ sites. These new biomarkers will help predict clinical outcome and point to novel future therapies in metastatic melanoma as well as other cancers

  7. CT lymphography-guided sentinel lymph node biopsy

    Authors summarized their feasibility studies for clinical significance of CT lymphography-guided sentinel lymph node (SLN) mapping and biopsy in the breast, lung and esophageal cancers, with use of a recently developed water-soluble contrast medium, iopamidol. Subjects with breast cancers were 68 patients of the mean age 58 years old with the mean tumor size 21 mm. Local anesthesia was done by intradermal and subcutaneous injections of lidocaine, iopamidol was injected around the tumor, and 3D-CT was then conducted 20-30 sec later with the 4-row multidetector CT equipment, Siemens Somatom Volume Zoom. The CT was completed within 10-15 min with exposure doses of 14-18 mGy. Biopsy was then performed according to the 3D-CT map. Subjects with early stage lung and esophageal cancers were each 9 patients (mean ages 63 and 66 y) with the mean tumor size 21 mm and operable one, respectively. 3D-CT and biopsy were conducted essentially similarly to above. Shortly after injection of the contrast medium, all pathways of lymph ducts from the tumor to SLN were imaged, based on whose map biopsy was possible. This procedure can be practically useful for identification and biopsy of SLN in those cancers. (T.I.)

  8. Current status of methodology research on nuclear medicine on sentinel lymph node biopsy in breast cancer

    Breast cancer is the most common malignancy of the female,and axillary lymph node dissection has been considered as the basic method in breast cancer surgery. Sentinel lymph node biopsy (SLNB) in recent years is accepted gradually both at home and abroad because it not only can avoid complications but also has the advantages of safe and simple operation, high accuracy, and slight trauma. It has taken the place of axillary lymph node dissection in the treatment of axillary node-negative patients. Nuclear medicine inspection has played a crucial role in SLNB, and radiotracers, injecting techniques,detecting methods and standards have great influence upon the accuracy and false-negative rate of axillary lymph nodes and internal mammary lymph nodes detection. In this review, the current methodology status of nuclear medicine is summarized on SLNB in breast cancer at home and abroad. (authors)

  9. Factors related to lymph node metastasis and surgical strategy used to treat early gastric carcinoma

    Kim, Dong Yi; Joo, Jae Kyoon; Ryu, Seong Yeob; Kim, Young Jin; Kim, Shin Kon

    2004-01-01

    AIM: The prognosis of early gastric carcinoma (EGC) is generally excellent after surgery. The presence or absence of lymph node metastasis in EGC is an important prognostic factor. The survival and recurrence rates of node-negative EGC are much better than those of node-positive EGC. This study examined the factors related to lymph node metastasis in EGC to determine the appropriate treatment for EGC.

  10. TOPOGRAPHIC CHARACTERISTICS OF THE LYMPH NODES OF THE DROMEDARY (Camelus dromedarius)

    P GAVRYLIN; D.E. Rahmoun; M LIESHCHOVA

    2016-01-01

    The architecture of the lymph node dromedary (Camelus dromedarius) differs from that shown in the conventional patterns of other mammalian animals, generally formed of a plurality of aggregates, the latter are surrounded by a connective tissue which extends over the whole area surface lymph node and each cluster is a node itself. Vascular distribution in these lymphoid aggregates is relatively abundant and each node receives one or two afferent lymphatic’s and is drained by four or five effer...

  11. Multi-detector row CT in the assessment of axillary lymph node metastasis in breast cancer

    The purpose of this study is to evaluate the diagnostic capability instead of clinical efficacy of multi-detector row CT (MDCT) in the assessment of axillary lymph node metastasis in breast cancer. MDCT was performed in 63 patients with breast cancer, and multiplanar reformation (MPR) and volume rendering (VR) images were reconstructed for the evaluation of bilateral axillary lymph nodes. Two hundred sixty eight lymph nodes were depicted with MDCT, and correlation with pathological findings was performed. The short axis length of lymph node was measured on MPR image, and the shape of the nodes was analyzed with the pathological results statistically. The diagnostic criteria on size and shape of lymph node metastasis were discussed Dynamic study with contrast media was also performed, and the CT value ratios (CTVR) of the lymph nodes and breast tumors were calculated. No relevance of axillary lymph node metastasis was noted to the pathological types of breast cancer. The average short axis length of the ipsilateral axillary nodes was 8.9 mm±3.8 (SD) while that of the contralateral nodes was 4.9 mm±1.1 (SD) showing significant difference. More than 6.5 mm in short length of the lymph node was thought to be an effective criterion for positive metastasis, and its sensitivity was 96%. Soybean-shape lymph node was statistically common in metastasis, while non-metastatic nodes were commonly demonstrated as letter ''c'' shape or ring-like shape. Statistical relevance was obtained between the CTVR of axillary lymph nodes and that of breast tumors, suggesting clinical usefulness of dynamic study using contrast media in the evaluation of lymph node metastasis. With MPR and VR images using MDCT, more accurate morphological evaluation of axillary lymph nodes was possible. When soybean-shape node with more than 6.5 mm in short axis is depicted in the axillar region on MDCT metastasis should be the consideration. Comparison with the contralateral side as a control in coronal

  12. The features of the human mesenteric lymph node histogenesis in the first half of the prenatal period of ontogenesis

    Dub, M. I.; Alieva, E. G.

    2013-01-01

    In recent years the important meanings are given to the role of mesenteric lymph node as a peripheral immune organ in the formation of local and general immune reactions. Features of the mesenteric lymph nodes morphogenesis are not well understood due to the different functions of these organs [1, 2]. There is still no consensus on the initial stages of the mesenteric lymph nodes. Many authors attribute the histogenesis of lymph nodes with the development of the mesenteric lymph vessels [3, 8...

  13. Lymphangiogenesis in Regional Lymph Nodes Is an Independent Prognostic Marker in Rectal Cancer Patients after Neoadjuvant Treatment

    Jakob, Christiane; Aust, Daniela E; Liebscher, Birgit; Baretton, Gustavo B.; Datta, Kaustubh; Muders, Michael H.

    2011-01-01

    One of the major prognostic factors in rectal cancer is lymph node metastasis. The formation of lymph node metastases is dependent on the existence of a premetastatic niche. An important factor preceding metastasis are lymph vessels which are located in the lymph node. Accordingly, the occurrence of intranodal lymphangiogenesis is thought to indicate distant metastasis and worse prognosis. To evaluate the significance of lymph node lymphangiogenesis, we studied formalin fixed, paraffin embedd...

  14. Magnetic Resonance Lymphography–Guided Selective High-Dose Lymph Node Irradiation in Prostate Cancer

    Purpose: To demonstrate the feasibility of magnetic resonance lymphography (MRL) –guided delineation of a boost volume and an elective target volume for pelvic lymph node irradiation in patients with prostate cancer. The feasibility of irradiating these volumes with a high-dose boost to the MRL-positive lymph nodes in conjunction with irradiation of the prostate using intensity-modulated radiotherapy (IMRT) was also investigated. Methods and Materials: In 4 prostate cancer patients with a high risk of lymph node involvement but no enlarged lymph nodes on CT and/or MRI, MRL detected pathological lymph nodes in the pelvis. These lymph nodes were identified and delineated on a radiotherapy planning CT to create a boost volume. Based on the location of the MRL-positive lymph nodes, the standard elective pelvic target volume was individualized. An IMRT plan with a simultaneous integrated boost (SIB) was created with dose prescriptions of 42 Gy to the pelvic target volume, a boost to 60 Gy to the MRL-positive lymph nodes, and 72 Gy to the prostate. Results: All MRL-positive lymph nodes could be identified on the planning CT. This information could be used to delineate a boost volume and to individualize the pelvic target volume for elective irradiation. IMRT planning delivered highly acceptable radiotherapy plans with regard to the prescribed dose levels and the dose to the organs at risk (OARs). Conclusion: MRL can be used to select patients with limited lymph node involvement for pelvic radiotherapy. MRL-guided delineation of a boost volume and an elective pelvic target volume for selective high-dose lymph node irradiation with IMRT is feasible. Whether this approach will result in improved outcome for these patients needs to be investigated in further clinical studies.

  15. Staging of early lymph node metastases with the sentinel lymph node technique and predictive factors in T1/T2 oral cavity cancer

    Pedersen, Nicklas Juel; Jensen, David Hebbelstrup; Hedbäck, Nora; Frendø, Martin; Kiss, Katalin; Lelkaitis, Giedrius; Mortensen, Jann; Christensen, Anders; Specht, Lena; von Buchwald, Christian

    BACKGROUND: The purpose of this study was to examine the diagnostic accuracy of detecting lymph node metastases and to identify predictive and prognostic clinicopathological factors in patients with oral squamous cell carcinoma (OSCC) undergoing sentinel lymph node biopsy (SLNB). METHODS: All...... factors for the presence of metastases. CONCLUSION: These data support the use of the SLNB technique as an accurate and safe staging tool in patients with OSCC with a cN0 neck. © 2015 Wiley Periodicals, Inc. Head Neck, 2015....

  16. Ultrasound of neck lymph nodes: How to do it and how do they look?

    Cervical lymphadenopathy is commonly caused by metastases, lymphoma, tuberculosis and reactive hyperplasia. Before making an accurate diagnosis of pathologic lymph nodes, a clear understanding of the normal appearances of cervical nodes is crucial. Ultrasound examination of cervical lymph nodes is common in routine clinical practice because of its high sensitivity and specificity when combined with ultrasound-guided fine-needle aspiration cytology (FNAC). This article reviews the ultrasound of cervical lymph nodes including classification of the nodes, equipment, scanning technique and sonographic appearances of normal and common abnormal lymph nodes. The sonographic appearance of unusual cervical lymphadenopathy and the value of three-dimensional ultrasound in the volumetric measurements of cervical nodes are also discussed

  17. Ultrasound of neck lymph nodes: How to do it and how do they look?

    Ying, Michael [Department of Optometry and Radiography, Hong Kong Polytechnic University, Hung Hom, Kowloon, Hong Kong (China); Ahuja, Anil T. [Department of Diagnostic Radiology and Organ Imaging, Chinese University of Hong Kong, Prince of Wales Hospital, Shatin New Territories, Hong Kong (China)]. E-mail: aniltahuja@cuhk.edu.hk

    2006-05-15

    Cervical lymphadenopathy is commonly caused by metastases, lymphoma, tuberculosis and reactive hyperplasia. Before making an accurate diagnosis of pathologic lymph nodes, a clear understanding of the normal appearances of cervical nodes is crucial. Ultrasound examination of cervical lymph nodes is common in routine clinical practice because of its high sensitivity and specificity when combined with ultrasound-guided fine-needle aspiration cytology (FNAC). This article reviews the ultrasound of cervical lymph nodes including classification of the nodes, equipment, scanning technique and sonographic appearances of normal and common abnormal lymph nodes. The sonographic appearance of unusual cervical lymphadenopathy and the value of three-dimensional ultrasound in the volumetric measurements of cervical nodes are also discussed.

  18. Radiation therapy and surgery in the treatment of regional lymph nodes in squamous cell carcinoma of the vulva

    A series of 244 patients with vulvar squamous cell carcinomas was analyzed with regard to treatment of the regional lymph nodes. In 144 patients, groin dissection was performed, supplemented in 24 cases by pelvic lymphadenectomy. Preoperative irradiation was given and in cases with positive nodes postoperative irradiation as well. Patients in whom lymph node dissection was not performed received irradiation. Treatment failures in the regional lymph node regions were analyzed and the policy concerning treatment of the regional lymph nodes is discussed. (orig.)

  19. Radiation therapy and surgery in the treatment of regional lymph nodes in squamous cell carcinoma of the vulva

    Simonsen, E.; Nordberg, U.B.; Johnsson, J.E.; Lamm, I.L.; Trope, C.

    1984-01-01

    A series of 244 patients with vulvar squamous cell carcinomas was analyzed with regard to treatment of the regional lymph nodes. In 144 patients, groin dissection was performed, supplemented in 24 cases by pelvic lymphadenectomy. Preoperative irradiation was given and in cases with positive nodes postoperative irradiation as well. Patients in whom lymph node dissection was not performed received irradiation. Treatment failures in the regional lymph node regions were analyzed and the policy concerning treatment of the regional lymph nodes is discussed. (orig.).

  20. Computerized tomography, lymphangiography, and ultrasound in the diagnosis of lymph node enlargement

    Computerized tomography, ultrasound, and lymphangiography have been compared in 26 cases. Lymphangiography alone is insufficient but still required for the pelvis. It can show filling defects in relatively normally sized glands that are not shown on CT when glands contain no contrast. Further, after lymphangiography has been performed, follow-up of treatment can be rapidly assessed with a plain abdominal film. Ultrasound can demonstrate substantial para-aortic and mesenteric glandular masses that are not detected by lymphangiography. It can be used for follow-up and for confirming CT findings. However, in 20% of the cases, bowel gas restricts its use. CT shows the para-aortic and mesenteric regions most clearly and most completely. It can detect small pathalogic lymph nodes that are not detected by lymphangiography or ultrasound. (orig.) 891 MG/orig. 892 MB

  1. Differentiation of Metastatic and Non-Metastatic Mesenteric Lymph Nodes by Strain Elastography in Surgical Specimens

    Havre, R F; Leh, S M; Gilja, O H;

    2016-01-01

    Purpose: To investigate if strain elastography could differentiate between metastatic and non-metastatic mesenteric lymph nodes ex-vivo. Materials and Methods: 90 mesenteric lymph nodes were examined shortly after resection from 25 patients including 17 patients with colorectal cancer and 8 patie...

  2. Noninvasive detection of clinically occult lymph-node metastases in prostate cancer.

    Harisinghani, M.G.; Barentsz, J.O.; Hahn, P.F.; Deserno, W.M.L.L.G.; Tabatabaei, S.; Hulsbergen-van de Kaa, C.A.; Rosette, J.J.M.H.C. de la; Weissleder, R.

    2003-01-01

    BACKGROUND: Accurate detection of lymph-node metastases in prostate cancer is an essential component of the approach to treatment. We investigated whether highly lymphotropic superparamagnetic nanoparticles, which gain access to lymph nodes by means of interstitial-lymphatic fluid transport, could b

  3. Feasibility of 13th lymph nodes as sentinels for periampullary carcinoma

    白晓枫

    2013-01-01

    Objective To study the feasibility and clinical value of 13th lymph nodes in predicting general lymph nodes metastases for periampullary carcinoma.Methods A total of 77 patients with pathologically confirmed periampullary carcinoma were recruited.And 26 (18 males and 8

  4. Ultrasonography of the supramammary lymph nodes for diagnosis of bovine chronic subclinical mastitis.

    Khoramian, B; Vajhi, A; Ghasemzadeh-Nava, H; Ahrari-Khafi, M S; Bahonar, A

    2015-01-01

    Currently, somatic cell count (SCC) and bacterial culture are considered as the gold standard of detecting subclinical Mastitis. Mastitis leads to proliferation of lymphocytes in the supramammary lymph nodes and subsequent enlargement of ipsilateral lymph node. Ultrasonography can be used to survey these changes. A portable ultrasound machine with a 2-5 MHz convex transducer was used to identify the supramammary lymph node size in 35 cows in a herd with chronic Staphylococcus aureus mastitis. After pre-milking udder preparation, a California mastitis test (CMT) was performed and individual milk samples were taken from each quarter for bacterial culture and somatic cell count (SCC) in accordance with NMC recommendations. The mean length (range 5.77-12.90 cm) and width (range 2.07-7.41 cm) of the lymph node were 9.2 and 4.03 cm, respectively. There was a positive correlation between lymph node size (length and depth) and culture of milk samples on ipsilateral quarters. Also, there was a significant difference correlation between CMT or mean log SCC of each side and size of supramammary lymph node in the same side. This study showed significant changes in supramammary lymph node dimensions in mastitis cases, so ultrasonography of this lymph node is probably a useful method for mastitis detection, especially in situations that test on milk is impossible. PMID:27175155

  5. Adjuvant radiotherapy after salvage lymph node dissection because of nodal relapse of prostate cancer versus salvage lymph node dissection only

    Nodal pelvic/retroperitoneal recurrent prostate cancer (PCa) after primary therapy can be treated with salvage lymph node dissection (salvage-LND) in order to delay disease progression and offer cure for a subset of patients. Whether adjuvant radiotherapy (ART) in affected regions improves the outcome by elimination of residual tumour burden remains unclear. A total of 93 patients with exclusively nodal PCa relapse underwent choline-positron-emission tomography-computed-tomography-directed pelvic/retroperitoneal salvage-LND; 46 patients had surgery only and 47 patients received ART in regions with proven lymph node metastases. In case of subsequent prostate specific antigen (PSA) progression, different imaging modalities were performed to confirm next relapse within or outside the treated region (TR). Mean follow-up was 3.2 years. Lymphatic tumour burden was balanced between the two groups. Additional ART resulted in delayed relapse within TR (5-year relapse-free rate 70.7 %) versus surgery only (5-year relapse-free rate 26.3 %, p < 0.0001). In both treatment arms, time to next relapse outside the TR was almost equal (median 27 months versus 29.6 months, p = 0.359). With respect to the detection of the first new lesion, regardless if present within or outside the TR, 5 years after the treatment 34.3 % of patients in the group with additional ART were free of relapse, versus 15.4 % in the surgery only group (p = 0.0122). ART had no influence on the extent of PSA reduction at latest follow-up compared to treatment with surgery only. ART after salvage-LND provides stable local control in TR and results in overall significant improved next-relapse-free survival, compared to patients who received surgery only in case of nodal PCa-relapse. (orig.)

  6. Prognostic value of retropharyngeal lymph nodes in nasopharyngeal carcinoma treated by intensity modulated radiotherapy (IMRT)

    Objective: To investigate the correlation of the the positive rate and necrosis rate of retropharyngeal lymph nodes with the clinical effects of intensity modulated radiotherapy (IMRT) in treatment of nasopharyngeal carcinoma (PNC). Methods: Seventy-two patients with PNC, 50 males and 22 females,with the median age of 50, underwent IMRT delivered into 33 times. The retropharyngeal lymph nodes involved and positive lymph nodes of neck were delineated on the CT image. The median dose and median fractionated dose for gross tumor volume (GTV) were 70.0 and 2.12 Gy respectively, and the median dose and median fractionated dose for clinical target volume (CTV) were 70.0 and 2.12 Gy respectively. The patients were followed up for 36 (5-54) months. Results: The metastasis rate of the neck lymph nodes was 90.3%, the metastasis rates in the regions Ⅰ-Ⅴ were 2.8%, 86.0%, 51.4%, 20.8%, and 37.5%, respectively. The metastasis rate of the retropharyngeal lymph nodes was 79.2%, and specifically the metastasis rates of the left, right, and bilateral retropharyngeal lymph nodes were 51.4%, 45.9%, and 18.1%, respectively. The cross metastasis rate was 6.9%. Necrosis of the retropharyngeal lymph nodes was found in 15 cases. The necrosis rates of the left, right, and bilateral retropharyngeal lymph nodes were 21.6%, 27.2%, 15.4%, respectively. Retropharyngeal lymph nodes metastasis was significantly correlated with N stage and clinical stage (Fuzhou 92:r =-0.383, -0.314, P<0.05; UICC:r =-0.434, -0.306, P<0.05). Local recurrence was observed in 4 patients,6 patients had distant metastasis, and 7 patients died. The positiveness of retropharyngeal lymph nodes was significantly correlated with the recurrence rate, distant metastasis rate,survival rate,and disease free survival rate (r = 0.085, 0.138, -0.140, -0.124, P<0.05), and the necrosis of the retropharyngeal lymph nodes was significantly correlated with the recurrence rate and distant metastasis rate (r = 0.256, -0.057, P<0

  7. Lymphatic spread of mesenchymal renal tumor to metastatic parathymic lymph nodes in rat

    Rozsa, David; Trencsenyi, Gyorgy; Kertai, Pal; Marian, Terez; Nagy, Gabor; Banfalvi, Gaspar

    2009-01-01

    Rat mesenchymal renal tumor cells (NeDe) transplanted under the kidney capsule of F344 rats resulted in metastases in the parathymic lymph nodes. Tumor cells were isolated from these tumor-bearing lymph nodes and 106 cells were implanted under the kidney capsule. Tumor growth after this implantation could be traced within six days. India ink was implanted to prove that there is a connection between the lymphatic vessels of the kidney capsule and the parathymic lymph ...

  8. Factors influencing sentinel lymph node identification failure in breast cancer surgery

    Straalman, K.; Kristoffersen, U.S.; Galatius, H.;

    2008-01-01

    The purpose of this study was to investigate potential risk factors for failed sentinel lymph node identification in breast cancer surgery. Patient characteristics, tumour characteristics, surgeon experience and detection success/failure were registered at 748 sentinel lymph node biopsy procedures...... at our inpatient clinic. Data were analysed with backward stepwise multiple logistic regression with a cut-off point of p<0.05. We found that increased age, increased BMI, medial tumour location and less surgeon experience independently were associated with a lower sentinel lymph node detection rate....... Tumour size, palpability and biopsy method were not significantly associated with the sentinel lymph node detection rate. In conclusion, it is possible to identify patients with a higher risk of sentinel lymph node identification failure and we recommend that these patients are operated by experienced...

  9. CXCR4 and Axillary Lymph Nodes: Review of a Potential Bio marker for Breast Cancer Metastasis

    CXCR4 is a 7-transmembrane G-protein chemokine receptor that allows for migration of hematopoietic cells from the bone marrow to the peripheral lymph nodes. Research has shown CXCR4 to be implicated in the invasion and metastasis of several cancers, including carcinoma of the breast. CXCL12 is the ligand for CXCR4 and is highly expressed in areas common for breast cancer metastasis, including the axillary lymph nodes. Axillary lymph nodes positive for breast carcinoma have been an important component of breast cancer diagnosis, treatment, and subsequent research. The goal of this paper is to analyze the literature that has explained the pathways from CXCR4 expression to breast cancer metastasis of the lymph nodes and the prognostic and/or predictive implications of lymph node metastases in the presence of elevated CXCR4

  10. CXCR4 and Axillary Lymph Nodes: Review of a Potential Biomarker for Breast Cancer Metastasis

    David Hiller

    2011-01-01

    Full Text Available CXCR4 is a 7-transmembrane G-protein chemokine receptor that allows for migration of hematopoietic cells from the bone marrow to the peripheral lymph nodes. Research has shown CXCR4 to be implicated in the invasion and metastasis of several cancers, including carcinoma of the breast. CXCL12 is the ligand for CXCR4 and is highly expressed in areas common for breast cancer metastasis, including the axillary lymph nodes. Axillary lymph nodes positive for breast carcinoma have been an important component of breast cancer diagnosis, treatment, and subsequent research. The goal of this paper is to analyze the literature that has explained the pathways from CXCR4 expression to breast cancer metastasis of the lymph nodes and the prognostic and/or predictive implications of lymph node metastases in the presence of elevated CXCR4.

  11. Effects of incision and irradiation on regional lymph node metastasis in carcinoma of the hamster tongue

    The effects of incision and irradiation on regional lymph node metastasis in DMBA-induced squamous cell carcinomas of the hamster tongue are reported. Metastasis to the submandibular lymph nodes was confirmed histologically in 48.0% of the animals. The incidence of lymph node metastasis was significantly increased (65.9%) after repeated incisions of tongue carcinomas. Three gray whole-body irradiation also increased the rate of metastasis from 31.0% to 46.3%. Higher incidences of lymphatic vessel invasion after incision and concomitant lymph node metastasis in the lymphatic invasion-positive group indicated a stepwise relationship leading to an increase in lymph node metastasis after incision. Because of the high incidence of metastases and close resemblance to human carcinomas in the tumor cell deposition and establishment of metastatic foci, DMBA-induced tongue carcinoma with invasion may serve as an experimental model of human oral carcinomas

  12. Comparative studies of diagnosis with US or CT of the cervical lymph node metastases in head and neck cancer

    Correct assessment of lymph node metastasis in the head-neck region is very important for management of head and neck cancer. 233 lymph nodes were removed by radical neck dissection from 12 cases with cancer in the head and neck region, who did not undergo any preoperative treatment, and the materials were histopathologically examined. The histopathological findings were compared with preoperative US and CT findings. Histopathologically, 26 lymph nodes were found positive for metastasis and the remaining 207 lymph nodes, negative. US detected 45 (19%) of 233 lymph nodes before operation, and 40 of the 45 lymph nodes (89%: 40/45) were qualitatively correctly diagnosed. CT detected 21 lymph nodes (19%), 16 of which were qualitatively correctly diagnosed (76%: 16/21). Of 26 lymph nodes which were histopathologically involved, 19 lymph nodes were correctly diagnosed by US and 11 by CT. Possible reasons explaining the superiority of US to CT in terms of diagnostic reliability are the following: US demonstrates more clearly the existence of lymph nodes than CT. US is more reliable for measuring sizes of lymph nodes than CT. In literature, CT has been often reported to be useful to diagnose cervical lymph node involvement in individual cases. However, we insist that it is necessary to diagnose individual lymph nodes strictly for correct assessment of the reliability of image diagnosis. (author)

  13. Sentinel lymph node biopsy in node-negative squamous cell carcinoma of the oral cavity and oropharynx.

    Burns, P

    2012-02-01

    OBJECTIVES: Considerable controversy exists regarding the merits of elective neck dissection in patients with early stage oral cavity and oropharyngeal squamous cell carcinoma. It is highly desirable to have a method of identifying those patients who would benefit from further treatment of the neck when they are clinically node-negative. The purpose of the present study was to examine the use of sentinel lymph node biopsy in identifying occult neck disease in a cohort of patients with node-negative oral cavity and oropharyngeal squamous cell carcinoma. DESIGN: We evaluated a total of 13 patients with oral cavity and oropharyngeal cancer who were clinically and radiologically node-negative. RESULTS: A sentinel lymph node was found in all 13 patients, revealing metastatic disease in five patients, four of whom had one or more positive sentinel lymph nodes. There was one false negative result, in which the sentinel lymph node was negative for tumour whereas histological examination of the neck dissection specimen showed occult disease. CONCLUSION: In view of these findings, we would recommend the use of sentinel lymph node biopsy in cases of oral cavity and oropharyngeal squamous cell carcinoma, in order to aid the differentiation of those patients whose necks are harbouring occult disease and who require further treatment.

  14. Diagnostic studies on the regional lymph node metastasis of oral squamous cell carcinoma

    To detect lymph nodes metastasis, clinical palpation, ultrasoundsonography (US) and 99mTc rhenium colloid lymphoscintigraphy (LSG) were carried out in forty-one cases of oral squamous cell carcinoma, and the results obtained from these examinations were compared to histopathological findings of the resected lymph nodes. All patients were classified according to TNM system, and only 56.9% of the lymph nodes diagnosed as metastasized by clinical palpation were confirmed histopathologically. As to the US findings, the involved lymph nodes showed heterogeneous or cyst-like hypoechogenisity. In LSG, the abnormal images detected by static imaging procedure were as follows: (1) absence, (2) enlargement, (3) blurred appearance, and (4) asymmetry of lymph node RI counts at the lymph node showing enlargement and absence with LSG were high and low, respectively. In relation to the histopathological findings, more than two thirds of the lymph nodes were occupied by tumor cells in the absent image, approximately half in the blurred image and less than one third with follicular hyperplasia in the enlarged image. The lymphatic flow, detected by dynamic imaging procedure, was disturbed and delayed on the tumor-bearing cervical side in most instances. The present results revealed that 85.7% of the involved lymph nodes were accurately estimated by using both US and LSG. So far as lymph node metastasis, US and LSG offered the different information so that a combination of US and LSG is thought to be useful for the detection of cervical lymph node metastasis in oral malignant tumors. (author) 65 refs

  15. Optimization of magnetic resonance sequences in lymph node staging of nasopharyngeal carcinoma

    CHEN Yun-bin; HU Chun-miao; PAN Jian-ji; MAO Yu; WEI Wei

    2010-01-01

    Background Detection rate of retropharyngeal lymph node metastasis in patients with nasopharyngeal carcinoma (NPC) needs to be improved. The purpose of this study was to compare three magnetic resonance (MR) sequences for detecting lymph nodes in patients with NPC.Methods Between July 2007 and March 2008, MR staging of pre-treated tumor was conducted on 120 patients with pathologically confirmed NPC. The outcome of three different sequences for MR NPC staging were compared: coronal short TI inversion recovery (STIR), axial proton density fat-suppressed (PDWl fs), and coronal contrast enhanced fast spin echo T1 weighted fat-suppressed (CE FSE T1WI fs). Nodal classification method (1999) was applied to count the number of retropharyngeal and cervical lymph nodes discovered by each MR sequence. Paired t tests were used for statistical analysis.Results A total of 2575 lymph nodes were found using coronal STIR sequence; 1816 lymph nodes for coronal CE FSE T1WI fs sequence and 2638 lymph nodes for axial PDWI fs sequence. Significant differences existed in the number of lymph nodes detected by axial PDWI fs and coronal CE FSE T1WI fs sequence (paired t test, P 0.05).Conclusions For the detection of retropharyngeal and cervical lymph nodes, coronal STIR sequence and axial PDWI fs sequence have similar performance and both sequences showed better detection than CE FSE T1WI fs sequence. Furthermore, by combining coronal STIR sequence and axial PDWI fs sequence, we can improve the detection of lymph nodes in NPC N-staging before treatment, especially for lymph nodes located in the thoracic entrance.

  16. Lymph node mapping in rabbit liver cancer with nanocarbon and methylene blue injecta

    Zhong Li

    2013-01-01

    Objective: To discuss the value of lymph node mapping in rabbit liver cancer with nanocarbon and methylene blue injecta. Methods: Rabbit liver cancer model was established by transplanting VX2 cells with laparotomy in celiac planting method. Twenty Japan white rabbits were divided into two groups randomly. Each group had 10 rabbits. Lymph node mapping in two groups rabbit liver cancer were observed. Two groups rabbit liver cancer and local lymph nodes were removed. The number and location of local lymph nodes were recorded, and then the samples were obtained from both groups. Results: The lymph nodes dyed time was (100.50±29.92) s in nanocarbon group, and (11.20±4.18) s in methylene blue group with statistical significance between two groups (P=0.000). In the comparison of lymph node fading time, nanocarbon group was (2.22±0.74) h, methylene blue group was (1.63±0.54) h, nanocarbon group was longer than the methylene blue group, but without statistical significance (P=0.058). The accuracy was 87.5%(35/40) in methylene blue group, while, the nanocarbon group was 87.2% (34/39) , with statistical significance (P=1.000). Conclusions: Experimental results show that application of nanocarbon injection and methylene blue injection during resection of liver cancer and local lymph nodes in rabbit liver cancer model has obvious tracer function in liver cancer and lymphatic drainage. It can reduce the complexity and risk of the operation, and avoid the blindness in the process of traditional lymph node dissection surgery. Besides, they can effectively reduce the number of residual lymph nodes after operation. It can achieve the lymph node dissection more thoroughly, promptly, easily and safely.

  17. Anatomical landmarks accurately determine interfractional lymph node shifts during radiotherapy of lung cancer patients

    Background and purpose: Low contrast in the cone-beam computed tomography (CBCT) scans hampers fast online evaluation of interfractional changes in the lymph node position on a daily basis. In this study we have investigated whether high-contrast anatomical landmarks in the vicinity of the nodes may be used as surrogates for the lymph node positions. Materials and methods: Forty lung cancer patients were treated with an online CBCT-based setup strategy involving soft-tissue match on the primary tumor. One hundred and sixteen lymph nodes were delineated separately on the planning-CT scans and categorized according to the lymph node stations. Five anatomical landmarks were selected as surrogate structures and assigned to the individual nodes. In addition, the carina was delineated. Registrations between the planning-CT and the daily CBCTs were performed retrospectively and positional deviations between the nodes and the surrogate structures or the carina were registered. Results: The mean displacement between lymph nodes and surrogate structures was 1.6 mm with systematic/random errors of 0.7/0.7 mm, significantly smaller than the mean displacement between nodes and the carina. Conclusions: The position of the lymph nodes can be evaluated using selected anatomical landmarks on a daily basis using CBCT

  18. Elastography in the assessment of sentinel lymph nodes prior to dissection

    Tourasse, Christophe, E-mail: christophe.tourasse@radiologie-lyon.com [Radiology Department, Hopital Prive Jean Mermoz, 55 avenue Jean Mermoz, 69008 Lyon (France); Denier, Jean Francois [Anatomopathology Department, Technipath, 41 allee des Cypres, 69760 Limonest (France); Awada, Azzam; Gratadour, Anne-Christel; Nessah-Bousquet, Karima [Gynaecological and Breast Surgery Department, Hopital Prive Jean Mermoz, 69008 Lyon (France); Gay, Joeel [SuperSonic Imagine, Les Jardins de la Duranne - Bat. F, 510, rue Rene Descartes, 13857 Aix-en-Provence Cedex (France)

    2012-11-15

    Objective: Breast cancer starts as a local tumor but can become metastatic and spread via the lymph nodes. When the pre-operative assessment of the axillary lymph nodes is negative patients generally undergo sentinel node biopsy (SNB), followed by a secondary surgical axillary lymph node dissection (ALND) if the SNB is positive. The extemporaneous anatomo-pathological analysis of the sentinel lymph node enables metastases to be detected and an ALND at the same time of the SNB. The goal of this study was to evaluate the added value of ShearWave Elastography (SWE), compared with the conventional pre-operative assessment, in the screening of sentinel lymph nodes with a high metastatic risk, which could then benefit from an extemporaneous anatomo-pathological analysis. Patients and methods: Women undergoing breast surgery with SNB were prospectively enrolled. Before surgery, they underwent ultrasound and elastography imaging of axillary lymph nodes using the SuperSonic Imagine device and its ShearWave Trade-Mark-Sign elastography mode (SWE Trade-Mark-Sign ). The results obtained were compared to the immunohistochemical results for the removed lymph nodes. Results: 65 patients were enrolled. From the 103 lymph nodes examined by elastography and the 185 lymph nodes removed we were able to pair 81; 70 were healthy and 11 were malignant. The stiffness measurements (mean and maximal values) were significantly different between the healthy and metastatic lymph nodes, (p < 0.05). The areas under the ROC curves were 0.76 (95% confidence interval (CI): 0.58-0.94) and 0.75 (95%CI: 0.55-0.95) for the mean and the maximal stiffness, respectively. Conclusion: These encouraging results show a correlation between the metastatic risk of lymph nodes and their increased mean stiffness. Elasticity variables and potential thresholds that seem to predict the metastatic status of axillary lymph nodes were identified. If confirmed by further larger studies, these results could be useful in

  19. Occult Pelvic Lymph Node Involvement in Bladder Cancer: Implications for Definitive Radiation

    Goldsmith, Benjamin; Baumann, Brian C.; He, Jiwei; Tucker, Kai; Bekelman, Justin; Deville, Curtiland; Vapiwala, Neha [Department of Radiation Oncology, Hospital of the University of Pennsylvania, Philadelphia, Pennsylvania (United States); Vaughn, David; Keefe, Stephen M. [Department of Medical Oncology, Hospital of the University of Pennsylvania, Philadelphia, Pennsylvania (United States); Guzzo, Thomas; Malkowicz, S. Bruce [Department of Urology, Hospital of the University of Pennsylvania, Philadelphia, Pennsylvania (United States); Christodouleas, John P., E-mail: christojo@uphs.upenn.edu [Department of Radiation Oncology, Hospital of the University of Pennsylvania, Philadelphia, Pennsylvania (United States)

    2014-03-01

    Purpose: To inform radiation treatment planning for clinically staged, node-negative bladder cancer patients by identifying clinical factors associated with the presence and location of occult pathologic pelvic lymph nodes. Methods and Materials: The records of patients with clinically staged T1-T4N0 urothelial carcinoma of the bladder undergoing radical cystectomy and pelvic lymphadenectomy at a single institution were reviewed. Logistic regression was used to evaluate associations between preoperative clinical variables and occult pathologic pelvic or common iliac lymph nodes. Percentages of patient with involved lymph node regions entirely encompassed within whole bladder (perivesicular nodal region), small pelvic (perivesicular, obturator, internal iliac, and external iliac nodal regions), and extended pelvic clinical target volume (CTV) (small pelvic CTV plus common iliac regions) were calculated. Results: Among 315 eligible patients, 81 (26%) were found to have involved pelvic lymph nodes at the time of surgery, with 38 (12%) having involved common iliac lymph nodes. Risk of occult pathologically involved lymph nodes did not vary with clinical T stage. On multivariate analysis, the presence of lymphovascular invasion (LVI) on preoperative biopsy was significantly associated with occult pelvic nodal involvement (odds ratio 3.740, 95% confidence interval 1.865-7.499, P<.001) and marginally associated with occult common iliac nodal involvement (odds ratio 2.307, 95% confidence interval 0.978-5.441, P=.056). The percentages of patients with involved lymph node regions entirely encompassed by whole bladder, small pelvic, and extended pelvic CTVs varied with clinical risk factors, ranging from 85.4%, 95.1%, and 100% in non-muscle-invasive patients to 44.7%, 71.1%, and 94.8% in patients with muscle-invasive disease and biopsy LVI. Conclusions: Occult pelvic lymph node rates are substantial for all clinical subgroups, especially patients with LVI on biopsy. Extended

  20. Occult Pelvic Lymph Node Involvement in Bladder Cancer: Implications for Definitive Radiation

    Purpose: To inform radiation treatment planning for clinically staged, node-negative bladder cancer patients by identifying clinical factors associated with the presence and location of occult pathologic pelvic lymph nodes. Methods and Materials: The records of patients with clinically staged T1-T4N0 urothelial carcinoma of the bladder undergoing radical cystectomy and pelvic lymphadenectomy at a single institution were reviewed. Logistic regression was used to evaluate associations between preoperative clinical variables and occult pathologic pelvic or common iliac lymph nodes. Percentages of patient with involved lymph node regions entirely encompassed within whole bladder (perivesicular nodal region), small pelvic (perivesicular, obturator, internal iliac, and external iliac nodal regions), and extended pelvic clinical target volume (CTV) (small pelvic CTV plus common iliac regions) were calculated. Results: Among 315 eligible patients, 81 (26%) were found to have involved pelvic lymph nodes at the time of surgery, with 38 (12%) having involved common iliac lymph nodes. Risk of occult pathologically involved lymph nodes did not vary with clinical T stage. On multivariate analysis, the presence of lymphovascular invasion (LVI) on preoperative biopsy was significantly associated with occult pelvic nodal involvement (odds ratio 3.740, 95% confidence interval 1.865-7.499, P<.001) and marginally associated with occult common iliac nodal involvement (odds ratio 2.307, 95% confidence interval 0.978-5.441, P=.056). The percentages of patients with involved lymph node regions entirely encompassed by whole bladder, small pelvic, and extended pelvic CTVs varied with clinical risk factors, ranging from 85.4%, 95.1%, and 100% in non-muscle-invasive patients to 44.7%, 71.1%, and 94.8% in patients with muscle-invasive disease and biopsy LVI. Conclusions: Occult pelvic lymph node rates are substantial for all clinical subgroups, especially patients with LVI on biopsy. Extended

  1. Sentinel Lymph Node Biopsy (SLNB) for Breast Cancer (BC) - Validation Protocol of the Technique

    Full text: The sentinel ganglion concept originates in the assumption according to which the primary tumor drains into a specific ganglionar area and then runs through the lymphatic nodes in an orderly, sequential mode. When neoplastic dissemination along the lymphatic pathway occurs, there is an initial invasion of a specific lymph node (rarely more than one) located on the drainage route. That firstly lymph node has been identified as the sentinel node, which mirrors the regional ganglionar status. In order to establish the indication for lymphadenectomy and avoid the situations in which such a surgical procedure would be of no use (N-), the only correct method consists in the identification and biopsy of the sentinel node. Radioactive tracing and/or use of vital staining enable the identification of the regional ganglionar group towards which the primary lesion is draining. The technique of sentinel lymph node identification and biopsy by means of radioactive tracing includes: - pre-surgical lymphoscintigraphy, - identification of the sentinel lymph node and its excisional biopsy, - intra-operative histopathological examination and immunohistochemical stains of the sentinel lymph node. Regional lymphadenectomy serves two major purposes: - diagnosis (axillary lymph node invasion represents an important prognostic factor) and therapeutic (to ensure local control of the disease). Regional lymph node invasion in breast cancer is directly related to the primary tumour size. In the less advanced stages (T1), as there is rarely invasion of the axillary lymph nodes, lymphadenectomy can be avoided in most cases. The paper presents the refinement of the technique, the validation of the method for the identification and biopsy of the sentinel lymph node in breast cancer using Tc99 and the intra-operative use of NEOPROBE 2000 gamma camera at the 'Prof. Dr. Alexandru Trestioreanu' Oncological Institute in Bucharest. 93 patients with primary breast cancer (T1, T2, N0

  2. Multiphoton microscopy as a diagnostic tool for pathological analysis of sentinel lymph nodes

    Lemiere, J.; Douady, J.; Estève, F.; Salameire, D.; Lantuejoul, S.; Lorimier, P.; Ricard, C.; van der Sanden, B.; Vial, J.-C.

    2009-02-01

    Multiphoton microscopy has shown a powerful potential for biomedical in vivo and ex vivo analysis of tissue sections and explants. Studies were carried out on several animal organs such as brain, arteries, lungs, and kidneys. One of the current challenges is to transfer to the clinic the knowledge and the methods previously developed in the labs at the preclinical level. For tumour staging, physicians often remove the lymph nodes that are localized at the proximity of the lesion. In case of breast cancer or melanoma, sentinel lymph node protocol is performed: pathologists randomly realize an extensive sampling of formol fixed nodes. However, the duration of this protocol is important and its reliability is not always satisfactory. The aim of our study was to determine if multiphoton microscopy would enable the fast imaging of lymph nodes on important depths, with or without exogenous staining. Experiments were first conducted on pig lymph nodes in order to test various dyes and to determine an appropriate protocol. The same experiments were then performed on thin slices of human lymph nodes bearing metastatic melanoma cells. We obtained relevant images with both endofluorescence plus second-harmonic generation and xanthene dyes. They show a good contrast between tumour and healthy cells. Furthermore, images of pig lymph nodes were recorded up to 120μm below the surface. This new method could then enable a faster diagnosis with higher efficiency for the patient. Experiments on thicker human lymph nodes are currently underway in order to validate these preliminary results.

  3. Prevalence of enlarged mediastinal lymph nodes in heavy smokers - a comparative study

    Kirchner, Johannes; Lorenz, Vivian-Wilma [Allgemeines Krankenhaus Hagen, Department of Diagnostic and Interventional Radiology, Hagen (Germany); Kirchner, Esther Maria [Staedtisches Klinikum Wedau, Clinic for Medicine, Duisburg (Germany); Goltz, Jan Peter; Kickuth, Ralph [University Hospital of Wuerzburg, Department of Radiology, Wuerzburg (Germany)

    2011-08-15

    To evaluate the frequency of enlarged hilar or mediastinal lymph nodes in heavy smokers (more than 10 pack years) compared with non- smokers. In a prospective study the CT findings of 88 consecutive patients (44 heavy smokers, 44 non- smokers) were analysed. Exclusion criteria were history of thoracic malignancy, sarcoidosis, occupational dust exposure or clinical evidence of pneumonia. Prevalence, size and site of enlarged lymph nodes were assessed by multidetector computed tomography (MDCT) and correlated with the cigarette consumption and the CT- findings of bronchitis and emphysema. Twenty-three of the 44 heavy smokers (52%) showed enlarged mediastinal lymph nodes. Non- smokers showed enlarged lymph nodes in 9% (4/44). The most common site of enlarged lymph nodes was the regional station 7 according to the ATS mapping (subcarinal). The difference between the frequency of enlarged lymph nodes in heavy smokers and non- smokers was significant (chi- square 19.3, p < 0.0001). Airway wall thickening and emphysema were often associated with an increased number of enlarged nodes. The present study demonstrates that enlarged mediastinal lymph nodes may occur in a rather high percentage of heavy smokers, especially in those with a MDCT finding of severe bronchitis. (orig.)

  4. Prevalence of enlarged mediastinal lymph nodes in heavy smokers - a comparative study

    To evaluate the frequency of enlarged hilar or mediastinal lymph nodes in heavy smokers (more than 10 pack years) compared with non- smokers. In a prospective study the CT findings of 88 consecutive patients (44 heavy smokers, 44 non- smokers) were analysed. Exclusion criteria were history of thoracic malignancy, sarcoidosis, occupational dust exposure or clinical evidence of pneumonia. Prevalence, size and site of enlarged lymph nodes were assessed by multidetector computed tomography (MDCT) and correlated with the cigarette consumption and the CT- findings of bronchitis and emphysema. Twenty-three of the 44 heavy smokers (52%) showed enlarged mediastinal lymph nodes. Non- smokers showed enlarged lymph nodes in 9% (4/44). The most common site of enlarged lymph nodes was the regional station 7 according to the ATS mapping (subcarinal). The difference between the frequency of enlarged lymph nodes in heavy smokers and non- smokers was significant (chi- square 19.3, p < 0.0001). Airway wall thickening and emphysema were often associated with an increased number of enlarged nodes. The present study demonstrates that enlarged mediastinal lymph nodes may occur in a rather high percentage of heavy smokers, especially in those with a MDCT finding of severe bronchitis. (orig.)

  5. A systematic review of tests for lymph node status in primary endometrial cancer

    Zamora Javier; Mann Christopher H; Selman Tara J; Khan Khalid S

    2008-01-01

    Abstract Background The lymph node status of a patient is a key determinate in staging, prognosis and adjuvant treatment of endometrial cancer. Despite this, the potential additional morbidity associated with lymphadenectomy makes its role controversial. This study systematically reviews the accuracy literature on sentinel node biopsy; ultra sound scanning, magnetic resonance imaging (MRI) and computer tomography (CT) for determining lymph node status in endometrial cancer. Methods Relevant a...

  6. A systematic review of tests for lymph node status in primary endometrial cancer

    Selman, Tara J; Mann, Christopher H; Zamora, Javier; Khan, Khalid S

    2008-01-01

    Background The lymph node status of a patient is a key determinate in staging, prognosis and adjuvant treatment of endometrial cancer. Despite this, the potential additional morbidity associated with lymphadenectomy makes its role controversial. This study systematically reviews the accuracy literature on sentinel node biopsy; ultra sound scanning, magnetic resonance imaging (MRI) and computer tomography (CT) for determining lymph node status in endometrial cancer. Methods Relevant articles w...

  7. Use of ultrasmall superparamagnetic iron oxide in lymph node MR imaging in prostate cancer patients

    A macrophage-specific magnetic resonance (MR) contrast agent allows the detection of small and otherwise undetectable lymph node metastases in patients with prostate cancer. This has an important clinical impact, as the diagnosis will be more precise and less invasive to obtain. Subsequently, this will reduce morbidity and health care costs. However, thorough knowledge of sequence parameters and planes, lymph node anatomy, appearance of normal and abnormal nodes, is essential when using this technique. This will be elaborated in this review

  8. Lymph node staging in colorectal cancer: Old controversies and recent advances

    Resch, Annika; Langner, Cord

    2013-01-01

    Outcome prediction based on tumor stage reflected by the American Joint Committee on Cancer (AJCC)/Union for International Cancer Control (UICC) tumor node metastasis (TNM) system is currently regarded as the strongest prognostic parameter for patients with colorectal cancer. For affected patients, the indication for adjuvant therapy is mainly guided by the presence of regional lymph node metastasis. In addition to the extent of surgical lymph node removal and the thoroughness of the patholog...

  9. Lymph Node Metastases and Prognosis in Left Upper Division Non-Small Cell Lung Cancers: The Impact of Interlobar Lymph Node Metastasis.

    Hiroaki Kuroda

    Full Text Available Left upper division segmentectomy is one of the major pulmonary procedures; however, it is sometimes difficult to completely dissect interlobar lymph nodes. We attempted to clarify the prognostic importance of hilar and mediastinal nodes, especially of interlobar lymph nodes, in patients with primary non-small cell lung cancer (NSCLC located in the left upper division.We retrospectively studied patients with primary left upper lobe NSCLC undergoing surgical pulmonary resection (at least lobectomy with radical lymphadenectomy. The representative evaluation of therapeutic value from the lymph node dissection was determined using Sasako's method. This analysis was calculated by multiplying the frequency of metastasis to the station and the 5-year survival rate of the patients with metastasis to the station.We enrolled 417 patients (237 men, 180 women. Tumors were located in the lingular lobe and at the upper division of left upper lobe in 69 and 348 patients, respectively. The pathological nodal statuses were pN0 in 263 patients, pN1 in 70 patients, and pN2 in 84 patients. Lymph nodes #11 and #7 were significantly correlated with differences in node involvement in patients with left upper lobe NSCLC. Among those with left upper division NSCLC, the 5-year overall survival in pN1 was 31.5% for #10, 39.3% for #11, and 50.4% for #12U. The involvement of node #11 was 1.89-fold higher in the anterior segment than that in the apicoposterior segment. The therapeutic index of estimated benefit from lymph node dissection for #11 was 3.38, #4L was 1.93, and the aortopulmonary window was 4.86 in primary left upper division NSCLC.Interlobar node involvement is not rare in left upper division NSCLC, occurring in >20% cases. Furthermore, dissection of interlobar nodes was found to be beneficial in patients with left upper division NSCLC.

  10. Use of high frequency ultrasound to monitor cervical lymph node alterations in mice.

    Elyse L Walk

    Full Text Available Cervical lymph node evaluation by clinical ultrasound is a non-invasive procedure used in diagnosing nodal status, and when combined with fine-needle aspiration cytology (FNAC, provides an effective method to assess nodal pathologies. Development of high-frequency ultrasound (HF US allows real-time monitoring of lymph node alterations in animal models. While HF US is frequently used in animal models of tumor biology, use of HF US for studying cervical lymph nodes alterations associated with murine models of head and neck cancer, or any other model of lymphadenopathy, is lacking. Here we utilize HF US to monitor cervical lymph nodes changes in mice following exposure to the oral cancer-inducing carcinogen 4-nitroquinoline-1-oxide (4-NQO and in mice with systemic autoimmunity. 4-NQO induces tumors within the mouse oral cavity as early as 19 wks that recapitulate HNSCC. Monitoring of cervical (mandibular lymph nodes by gray scale and power Doppler sonography revealed changes in lymph node size eight weeks after 4-NQO treatment, prior to tumor formation. 4-NQO causes changes in cervical node blood flow resulting from oral tumor progression. Histological evaluation indicated that the early 4-NQO induced changes in lymph node volume were due to specific hyperproliferation of T-cell enriched zones in the paracortex. We also show that HF US can be used to perform image-guided fine needle aspirate (FNA biopsies on mice with enlarged mandibular lymph nodes due to genetic mutation of Fas ligand (Fasl. Collectively these studies indicate that HF US is an effective technique for the non-invasive study of cervical lymph node alterations in live mouse models of oral cancer and other mouse models containing cervical lymphadenopathy.

  11. Use of high frequency ultrasound to monitor cervical lymph node alterations in mice.

    Walk, Elyse L; McLaughlin, Sarah; Coad, James; Weed, Scott A

    2014-01-01

    Cervical lymph node evaluation by clinical ultrasound is a non-invasive procedure used in diagnosing nodal status, and when combined with fine-needle aspiration cytology (FNAC), provides an effective method to assess nodal pathologies. Development of high-frequency ultrasound (HF US) allows real-time monitoring of lymph node alterations in animal models. While HF US is frequently used in animal models of tumor biology, use of HF US for studying cervical lymph nodes alterations associated with murine models of head and neck cancer, or any other model of lymphadenopathy, is lacking. Here we utilize HF US to monitor cervical lymph nodes changes in mice following exposure to the oral cancer-inducing carcinogen 4-nitroquinoline-1-oxide (4-NQO) and in mice with systemic autoimmunity. 4-NQO induces tumors within the mouse oral cavity as early as 19 wks that recapitulate HNSCC. Monitoring of cervical (mandibular) lymph nodes by gray scale and power Doppler sonography revealed changes in lymph node size eight weeks after 4-NQO treatment, prior to tumor formation. 4-NQO causes changes in cervical node blood flow resulting from oral tumor progression. Histological evaluation indicated that the early 4-NQO induced changes in lymph node volume were due to specific hyperproliferation of T-cell enriched zones in the paracortex. We also show that HF US can be used to perform image-guided fine needle aspirate (FNA) biopsies on mice with enlarged mandibular lymph nodes due to genetic mutation of Fas ligand (Fasl). Collectively these studies indicate that HF US is an effective technique for the non-invasive study of cervical lymph node alterations in live mouse models of oral cancer and other mouse models containing cervical lymphadenopathy. PMID:24955984

  12. Prognostic value of the lymph node ratio in stage Ⅲcolorectal cancer

    Jing-Qing Ren; Jian-Wei Liu; Zhi-Tang Chen; Shao-Jie Liu; Shi-Jie Huang; Yong Huang; Jing-Song Hong

    2012-01-01

    The nodal stage of colorectal cancer is based on the number of positive nodes.It is inevitably affected by the number of removed lymph nodes,but lymph node ratio can be unaffected.We investigated the value of lymph node ratio in stage Ⅲ colorectal cancer in this study.The clinicopathologic factors and follow-up data of 145 cases of stage Ⅲ colorectal cancer between January 1998 and December 2008 were analyzed retrospectively.The Pearson and Spearman correlation analyses were used to determine the correlation coefficient,the Kaplan-Meier method was used to analyze survival,and the Cox proportional hazard regression model was used for multivariate analysis in forward stepwise regression.We found that lymph node ratio was not correlated with the number of removed lymph nodes (r =-0.154,P =0.065),but it was positively correlated with the number of positive lymph nodes (r =0.739,P <0.001) and N stage (r =0.695,P < 0.001),Kaplan-Meier survival analysis revealed that tumor configuration,intestinal obstruction,serum carcinoembryonic antigen (CEA) concentration,T stage,N stage,and lymph node ratio were associated with disease-free survival of patients with stage Ⅲ colorectal cancer (P < 0.05).Multivariate analysis showed that serum CEA concentration,T stage,and lymph node ratio were prognostic factors for disease-free survival (P < 0.05),whereas N stage failed to achieve significance (P =0.664).We confirmed that lymph node ratio was a prognostic factor in stage Ⅲ colorectal cancer and had a better prognostic value than did N stage.

  13. An Image-Based Model of Fluid Flow Through Lymph Nodes.

    Cooper, Laura J; Heppell, James P; Clough, Geraldine F; Ganapathisubramani, Bharathram; Roose, Tiina

    2016-01-01

    The lymphatic system returns fluid to the bloodstream from the tissues to maintain tissue fluid homeostasis. Lymph nodes distributed throughout the system filter the lymphatic fluid. The afferent and efferent lymph flow conditions of lymph nodes can be measured in experiments; however, it is difficult to measure the flow within the nodes. In this paper, we present an image-based modelling approach to investigating how the internal structure of the node affects the fluid flow pathways within the node. Selective plane illumination microscopy images of murine lymph nodes are used to identify the geometry and structure of the tissue within the node and to determine the permeability of the lymph node interstitium to lymphatic fluid. Experimental data are used to determine boundary conditions and optimise the parameters for the model. The numerical simulations conducted within the model are implemented in COMSOL Multiphysics, a commercial finite element analysis software. The parameter fitting resulted in the estimate that the average permeability for lymph node tissue is of the order of magnitude of [Formula: see text]. Our modelling shows that the flow predominantly takes a direct path between the afferent and efferent lymphatics and that fluid is both filtered and absorbed across the blood vessel boundaries. The amount that is absorbed or extravasated in the model is dependent on the efferent lymphatic lumen fluid pressure. PMID:26690921

  14. Mediastinal lymph node enlargement on CT scans in idiopathic pulmonary fibrosis

    Ahn, Joong Mo; Im, Jung Gi; Yu, Kyu In; Kim, Hyeong Seog [Seoul National University College of Medicine, Seoul (Korea, Republic of); Kim, Dae Young [Chung Buk National University College of Medicine, Chungju (Korea, Republic of); Yu, Pil Mun [Dankuk University College of Medicine, Seoul (Korea, Republic of)

    1992-09-15

    The increase in size of lymph node on CT scan is the single most important finding of lymphadenopathy. The purpose of this study was to evaluate the size of mediastinal lymph nodes in patients with idiopathic pulmonary fibrosis with no evidence of malignancy or current infection. CT scans of 70 patients (16 with conventional CT and 54 with high-resolution CT) were assessed for lymph node size and location. The duration of symptoms, and the extent and pattern of the parenchymal lung disease on CT scans were correlated with lymph node enlargement. In 54 of 70 patients, more than one lymph nodes were large than 1-1.5 cm. The prevalence of node enlargement increased significant with a longer duration of symptom (p=0.001), large extent of the disease (p=0.043), and with a greater proportion of honeycomb pattern (p=0.033). Right paratracheal, subcarinal, right tracheobronchial, and paraesophageal nodes were the most common sites of node enlargement. In conclusion, mediastinal lymph node enlargement is common in patients with idiopathic pulmonary fibrosis and is more frequently seen in patients with a longer duration of clinical symptoms, greater extent of the disease, and with a larger proportion of honeycomb pattern.

  15. Mediastinal lymph node enlargement on CT scans in idiopathic pulmonary fibrosis

    The increase in size of lymph node on CT scan is the single most important finding of lymphadenopathy. The purpose of this study was to evaluate the size of mediastinal lymph nodes in patients with idiopathic pulmonary fibrosis with no evidence of malignancy or current infection. CT scans of 70 patients (16 with conventional CT and 54 with high-resolution CT) were assessed for lymph node size and location. The duration of symptoms, and the extent and pattern of the parenchymal lung disease on CT scans were correlated with lymph node enlargement. In 54 of 70 patients, more than one lymph nodes were large than 1-1.5 cm. The prevalence of node enlargement increased significant with a longer duration of symptom (p=0.001), large extent of the disease (p=0.043), and with a greater proportion of honeycomb pattern (p=0.033). Right paratracheal, subcarinal, right tracheobronchial, and paraesophageal nodes were the most common sites of node enlargement. In conclusion, mediastinal lymph node enlargement is common in patients with idiopathic pulmonary fibrosis and is more frequently seen in patients with a longer duration of clinical symptoms, greater extent of the disease, and with a larger proportion of honeycomb pattern

  16. Adjuvant radiation therapy in metastatic lymph nodes from melanoma

    To analyze the outcome after adjuvant radiation therapy with standard fractionation regimen in metastatic lymph nodes (LN) from cutaneous melanoma. 86 successive patients (57 men) were treated for locally advanced melanoma in our institution. 60 patients (69%) underwent LN dissection followed by radiation therapy (RT), while 26 patients (31%) had no radiotherapy. The median number of resected LN was 12 (1 to 36) with 2 metastases (1 to 28). Median survival after the first relapse was 31.8 months. Extracapsular extension was a significant prognostic factor for regional control (p = 0.019). Median total dose was 50 Gy (30 to 70 Gy). A standard fractionation regimen was used (2 Gy/fraction). Median number of fractions was 25 (10 to 44 fractions). Patients were treated with five fractions/week. Patients with extracapsular extension treated with surgery followed by RT (total dose ≥50 Gy) had a better regional control than patients treated by surgery followed by RT with a total dose <50 Gy (80% vs. 35% at 5-year follow-up; p = 0.004). Adjuvant radiotherapy was able to increase regional control in targeted sub-population (LN with extracapsular extension)

  17. IMMUNOLOGICAL RESPONSE IN BOVINE LYMPH NODES STIMULATED WITH SUBUNITS VACCINES

    Gabriel Andres Tafur Gomez

    2013-01-01

    Full Text Available The vaccination process belongs to the public health intervention methodologies that help prevent infections. Vaccinations performed successfully in the history of medicine reported the significance of this procedure to increase the quality of life, prevent zoonoses and improve animal production. Vaccine emergence remained without exact rules for a long time, maintaining a close relationship with pathogens. However, subunit vaccines, with a difference from the classical idea of protective immunity with microorganisms showed it is possible to trigger T-dependent responses with peptide, revealing new rules for vaccine development. This vaccination process starts by the modulation chance of adaptive immune response through peptide sequences process by APCs for immune synapse formation interceded for pMHC-TCR as a scaffold to T cells priming. In this way the immunological signal triggered by immune synapses is amplified in lymph nodes. As a consequence, T and B cells modulated by peptide activity interact between the B cell follicles region and T cell aggregates, which constitute the paracortical region of secondary lymphoid tissue to form connate unions as a prerequisite for clonal amplification and subsequent immunological memory. Indicating the knowledge of the mechanisms of immune response generated by peptides immunization is essential for understanding modulation, amplification and immune protection as demands for good subunits vaccine.

  18. Unicentric Castleman's Disease Arising from an Intrapulmonary Lymph Node

    Hideki Ota

    2013-01-01

    Full Text Available Castleman's disease is an uncommon lymphoproliferative disorder of unknown etiology, most often involving the mediastinum. It has 2 distinct clinical forms: unicentric and multicentric. Unicentric Castleman's disease arising from an intrapulmonary lymph node is rare, and establishing a preoperative diagnosis of this disease is very difficult mainly due to a lack of specific imaging features. We report a case of intrapulmonary unicentric Castleman's disease in an asymptomatic 19-year-old male patient who was accurately diagnosed by preoperative computed tomography (CT. The mass was incidentally found on a routine chest X-ray. A subsequent dynamic CT showed a well-defined, hypervascular, soft-tissue mass with small calcifications located in the perihilar area of the right lower lung. Three-dimensional CT (3D-CT angiography indicated that the mass was receiving its blood supply through a vascular network at its surface that originated from 2 right bronchial arteries. The clinical history and CT findings were consistent with a diagnosis of unicentric Castleman's disease, and we safely and successfully removed the tumor via video-assisted thoracoscopic surgical lobectomy. This case shows that the imaging characteristics of these rare tumors on contrast-enhanced CT combined with 3D-CT angiography can be helpful in reliably establishing a correct preoperative diagnosis.

  19. Multispectral Real-time Fluorescence Imaging for Intraoperative Detection of the Sentinel Lymph Node in Gynecologic Oncology

    Crane, Lucia M.A.; Themelis, George; Buddingh, K. Tim; Harlaar, Niels J.; Pleijhuis, Rick G; Sarantopoulos, Athanasios; van der Zee, Ate G.J.; Ntziachristos, Vasilis; van Dam, Gooitzen M.

    2010-01-01

    The prognosis in virtually all solid tumors depends on the presence or absence of lymph node metastases.1-3 Surgical treatment most often combines radical excision of the tumor with a full lymphadenectomy in the drainage area of the tumor. However, removal of lymph nodes is associated with increased morbidity due to infection, wound breakdown and lymphedema.4,5 As an alternative, the sentinel lymph node procedure (SLN) was developed several decades ago to detect the first draining lymph node ...

  20. Preoperative axillary lymph node staging by ultrasound-guided cytology using a four-level sonographic score

    De Coninck, Caroline; NOËL, JEAN-CHRISTOPHE; Boutemy, Rachel; Simon, Philippe

    2016-01-01

    Background The staging of axillary lymph nodes is critical to the management and prognosis of breast cancer, the most frequent cancer in females. Neoadjuvant therapy and lymph node dissection are recommended when malignant cells invade the lymph nodes. Therefore the pre-operative examination of these lymph nodes is crucial to treatment. Methods In this study, we examined the effectiveness of cytology through ultrasound-guided fine needle aspiration (USG-FNA) and ultrasound (US) imaging using ...

  1. Ratio of Metastatic to Examined Lymph Nodes, a Helpful Staging System and Independent Prognostic Factor of Esophagogastric Junction Cancer

    Zhang, Hao; Wang, Wei; Dongmei DIAO; Cheng, Yao; SONG, YONGCHUN; Zhu, Kun; DANG, CHENGXUE

    2013-01-01

    Background The incidence of the esophagogastric junction cancer is growing rapidly. The purpose of this study is to clarify the outcome of the ratio between metastatic and examined lymph nodes in esophagogastric junction cancer patients with or without 7 examined lymph nodes. Methods A total of 3,481 patients who underwent operation are identified from the Surveillance, Epidemiology, and End Results database. Different lymph nodes resected groups are analyzed to test the lymph nodes ratio fac...

  2. Analysis on relative factors of lymph node metastasis and pattern of postoperative locoreginal relapse of esophageal carcinoma%食管癌淋巴结转移影响因素及术后区域复发规律分析

    Yichun Wang; Fan Wang; Lingling Kong

    2012-01-01

    Objective: We aimed to study the relative factors of lymph node metastasis of esophageal carcinoma, and to analyze the distribution rule of lymph node metastasis of post esophagectomy patients for guiding the radiotherapy. Methods:To collect the patients' data (102 cases) in our hospital from 2001 to 2009, who were found lymph node metastasis confirmed by pathologic in a certain period of time after esophageal cancer surgery. The factors affected the lymph node metastasis in esophageal cancer were analysed by single logistic regression and Logistic Regression Method. To analyze the rule of postoperative lymph node metastasis in different regions, according to the lymph node partition, in accordance with paragraphs of esophageal cancer in different groups. Results: Of the 102 patients after esophageal cancer surgery, who were confirmed by pathological examination, 50 cases had positive lymph node metastasis and 52 cases had negative, the lymph node metastasis rate was 49.0%. Lymph node metastasis rates of different depth, length and paragraph of tumor invasion had statistical difference (P 0.05). Multivariate analysis showed that the lesion length, depth of invasion and paragraph of tumor were meaningful factors affecting the lymph node metastasis. Of the 102 patients, 132 sites node metastasis were found by imaging study and histopathology with lower neck and supraclavicular node 59 (44.70%), upper mediastinum node 51 (38.64%), A-P windows node 1 (0.76%), anterior mediastinum node 1 (0.76%), Subcarinal node 5 (3.79%), paraesophageal node 3 (2.27%), hilar node 3 (2.27%), abdominal node 9 (6.82%). Conclusion: The length and depth of invasion, and paragraph of esophageal cancer are meaningful factors that affect the lymph node metastasis. The longer of lesion, deeper of infiltration and lower of paragraph, the easier to get independently lymph node metastasis. The postoperative lymph node metastasis was mainly distributed in the lower neck and supraclavicular region

  3. Magnetic resonance lymphography of profundus lymph nodes with liposomal gadolinium-diethylenetriamine pentaacetic acid

    Fujimoto, Yoshiko; Oku, Naoto [Univ. of Shizuoka (Japan). School of Pharmaceutical Sciences; Okuhata, Yoshitaka; Tyngi, Shia; Namba, Yukihiro

    2000-01-01

    Lymphography, especially imaging of profundus lymph nodes, is a useful tool for diagnosis of cancer metastases in lymph nodes. However, positive enhancement agents for magnetic resonance lymphography (MRL) have not been available, since the positive imaging agents so far introduced are low-molecular-weight materials that are not trapped in lymph nodes. For the purpose of improved positive enhanced MRL, we employed liposomes as carriers of a positive enhancer, gadolinium-diethylenetriamine pentaacetic acid (Gd-DTPA). Magnetic resonance (MR) imaging was performed after subcutaneous injection of Gd-liposomes into the hind feet of rabbits which had reactive enlarged retroperitoneal lymph nodes. As a result, not only popliteal but also profundus retroperitoneal lymph nodes were positively enhanced by Gd-liposomes, especially after 20 min massage of the injected sites. Gd-Liposomes containing dipalmitoylphosphatidylglycerol were more effective than Gd-liposomes containing palmityl-D-glucuronide, a type of long-circulating liposomes, suggesting that liposomal accumulation in lymph node is, at least partly, mediated by the trapping of liposomes by macrophages. These data show that liposomes modified with Gd-DTPA are effective for positive enhancement of both regional and profundus lymph nodes in MR lymphography. (author)

  4. Magnetic resonance lymphography of profundus lymph nodes with liposomal gadolinium-diethylenetriamine pentaacetic acid

    Lymphography, especially imaging of profundus lymph nodes, is a useful tool for diagnosis of cancer metastases in lymph nodes. However, positive enhancement agents for magnetic resonance lymphography (MRL) have not been available, since the positive imaging agents so far introduced are low-molecular-weight materials that are not trapped in lymph nodes. For the purpose of improved positive enhanced MRL, we employed liposomes as carriers of a positive enhancer, gadolinium-diethylenetriamine pentaacetic acid (Gd-DTPA). Magnetic resonance (MR) imaging was performed after subcutaneous injection of Gd-liposomes into the hind feet of rabbits which had reactive enlarged retroperitoneal lymph nodes. As a result, not only popliteal but also profundus retroperitoneal lymph nodes were positively enhanced by Gd-liposomes, especially after 20 min massage of the injected sites. Gd-Liposomes containing dipalmitoylphosphatidylglycerol were more effective than Gd-liposomes containing palmityl-D-glucuronide, a type of long-circulating liposomes, suggesting that liposomal accumulation in lymph node is, at least partly, mediated by the trapping of liposomes by macrophages. These data show that liposomes modified with Gd-DTPA are effective for positive enhancement of both regional and profundus lymph nodes in MR lymphography. (author)

  5. National equipment of intraoperatory gamma detection in the identification of sentinel lymph node in animal model

    Santos, Paula Cristina Fada dos [Universidade Federal de Sao Paulo (UNIFESP-EPM), Sao Paulo, SP (Brazil). Post-graduate Program on Plastic Surgery], e-mail: ppfada@hotmail.com; Santos, Ivan Dunshee de Abranches Oliveira [Universidade Federal de Sao Paulo (UNIFESP-EPM), Sao Paulo, SP (Brazil). Dept. of Surgery; Nahas, Fabio Xerfan; Ferreira, Lydia Masako [Universidade Federal de Sao Paulo (UNIFESP-EPM), Sao Paulo, SP (Brazil). Dept. of Surgery. Div. of Plastic Sugery; Oliveira Filho, Renato Santos de [University of Sao Paulo (USP), SP (Brazil). Faculty of Medicine

    2009-07-01

    Purpose: To investigate a national equipment of intraoperatory gamma detection in the identification of sentinel lymph node. Methods: Thirty young adult male rats were used. After anesthetized, animals were divided into two groups of 15 animals each. Animals from group A received dextram 500 - Tc{sup 99} radiopharmaceutical and patent blue V and those from group B received only patent blue V to map the lymphatic drainage. The presence of radiation in the background area, in the area of injection and of the ex vivo sentinel lymph node of group A were measured. After the exeresis, each lymph node in group A and in group B was mixed forming a new random sequence and the radioactive reading of each lymph node was carried out, using both pieces of equipment. Results: The hottest sentinel lymph node was identified by the national equipment when radiation was measured in the area of lymphatic drainage after the Dextran 500 was injected. Also, the ex vivo sentinel lymph node. The national equipment has also detected radiation in the lymph nodes that had not received radiopharmaceutical, leading to false positive, checked by the application of Mann-Whitney tests and Student's paired t-tests. The Cronbach alpha has shown high internal consistency of data 0,9416. Conclusions: The national equipment of intraoperatory gamma detection identifies the LS and showed false positives LS and needs improvement. (author)

  6. National equipment of intraoperatory gamma detection in the identification of sentinel lymph node in animal model

    Purpose: To investigate a national equipment of intraoperatory gamma detection in the identification of sentinel lymph node. Methods: Thirty young adult male rats were used. After anesthetized, animals were divided into two groups of 15 animals each. Animals from group A received dextram 500 - Tc99 radiopharmaceutical and patent blue V and those from group B received only patent blue V to map the lymphatic drainage. The presence of radiation in the background area, in the area of injection and of the ex vivo sentinel lymph node of group A were measured. After the exeresis, each lymph node in group A and in group B was mixed forming a new random sequence and the radioactive reading of each lymph node was carried out, using both pieces of equipment. Results: The hottest sentinel lymph node was identified by the national equipment when radiation was measured in the area of lymphatic drainage after the Dextran 500 was injected. Also, the ex vivo sentinel lymph node. The national equipment has also detected radiation in the lymph nodes that had not received radiopharmaceutical, leading to false positive, checked by the application of Mann-Whitney tests and Student's paired t-tests. The Cronbach alpha has shown high internal consistency of data 0,9416. Conclusions: The national equipment of intraoperatory gamma detection identifies the LS and showed false positives LS and needs improvement. (author)

  7. Tumor suppressor genes are frequently methylated in lymph node metastases of breast cancers

    Xu Jia

    2010-07-01

    Full Text Available Abstract Introduction Metastasis represents a major adverse step in the progression of breast carcinoma. Lymph node invasion is the most relevant prognostic factor; however little is known on the molecular events associated with lymph node metastasis process. This study is to investigate the status and role of methylation in lymph node metastatic tumors. Materials and methods Bisulfite pyrosequencing is used to screen 6 putative tumor suppressor genes (HIN-1, RASSF1A, RIL, CDH13, RARβ2 and E-cadherin in 38 pairs of primary breast tumors and lymph node metastases. Results We found that HIN-1, CDH13, RIL, RASSF1A and RARβ2 were frequently methylated both in primary and metastatic tissues (range: 55.3%~89.5%. E-cadherin was not frequently methylated in either setting (range: 18.4%~23.7%. The methylation status of HIN-1, CDH13, RIL, and RARβ2 in lymph nodes metastasis were correlated with that in primary tumors. The Pearson correlation values ranged from 0.624 to 0.472 (p values HIN-1 methylation and hormone status in metastatic lymph nodes. Hypermethylation of HIN-1 in metastasis lymph nodes was significantly associated with expression of ER (odds ratio, 1.070; P = 0.024 and with PR (odds ratio, 1.046; P = 0.026. Conclusions This study suggests that hypermethylation of tumor suppressor genes is extended from primary to metastatic tumors during tumor progression.

  8. Clinical significance of axillary lymph nodes a observed in mediolateral oblique view of mammography

    To evaluate the radiologic characteristics of axillary lymph nodes which are found on mediolateral oblique (MLO) view of mammography and to assess their clinical significance. We retrospectively evaluated 119 cases axillary lymph nodes on MLO view of 410 cases of mammography in 205 patients regarding the size, bilaterality, number, grade of density, presence of central lucency, calcification of lymph nodes and presence of associated parenchymal pathologic lesions in breast. Axillary lymph nodes on MLO view were demonstrated in 119 (29%) among 410 cases. Axillary lymph nodes (112 cases) in cases without breast parenchymal lesions or with benign breast lesions showed; unilaterality in 68 cases (61%), smaller than 1.5 cm in 100 cases (89%), lower density than breast parenchyma in 99 cases (88%), presence of central lucency in 99 cases (88%) and calcification in 3 cases (2.7%). Axillary lymph nodes (7 cases) in cases with breast cancer showed small size of less than 1.5 cm in 4 cases (57%), absence of central lucency in 7 cases (100%) and iso-to higher density than breast parenchyma in 7 cases (100%). Axillary lymph nodes noted on MLO view of mammography, more than 1.5 cm in diameter, absence of central lucency and iso to higher density than breast parenchyma could be suggested as clinically significant

  9. Prognostic Significance of Axillary Lymph Node Micrometastases and Microvessel Count in Breast Cancer

    RuiHui; FengyunZhao

    2004-01-01

    OBJECTIVE To investigate the influence of axillary lymph node micrometastases and the microvessel count on the prognosis of patients with breast cancer. METHODS Forty-eight patients with breast cancer, who had no tumor cells in their regional lymph nodes based on conventional histopathologic examination, were re-examined with immunohistochemical LSAB techniques. H&E, anti-EMA, CK 19 and FVlII factor staining was used to identify tumor cells in both lymph nodes and tumor tissues and to count the microvessels. A total of 882 lymph nodes were examined. RESULTS Immunostaining-positive tumor cells were found in 9.0 %(79/882) of the dissected lymph nodes. The positive rates were not significantly different between a surviving group and a deceased group (P>0.05). The microvessel count was significantly higher in group that had died (P<0.001). CONCLUSION The lymph node micrometastases did not show any correlation with patients'survival, but the microvessel density had a negative correlation with the survival period in breast cancer patients who had negative axillary lymph nodes.

  10. Annexin A7 suppresses lymph node metastasis of hepatocarcinoma cells in a mouse model

    Hepatocellular carcinoma (HCC) is one of the leading causes of cancer death in China. This study investigated the effects of Annexin A7 (ANXA7) on the inhibition of HCC lymph node metastasis in a mouse model. The stable knockup and knockdown of Annexin A7-expressing HCC cells using Annexin A7 cDNA and shRNA vectors, respectively, were injected into a mouse footpad to establish primary and metastatic tumors in mice. On the 14th, 21st, and 28th days after HCC cells inoculation, the mice were sacrificed for inspection of primary and secondary tumors and immunohistochemistry of Annexin A7 expression. The lymph node metastasis rate of the FANXA7-control group was 77%, and the lymph node metastasis rate of the FANXA7-down group was 100% (p < 0.05). In contrast, the lymph node metastasis rate of the PANXA7-up group was 0% and that of the PANXA7-control group was 36% (p < 0.05). Furthermore, immunohistochemistry experiments revealed that the subcellular localization of Annexin A7 protein in both primary and lymph node-metastasized tumors was mainly in the cytosol. In addition, the expression of the 47 kDa and 51 kDa isoforms of Annexin A7 protein changed during tumor progression. This study indicated that Annexin A7 expression was able to inhibit HCC lymph node metastasis, whereas knockdown of Annexin A7 expression significantly induced HCC metastasis to local lymph nodes

  11. Reproducible isolation of lymph node stromal cells reveals site-dependent differences in fibroblastic reticular cells

    Anne L Fletcher

    2011-09-01

    Full Text Available Within lymph nodes, non-hematopoietic stromal cells organize and interact with leukocytes in an immunologically important manner. In addition to organizing T and B cell segregation and expressing lymphocyte survival factors, several recent studies have shown that lymph node stromal cells shape the naïve T cell repertoire, expressing self-antigens which delete self-reactive T cells in a unique and non-redundant fashion. A fundamental role in peripheral tolerance, in addition to an otherwise extensive functional portfolio, necessitates closer study of lymph node stromal cell subsets using modern immunological techniques; however this has not routinely been possible in the field, due to difficulties reproducibly isolating these rare subsets. Techniques were therefore developed for successful ex vivo and in vitro manipulation and characterization of lymph node stroma. Here we discuss and validate these techniques in mice and humans, and apply them to address several unanswered questions regarding lymph node composition. We explored the steady-state stromal composition of lymph nodes isolated from mice and humans, and found that marginal reticular cells and lymphatic endothelial cells required lymphocytes for their normal maturation in mice. We also report alterations in the proportion and number of fibroblastic reticular cells (FRCs between skin-draining and mesenteric lymph nodes. Similarly, transcriptional profiling of FRCs revealed changes in cytokine production from these sites. Together, these methods permit highly reproducible stromal cell isolation, sorting, and culture.

  12. Lymph node enlargement in pulmonary arterial hypertension due to chronic thromboembolism

    The aim of this study was to determine the prevalence and location of enlarged mediastinal and hilar lymph nodes in patients with pulmonary arterial hypertension (PAH) due to chronic pulmonary thromboembolism (CPTE) and to identify possible causes. Thoracic CT images of 85 patients(43 men and 42 women, aged 18-80 years) with PAH in whom CPTE was confirmed at surgery (n = 75) or angiography and angioscopy (n = 10) were evaluated by two thoracic radiologists to determine the presence, size and location of lymph nodes more than 1 cm in the short axis. The presence of pleural and pericardial effusions and parenchymal abnormalities were also noted. Enlarged lymph nodes were identified in 38 patients (44.7%), including 11 with possible causes of lymphadenopathy other than CPTE. In the 27 patients with CPTE alone, 67 enlarged lymph nodes were detected (average 2.5 per patient). Nine patients had three or more enlarged lymph nodes. The most common sites of lymph node enlargement were American Thoracic Society locations 7 (n = 13), 6 (n = 10), 11L (n = 9), 10R (n = 7) and 4R (n = 7). Pleural and pericardial effusions were more common in patients with CPTE who also had lymphadenopathy than in the group with no lymphadenopathy (P < 0.05). Lymph node enlargement is common in patients with PAH caused by CPTE. The frequent association of lymphadenopathy with pleural and pericardial effusions suggest a possible pathophysiological mechanism of increased lymphatic flow caused by right heart failure.

  13. A Lymph Node Ratio of 10% Is Predictive of Survival in Stage III Colon Cancer: A French Regional Study

    Sabbagh, Charles; Mauvais, François; Cosse, Cyril; Rebibo, Lionel; Joly, Jean-Paul; Dromer, Didier; Aubert, Christine; Carton, Sophie; Dron, Bernard; Dadamessi, Innocenti; Maes, Bernard; Perrier, Guillaume; Manaouil, David; Fontaine, Jean-François; Gozy, Michel

    2014-01-01

    Lymph node ratio (LNR) (positive lymph nodes/sampled lymph nodes) is predictive of survival in colon cancer. The aim of the present study was to validate the LNR as a prognostic factor and to determine the optimum LNR cutoff for distinguishing between “good prognosis” and “poor prognosis” colon cancer patients.

  14. Axillary lymph nodes siliconoma in a woman with intracapsular implant rupture

    Full text: Introduction: Siliconoma, or silicone granuloma is the migration of silicon particles in the axillary lymph nodes, muscle and other non- ruptured or intact silicone implant. The latter is a relatively rare finding, and usually occurs in patients with extracapsular rupture of silicone prosthesis and has a typical ultrasound image. We present a case of a young woman with bilateral silicone prostheses placed 5 years ago, where in the right axilla are enlarged, structurally altered lymph nodes in the clinical and ultrasonography studies. Subsequent magnetic resonance examination shows intracapsular rupture ipsilateral silicone prosthesis and migration of silicon particles in the axillary lymph nodes. What you will learn: In this case we present twenty-three year old woman who reported pain and ‘swelling’ in the right axilla. The patient is with bilateral silicone prosthesis, she is not febrile and not reported other illness. After physical examination enlarged and tender lymph nodes in the right axilla was found. Several structurally altered and enlarged lymph nodes were visualized by ultrasound. These lymph nodes are hypoechogenic with obliterated fatty hilus. Due to the suspicion of silicone ‘extravasation’ in axillary lymph nodes, a magnetic resonance study of both mammary glands was performed. The images show intracapsular rupture of the right prosthesis without reliable data on silicone gel outside the fibrous capsule. Discussion: Siliconoma is a complication after plastic surgery of the breast and can affect both the axillary lymph nodes, and other lymphatic chains and also muscle and lung. Most frequently it occurs at damage of the extracapsular silicone prostheses. More rarely siliconoma occurs in siliconoma intracapsular damage, as in the presented case or in a silicone gel microbleed. Conclusion: The presence of siliconoma in axillary lymph nodes is relatively rare complication in plastic surgery of the breast. Methods of imaging diagnostic

  15. Large lymph node size harvested as prognostic factor in gastric cancer?

    F. Espín

    2010-03-01

    Full Text Available Objective: knowledge regarding prognostic factors in gastric cancer is essential to decide on single patient management. We aim to establish the value of large lymph node size in order to improve perioperative approach. Material and methods: charts of one hundred and twenty-eight consecutive patients undergoing gastrectomy for resectable gastric cancer were reviewed between January 1996 and December 2005. Patients were split in two groups according to large lymph node size harvested, group I, lymph node size ≤ 10 mm and group II, lymph node size > 10 mm. Overall five-year survival related to cancer were analyzed as a main endpoint. Prognostic factors as TNM classification and degree of differentiation have been considered. Results: there were no differences regarding age and gender (67.4 vs. 64; p = 0.34 and 66,1 vs. 68,1%; p = 0.27, respectively. Nevertheless, a significant difference has been found according to T1-T2 of TNM stage (78.1 vs. 39.1% p = < 0.001, for N grade staging, has statistical signification for grade N0 (62.7 vs. 30.5%; p < 0.001, and for Ia and Ib stages (57.6 vs. 17.4%. Five years overall survival has a great statistical signification (p log-rank = 0.0003, however, overall survival between groups with positive lymph nodes according to lymph node size was close to signification, (p log-rank = 0.0636. Conclusions: our data indicates that large lymph node size could be a powerful predictor for overall survival in gastric cancer, when it could be evaluated in preoperative period. In our opinion lymph node size should be considered for perioperative chemotherapy schemas. Detection and staging techniques for lymph node affection acquire much more importance.

  16. Roles of preoperative lymphoscintigraphy for sentinel lymph node biopsy in breast cancer patients

    The objective of this study was to evaluate roles of preoperative lymphoscintigraphy for sentinel lymph node biopsy in breast cancer patients. Five hundred and sixty-five consecutive breast cancer patients were prospectively randomized into groups with or without preoperative lymphoscintigraphy. In a group with lymphoscintigraphy, 238 patients had sentinel lymph nodes spotted in lymphoscintigram. The visualization of sentinel lymph nodes in lymphoscintigram was not associated with patients' age, primary tumor size and location, histopathologic type and time interval from injection of radiocolloid to lymphoscintigraphy. However, patients with axillary metastasis had a lower identification rate of sentinel lymph nodes by lymphoscintigraphy than those without metastasis (P=0.003). The identification rate of axillary sentinel lymph nodes was 99.3% in the group and the rate was similar whether there was sentinel lymph nodes spotted in axillary in lymphoscintigram or not (99.6% vs. 98.1%, P=0.327). The false-negative rate in this group was 4.2%. While in a group without lymphoscintigraphy, the identification rate and the false-negative rate were 99.6% and 4.8%, respectively. There was no significant difference between the two groups in the identification rate of axillary sentinel lymph nodes (P=0.594) and in the false-negative rate (P=1.00). Preoperative lymphoscintigraphy could neither improve the identification rate nor reduce the false-negative rate of breast cancer sentinel lymph node biopsy, and it is not necessary for sentinel lymph node biopsy in breast cancer patients. (author)

  17. Artificial Neural Network System in Evaluating Cervical Lymph Node Metastasis of Squamous Cell Carcinoma

    The purpose of this study was to evaluate cervical lymph node metastasis of oral squamous cell carcinoma patients by MRI film and neural network system. The oral squamous cell carcinoma patients(21 patients, 59 lymph nodes) who have visited SNU hospital and been taken by MRI, were included in this study. Neck dissection operations were done and all of the cervical lymph nodes were confirmed with biopsy. In MR images, each lymph node were evaluated by using 6 MR imaging criteria(size, roundness, heterogeneity, rim enhancement, central necrosis, grouping) respectively. Positive predictive value, negative predictive value, and accuracy of each single MR imaging criteria were calculated. At neural network system, the layers of neural network system consisted of 10 input layer units, 10 hidden layer units and 1 output layer unit. 6 MR imaging criteria previously described and 4 MR imaging criteria (site I-node level 2, site II-other node level, shape I-oval, shape II-bean) were included for input layer units. The training files were made of 39 lymph nodes(24 metastatic lymph nodes, 10 non-metastatic lymph nodes) and the testing files were made of other 20 lymph nodes(10 metastatic lymph nodes, 10 non-metastatic lymph nodes). The neural network system was trained with training files and the output level (metastatic index) of testing files were acquired. Diagnosis from neural network was decided according to 4 different standard metastatic index-68, 78, 88, 98 respectively and positive predictive values, negative predictive values and accuracy of each standard metastatic index were calculated. In the diagnosis of using single MR imaging criteria, the rim enhancement criteria had the highest positive predictive value, 0.95 and the size criteria showed the highest at negative predictive value, 0.77. The highest accurate criteria was heterogeneity with the accuracy of 0.81 and the lowest one was central necrosis with accuracy of 0.59. In the diagnosis of using neural network

  18. Normal mediastinal lymph nodes: number and size according to American Thoracic Society Mapping

    CT was used to investigate the number and size of normal mediastinal lymph nodes at 11 intrathoracic nodal stations defined by the American Thoracic Society lymph-node mapping scheme. Nodal size was measured both as short- and long-axis diameters in the transverse plane. Findings for 56 patients show the largest normal mediastinal nodes to be in the subcarinal and right tracheobronchial regions. Upper paratracheal nodes were smaller than lower paratracheal or tracheobronchial nodes, and right-sided tracheobronchial nodes were larger than left-sided ones. From the distributions of node sizes, thresholds were set above which nodes in any region might be considered enlarged. These thresholds, in agreement with a prior investigation of patients with lung cancer, suggest 1.0 cm as the upper limit of normal for the short axis of a mediastinal node in the transverse plane

  19. Cystic lymph node enlargement of the neck: filariasis as a rare differential diagnosis in MRI

    Schick, Christoph; Thalhammer, Axel; Balzer, Joern O.; Abolmaali, Nasreddin; Vogl, Thomas J. [Department of Diagnostic and Interventional Radiology, University of Frankfurt, Theodor-Stern-Kai 7, 60590 Frankfurt/Main (Germany)

    2002-09-01

    Cervical lymph node enlargement is a common feature of most inflammatory and neoplastic entities of the head and neck. Filariasis can lead to lymphangiectasis resembling lymph node enlargement; however, this is a rare differential diagnosis in European patients. As ethnic minorities are increasing throughout Europe and personal mobility, e.g. during holidays, is increasing, such rare differential diagnoses have to be taken into consideration. We present the case of an Iraqi patient referred to as for a suspected cystic lymph node mass that was verified histologically by open MRI biopsy and proved to be a cystic manifestation of filariasis. (orig.)

  20. Separate Roles for Antigen Recognition and Lymph Node Inflammation in CD8+ Memory T Cell Formation

    Fransen, Marieke F.; van Stipdonk, Marianne J.; Sluijter, Marjolein; Schoenberger, Stephen P.; Melief, Cornelis J; Offringa, Rienk

    2010-01-01

    Priming of naive CD8+ T cells by pathogens or vaccines generally involves their interaction with Ag-loaded dendritic cells (DCs) in the context of an inflamed lymph node. Lymph node activation fosters DC and T cell encounters and subsequently provides newly primed T cells with nurturing conditions. We dissected these two aspects by infusing in vitro primed CD8+ T cells into naive recipient mice harboring a single activated lymph node and comparing the fate of these T cells with those infused ...

  1. Is rectal cancer prone to metastasize to lymph nodes than colon cancer?

    Takashi Akiyoshi; Toshiaki Watanabe; Masashi Ueno; Tetsuichiro Muto

    2011-01-01

    The biology of colorectal cancer differs according to itsitss location within the large intestine. A report publishedinpublished inin a previous issue of World Journal of Gastroenterology (November 2010) evaluated the importance of tumor location as a risk factor for lymph node metastasis in colorectal cancer, and showed that rectal cancer is prone to metastasize to lymph nodes as compared with colon cancer. However, in order to conclude that the tumor location is independently associated with the occurrence of lymph node metastasis, it is necessary to consider a selection bias or other patient- and tumor-related factors carefully.

  2. Advanced malignant melanoma during pregnancy: technical description of sentinel lymph node biopsy followed by radical lymph node dissection

    Alberto Julius Alves Wainstein

    2015-12-01

    Full Text Available Abstract Introduction: melanoma is a very aggressive cancer, with increasing incidence, and is currently the fifth most common cancer in men and the sixth most common in women in the United States. Melanoma is not unusual in pregnancy, with an estimated occur-rence rate of 1:1.000. Although not the most common cancer in pregnancy, melanoma is the tumor with the highest incidence ofplacenta and fetus metastases. Description: a 29-year-old lady, 4 weeks after conception underwent resection of an atypical pigmented lesion after a diagnosis of stage T4b melanoma. At 16 weeks she underwent a broad local excision and sentinel lymph node (SLN biopsy. SLN was evaluated histologically and tested positive for melanoma. A radical axillary lymphadenectomy was performed on the patient without evidence of metas-tasis in any other LN. In the 40th week of pregnancy, labor was induced and a healthy newborn was deli-vered via cesarean. Discussion: melanoma management in pregnancy is more complex and requires multidisciplinary coor-dination, as well as extensive discussion with the patient and her family. We present a case report description in which treatment recommendations are established according to no pregnancy experience.

  3. Robot-Assisted Extended Pelvic Lymph Nodes Dissection for Prostate Cancer: Personal Surgical Technique and Outcomes

    Porpiglia Francesco

    2015-12-01

    Full Text Available Objective: Extended pelvic lymph nodes dissection (EPLND allows the removal of a higher number of lymph nodes than limited PLND. The aims of this study were to describe our robot-assisted EPLND (RAEPLND technique with related complications, and to report the number of lymph nodes removed and the rate of lymph nodal metastasis. Materials and Methods: 153 patients underwent RAEPLND prior to robot-assisted radical prostatectomy (RARP. Indications were defined according to Briganti nomogram, to predict risk of lymph-nodal metastasis. Lymphatic packages covering the distal tract of the common iliac artery, the medial portion of the external iliac artery, the external iliac vein and the internal iliac vessels, together with the obturator and the presacral lymphatic packages were removed on both sides. Results: Median preoperative PSA was 7.5 ng/mL (IQR 5.5–11.5. Median operative time was 150 min (135–170. Median RAEPLND alone operative time was 38 min (32.75–41.25; for right and left side, 18 (15–29 and 20 min (15.75–30 (p=0.567. Median number of lymph nodes retrieved per patient was 25 (19.25–30; 13 (11–16 and 11 (8–15 for right and left side. In 19 patients (12.41% metastasis was found at the level of pelvic lymph nodes. Median number of positive lymph nodes was 1 (1–4.6 per patient. Complications occurred in 11 patients (7.3%. Conclusions: the number of lymph nodes removed was comparable to published data about open series, allowing the increase of detection rate of lymph nodal metastasis for minimally invasive approach without compromising complications' rate if performing the procedure following reported technique.

  4. Observation of the Primo Vessel Approaching the Axillary Lymph Node with the Fluorescent Dye, DiI

    2014-01-01

    The primo vascular system (PVS) floating in lymph fluid has mostly been observed in large caliber ducts around the caudal vena cava and the thoracic duct of rabbits, rats, and mice. But the PVS has not been traced up to the lymph nodes. It has not been established whether the PVS leaves the lymph vessel through the lymph vessel wall or it enters the lymph nodes. Therefore, observing the PVS entering a lymph node, for example, the axillary node, is desirable. In the current work, we traced the...

  5. The study for breast lymphoscintigraphy of sentinal lymph node in breast cancer

    Kim, Hwa Gon; Kim, Chang Soo; Kim, Myung Jun [College of Health Sciences, Catholic University of Pusan, Busan (Korea, Republic of)

    2006-06-15

    In the past, most patient of breast cancer suffered side effects due to the useless removement of Axillary Lymph Node, but there is no need to remove it because of the result in this study. The purpose of this study is to save surgery time and side effects after surgical operation for patients with breast cancer by making decisions of operation range for metastasis in first Stenosis Lymph Node using the {sup 99m}Tc-Tincolloid Scintigraphy and the Micro Probe for radioisotope. As a result of this study, 15 among 20 patients became objects of this study could reduced side effects for operation because there were no axillary lymph node operations. However there is no standard for method of this treatment. It should be standardize where inject point is, how much {sup 99m}Tc-Tincolloid should be injected (radioactivity value), and the need of massage and Lymph Scintigraphy. Nevertheless I think that this result of study is useful to reduce suffering and side effects from breast cancer and also we should try to do that continuously. The objects for this study were 20 patients diagnosed as breast cancer by Ultrasonography, Mammography and Biopsy. The average of patient age was 45.4 years and its range was between 31 and 71 years. In case of clinical period there were 9 patients of Period I and 11 patients of Period II. The equipment for this study were {sup 99m}Tc-Tincolliod describing the Stenosis Lymph Node as a tracer. Micro Probe: Neoprobe 2000 (the rest is Gamma Probe) tracing the location, and MS-II Gamma Camera: SIEMENS (the rest is MS-II Gamma Camera) describing the image. There were 3 methods for this study, after selecting one of those methods all 20 patients were performed Stenosis Lymph Node diagnosis and Gamma Probe in operation room. The result was that I imaged all the 20 patients, and seek the Stenosis Lymph Node by using Gamma Probe. Metastasis in Stenosis Lymph Node was 5 and Metastasis in Axillary Lymph Node was 3 between Metastasis in Stenosis Lymph

  6. The study for breast lymphoscintigraphy of sentinal lymph node in breast cancer

    In the past, most patient of breast cancer suffered side effects due to the useless removement of Axillary Lymph Node, but there is no need to remove it because of the result in this study. The purpose of this study is to save surgery time and side effects after surgical operation for patients with breast cancer by making decisions of operation range for metastasis in first Stenosis Lymph Node using the 99mTc-Tincolloid Scintigraphy and the Micro Probe for radioisotope. As a result of this study, 15 among 20 patients became objects of this study could reduced side effects for operation because there were no axillary lymph node operations. However there is no standard for method of this treatment. It should be standardize where inject point is, how much 99mTc-Tincolloid should be injected (radioactivity value), and the need of massage and Lymph Scintigraphy. Nevertheless I think that this result of study is useful to reduce suffering and side effects from breast cancer and also we should try to do that continuously. The objects for this study were 20 patients diagnosed as breast cancer by Ultrasonography, Mammography and Biopsy. The average of patient age was 45.4 years and its range was between 31 and 71 years. In case of clinical period there were 9 patients of Period I and 11 patients of Period II. The equipment for this study were 99mTc-Tincolliod describing the Stenosis Lymph Node as a tracer. Micro Probe: Neoprobe 2000 (the rest is Gamma Probe) tracing the location, and MS-II Gamma Camera: SIEMENS (the rest is MS-II Gamma Camera) describing the image. There were 3 methods for this study, after selecting one of those methods all 20 patients were performed Stenosis Lymph Node diagnosis and Gamma Probe in operation room. The result was that I imaged all the 20 patients, and seek the Stenosis Lymph Node by using Gamma Probe. Metastasis in Stenosis Lymph Node was 5 and Metastasis in Axillary Lymph Node was 3 between Metastasis in Stenosis Lymph Node cases. Finally

  7. Liposome-coated quantum dots targeting the sentinel lymph node

    Chu Maoquan, E-mail: mqchu98@tongji.edu.cn; Zhuo Shu; Xu Jiang; Sheng Qiunan; Hou Shengke; Wang Ruifei [Tongji University, School of Life Science and Technology (China)

    2010-01-15

    Sentinel lymph node (SLN) mapping with near-infrared (NIR) quantum dot (QDs) have many advantages over traditional methods. However, as an inorganic nanomaterial, QDs have low biocompatibility and low affinity to the lymphatic system. Here, we encapsulated QDs into nanoscale liposomes and then used these liposome-coated QDs for SLN mapping. The results showed that the liposome-coated QDs exhibited core-shell characterization, and their fluorescence emission did not decrease but slightly increased after being continuously excited by a xenon lamp source (150 W) at 488 nm at 37 {sup o}C for 1 h. After storing at 4 {sup o}C for more than one and half years, the liposome-coated QDs were found to have retained their spherical structure containing a large amount of QDs. When liposome-coated QDs with average size of 55.43 nm were injected intradermally into the paw of a mouse, the SLN was strongly fluorescent within only a few seconds and visualized easily in real time. Moreover, the fluorescence of the QDs trapped in the SLN could be observed for at least 24 h. Compared with the SLN mapping of QDs absent of liposomes and liposome-coated QDs with a larger average size (100.3 and 153.6 nm), more QDs migrated into the SLN when the liposome-coated QDs with smaller average size (55.43 nm) were injected. This technique may make a great contribution to the improvement of the biocompatibility of QDs and the targeting delivery capacity of QDs into the SLN.

  8. Incidence of pelvic lymph node metastasis in radical prostatectomy

    Jeremić Nebojša

    2006-01-01

    Full Text Available Background/Aim. Radical prostatectomy (RP provides the best cancer control in patients with clinically prostate gland confined cancer. Multiple models and nomograms combining preoperative prostate-specific antigen (PSA serum level, clinical stage and Gleason score have been developed to predict the probability of metastatic disease. In prostate cancer (PC the presence of metastases to the pelvic lymph nodes (PLNs is recognized widely as an unfavorable prognostic factor. Currently, PLNs dissection is not done in a low-risk group of prostate cancer patients. The aim of this study was to analyze PLN metastases in PC patients, in clinically localized stages of PC. Methods. Radical prostatectomy specimens with pelvic lymphadenectomy specimens from 82 PC patients were reviewed. In this group of patients, serum preoperative PSA values ranged from 2 to 23 ng/ml. Results. We diagnosed 11/82 (13.4% patients with PLN metastases. There were 8 (72% patients with pT3c pathological stage, and 3 (28% patients with pT4a stage. PSA below 4 ng/ml was detected in 2/5 (40% patients with PLN metastases. There was no statistically significant difference between preoperative PSA values and postoperative T stage, and PLN metastases. A statistically significant correlation between PLN metastases and the stage was found in the patients with pT4 and the patients with pT3c PC stages (p < 0.05. Conclusion. Recent RP series indicate PLN metastases to be less than 10%. We demonstrated higher detection of PLN metastases (13.4% in our RP series. Our results suggest that PLNs dissection should be performed even in patients with low-risk PC.

  9. Liposome-coated quantum dots targeting the sentinel lymph node

    Sentinel lymph node (SLN) mapping with near-infrared (NIR) quantum dot (QDs) have many advantages over traditional methods. However, as an inorganic nanomaterial, QDs have low biocompatibility and low affinity to the lymphatic system. Here, we encapsulated QDs into nanoscale liposomes and then used these liposome-coated QDs for SLN mapping. The results showed that the liposome-coated QDs exhibited core-shell characterization, and their fluorescence emission did not decrease but slightly increased after being continuously excited by a xenon lamp source (150 W) at 488 nm at 37 oC for 1 h. After storing at 4 oC for more than one and half years, the liposome-coated QDs were found to have retained their spherical structure containing a large amount of QDs. When liposome-coated QDs with average size of 55.43 nm were injected intradermally into the paw of a mouse, the SLN was strongly fluorescent within only a few seconds and visualized easily in real time. Moreover, the fluorescence of the QDs trapped in the SLN could be observed for at least 24 h. Compared with the SLN mapping of QDs absent of liposomes and liposome-coated QDs with a larger average size (100.3 and 153.6 nm), more QDs migrated into the SLN when the liposome-coated QDs with smaller average size (55.43 nm) were injected. This technique may make a great contribution to the improvement of the biocompatibility of QDs and the targeting delivery capacity of QDs into the SLN.

  10. Suggestion of optimal patient characteristics for sentinel lymph node mapping in colorectal adenocarcinoma

    Claudio A Quadros

    2010-12-01

    Full Text Available CONTEXT: In a previously published study, the variables lower rectal tumor site, preoperative chemoradiotherapy and large tumors were considered as independent risk factors for the inability of sentinel lymph node identification in patients with colorectal adenocarcinoma. OBJECTIVES: To determine if these variables could interfere in the precision and upstaging benefit of sentinel lymph node mapping in colorectal cancer. METHODS: A database composed of 52 patients submitted to lymphatic mapping using technetium-99m-phytate and patent blue was reviewed. Only patients with tumors smaller than 5.0 cm, not submitted to preoperative chemoradiotherapy and without lower rectal cancer were included. RESULTS: With these parameters, 11 patients remained to be studied. The sentinel lymph node identification rate was 100%, with a sensitivity of 100%, negative predictive value of 100%, no false negatives and accuracy of 100%. Sentinel lymph nodes were the only metastatic nodes in 36.4% of the patients, micrometastases (<0.2 cm or only identified by immunohistochemistry provided an upstaging rate of 27.1% and metastases an upstaging rate of 9.1%. CONCLUSION: The parameters proposed in this study for selection of colorectal adenocarcinoma patients to be submitted to sentinel lymph node mapping identified optimal accuracy and good upstaging results. As the number of included patients was low, these results could serve as guidance for proper patient selection in further prospective lymph node mapping studies in colorectal cancer patients.

  11. Nonimage-guided fine needle aspiration biopsy of palpable axillary lymph nodes in breast cancer patients.

    Marti, Jennifer L; Ayo, Diego; Levine, Pascale; Hernandez, Osvaldo; Rescigno, John; Axelrod, Deborah M

    2012-01-01

    We report the utility of office-based, nonimaged guided fine needle aspiration of palpable axillary lymph nodes in breast cancer patients. We examine the sensitivity and specificity of this procedure, and examine factors associated with a positive fine needle aspiration biopsy result. Although the utility of ultrasound-guided fine needle aspiration biopsy (FNA) of axillary lymph nodes is well established, there is little data on nonimage guided office-based FNA of palpable axillary lymphadenopathy. We investigated the sensitivity and specificity of nonimage-guided FNA of axillary lymphadenopathy in patients presenting with breast cancer, and report factors associated with a positive FNA result. Retrospective study of 94 patients who underwent office-based FNA of palpable axillary lymph nodes between 2004 and 2008 was conducted. Cytology results were compared with pathology after axillary sentinel node or lymph node dissection. Nonimage-guided axillary FNA was 86% sensitive and 100% specific. On univariate analysis, patients with positive FNA cytology had larger breast tumors (p = 0.007), more pathologic positive lymph nodes (p benefits select patients, permitting avoidance of axillary ultrasound, sentinel lymph node biopsy, or delay in receiving neoadjuvant therapy. This results in time and cost savings for the health care system, and expedites definitive management. PMID:22098412

  12. Convective diffusion of nanoparticles from the epithelial barrier toward regional lymph nodes.

    Dukhin, Stanislav S; Labib, Mohamed E

    2013-11-01

    Drug delivery using nanoparticles as drug carriers has recently attracted the attention of many investigators. Targeted delivery of nanoparticles to the lymph nodes is especially important to prevent cancer metastasis or infection, and to diagnose disease stage. However, systemic injection of nanoparticles often results in organ toxicity because they reach and accumulate in all the lymph nodes in the body. An attractive strategy would be to deliver the drug-loaded nanoparticles to a subset of draining lymph nodes corresponding to a specific site or organ to minimize systemic toxicity. In this respect, mucosal delivery of nanoparticles to regional draining lymph nodes of a selected site creates a new opportunity to accomplish this task with minimal toxicity. One example is the delivery of nanoparticles from the vaginal lumen to draining lymph nodes to prevent the transmission of HIV in women. Other known examples include mucosal delivery of vaccines to induce immunity. In all cases, molecular and particle transport by means of diffusion and convective diffusion play a major role. The corresponding transport processes have common inherent regularities and are addressed in this review. Here we use nanoparticle delivery from the vaginal lumen to the lymph nodes as an example to address the many aspects of associated transport processes. In this case, nanoparticles penetrate the epithelial barrier and move through the interstitium (tissue) to the initial lymphatics until they finally reach the lymph nodes. Since the movement of interstitial liquid near the epithelial barrier is retarded, nanoparticle transport was found to take place through special foci present in the epithelium. Immediately after nanoparticles emerge from the foci, they move through the interstitium due to diffusion affected by convection (convective diffusion). Specifically, the convective transport of nanoparticles occurs due to their convection together with interstitial fluid through the

  13. Immunoexpression of cyclooxygenase-2 in primary gastric carcinomas and lymph node metastases

    Paulo RC Almeida; Francisco VA Ferreira; Cássio C Santos; Francisco D Rocha-Filho; Raul RP Feitosa; Esther AA Falc(a)o; Belise K Cavada; Roberto CP Lima-Júnior; Ronaldo A Ribeiro

    2012-01-01

    AIM:To evaluate immunoexpression of cyclooxygenase-2 (COX-2) in primary gastric carcinomas and respective lymph node metastases.METHODS:Immunohistochemistry to analyze COX-2 expression was performed on tissue microarray slices obtained from 36 specimens of gastrectomy and satellite lymph nodes from patients with gastric carcinoma.RESULTS:Immunostaining was seen in most cases,and COX-2 expression was higher in lymph node metastases than in corresponding primary gastric tumors of intestinal,diffuse and mixed carcinomas,with a statistically significant difference in the diffuse histotype (P=0.0108).CONCLUSION:COX-2 immunoexpression occurs frequently in primary gastric carcinomas,but higher expression of this enzyme is observed in lymph node metastases of the diffuse histotype.

  14. Efficacy of concurrent chemoradiotherapy in cases with cervical lymph node metastasis from oropharyngeal or hypopharyngeal cancer

    We reported the efficacy of concurrent chemoradiotherapy(CCRT) for cervical lymph node metastasis in patients with oropharyngeal or hypopharyngeal squamous cell carcinoma. The subjects were 17 patients with oropharyngeal or hypopharyngeal cancer with cervical lymph node metastasis, who underwent CCRT treatment between January 2005 and December 2009. The proportion of patients showing a complete response (CR) was 64.7%; however, if patients without any residual viable cancer cells in the specimens obtained by neck dissection were also defined as CR, then, 82.4% achieved CR. Thus, CCRT showed good efficacy without the need for planned neck dissection (PND). The limited recurrence cases and absence of serious complications associated with neck dissection after CCRT suggested that PND is not necessarily required. However, since assessment of cervical lymph nodes after CCRT is difficult, it would be desirable to develop a reliable examination and to study the most suitable examination for detecting the presence/absence of cervical lymph node metastasis. (author)

  15. A study on cervical lymph node metastasis from cancer of unknown primary origin

    Between 2002 and 2011, we treated 18 cases of cervical lymph node metastasis from cancer of unknown primary origin. The subjects were 15 men and 3 women, ranging in age from 45 to 83 years (mean: 65.5 years). The histopathological tumor types were squamous cell carcinoma (15 cases), mucoepidermoid carcinoma (1 case), adenocarcinoma (1 case), and undifferentiated carcinoma (1 case). The largest metastatic lymph nodes were located in the upper deep cervical region in 16 cases. For histologic diagnosis of the metastatic lymph nodes, FNAB (fine needle aspiration biopsy) was conducted in 14 cases and open biopsy in 4 cases. Neck dissection was performed in 17 cases, of which 14 also received postoperative radiotherapy. The overall 5-year survival rate in this study was 63.6%. For the control of metastatic lymph nodes and minute tumors at the primary site, combination therapy consisting of neck dissection and chemoradiotherapy is desirable. (author)

  16. Effects of ionizing radiation and benzene on some parameters of immunoreactivity in spleen and lymph nodes

    Under the influence of the combined action of gamma-radiation (1 Gy, 1.15 Gy/min) and benzene the sinergistic reduction of proportion and absolute content of B-cells and less expressed reduction of absolute content of T-cells in spleen and lymph nodes was observed. In spleen the thymus-dependent humoral immune response was resistant to combined effect of irradiation and benzene, while in lymph nodes it was highly sensitive. The profound suppression of antibody formation in lymph nodes was characterized by synergism. It was accompanied by the block of specific recruitment of antigen sensitive cells within drained lymph nodes from migration streem. The suppression of local immune response resulting from the combined effect of radiation and toxicants may be the cause of protective immunity disturbance. (author)

  17. Detection of axillary lymph node involvement of breast cancer by Tc-99m MIBI scintimammography

    Breast cancer is the most common malignancy among women, leading to hundreds of thousands of deaths annually around the world. Lymph node status is the most important prognostic indicator in newly diagnosed breast cancer. The presence of axillary lymph node metastases has major prognostic implications in breast cancer patients, and it is an important criterion in determining the need for adjuvant chemotherapy. There is not an accurate anatomical test for detecting axillary lymph node metastasis and clinical examination has inappropriate diagnostic values. Routine lymph node dissection is the only accepted method for therapeutic decisions but it is invasive and produces significant morbidity such as lymphedema and infections. On the other hand, an important proportion of breast cancer patients are nodenegative. Ultrasonography has also been reported to be helpful, especially in conjunction with fine needle aspiration biopsy

  18. Surgery for lymph node metastases of medullary thyroid carcinoma: A review.

    Jin, Linda X; Moley, Jeffrey F

    2016-02-01

    Medullary thyroid carcinoma (MTC) is a neuroendocrine malignancy of the thyroid C cells that occurs in hereditary and sporadic clinical settings. Metastatic spread commonly occurs to cervical and mediastinal lymph nodes. MTC cells do not concentrate radioactive iodine and are not sensitive to hormonal manipulation, and therefore surgery is the most effective option for curative therapy, reduction in tumor burden, or effective palliation. In patients undergoing preventative surgery for hereditary MTC, central lymph node dissection should be considered if the calcitonin level is elevated. Preservation of parathyroid function in these young patients is of paramount importance. In patients with established primary tumors, systematic surgical removal of lymph node basins (compartmental dissection) should be guided by ultrasound mapping of lymph node metastases and level of serum calcitonin. A "berry-picking" approach is discouraged. Newly approved targeted molecular therapies offer wider treatment options for patients with progressive or metastatic disease. PMID:26539937

  19. Cytologic patterns of lymph node diseases in Hawassa University Referral Hospital, Southern Ethiopia

    Gemechu Ameya Buli; FekadeYerakly Lukas

    2015-01-01

    Objective: To assess the cytological patterns of lymph node diseases in patient attended Hawassa University Referral Hospital, Southern Ethiopia. Methods: A five years retrospective descriptive study design was conducted on fine needle aspiration cytology reports of patients referred to pathology laboratory of Hawassa University Referral Hospital from September, 2009 to September, 2014. Results: A total of 1 067 lymph nodes were aspirated in the study period. Cervical lymphadenopathy was the most frequent (48.82%) followed by submandibular (22.77%) lymph nodes. The age group of 11-20 years was the most affected age group while age group above 60 with less frequency. Tuberculosis lymphadenitis was the highest (48.82%), chronic non-specific lymphadenitis (20.33%), reactive (16.21%), pyogenic abscess (5.99%) and the rest were malignancies. Conclusions: Lymphadenopathy can be associated with a wide range of disorders. However tuberculosis lymphadenitis is the most common cause of enlarged lymph node in the study area.

  20. Status and prognosis of lymph node metastasis in patients with cardia cancer – A systematic review

    Okholm, Cecilie; Svendsen, Lars Bo; Achiam, Michael P

    2014-01-01

    BACKGROUND: Adenocarcinoma of the gastroesophageal junction (GEJ) has a poor prognosis and survival rates significantly decreases if lymph node metastasis is present. An extensive lymphadenectomy may increase chances of cure, but may also lead to further postoperative morbidity and mortality....... Therefore, the optimal treatment of cardia cancer remains controversial. A systematic review of English publications dealing with adenocarcinoma of the cardia was conducted to elucidate patterns of nodal spread and prognostic implications. METHODS: A systematic literature search based on PRISMA guidelines...... identifying relevant studies describing lymph node metastasis and the associated prognosis. Lymph node stations were classified according to the Japanese Gastric Cancer Association guidelines. RESULTS: The highest incidence of metastasis is seen in the nearest regional lymph nodes, station no. 1-3 and...

  1. The significance of enlarged cervical lymph nodes in diagnosing thyroid cancer

    Hossam Eldin Mohamed

    2016-01-01

    Conclusion: ECLN are associated with an increased likelihood of thyroid malignancy in the patients undergoing evaluation of a suspicious nodule. The risk of malignancy in thyroid nodules increases with the presence of suspicious ultrasonographic features on cervical lymph nodes.

  2. The relation between lymph node status and survival in Stage I-III colon cancer

    Lykke, J.; Roikjær, Ole; Jess, P.

    2013-01-01

    Aim: This study involved a large nationwide Danish cohort to evaluate the hypothesis that a high lymph node harvest has a positive effect on survival in curative resected Stage I-III colon cancer and a low lymph node ratio has a positive effect on survival in Stage III colon cancer. Method......: Analysis of overall survival was conducted using a nationwide Danish cohort of patients treated with curative resection of Stage I-III colon cancer. All 8901 patients in Denmark diagnosed with adenocarcinoma of the colon and treated with curative resection in the period 2003-2008 were identified from the...... independent prognostic factors in multivariate analysis. Conclusion: High lymph node count was associated with improved overall survival in colon cancer. Lymph node ratio was superior to N-stage in differentiating overall survival in Stage III colon cancer. Stage migration was observed. © 2012 The Authors...

  3. Sentinel Lymph Node Occult Metastases Have Minimal Survival Effect in Some Breast Cancer Patients

    Detailed examination of sentinel lymph node tissue from breast cancer patients revealed previously unidentified metastases in about 16% of the samples, but the difference in 5-year survival between patients with and without these metastases was very small

  4. Computed tomographic high-attenuation mediastinal lymph nodes after aluminum exposition

    Vahlensieck, M.; Overlack, A. [Medical Faculty, Univ. of Bonn (Germany); Mueller, K.M. [Inst. fuer Pathologie, Kliniken Bergmannsheil, Bochum (Germany)

    2000-12-01

    A case with increased computed tomographic densities of mediastinal lymph nodes with histologically proven aluminum storage is presented. We suggest consideration of aluminosis as differential diagnosis in patients with increased native CT densities beyond 50 HU. (orig.)

  5. Partial axillary lymph node dissection inferior to the intercostobrachial nerves complements sentinel node biopsy in patients with clinically node-negative breast cancer

    Li, Jianyi; Jia, Shi; Zhang, Wenhai; QIU, FANG; Zhang, Yang; Gu, XI; Xue, Jinqi

    2015-01-01

    Background The practice of breast cancer diagnosis and treatment in China varies to that in western developed countries. With the unavailability of radioactive tracer technique for sentinel lymph nodes biopsy (SLNB), using blue dye alone has been the only option in China. Also, the diagnosis of breast malignant tumor in most Chinese centres heavily relies on intraoperative instant frozen histology which is normally followed by sentinel lymph nodes mapping, SLNB and the potential breast and ax...

  6. Computed tomographic feature of regional lymph nodes involvement in primary hepatocellular carcinoma

    The resectability of hepatocellular carcinoma is determined by the extent of hepatic involvement, the presence or absence of venous invasion and the presence or absence of extrahepatic metastasis. Extrahepatic spread to regional lymph node represent contraindication to surgical resection. Despite the importance of regional node metastasis, their CT appearance is poorly understood. 19 cases of hepatoma collected during Oct, 1982 to May, 1985 at New York Hospital-Cornell Medical center and 73 cases of hepatoma collected during Mar, 1985 to Sept, 1986 at Yonsei University Medical College were reviewed and analysed. Regional lymph node involvement were divided into four main groups with subgrouping according to the location and lymphatic pathway. 1.lymph nodes in lesser omentum: hepatic, portocaval, left gastric and celiac nodes. 2.lymph nodes around pancrease head: subpyloric, superior mesenteric, preaortic retropancreatic, and precaval retropancreatic lymph nodes. 3.paraaortic nodes: left paraaortic, interaorticocaval, retrocaval and preaortic below 3rd duodenum. 4.phrenic nodes: lower parasternal, middle phrenic and retrocrural nodes. The results were as follows: 1.The frequency of regional node involvement, cases collected at New York Hospital-Cornell Medical center, is hepatic node in 5 (26.3%), portocaval node in 8 (42.1%), left gastric in 4 (21.1%), celiac in 7 (36.8%), precaval retropancreatic in 5 (26.3%) preaortic retropancreatic in 4 (21.1%) interaorticocaval in 7 (36.8%) retrocaval in 4 (21.4%) and lower parasternal in (5.3%). 2.The frequency of regional node involvement, cases collected at Yonsei University college of Medicine, is hepatic in 20.5%, portocaval in 24.7% left gastric in 19.2% celiac in 19.2%, precaval retropancreatic in 8.2%, preaortic retropancreatic in 5.5%, left paraaortic in 12.3%, interaorticocaval in 12.3%, retrocaval in 11.0% low parasternal in 0.8%, superior mesenteric in 4.1% subpyloric 1.4% and preaortic below 3rd duodenum in 1

  7. The expression of HSP60 and HSP10 in large bowel carcinomas with lymph node metastase

    The involvement of Heat Shock Proteins (HSP) in cancer development and progression is a widely debated topic. The objective of the present study was to evaluate the presence and expression of HSP60 and HSP10 in a series of large bowel carcinomas and locoregional lymph nodes with and without metastases. 82 Astler and Coller's stage C2 colorectal cancers, of which 48 well-differentiated and 34 poorly-differentiated, were selected along with 661 lymph nodes, including 372 with metastases and 289 with reactive hyperplasia only, from the same tumours. Primitive tumours and both metastatic and reactive lymph nodes were studied; specifically, three different compartments of the lymph nodes, secondary follicle, paracortex and medullary sinus, were also analysed. An immunohistochemical research for HSP60 and HSP10 was performed and the semiquantitative results were analysed by statistical analysis to determine the correlation between HSPs expression and 1) tumour grading; 2) degree of inflammation; 3) number of lymph nodes involved; 4) lymph node compartment hyperplasia. Moreover, western blotting was performed on a smaller group of samples to confirm the immunohistochemical results. Our data show that the expression of HSP60, in both primary tumour and lymph node metastasis, is correlated with the tumoral grade, while the HSP10 expression is not. Nevertheless, the levels of HSP10 are commonly higher than the levels of HSP60. In addition, statistical analyses do not show any correlation between the degree of inflammation and the immunopositivity for both HSP60 and HSP10. Moreover, we find a significant correlation between the presence of lymph node metastases and the positivity for both HSP60 and HSP10. In particular, metastatic lymph nodes show a higher percentage of cells positive for both HSP60 and HSP10 in the secondary follicles, and for HSP10 in the medullary sinuses, when compared with hyperplastic lymph nodes. HSP60 and HSP10 may have diagnostic and prognostic

  8. A self-control study of three radiopharmaceuticals for locating sentinel lymph node

    Objective: To compare the uptake of antimony colloid, sulfur colloids and DX in the parasternal lymph node of rabbits and to investigate which one is the most suitable for locating sentinel lymph node. Methods: Six rabbits were used in this auto-control study. Radio labeled sulfur colloids, antimony colloid or DX was injected subcutaneously at both side of the xiphoid process. For each rabbit, which pharmaceutical injected firstly and secondly was at random. At first, one of the three pharmaceuticals was used. After a certain period of time, radioactivity of the chest wall of the rabbits was detected. If the radioactivity was proven to be as low as background, another kind of radiopharmaceuticals was injected and the radioactivity was detected. Then after another period of time, the last radiopharmaceutical was injected if the radioactivity of the chest wall was proven to be low enough. The sites of injection were marked. Whole body scan was performed at different time after injection. Radioactivity of the parasternal lymph node and the injected sites was detected with gamma probe. Uptake-time curves were drawn for the three radiopharmaceuticals. The relationship between size of particle and lymphatic uptake rate was studied. Results: At 4 hours after injection, the percent uptake of DX, sulfur colloids and antimony colloid was 10.41% +/- 0.92%, 3.16% +/- 0.30% and 8.06% +/- 0.50, respectively. The difference among the uptake rate of the three radiopharmaceuticals in the parasternal lymph node was statistically significant (p<0.05). The radiopharmaceutical that is the smallest in diameter in this research was DX, which moved quickly along the lymphatic chain. The ratio of radioactivity of the first lymph node to other lymph node along the lymphatic chain was not high enough and the first lymph node can not be easily identified by gamma probe. Sulfur colloid was the largest in diameter. It was trapped by the first lymph node along the lymphatic chain after being

  9. Lymphatic mapping and sentinel lymph node detection in patients with breast cancer

    Objectives: To localize sentinel lymph node (SLN) and to test the hypothesis that the histologic characteristics of the SLN can predict the histologic characteristic of the remaining lymph nodes along the lymphatic chain. To calculate the absorbed dose of patients, doctors and nurses. Methods: Seventy-one patients with early-stage breast cancer underwent SLN localization using filtered technetium-99m labeled sulfur colloid, blue dye, or combination of them. SLN was identified as a blue lymph node and/or a 'hot lymph node' detected by ex vivo gamma probe. A 'hot lymph node' is the lymph node the radioactivity of which was 10 times higher than that of background. Pathological examination was performed with all resected lymph nodes. The approximate absorbed dose of the patients, doctors and nurses was calculated by using MIRD techniques. Results: For patients who were injected with only blue dye, the sensitivity, accuracy and false negative rate was 80.0%, 90.7% and 20.0% respectively. For patients who were injected with only radioactive colloids, the sensitivity, accuracy and false negative rate was 100%, 100% and 0% respectively. For patients who were injected with both blue dye and radioactive colloids, the sensitivity, accuracy and false negative rate was 100%, 100% and 100% respectively. The absorbed dose of breast tissue was 26.52 rad. The absorbed dose of nuclear medicine doctors, surgeons, nurses and pathologists was 1.9x10-2 rad, 9.6x10-3 rad, 3.8x10-4 rad and 9.6x10-3 rad respectively. Conclusions: Lymphatic mapping and SLN biopsy were the most effective when a combination of blue dye and radio-labeled sulfur colloid was used. Radio-labeled sulfur colloid was safe to patients and the medical staff. SLN biopsy had the potential value for avoiding unnecessary axillary lymph nodes resection for patients with early-stage breast cancer

  10. Occult distal urethral carcinoma presenting as metastatic carcinoma in the inguinal lymph nodes.

    Hammer-Hansen, Niels; Høyer, Søren; Jensen, Jørgen Bjerggaard

    2015-02-01

    A 65-year-old man presented with metastatic squamous cell carcinoma in the inguinal lymph nodes from an unknown primary tumour. The initial work-up lacked clinical examination of the glans penis, in part due to the patient having phimosis. More than a year after presentation, a primary tumour, located distally on the penis, was diagnosed. A discussion of urethral carcinoma as well as inguinal lymph-node metastasis of unknown primary tumour is presented. PMID:25313619

  11. Exploring molecular links between lymph node invasion and cancer prognosis in human breast cancer

    Kim, Sangwoo; Nam, Hojung; Lee, Doheon

    2011-01-01

    Abstract Background Lymph node invasion is one of the most powerful clinical factors in cancer prognosis. However, molecular level signatures of their correlation are remaining poorly understood. Here, we propose a new approach, monotonically expressed gene analysis (MEGA), to correlate transcriptional patterns of lymph node invasion related genes with clinical outcome of breast cancer patients. Results Using MEGA, we scored all genes with their transcriptional patterns ov...

  12. Exploring molecular links between lymph node invasion and cancer prognosis in human breast cancer

    Kim Sangwoo; Nam Hojung; Lee Doheon

    2011-01-01

    Abstract Background Lymph node invasion is one of the most powerful clinical factors in cancer prognosis. However, molecular level signatures of their correlation are remaining poorly understood. Here, we propose a new approach, monotonically expressed gene analysis (MEGA), to correlate transcriptional patterns of lymph node invasion related genes with clinical outcome of breast cancer patients. Results Using MEGA, we scored all genes with their transcriptional patterns over progression level...

  13. Rapid Stereology Based Quantitative Immunohistochemistry of Dendritic Cells in Lymph Nodes: A Methodological Study

    van Hensbergen, Yvette; Luykx‐de Bakker, Sylvia A.; Heideman, Daniëlle A.M.; Meijer, Gerrit A.; Pinedo, Herbert M.; Paul J. van Diest

    2001-01-01

    This study was done to arrive at a fast and reliable protocol for assessment of fractional volumes of immunohistochemically stained dendritic cells in lymph nodes. Twenty axillary lymph nodes of patients with locally advanced breast cancer were immuno‐histochemically stained with an S100 antibody. Fractional volumes of dendritic cells were assessed by stereology based quantitative immunohistochemistry using an interactive video overlay system including an automated microscope. The gold standa...

  14. Handheld array-based photoacoustic probe for guiding needle biopsy of sentinel lymph nodes

    Kim, Chulhong; Todd N. Erpelding; Maslov, Konstantin; Jankovic, Ladislav; Akers, Walter J.; Liang SONG; Achilefu, Samuel; Margenthaler, Julie A.; Pashley, Michael D.; Wang, Lihong V.

    2010-01-01

    By modifying a clinical ultrasound array system, we develop a novel handheld photoacoustic probe for image-guided needle biopsy. The integration of optical fiber bundles for pulsed laser light delivery enables photoacoustic image-guided insertion of a needle into rat axillary lymph nodes with accumulated indocyanine green (ICG). Strong photoacoustic contrast of the needle is achieved. After subcutaneous injection of the dye in the left forepaw, sentinel lymph nodes are easily detected, in viv...

  15. Plasma cells increased markedly in lymph node in hemophagocytic syndrome: a case report

    Congyang, Li; Xuexin, Hu; Hao, Li; Chunge, Li; Yingye, Miao

    2009-01-01

    Introduction Hemophagocytic syndrome is a rare clinicopathological condition characterized by the activation of the mononuclear phagocyte system, resulting in hemophagocytosis in the reticuloendothelial systems. The pathogenesis of HPS remains unclear. Case presentation We report the case of a 20-year-old soldier suffering from HPS. Because of long history fever and no reasons being found, his left groin lymph node and left neck lymph node biopsy were done with two weeks interval. We found a ...

  16. Current Status of Optical Imaging for Evaluating Lymph Nodes and Lymphatic System

    Lee, Eun Seong; Kim, Tae Sung; Kim, Seok-Ki

    2015-01-01

    Optical imaging techniques use visual and near infrared rays. Despite their considerably poor penetration depth, they are widely used due to their safe and intuitive properties and potential for intraoperative usage. Optical imaging techniques have been actively investigated for clinical imaging of lymph nodes and lymphatic system. This article summarizes a variety of optical tracers and techniques used for lymph node and lymphatic imaging, and reviews their clinical applications. Emerging ne...

  17. Comparison of five staging systems of lymph node metastasis in the gastric carcinoma

    Ali Chehrei; Sakineh Amoueian; Jamshid Ansari; Mehdi Montazer; Mohammad Hossein Sanei

    2013-01-01

    Background: The presence of metastatic lymph nodes is the most important prognostic factor for gastric carcinoma; however, the optimal system for the accurate staging of lymph node metastasis for patients with gastric cancer remains controversial. This study was designed to compare five systems in relation to the N classification of gastric carcinoma. Materials and Methods: This multicentric historical cohort study was conducted on 148 patients with M0 gastric adenocarcinoma who underwent gas...

  18. Lymph node metastases and prognosis in oesophageal carcinoma- a systematic review

    Kayani, B.; Zacharakis, E.; Ahmed, K.; Hanna, G. B.

    2011-01-01

    Abstract Oesophageal cancer is the seventh most common cause of cancer-related death in the developed world and the incidence of oesophageal adenocarcinoma is now the fastest growing of any gastrointestinal cancer. Lymph node involvement is the single most important prognostic factor in oesophageal cancer. Imaging to determine the extent of lymph node involvement and plan treatment often requires a combination of modalities to avoid under-staging. The seventh edition of the staging...

  19. Effects of autotransplanted lymph node fragments on the lymphatic system in the pig model

    Blum, K. S.; Hadamitzky, C.; Gratz, K. F.; Pabst, R.

    2009-01-01

    Abstract Secondary lymphedema often develops after removal of lymph nodes in combination with radiation therapy, in particular in patients with breast cancer, inguinal cancer, cervical cancer and melanoma. No convincing treatment for the prevention and therapy of acquired lymphedema exists so far, therefore we wanted to show the reintegration of transplanted avascular lymph node fragments in the lymphatic system and positive effects of the transplanted fragments on the restoration ...

  20. Differential T Cell Function and Fate in Lymph Node and Nonlymphoid Tissues

    Harris, N. L.; Watt, V; Ronchese, F.; Le Gros, G.

    2002-01-01

    The functions and fate of antigen-experienced T cells isolated from lymph node or nonlymphoid tissues were analyzed in a system involving adoptive transfer of in vitro-activated T cells into mice. Activated T cells present in the lymph nodes could be stimulated by antigen to divide, produce effector cytokines, and migrate to peripheral tissues. By contrast, activated T cells that had migrated into nonlymphoid tissues (lung and airway) produced substantial effector cytokines upon antigen chall...

  1. Distinctive localization of antigen-presenting cells in human lymph nodes

    Angel, Catherine E.; Chen, Chun-Jen J.; Horlacher, Oliver C.; Winkler, Sintia; John, Thomas; Browning, Judy; MacGregor, Duncan; Cebon, Jonathan; Dunbar, P. Rod

    2009-01-01

    Professional antigen-presenting cells (APCs) are sentinel cells of the immune system that present antigen to T lymphocytes and mediate an appropriate immune response. It is therefore surprising that knowledge of the professional APCs in human lymph nodes is limited. Using 3-color immunohistochemistry, we have identified APCs in human lymph nodes, excluding plasmacytoid APCs, that fall into 2 nonoverlapping classes: (1) CD209+ APCs, coexpressing combinations of CD206, CD14, and CD68, that occu...

  2. Accumulation of Immature Langerhans Cells in Human Lymph Nodes Draining Chronically Inflamed Skin

    Geissmann, F.; Dieu-Nosjean, M.C.; Dezutter, C.; Valladeau, J.; Kayal, S.; Leborgne, M; Brousse, N; Saeland, S.; Davoust, J.

    2002-01-01

    The coordinated migration and maturation of dendritic cells (DCs) such as intraepithelial Langerhans cells (LCs) is considered critical for T cell priming in response to inflammation in the periphery. However, little is known about the role of inflammatory mediators for LC maturation and recruitment to lymph nodes in vivo. Here we show in human dermatopathic lymphadenitis (DL), which features an expanded population of LCs in one draining lymph node associated with inflammatory lesions in its ...

  3. THE EXPRESSION OF HSP60 AND HSP10 IN LARGE BOWEL CARCINOMAS WITH LYMPH NODE METASTASE

    Bartolotta Tommaso E; Marasà Lorenzo; Bucchieri Fabio; Rappa Francesca; David Sabrina; Cappello Francesco; Farina Felicia; Zummo Giovanni

    2005-01-01

    Abstract Background The involvement of Heat Shock Proteins (HSP) in cancer development and progression is a widely debated topic. The objective of the present study was to evaluate the presence and expression of HSP60 and HSP10 in a series of large bowel carcinomas and locoregional lymph nodes with and without metastases. Methods 82 Astler and Coller's stage C2 colorectal cancers, of which 48 well-differentiated and 34 poorly-differentiated, were selected along with 661 lymph nodes, including...

  4. Electron microscopic study on amyloid fibril formation in human lymph nodes

    Michio Dobashi; Fumiaki Yuda; Akihiro Masuda; Kazuo Terashima; Yutaka lmai

    1986-01-01

    The purpose of this investigation was to clarify the mechanisms of amyloid fibril formation in human lymph nodes. In our present study, amyloid deposition was observed diffusely in all compartments of the lymph nodes. The deposition form showed extremely characteristic findings in its morphological features. Namely, amyloid deposits mainly consisted of clusters of round or oval nodules. Each amyloid nodule was frequently enclosed with long-stretched cytoplasmic...

  5. Sentinel lymph node mapping of a breast cancer of the vulva: Case report and literature review

    Cripe, James; Eskander, Ramez; Tewari, Krishnansu

    2015-01-01

    Ectopic breast tissue is rare and typically presents as an axillary mass. Previous reports have identified ectopic breast tissue in the vulva, but malignancy is exceedingly uncommon. We present a 62 years old with locally advanced breast carcinoma arising in the vulva demonstrates the utilization of sentinel lymph node mapping to identify metastatic lymph nodes previously unable to be identified via traditional surgical exploration. Our case supports the principles of adjuvant therapy for bre...

  6. Scanning acoustic microscopy for characterization of neoplastic and inflammatory lesions of lymph nodes

    Miura, Katsutoshi; Nasu, Hatsuko; Yamamoto, Seiji

    2013-01-01

    A scanning acoustic microscope (SAM) imaging system calculates and color codes speed of sound (SOS). We evaluated the SAM results for lymph node imaging and compared these results with those of light microscopy (LM). SAM showed normal structures and localized/diffuse lesions of the lymph node. Our results revealed that as a rule, soft areas such as cystic necrosis presented less SOS while harder areas such as coagulative necrosis, granulomas, and fibrosis exhibited greater SOS. SOS increased ...

  7. Recurrent giant cell tumor of bone with simultaneous regional lymph node and pulmonary metastases

    Qureshi, Sajid S.; Puri, Ajay; Agarwal, Manish [Tata Memorial Hospital, Department of Bone and Soft Tissue, Bombay (India); Desai, Saral; Jambhekar, Nirmala [Tata Memorial Hospital, Department of Pathology, Bombay (India)

    2005-04-01

    Giant cell tumors of bone are known for their unpredictable behavior characterized occasionally even by metastases. Most metastases lodge in the lungs but other rare sites are regional lymph nodes, mediastinum, skin, scalp and the pelvis. In this case report we document a case of giant cell tumor of the patella in which, associated with local recurrence, there were simultaneous metastases to lymph nodes and lungs. (orig.)

  8. The trial of ultrasonography for metastatic lymph nodes and the investigation of radiotherapeutic effect with ultrasonography

    The Ultrasonographic examination to 174 cases of superficial metastatic lymph nodes and 104 cases of intraabdominal metastatic lymph nodes was performed from July 1980 to September 1984. Radiation therapy was performed to 94 cases of these 278 cases, and the author followed the therapeutic effect by ultrasonography. Furthermore, experimental ultrasonogram of the resected lymph nodes was gained, and the auther reached following conclusion; 1. Two hundreds and fifty-three cases (91 %) of total 278 cases revealed low echo patterns, and rest 25 cases (9 %) were mixed echo patterns. Concerning the size of lymph nodes, lymph nodes in 210 cases (83 %) of total 253 cases which were displayed as low echo patterns were less than 40 mm in maximum diameter, and in 15 cases (60 %) of 25 cases with mixed echo patterns, they were more than 40 mm in maximum diameter. 2. In 94 cases which were received radiation therapy, 38 cases (40 %) were assesed as ''Complete Response (CR)''. And these CR were recognized with high rate in the cases of malignant lymphoma (81 %) and lung cancer (50 %). CR rate was 53 % in cases which maximum diameter were less than 30 mm, and 24 % more than 30 mm. Also CR rate was 44 % in cases with low echo patterns and 21 % in those with mixed echo patterns. Location of lymph nodes and radiation dose had no influence on CR rate. V 1/2 dose was less than 30 Gy in 53 cases (86 %) of 74 cases and was less than 30 Gy in 37 cases (97 %) of 38 cases with CR. 3. In resected lymph nodes, metastatic lymph nodes were shown with high rate as low echo patterns. Assuming that the low echo pattern means metastasis, their sensitivity, specificity and accuracy were respectively 91 %, 56 % and 81 %. (author)

  9. Impact of tumor chronology and tumor biology on lymph node metastasis in breast cancer

    Smeets, Ann; Ryckx, Andries; Belmans, Ann; Wildiers, Hans; Neven, Patrick; Floris, Giuseppe; Schöffski, Patrick; Christiaens, Marie-Rose

    2013-01-01

    Synopsis The significance of nodal metastasis in breast cancer is under discussion. We investigated the impact of variables of tumor chronology and tumor biology on the presence of lymph node metastases. Purpose Lymph node involvement is the main prognostic factor in breast cancer. However, it is under discussion whether nodal metastasis in breast cancer only reflects the chronological age of the tumor or whether it is also a marker of tumor biology. The goal of our study was to investigate t...

  10. Decreased Lymphangiogenesis and Lymph Node Metastasis by mTOR Inhibition in Head and Neck Cancer

    Patel, Vyomesh; Marsh, Christina A.; Dorsam, Robert T.; Mikelis, Constantinos M.; Masedunskas, Andrius; Amornphimoltham, Panomwat; Nathan, Cherie Ann; Singh, Bhuvanesh; Weigert, Roberto; Molinolo, Alfredo A.; Gutkind, J. Silvio

    2011-01-01

    Despite our improved understanding of cancer, the 5-year survival rate for head and neck squamous cell carcinomas (HNSCC) patients remains relatively unchanged at 50% for the past three decades. HNSCC often metastasize to locoregional lymph nodes, and lymph node involvement represents one of the most important prognostic factors of poor clinical outcome. Among the multiple dysregulated molecular mechanism in HNSCC, emerging basic, preclinical, and clinical findings support the importance of t...

  11. The prognostic significance of extramural deposits and extracapsular lymph node invasion in colon cancer.

    Al Sahaf, Osama

    2011-08-01

    The status of resected lymph nodes in colon cancer determines prognosis and further treatment. The American Joint Committee on Cancer staging system has designated extramural nodules as nonnodal disease and classified them as extensions of the T category in the sixth edition and as site-specific tumor deposits in the seventh edition. Extracapsular lymph node extension is an established poor prognostic indicator in many cancers. Its significance in colon cancer has not been extensively investigated.

  12. Adjuvant radiotherapy after salvage lymph node dissection because of nodal relapse of prostate cancer versus salvage lymph node dissection only

    Rischke, Hans Christian [University of Freiburg, Department of Radiation Oncology, Freiburg (Germany); University of Freiburg, Department of Nuclear Medicine, Freiburg (Germany); Schultze-Seemann, Wolfgang; Kroenig, Malte; Schlager, Daniel; Jilg, Cordula Annette [University of Freiburg, Department of Urology, Freiburg (Germany); Wieser, Gesche [University of Freiburg, Department of Nuclear Medicine, Freiburg (Germany); Drendel, Vanessa [University of Freiburg, Department of Pathology, Freiburg (Germany); Stegmaier, Petra; Henne, Karl; Volegova-Neher, Natalia; Grosu, Anca-Ligia [University of Freiburg, Department of Radiation Oncology, Freiburg (Germany); Krauss, Tobias; Kirste, Simon [University of Freiburg, Department of Radiology, Freiburg (Germany)

    2015-04-01

    Nodal pelvic/retroperitoneal recurrent prostate cancer (PCa) after primary therapy can be treated with salvage lymph node dissection (salvage-LND) in order to delay disease progression and offer cure for a subset of patients. Whether adjuvant radiotherapy (ART) in affected regions improves the outcome by elimination of residual tumour burden remains unclear. A total of 93 patients with exclusively nodal PCa relapse underwent choline-positron-emission tomography-computed-tomography-directed pelvic/retroperitoneal salvage-LND; 46 patients had surgery only and 47 patients received ART in regions with proven lymph node metastases. In case of subsequent prostate specific antigen (PSA) progression, different imaging modalities were performed to confirm next relapse within or outside the treated region (TR). Mean follow-up was 3.2 years. Lymphatic tumour burden was balanced between the two groups. Additional ART resulted in delayed relapse within TR (5-year relapse-free rate 70.7 %) versus surgery only (5-year relapse-free rate 26.3 %, p < 0.0001). In both treatment arms, time to next relapse outside the TR was almost equal (median 27 months versus 29.6 months, p = 0.359). With respect to the detection of the first new lesion, regardless if present within or outside the TR, 5 years after the treatment 34.3 % of patients in the group with additional ART were free of relapse, versus 15.4 % in the surgery only group (p = 0.0122). ART had no influence on the extent of PSA reduction at latest follow-up compared to treatment with surgery only. ART after salvage-LND provides stable local control in TR and results in overall significant improved next-relapse-free survival, compared to patients who received surgery only in case of nodal PCa-relapse. (orig.) [German] Das nodal positive Prostatakarzinom(PCa)-Rezidiv nach Primaertherapie kann durch eine Salvage-Lymphadenektomie (Salvage-LND) therapiert werden. Der Krankheitsprogress wird aufgehalten und selektionierte Patienten

  13. Isolation of Escherichia coli from lymph nodes of bovine carcasses and detection of hlyA gene with PCR

    P. Sechi

    2012-10-01

    Full Text Available A potential source of pathogenic bacteria in ground beef is the lymphatic system, specifically the lymph nodes. The objective of the current study was to determine the prevalence of Escherichia coli in bovine lymph nodes. Bovine lymph nodes (n = 200 were collected from 100 carcasses at a commercial slaugh-terhouse. 192 lymph nodes sampled were obtained from 96 regular slaughter, and the remainder 8 were obtained from 4 emergency slaughter. Subiliaci lymph nodes were collected for this study. E. coli preva-lence in the lymph node samples was high, with an overall prevalence of 59.00%. Lymph nodes from emergency slaughter carcasses had a higher prevalence (75.00% of E. coli than did those from regular slaughter carcasses (58.33%. hlyA gene was never detected.

  14. CONSIDERATIONS ON ANATOMY AND PHYSIOLOGY OF LYMPH VESSELS OF UPPER AERO DIGESTIVE ORGANS AND CERVICAL SATELLITE LYMPH NODE GROUP.

    Ciupilan, Corina; Stan, C I

    2016-01-01

    The almost constant local regional development of the cancers of upper aero digestive organs requires the same special attention to cervical lymph node metastases, as well as to the primary neoplastic burning point. The surgical therapy alone or associated has a mutilating, damaging character, resulting in loss of an organ and function, most of the times with social implications, involving physical distortions with aesthetic consequences, which make the reintegration of the individual into society questionable. The problem of cervical lymph node metastases is vast and complex, reason why we approached several anatomical and physiological aspects of lymph vessels of the aero digestive organs. Among the available elements during treatment, the headquarters of the tumour, its histologic degree, and its infiltrative nature, each of them significantly influences the possibility of developing metastases. PMID:27483727

  15. Analysis of reticulin fiber pattern in lymph nodes with metastasis from oral squamous cell carcinoma

    Shanmukha Raviteja Yinti

    2015-01-01

    Full Text Available Introduction: The aim of the study was to determine the susceptibility of lymph nodes to metastasis in oral squamous cell carcinoma (OSCC by analyzing the alterations in reticulin fiber pattern. Materials and Methods: This retrospective study on 30 cases of OSCC had 15 cases that presented with lymph node metastasis (test group and 15 cases without metastatic episodes (control group. Four micron thick sections of the tumor proper and the resected lymph nodes of the cases were stained with hematoxylin and eosin, and Gordon and Sweet′s stain for reticulin. Statistical analysis of the variations in the staining patterns of reticulin at the invasive tumor front (ITF, involved and uninvolved lymph nodes were done with Statistical Package for Social Sciences (SPSS 15 version using chi-square test. Results: The assessment of reticulin fiber patterns at the ITF, cortical and medullary areas of lymph nodes in test cases showed thin, long individual fibers, as compared to thick, shorter interlacing fibers that were seen in control cases. The peritumoral and uninvolved areas in metastatic lymph nodes of almost all test cases showed very scant fibers. Conclusion: Reticulin pattern alteration by aggressive tumors may be appreciated as a part of the wide spectrum of "proneoplastic" stromal alterations. The histopathologist can discern these changes and thereby aid the clinician in predicting tumor behavior, the clinical course of the disease, and weighing the prognostic implications.

  16. Prediction of lymph node status in patients with intrahepatic cholangiocarcinoma: analysis of 320 surgical cases

    Zhao-ChongZeng

    2011-11-01

    Full Text Available Purpose: This study was conducted to identify factors involved in lymph node metastasis (LNM and evaluate their role in predicting LNM in clinically lymph node negative (clinical stage I-III intrahepatic cholangiocarcinoma (ICC. Materials and Methods: We selected 320 patients who were diagnosed with ICC with no apparent clinical LNM (T1-3N0M0. Age, gender, tumor boundary, histological differentiation, tumor size and CA19-9 value were the studied factors. Univariate and multivariate logistic analysis were conducted. Receiver operating characteristics (ROC curve analysis was used to test the predicting value of each factor and a test which combined the associated factors was used to predict LNM. Results: LNM was observed in 76 cases (76/320, 23.8%. Univariate and multivariate analysis showed that histological differentiation as well as tumor boundary and tumor size significantly correlated with LNM. The sensitivity and negative predictive value (NPV for LNM for the three factors when combined was 96.1% and 95% respectively. This means that 5% of the patients who did not have the risk factors mentioned above developed LNM. Conclusions: This model used the combination of three factors (low-graded histological differentiation, distinct tumor boundary, small tumor size and they proved to be useful in predicting lymph node metastasis in ICC with clinically lymph node negative cases. In patients with these criteria, lymph node dissection or lymph node irradiation may be omitted and such cases may also be good candidates for stereotactic body radiotherapy (SBRT.

  17. Primary Mucoepidermoid Carcinoma Arising from Ectopic Salivary Tissue within an Intraparotid Lymph Node

    Faras, Fatemah; Abo-Alhassan, Fawaz; Bastaki, Jassem; Al-Sihan, Mutlaq K.

    2015-01-01

    Ectopic salivary tissue is commonly found in intraparotid and periparotid lymph nodes. Warthin tumor is the most common tumor arising in ectopic salivary gland tissue and in intraparotid lymph nodes. Although rare, neoplastic transformation of the ectopic salivary tissues is conceivable and other types of salivary gland neoplasms arising in intraparotid lymph nodes have been reported. Herein we report a rare case of a 32-year-old Kuwaiti male who presented with a mass in the right parotid gland. A preoperative fine needle aspiration suggested Warthin tumor. The patient underwent a superficial parotidectomy. The specimen showed a mass within the parotid parenchyma abutting the deep margin. Hematoxylin and Eosin stained sections of the lesion showed solid islands and cysts composed of epidermoid cells, mucus cells, and intermixed smaller “intermediate” cells within an intraparotid lymph node. The tumor was seen infiltrating the parotid parenchyma at the deep margin. Metastasis from distant sites was ruled out clinically, and the diagnosis rendered was MEC, low-grade, arising from ectopic salivary tissue in an intraparotid lymph node. Such cases are extremely rare and the presence of malignancies within lymph nodes may pose a diagnostic pitfall, which can affect patient management. PMID:26697253

  18. Prognostic implication of predominant histologic subtypes of lymph node metastases in surgically resected lung adenocarcinoma.

    Suda, Kenichi; Sato, Katsuaki; Shimizu, Shigeki; Tomizawa, Kenji; Takemoto, Toshiki; Iwasaki, Takuya; Sakaguchi, Masahiro; Mitsudomi, Tetsuya

    2014-01-01

    The International Association for the Study of Lung Cancer, American Thoracic Society, and European Respiratory Society (IASLC/ATS/ERS) proposed a new classification for lung adenocarcinoma (AD) based on predominant histologic subtypes, such as lepidic, papillary, acinar, solid, and micropapillary; this system reportedly reflects well outcomes of patients with surgically resected lung AD. However, the prognostic implication of predominant histologic subtypes in lymph nodes metastases is unclear so far. In this study, we compared predominant subtypes between primary lung tumors and lymph node metastatic lesions in 24 patients with surgically treated lung adenocarcinoma with lymph node metastases. Additionally, we analyzed prognostic implications of these predominant histologic subtypes. We observed several discordance patterns between predominant subtypes in primary lung tumors and lymph node metastases. Concordance rates were 22%, 64%, and 100%, respectively, in papillary-, acinar-, and solid-predominant primary lung tumors. We observed that the predominant subtype in the primary lung tumor (HR 12.7, P = 0.037), but not that in lymph node metastases (HR 0.18, P = 0.13), determines outcomes in patients with surgically resected lung AD with lymph node metastases. PMID:25371901

  19. Prognostic Implication of Predominant Histologic Subtypes of Lymph Node Metastases in Surgically Resected Lung Adenocarcinoma

    Kenichi Suda

    2014-01-01

    Full Text Available The International Association for the Study of Lung Cancer, American Thoracic Society, and European Respiratory Society (IASLC/ATS/ERS proposed a new classification for lung adenocarcinoma (AD based on predominant histologic subtypes, such as lepidic, papillary, acinar, solid, and micropapillary; this system reportedly reflects well outcomes of patients with surgically resected lung AD. However, the prognostic implication of predominant histologic subtypes in lymph nodes metastases is unclear so far. In this study, we compared predominant subtypes between primary lung tumors and lymph node metastatic lesions in 24 patients with surgically treated lung adenocarcinoma with lymph node metastases. Additionally, we analyzed prognostic implications of these predominant histologic subtypes. We observed several discordance patterns between predominant subtypes in primary lung tumors and lymph node metastases. Concordance rates were 22%, 64%, and 100%, respectively, in papillary-, acinar-, and solid-predominant primary lung tumors. We observed that the predominant subtype in the primary lung tumor (HR 12.7, P = 0.037, but not that in lymph node metastases (HR 0.18, P = 0.13, determines outcomes in patients with surgically resected lung AD with lymph node metastases.

  20. Patho-anatomical demonstration of lymph node metastases in a surgical specimen.

    Schmitz-Moormann, P; Thomas, C; Pohl, C; Söhl, R

    1982-10-01

    The prognosis of malignant disease is mainly determined by the demonstration or exclusion of lymph node metastases. However, other findings must also be considered, e.g., the number of lymph nodes examined and involved by tumor, differentiation between micro- and macrometastases, intranodal and perinodal growth, and non-neoplastic changes. These findings cannot be established with certainty when conventional examination methods (lamination and palpation) are used. Satisfactory results can only be obtained by employing a clearing technique and by processing the lymph nodes in step sections. For the speedy clearing of adipose tissue two devices have been developed in which hot acetone and xylene act on the tissue. In the transparent adipose tissue the lymph nodes can be easily recognized and accurately correlated topographically. In comparison to the routine method, the number of lymph nodes and nodal metastases detected can be doubled or tripled with this technique and with step sections. In particular, lymph nodes less than 5 mm in size and micrometastases (less than 2 mm) are visualized. PMID:7155982

  1. Clinicopathological Characteristics as Predictive Factrs for Lymph Node Metastasis in Submucosal Gastric Cancer

    2007-01-01

    OBJECTIVE To identify clinicopathological characteristics as predictive factors for lymph node metastasis in submucosal gastric cancer, and in addition to establish objective criteria as indications for endoscopic submucosal dissection (ESD).METHODS Data from 130 patients with submucosal gastric cancer were collected, and the relationship between their clinicopathological characteristics and the presence of lymph node metastasis was retrospectively analyzed by multivariate analysis.RESULTS In the multivariate logistic regression model, a tumor size of 2 cm or more and an undifferentiated histologic type were found to be independent risk clinicopathological characteristics for lymph node metastasis.Among 130 patients with submucosal carcinoma, no lymph node metastases were observed in 17 patients who showed neither of the two risk clinicopathological characteristics. Lymph node metastasis occurred in 61.1% (22/36) of the patients who had both risk clinicopathological characteristics.CONCLUSION A tumor size of 2 cm or more and an undifferentiated histologic type were significantly and independently related to lymph node metastasis in submucosal gastric cancer. It is rational for the paitients with neither of these two independent risk clinicopathological characteristics to undergo an ESD.

  2. Cytological evaluation of enlarged lymph nodes in metastatic disease: A hospital-based assessment

    Ghazala Mehdi

    2015-01-01

    Full Text Available Background: Lymphadenopathy is a heterogeneous entity with many underlying causes, ranging from self-limiting benign disease to severe neoplastic proliferations. Fine-needle aspiration is a cost-effective and reliable tool for initial investigation of enlarged lymph nodes. Materials and Methods: A study was conducted on 326 patients with metastatic disease in order to evaluate the efficacy of cytology in diagnosing malignancies metastatizing to the lymph node and predicting their primary origin as well as to find the relative frequency of different malignancies. The findings were also correlated with histopathology. Results: Cervical lymph nodes were the most frequently involved group, followed by axillary, supraclavicular, and inguinal lymph nodes. Squamous cell carcinoma (SCC and adenocarcinoma were the most common cytological diagnosis. Among the cases with known primary tumors, head and neck was the most common site followed by breast carcinoma. Most common lymph node group to be aspirated in cases with unknown primary was cervical lymph node, and SCC was most frequently diagnosed cases. Sensitivity and positive predictive value of cytological diagnosis were calculated to be 100% and 93.1%, respectively. Conclusion: Fine-needle aspiration cytology has a very high sensitivity and positive predictive value and hence, a presumptive diagnosis can be made along with the detection of the primary site in case of metastatic disease.

  3. [Structuro-functional changes in dog liver and regional lymph node lysosomes in toxic hepatitis].

    Borodin, Iu I; Korolenko, T A; Malygin, A E; Pupyshev, A B; Sharaĭkina, E O

    1978-10-01

    Structural and functional changes in the dog liver and regional lymph nodes lysosomes were studied during toxic hepatitis induced by CCl4 administration (single and repeated). Total activity of lysosomal enzymes (acid RNA-ase and beta-galactosidase) was higher in the regional lymph nodes than in the liver, reflecting the barrier, protective function of the organ. During acute toxic hepatitis the specific activities of acid RNA-ase and cathepsin D displayed a sharp rise. No normalization of the indices under study occurred during the observation period (from 8 to 30 days). At the same time there was a rise of the regional lymph node weight and an elevation of the relative macrophage and neutrophil content in the sinuses. The increased activity of the lysosome enzymes in the regional lymph nodes in injury of the liver was connected with greater functional load on the lymph nodes effecting hydrolysis of biopolymeres which penetrated into the regional lymphatic node with the lymph. PMID:708870

  4. A new method in thoracoscopic inferior mediastinal lymph node biopsy: a case report

    Sanlı Maruf

    2009-11-01

    Full Text Available Abstract Introduction We performed video-thoracoscopy with a video-mediastinoscope to conduct a mediastinal lymph node biopsy. Here, we discuss the various advantages of the method. Case presentation A 56-year-old Turkish Caucasian man had been complaining of dyspnea on exertion, hacking cough, fever and continuous sweating for one and a half months. Thoracic computed tomography revealed enlarged paratracheal and aorticopulmonary lymph nodes, the largest of which was 1 cm in diameter and reticulo-micronodular interstitial infiltration extending symmetrically to the pleural surfaces in both pulmonary perihilar areas. Computed tomography supported positron emission tomography showed increased fluorodeoxyglucose retention in lymph nodes in both hilar areas (10R and 10L (maximum standardized uptake values 5.6 and 5.7, and in the right lower paratracheal (4R (maximum standardized uptake value 4.1 and right para-esophageal (8 (maximum standardized uptake value 8.9 lymph nodes. Pathological examination of the right lymph node number 8 biopsy using the video-mediastinoscope revealed the presence of granulomatous inflammation. No problems were observed during the postoperative period. Conclusion The use of the video-mediastinoscope for inferior lymph node biopsy in thoracoscopy is an easy, safe and practical method, especially in patients with pleural adhesions.

  5. Dua-energy virtual noncontrast imaging in diagnosis of cervical metastasis lymph nodes

    Fei Fu

    2015-01-01

    Full Text Available Objective: The aim of this study was to evaluate the clinical value of dua-energy virtual noncontrast imaging (DVNCT in the diagnosis of cervical metastasis lymph nodes. Materials and Methods: From February 2014 to January 2015, 41 patients with 98 enlarged cervical lymph nodes were recruited in this study. All the enlarged lymph nodes were pathology confirmed. The patients received DVNCT and conventional noncontrast scan. The difference of average computed tomography (CT value, signal to noise ratio, a contrast to noise ratio, image subjective assessment, and lesion detectability between virtual noncontrast imaging and conventional noncontrast scan were compared. The radiation dose of virtual noncontrast imaging and real noncontrast imaging of cervical lymph node were also compared. The diagnostic sensitivity and specificity for DVNCT was also evaluated. Results: No statistical difference of average CT value, signal to noise ratio, a contrast to noise ratio, image subjective assessment, and radiation dosage between virtual noncontrast imaging and conventional noncontrast scan were found. However, the radiation dosage of DVNCT was significant lower than that of conventional noncontrast scan (P < 0.05. The diagnostic sensitivity and specificity for malignant metastasis lymph node were 88.6% and 70.3% by DVNCT. Conclusion: DVNCT combined with contrast imaging can provide clear images in the diagnosis of enlarged cervical lymph nodes and reduce radiation dosage.

  6. Intraoperative rapid detection of micrometastasis in sentinel lymph nodes of oral malignant tumors

    Metastases to cervical lymph nodes are the most significant prognostic factor for patients with oral malignant tumors. Because oral neoplastic cells often have subclinical metastases in the neck, the management and treatment of patients with a clinically N0 neck remains controversial. In the previous study, we developed a method for the genetic diagnosis of micrometastasis in cervical lymph nodes. In the present study, we performed sentinel lymph node biopsy on 10 cases with clinically N0 necks and attempted to detect the micrometastasis rapidly. Sentinel lymph node was identified by 99mTc-Tin colloid and blue dye injection. Subsequently, extirpated sentinel lymph nodes were subjected to pathological examination using serial sections and to genetic diagnosis based on squamous cell carcinoma (SCC) mRNA by real-time quantitative polymerase chain reaction (PCR). Using these techniques, we demonstrated that 3 cases contained subclinical metastases. These results suggest that rapid detection of micrometastases in sentinel lymph nodes is very useful for the treatment of patients with a clinically N0 neck. (author)

  7. Prevention of Lymphedematous Change in the Mouse Hindlimb by Nonvascularized Lymph Node Transplantation.

    Shioya, Ryuta; Furukawa, Hiroshi; Murao, Naoki; Hayashi, Toshihiko; Oyama, Akihiko; Funayama, Emi; Yamamoto, Yuhei; Saito, Noriko

    2016-04-01

    Lymphedema is a condition characterized by progressive swelling and adipose deposition that occurs commonly after lymphadenectomy. Recent clinical studies have suggested that the transfer of lymph nodes to the lymphedematous limb can improve lymphatic function. In this report, we investigate dynamic modulation of lymphatic flow and the microscopic changes of lymphatic regeneration using a lymphedema mouse model that was treated with nonvascularized lymph node transplantation. To evaluate the effect of lymph node transplantation in this model, paw volume was measured using a water displacement plethysmometer; an indocyanine green fluorescence-sensitive camera system was used. The improvement of edema was evident in the paw of the transplantation group. The abnormal fluorescence image pattern gradually improved and disappeared 4 weeks postoperatively in the transplantation group. Uptake in the transplanted lymph node was observed 4 weeks postoperatively. This finding suggested that the transplanted lymph node was engrafted. A collateral pathway was observed in the ventral area 1 week postoperatively. The collateral pathway may have contributed to the early improvement of edema. Our findings suggest that lymph node transplantation can restore lymphatic function. This result has important conceptual implications in the treatment of postsurgical lymphedema. PMID:25664410

  8. Enlarged hilar and mediastinal lymph nodes in chronic obstructive pulmonary disease

    Full text: Methods: In a retrospective study, 89 patients with proven COPD were analysed. Exclusion criteria were history of malignant disease or clinical evidence of pneumonia. Prevalence, size, and localisation of enlarged lymph nodes were assessed by multi-slice computed tomography (MSCT) and correlated with the clinical stages following the GOLD classification as well as the MSCT findings of bronchitis and emphysema. Results: 44/89 (49%) of our patients showed enlarged lymph nodes. Lymph node enlargement was more often seen in the mediastinum (48%) than the hilar region (20%). The most common localisation of enlarged mediastinal lymph nodes was the regional station 7 following the ATS mapping (infracarinal). Patients with a stage I following the GOLD classification showed enlarged lymph nodes in 49% (18/37), stage II in 46% (12/26), stage III in 58% (7/12) and stage IV in 50% (7/14). These findings did not differ significantly (P> 0.05). Severe airway wall thickening (42/89) was significantly more often associated with an increase of nodal enlargement (64%) (P < 0.05). Conclusion: The present study demonstrates that enlarged hilar and mediastinal lymph nodes may occur in a rather high percentage of patients suffering from COPD, especially in those with the MSCT finding of severe bronchitis.

  9. Local behavior and lymph node metastases of Wilms' tumor: accuracy of computed tomography; Comportamento local e metastases linfonodais do tumor de Wilms: acuracia da tomografia computadorizada

    Silva, Eduardo Just da Costa e, E-mail: eduardojust@oi.com.br [Universidade Federal de Pernambuco (UFPE), Recife, PE (Brazil); Instituto Materno Infantil de Pernambuco (IMIP), Recife, PE (Brazil); Silva, Giselia Alves Pontes da [Universidade Federal de Pernambuco (UFPE), Recife, PE (Brazil). Dept. Maternal Infantil

    2014-01-15

    Objective: to evaluate the accuracy of computed tomography for local and lymph node staging of Wilms' tumor. Materials and methods: each case of Wilms' tumor was evaluated for the presence of abdominal lymph nodes by a radiologist. Signs of capsule and adjacent organ invasion were analyzed. Surgical and histopathological results were taken as the gold standard. Results: sensitivity was 100% for both mesenteric and retroperitoneal lymph nodes detection, and specificity was, respectively, 12% and 33%, with positive predictive value of 8% and 11% and negative predictive value of 100%. Signs of capsular invasion presented sensitivity of 87%, specificity of 77%, positive predictive value of 63% and negative predictive value of 93%. Signs of adjacent organ invasion presented sensitivity of 100%, specificity of 78%, positive predictive value of 37% and negative predictive value of 100%. Conclusion: computed tomography tumor showed low specificity and low positive predictive value in the detection of lymph node dissemination. The absence of detectable lymph nodes makes their presence unlikely, and likewise regarding the evaluation of local behavior of tumors. (author)

  10. Accuracy of EUS for estimating the depth of tumor invasion and for diagnosing lymph node metastasis and recurrence in patients with m3 and sm esophageal carcinomas

    Esophagus-preserving therapy has been increasingly used to treat esophageal cancer invading the m3 and sm, thereby avoiding radical surgery. However, many problems remain to be solved, including the diagnosis of lymph node metastasis and recurrence and the assessment of long-term outcomes. We studied 132 patients who had esophageal cancer with m3 and sm invasion. Clinical course after esophagus-preserving therapy, and the accuracy and roles of endoscopic ultrasonography (EUS) for diagnosing the depth of tumor invasion, lymph node metastasis, and recurrence were assessed. EUS can be used to examine the cervical, thoracic, and abdominal regions, without being affected by heat beats. Therefore, EUS can more clearly depict lymph nodes than CT or US. The accuracy of EUS was 86.4% for estimating the depth of tumor invasion and 82% for diagnosing lymph node metastasis. All cases of nodal recurrence were diagnosed by EUS. Among patients who received chemoradiotherapy, enlarged lymph nodes often appeared around 3 years after treatment, and recurrence was diagnosed slightly later than that in patients who underwent endoscopic mucosal resection. Endoscopic ultrasound-guided fine-needle aspiration biopsy was sometimes performed to determine the treatment policy. Patients who receive chemoradiotherapy should undergo regular long-term follow-up by CT, US, and EUS. EUS is essential for the earlier detection of recurrence. (author)

  11. Metastatic characteristics of lymph node in cervical region and radiotherapy target volume after dissection of thoracic esophageal carcinoma

    Objective: To investigate the metastatic characteristics of cervical lymph node in thoracic esophageal cancer of two-field lymph node dissection after radical surgery and to provide evidence for postoperative radiotherapy. Methods: Local-regional lymph node metastasis after surgery of 126 cases with esophageal squamous cell carcinoma from 2004 to 2009 were reviewed. Boundaries of cervical lymph node were according to Som, s imaging-based nodal classification system. Enumeration data were compared by χ2 test , and the risk factors of lymph node metastasis were analyzed with Logistic regressive model. Results: Lymph node metastasis rate of cervical region was up to 68.3% in all the cases with local-regional lymph node metastasis (86/126), and lymph node metastasis rate in level I was higher than those in the other levels (43.7%, 55/126). There was obvious difference in lymph node metastasis rate between the right and the left cervical region (53.2% vs 30.2%, χ2 = 13.73, P = 0.000). Moreover, the results also shown that lymph node metastasis rate was notably increased in level I, II and IIIa of the right compared with those of the left, showing statistical significance (43.70% : 15.1%, 17.5% : 7.1%, 17.5% : 5.6%, χ2 = 24.79, 6.22, 8.77, P =0.000, 0.013, 0.003). The sum of lymph node metastasis rate was 95% (82/86) in para-recurrent nerve and medial jugular vein, and 85% (73/86) in para-recurrent nerve. In addition,multivariate analysis showed that lymph node metastasis in level I was high risk factor for lymph node metastasis of level II. Conclusions: Lymph node metastasis of cervical region mainly focused on para-recurrent nerve and medial jugular vein. (authors)

  12. Distribution pattern of lymph node metastases and its implication in individualized radiotherapeutic clinical target volume delineation of regional lymph nodes in patients with stage IA to IIA cervical cancer

    To study the distribution pattern of lymph node metastases of stage IA to IIA cervical cancer and to clarify the individualized clinical target volume delineation of regional lymph nodes (CTVn). A total of 665 cases with International Federation Gynecology and Obstetrics stage IA to IIA cervical cancer who underwent radical hysterectomy and pelvic lymphadenectomy were retrospectively reviewed. The clinicopathological factors related to lymph node metastases were analyzed using logistic regression analysis. Pelvic lymph node metastases were found in 168 of 665 patients resulting in a metastasis rate of 25.3%. Binary logistic regression analysis showed that age, lymph vascular space involvement, and deep stromal invasion statistically influenced pelvic lymph node metastases (p = 0.017, < 0.001, < 0.001, respectively). Pathological morphology type, lymph node metastases of the obturator, the external iliac and internal iliac, and the para-aortic had a strong influence on lymph node metastases of the common iliac (p = 0.022, 0.003, < 0.001, 0.009, respectively). Tumor size and lymph node metastases of the common iliac were significantly related to lymph node metastases of the para-aortic (p = 0.045, < 0.001, respectively). Lymph node metastases of the obturator, the external iliac and internal iliac were strongly correlated to lymph node metastases of the circumflex iliac node distal to the external iliac node (CINDEIN; p = 0.027, 0.024, respectively). Factors related to lymph node metastases should be comprehensively considered to design and tailor CTVn for radiotherapy of cervical cancer. Selective regional irradiation including the correlated lymphatic drainage regions should be performed

  13. Changes in human lymphocyte subpopulations in tonsils and regional lymph nodes of human head and neck squamous carcinoma compared to control lymph nodes

    González-Femandez África

    2001-04-01

    Full Text Available Abstract Background Lymphoid tissues constitute basic structures where specific immune responses take place. This leads to the development of germinal centres (GCs, migration of cells and the generation of memory cells. Here, we have compared human tumour reactive lymph nodes and tonsils with control lymph nodes. Results The study by flow cytometry shows that in control lymph nodes the majority of cells were naive T-lymphocytes (CD45RA+/CD7+. In reactive nodes, although the percentage of CD45RO+ T cells remains constant, there is an increase in the number of B-lymphocytes, and a reduction in naive T cells. The percentage of cells expressing CD69 was similar in reactive nodes and in controls. In both cases, we have found two populations of B cells of either CD69- or CD69dull. Two populations of T cells, which are either negative for CD69 or express it in bright levels (CD69bright, were also found. The analysis of tissue sections by confocal microscopy revealed differences between control, tonsils and tumor reactive lymph nodes. In control lymph nodes, CD19 B cells are surrounded by a unique layer of CD69bright/CD45RO+ T cells. GCs from tonsils and from tumour reactive nodes are mainly constituted by CD19 B cells and have four distinct layers. The central zone is composed of CD69- B cells surrounded by CD69bright/CD45RO+ T cells. The mantle region has basically CD69dull B-lymphocytes and, finally, there is an outer zone with CD69-/CD45RO+ T cells. Conclusions Human secondary lymphoid organs react with an increase in the proportion of B lymphocytes and a decrease in the number of CD45RA+ T cells (naive. In tonsils, this is due to chronic pathogen stimulation, whereas in lymph nodes draining head and neck carcinomas the reaction is prompted by surrounded tumors. During this process, secondary lymphoid organs develop secondary follicles with a special organization of T and B cells in consecutive layers, that are described here by confocal microscopy

  14. Lymph system

    The lymph system is a network of organs, lymph nodes, lymph ducts, and lymph vessels that make and move lymph from tissues to the bloodstream. The lymph system is a major part of the body's immune ...

  15. Metastatic squamous cell carcinoma urinary bladder coexisting with tuberculosis in pelvic lymph nodes.

    Karthikeyan, Vilvapathy Senguttuvan; Manikandan, Ramanitharan; Jacob, Sajini Elizabeth; Murugan, P Puvai

    2013-01-01

    Squamous cell carcinoma (SCC) of the urinary bladder is usually associated with Schistosoma haematobium and chronic bladder irritation. We report a case of coexistent metastatic SCC and tuberculosis in obturator lymph nodes in radical cystoprostatectomy and pelvic lymphadenectomy specimens. Though tubercular iliac lymphadenitis and metastatic transitional carcinoma following intravesical BCG has been reported, the concurrent presence of non-transitional cell cancer and primary lymph nodal tuberculosis in regional lymph nodes is rare. This case is reported to highlight the paucity of management guidelines available presently in the treatment of such patients who require systemic chemotherapy and antitubercular therapy. PMID:24296773

  16. Angiomyomatous hamartoma of lymph nodes: Clinicopathological study of 6 cases with review of literature

    Sudheer Arava

    2016-01-01

    Full Text Available Angiomyomatous hamartoma (AMH is a rare disease with predisposition for inguinal and femoral lymph nodes. Histologically, it is characterized by replacement of lymph nodal parenchyma with irregularly distributed thick walled blood vessels, haphazardly arranged smooth muscle cells, variable amount of fat and fibrous tissue in a sclerotic lymphatic stroma. Few cases have also been reported in popliteal and sub - mandibular location. The exact pathogenesis is still not known. Although this entity is very rare, its recognition is important in discriminating it from other benign and malignant vascular lesions of lymph nodes.

  17. Comparison of Tl SPECT and FDG PET in the diagnosis of lymph node metastases from lung cancer

    Higashi, Kohtaro; Ueda, Yoshimichi; Yagishita, Masami [Kanazawa Medical Univ., Uchinada, Ishikawa (Japan)] [and others

    1999-01-01

    This study compared FDG PET with Tl SPECT in the diagnosis of lymph node metastases from lung cancer. FDG PET and Tl SPECT were performed in the 42 patients with lung cancer. All patients had thoracotomy. FDG PET detected mediastinal lymph node metastasis that was negative on Tl SPECT, whereas both techniques excluded tumor involvement in enlarged node at CT. However, both techniques may show false-negative results for microscopic metastases in normal-sized lymph node. (author)

  18. Sentinel lymph node biopsy as guidance for radical trachelectomy in young patients with early stage cervical cancer

    The purpose of this study was to assess the feasibility and accuracy of sentinel lymph nodes (SLNs) detection using 99mTc phytate in predicting pelvic lymph nodes status for radical abdominal trachelectomy (RAT) in patients with early stage cervical cancer. Sixty-eight women with stage IA2-IB1 cervical cancer and scheduled to undergo fertility-sparing surgery enrolled in this study. 99mTc-labeled phytate was injected before surgery. Intraoperatively, SLNs were identified, excised, and submitted to fast frozen section. Systematic bilateral pelvic lymphadenectomy and/or para-aortic lymph node dissection was performed. Then RAT was performed in patients with negative SLNs. All nodes were sent for routine pathological examination and immunostained with anti-cytokeratin antibody to detect micrometastases. Outcomes of follow up and fertility were observed. SLNs were identified in 64 of 68 patients (94.1%). Of these, SLNs of 8 patients (11.8%) were positive on frozen sections and proved to be metastasis by final pathologic examination. The sensitivity, accuracy, and false negative rates were 100%, 100%, and 0%, respectively. All 60 patients with negative SLN underwent RAT successfully. Two relapses occurred and no one died of tumor progression during follow-up. Five of the 15 patients with procreative desire conceived 8 pregnancies (3 term delivery, 2 premature birth, 1 spontaneous abortion, and 2 were still in the duration of pregnancy) after surgery. The identification of SLN using 99mTc-labeled phytate is accurate and safe to assess pelvic nodes status in patients with early cervical cancer. SLNs biopsy guided RAT is feasible for patients who desire to have fertility preservation

  19. Intraoperative mapping of sentinel lymph node metastases using a clinically translated ultrasmall silica nanoparticle.

    Bradbury, Michelle S; Pauliah, Mohan; Zanzonico, Pat; Wiesner, Ulrich; Patel, Snehal

    2016-07-01

    The management of regional lymph nodes in patients with melanoma has undergone a significant paradigm shift over the past several decades, transitioning from the use of more aggressive surgical approaches, such as lymph node basin dissection, to the application of minimally invasive sentinel lymph node (SLN) biopsy methods to detect the presence of nodal micrometastases. SLN biopsy has enabled reliable, highly accurate, and low-morbidity staging of regional lymph nodes in early stage melanoma as a means of guiding treatment decisions and improving patient outcomes. The accurate identification and staging of lymph nodes is an important prognostic factor, identifying those patients for whom the expected benefits of nodal resection outweigh attendant surgical risks. However, currently used standard-of-care technologies for SLN detection are associated with significant limitations. This has fueled the development of clinically promising platforms that can serve as intraoperative visualization tools to aid accurate and specific determination of tumor-bearing lymph nodes, map cancer-promoting biological properties at the cellular/molecular levels, and delineate nodes from adjacent critical structures. Among a number of promising cancer-imaging probes that might facilitate achievement of these ends is a first-in-kind ultrasmall tumor-targeting inorganic (silica) nanoparticle, designed to overcome translational challenges. The rationale driving these considerations and the application of this platform as an intraoperative treatment tool for guiding resection of cancerous lymph nodes is discussed and presented within the context of alternative imaging technologies. WIREs Nanomed Nanobiotechnol 2016, 8:535-553. doi: 10.1002/wnan.1380 For further resources related to this article, please visit the WIREs website. PMID:26663853

  20. Near infrared imaging to identify sentinel lymph nodes in invasive urinary bladder cancer

    Knapp, Deborah W.; Adams, Larry G.; Niles, Jacqueline D.; Lucroy, Michael D.; Ramos-Vara, Jose; Bonney, Patty L.; deGortari, Amalia E.; Frangioni, John V.

    2006-02-01

    Approximately 12,000 people are diagnosed with invasive transitional cell carcinoma of the urinary bladder (InvTCC) each year in the United States. Surgical removal of the bladder (cystectomy) and regional lymph node dissection are considered frontline therapy. Cystectomy causes extensive acute morbidity, and 50% of patients with InvTCC have occult metastases at the time of diagnosis. Better staging procedures for InvTCC are greatly needed. This study was performed to evaluate an intra-operative near infrared fluorescence imaging (NIRF) system (Frangioni laboratory) for identifying sentinel lymph nodes draining InvTCC. NIRF imaging was used to map lymph node drainage from specific quadrants of the urinary bladder in normal dogs and pigs, and to map lymph node drainage from naturally-occurring InvTCC in pet dogs where the disease closely mimics the human condition. Briefly, during surgery NIR fluorophores (human serum albumen-fluorophore complex, or quantum dots) were injected directly into the bladder wall, and fluorescence observed in lymphatics and regional nodes. Conditions studied to optimize the procedure including: type of fluorophore, depth of injection, volume of fluorophore injected, and degree of bladder distention at the time of injection. Optimal imaging occurred with very superficial injection of the fluorophore in the serosal surface of the moderately distended bladder. Considerable variability was noted from dog to dog in the pattern of lymph node drainage. NIR fluorescence was noted in lymph nodes with metastases in dogs with InvTCC. In conclusion, intra-operative NIRF imaging is a promising approach to improve sentinel lymph node mapping in invasive urinary bladder cancer.

  1. Effect of 144Ce inhaled in fused clay particles on the tracheobronchial lymph nodes

    Tracheobronchial lymph node changes and lymphopenia are sequelae to inhalation of relatively insoluble radioactive aerosols by Beagle dogs. To assess the development of these lesions, tracheobronchial lymph nodes from dogs that inhaled 144Ce in fused clay particles were examined at intervals from 2 to 730 days after exposure. Initial lung burdens in the dogs studied ranged from 33 to 63 μCi/kg body weight. The concentration of radioisotope in the tracheobronchial lymph nodes increased during the first year after exposure and exceeded that in the lung about 100 days after exposure. Autoradiographs of the lymph nodes showed that 144Ce particles were present in macrophages in the paracortical zone two days after exposure and that concentrations continued to increase in the paracortical zone and medullary cords. Histologic changes in the nodes included atrophy of the germinal centers and lymphocytic follicles, loss of lymphocytes and accumulation of macrophages in the paracortical zone, accumulation of pigment and isotope-laden macrophages in the medullary cords, occasional infiltrates of neutrophils in the medullary cords and, at later time periods, focal fibrosis of the medullary cords. Tracheobronchial lymph node weights of the dogs exposed to 144Ce in fused clay were not decreased until 512 days after exposure. These findings indicate that tracheobronchial lymph nodes accumulate relatively high burdens of 144Ce after inhalation of 144Ce in a relatively insoluble form and that the pathologic changes resulting from these burdens are basically atrophic in nature. Primary neoplasms in lymph nodes have not been observed in dogs with initial lung burdens from 0.0024 to over 30 μCi/kg body weight followed for up to 2000 days post-exposure. At the higher levels, however, a high incidence of primary pulmonary neoplasia has been observed. (U.S.)

  2. Computed tomography image of the mediastinal and axillary lymph nodes in clinically sound Rottweilers

    Ana Carolina B. Fonseca Pinto

    2013-03-01

    Full Text Available Trough computed tomography (CT, it is possible to evaluate lymph nodes in detail and to detect changes in these structures earlier than with radiographs and ultrasound. Lack of information in the veterinary literature directed the focus of this report to normal aspects of the axillary and mediastinal lymph nodes of adult dogs on CT imaging. A CT scan of 15 normal adult male and female Rottweilers was done. To define them as clinically sound, anamnesis, physical examination, complete blood count, renal and hepatic biochemistry, ECG, and thoracic radiographs were performed. After the intravenous injection of hydrosoluble ionic iodine contrast medium contiguous 10mm in thickness thoracic transverse images were obtained with an axial scanner. In the obtained images mediastinal and axillary lymph nodes were sought and when found measured in their smallest diameter and their attenuation was compared to musculature. Mean and standard deviation of: age, weight, body length and the smallest diameter of the axillary and mediastinal lymph nodes were determined. Mean and standard deviation of parameters: age 3.87±2.03 years, weight 41.13±5.12, and body length 89.61±2.63cm. Axillary lymph nodes were seen in 60% of the animals, mean of the smallest diameter was 3.58mm with a standard deviation of 2.02 and a minimum value of 1mm and a maximum value of 7mm. From 13 observed lymph nodes 61.53% were hypopodense when compared with musculature, and 30.77% were isodense. Mediastinal lymph nodes were identified in 73.33% of the dogs; mean measure of the smallest diameter was 4.71mm with a standard deviation of 2.61mm and a minimum value of 1mm, and a maximum value of 8mm. From 14 observed lymph nodes 85.71% were isodense when compared with musculature and 14.28% were hypodense. The results show that it is possible to visualize axillary and mediastinal lymph nodes in adult clinically sound Rottweilers with CT using a slice thickness and interval of 10mm. The

  3. The Safety and Efficiency of the Ultrasound-guided Large Needle Core Biopsy of Axilla Lymph Nodes

    Kim, Ki Hong; Son, Eun Ju; Kim, Eun-Kyung; Ko, Kyung Hee; Kang, Haeyoun; Oh, Ki Keun

    2008-01-01

    Purpose To evaluate the safety and efficiency of the Ultrasound (US)-guided large needle core biopsy of axilla lymph nodes. Materials and Methods From March 2004 to September 2005, 31 patients underwent the US-guided core biopsy for axilla lymph nodes. Twenty five lesions out of 31 were detected during breast US, and 6 of 31 cases were palpable. Lymph nodes were classified based on their shape and cortical morphology. The core biopsy of axilla lymph nodes was performed on suspicious lymph nod...

  4. Sheep lymph-nodes as a biological indicator of environmental exposure to fluoro-edenite.

    Ledda, Caterina; Loreto, Carla; Pomara, Cristoforo; Rapisarda, Giuseppe; Fiore, Maria; Ferrante, Margherita; Bracci, Massimo; Santarelli, Lory; Fenga, Concettina; Rapisarda, Venerando

    2016-05-01

    A significantly increased incidence of pleural mesothelioma in Biancavilla (Sicily, Italy) has been attributed to exposure to fluoro-edenite (FE), a fibrous amphibole extracted from a local stone quarry. The lymph-nodes draining the pulmonary lobes of sheep grazing around the town were examined, to gain insights into fibre diffusion. The pasture areas of six sheep flocks lying about 3km from Biancavilla were located using the global positioning system. The cranial tracheobronchial and one middle mediastinal lymph-node as well as four lung tissue samples were collected from 10 animals from each flock and from 10 control sheep for light and scanning electron microscopy (SEM) examination. The lymph-nodes from exposed sheep were enlarged and exhibited signs of anthracosis. Histologically, especially at the paracortical level, they showed lymph-follicle hyperplasia with large reactive cores and several macrophages (coniophages) containing grey-brownish particulate interspersed with elements with a fibril structure, forming aggregates of varying dimensions (coniophage nodules). Similar findings were detected in some peribronchiolar areas of the lung parenchyma. SEM examination showed that FE fibres measured 8-41µm in length and 0.4-1.39µm in diameter in both lymph-nodes and lung tissue. Monitoring of FE fibres in sheep lymph-nodes using appropriate techniques can help set up environmental pollution surveillance. PMID:26855127

  5. Endoscopic ultrasound elastography for evaluation of lymph nodes and pancreatic masses: a multicenter study

    Giovannini, Marc; Thomas, Botelberge; Erwan, Bories;

    2009-01-01

    AIM: To evaluate the ability of endoscopic ultrasound (EUS) elastography to distinguish benign from malignant pancreatic masses and lymph nodes. METHODS: A multicenter study was conducted and included 222 patients who underwent EUS examination with assessment of a pancreatic mass (n = 121) or lymph...... study was performed. RESULTS: The sensitivity and specificity of EUS elastography to differentiate benign from malignant pancreatic lesions are 92.3% and 80.0%, respectively, compared to 92.3% and 68.9%, respectively, for the conventional B-mode images. The sensitivity and specificity of EUS...... elastography to differentiate benign from malignant lymph nodes was 91.8% and 82.5%, respectively, compared to 78.6% and 50.0%, respectively, for the B-mode images. The kappa coefficient was 0.785 for the pancreatic masses and 0.657 for the lymph nodes. CONCLUSION: EUS elastography is superior compared to...

  6. Lymph node dissection in patients with malignant melanoma is associated with high risk of morbidity

    Ul-Mulk, Jamshaid; Hölmich, Lisbet Rosenkrantz

    2012-01-01

    Malignant melanoma is one of the most rapidly increasing cancer types globally, and it is by far the most serious skin cancer. Patients with a melanoma ≥ 1 mm in Breslow thickness are offered sentinel node (SN) biopsy and subsequent radical lymph node dissection if the biopsy is positive. The obj...

  7. Improved false negative rate of axillary status using sentinel lymph node biopsy and ultrasound-suspicious lymph node sampling in patients with early breast cancer

    The false negative rate of sentinel lymph node biopsy (SLNB) is 5-10%, and results in improper patient management. The study was to assess the value of ultrasound-suspicious axillary lymph node biopsy (USALNB) in patients with early breast cancer, and to compare SLNB combined with USALNB (SLNB + USALNB) with SLNB alone. From January 2010 to July 2013, 216 patients with early breast cancer were enrolled consecutively at the Department of Breast and Thyroid Surgery, Qianfoshan Hospital, Shandong University. All patients underwent wire localization of the suspicious node by color Doppler ultrasonography, followed by SLNB 2–3 hours later, suspicious node lymphadenectomy, and level ≥ II axillary dissection (as the gold standard). The predictive values of node status between SLNB + USALNB and SLNB alone were compared. The success rate of SLNB was 99.1% (214/216). After axillary dissection, 71 patients were confirmed with axillary lymph node metastases by pathological examinations. Eight false negatives were observed using SLNB alone, resulting in sensitivity of 88.7%, specificity of 100%, false negative rate of 11.3%, and false positive rate of 0% in predicting the axillary node status. SLNB + USALNB resulted in sensitivity of 97.2%, specificity of 100%, false negative rate of 2.8%, and false positive rate of 0%. The false negative rate of SLNB + USALNB was significantly different from that of SLNB alone (P = 0.031). SLNB + USALNB seems to be a low-risk procedure that might be useful in reducing the false negative rate of SLNB, improving the accuracy of axillary nodes evaluation in early breast cancer

  8. Sentinel lymph node biopsy in breast cancer--the Aarhus experience

    Lauridsen, M C; Garne, J P; Hessov, I;

    2000-01-01

    Eighty patients, with newly diagnosed unifocal breast cancer and with no axillary metastases verified by ultrasonography, underwent sentinel lymph node (SLN) and subsequent axillary lymph node dissection. To identify the SLN, we used a combination of Tc-99m labelled colloid (Albures) and blue dye...... as SLNs that tested negative but with higher nodes that tested positive. If SLN biopsy is accepted as a routine procedure and when the exact indications are defined, the method described probably could be offered to the majority of breast cancer patients....

  9. Correlation between elevated FOXP3 expression and increased lymph node metastasis of gastric cancer

    WANG Li-hong; SU Lin; WANG Jing-tong

    2010-01-01

    Background FOXP3 was thought to express in the T-cell lineage exclusively until recently when FOXP3 was shown to be expressed by cancer cells. It was indicated that FOXP3 may play a wider role in biology by endowing tumor cells with immune suppressive activity. However, researches between FOXP3 and lymph node metastasis of gastric cancer were relatively infrequent, so the present work was aimed to investigate the relationship between FOXP3 expression and lymph node metastasis in human gastric cancer.Methods A total of 122 gastric cancer patients were enrolled in this study, and gastric tumor specimens and lymph nodes were acquired. Thirty patients who had chronic superficial gastritis diagnosed by gastroscopy contemporaneously in the Peking University People's Hospital were chosen randomly as the control group. Immunohistochemistry was performed to evaluate FOXP3 expression. A survival analysis on the 122 patients was then performed. Then, NCI-N87cell lines were used to confirm FOXP3 expression in gastric carcinoma cells. Finally, evaluation of FOXP3 expression in gastric tumor and peritumor tissues in 12 patients were conducted using immunohistochemistry and Western blotting. A X2 test or Fisher's exact test (bilateral) was conducted to compare the percentage of positive percentage staining between groups. Kaplan-Meier analysis was performed for survival analysis.Results FOXP3 was expressed by gastric cancer cells and peritumor epithelial cells. FOXP3 expression was increased in primary tumors (58.2%) than that in control group (26.7%). In the lymph-node metastasis group, the incidence of lymph node metastasis which was less than 60% had a significant upregulation of FOXP3 in primary tumors and lymph nodes.However, the frequency of FOXP3 expression had no relationship with survival.Conclusion FOXP3 probably has a relationship with lymph node metastasis of gastric cancer.

  10. Automatic localization of IASLC-defined mediastinal lymph node stations on CT images using fuzzy models

    Matsumoto, Monica M. S.; Beig, Niha G.; Udupa, Jayaram K.; Archer, Steven; Torigian, Drew A.

    2014-03-01

    Lung cancer is associated with the highest cancer mortality rates among men and women in the United States. The accurate and precise identification of the lymph node stations on computed tomography (CT) images is important for staging disease and potentially for prognosticating outcome in patients with lung cancer, as well as for pretreatment planning and response assessment purposes. To facilitate a standard means of referring to lymph nodes, the International Association for the Study of Lung Cancer (IASLC) has recently proposed a definition of the different lymph node stations and zones in the thorax. However, nodal station identification is typically performed manually by visual assessment in clinical radiology. This approach leaves room for error due to the subjective and potentially ambiguous nature of visual interpretation, and is labor intensive. We present a method of automatically recognizing the mediastinal IASLC-defined lymph node stations by modifying a hierarchical fuzzy modeling approach previously developed for body-wide automatic anatomy recognition (AAR) in medical imagery. Our AAR-lymph node (AAR-LN) system follows the AAR methodology and consists of two steps. In the first step, the various lymph node stations are manually delineated on a set of CT images following the IASLC definitions. These delineations are then used to build a fuzzy hierarchical model of the nodal stations which are considered as 3D objects. In the second step, the stations are automatically located on any given CT image of the thorax by using the hierarchical fuzzy model and object recognition algorithms. Based on 23 data sets used for model building, 22 independent data sets for testing, and 10 lymph node stations, a mean localization accuracy of within 1-6 voxels has been achieved by the AAR-LN system.

  11. Sentinel lymph nodes in gynaecological malignancies: frontline between TNM and clinical staging systems?

    Numerous investigations have recently proved the importance of sentinel lymph node detection in various malignant tumours. It is widely accepted that this procedure is to be recommended only in patients with early stage tumours. The lymph node status and prognosis are closely related. Appropriate staging is essential in the management of malignant tumours and should be individualised. In many cases, the nodal status does not correlate with the clinical stage of the disease. In this survey, we consider some of the most common gynaecological malignancies and the type of staging most appropriate to them. Differences between these staging systems, and controversies concerning them, are related to the concept of sentinel lymph node investigation. The authors believe that sentinel node sampling is in fact a beneficial method in both early and advanced stage disease for determination of the tumour status and individualisation of surgical interventions. (orig.)

  12. Role of cytostatic agent and radiotherapy in the treatment of patients with radiation-resistant testicular tumours and with inoperable metastases to retroperitoneal lymph nodes

    In 5 out of 19 patients with radiation-resistant testicular tumours qualified for abdominal lymphadenectomy inoperable metastases to the lymph nodes were found. Three of these patients died within 4-6 months despite treatment with cytostatic and radiotherapy. In one of the two remaining patients necrosis of the metastases was observed after hemicastration and administration of nitrogen mustard, in the other cause the further progression of the neoplasm was stopped with cytostatic agents and radiotherapy. (author)

  13. Localisation of sentinel lymph nodes: Will it influence the management of penis carcinoma?

    Aim: Patients in developing countries often present with advanced penis carcinoma and palpable inguinal lymph nodes. Since secondary infection is almost invariably present, distinguishing clinically between reactive nodes and metastasis can be difficult. The aim of our study was to evaluate dynamic sentinel node localisation for the detection of inguinal metastases in patients with penile carcinoma, in order to avoid the morbidity of full inguinal block dissection. Material and Methods: Patients with penis carcinoma presenting at the Department of Urology were included in the study. All patients underwent a scintigraphic sentinel node localisation procedure one day prior to surgery. Blue dye was injected immediately prior to surgery. Aided by a gamma probe and/or by visualising a blue node, the sentinel nodes were identified and removed. In patients with a small, well differentiated primary lesion and non-palpable nodes only the sentinel nodes were removed. In those with locally advanced or poorly differentiated primary lesions and/or clinically palpable nodes, a full inguinal block dissection was performed immediately after sentinel node biopsy and penectomy. Results: Seventeen patients with a mean age of 55 years (range 33-83 years) were included in the study. Sentinel nodes were detected bilaterally in ten patients and unilaterally in six. In one patient no sentinel node could be detected scintigraphically. Tumour involvement of sentinel nodes was found in only 1 patient, in whom malignancy was also found in other ipsilateral nodes removed at block dissection. In two patients the sentinel nodes were tumour negative, but metastases were shown in other inguinal nodes removed at block dissection. Conclusion: In this evaluation dynamic sentinel lymph node localisation followed by immediate inguinal block dissection was true positive in 1 and false negative in 2 of 17 patients with penile carcinoma. Further study and follow-up is required before routine use of the

  14. Lymphangiogenesis in regional lymph nodes is an independent prognostic marker in rectal cancer patients after neoadjuvant treatment.

    Christiane Jakob

    Full Text Available One of the major prognostic factors in rectal cancer is lymph node metastasis. The formation of lymph node metastases is dependent on the existence of a premetastatic niche. An important factor preceding metastasis are lymph vessels which are located in the lymph node. Accordingly, the occurrence of intranodal lymphangiogenesis is thought to indicate distant metastasis and worse prognosis. To evaluate the significance of lymph node lymphangiogenesis, we studied formalin fixed, paraffin embedded adenocarcinomas and regional lymph nodes of 203 rectal cancer patients who were treated with neoadjuvant radiochemotherapy and consecutive curative surgery with cancer free surgical margins (R0. Regional lymph node lymph vessels were detected by immunohistochemistry for podoplanin (D2-40. Our results show that the presence of lymphatic vessels in regional lymph nodes significantly affects the disease-free survival in univariate and multivariate analyses. In contrast, there was no correlation between peritumoral or intratumoral lymph vessel density and prognosis. Indeed, our study demonstrates the importance of lymphangiogenesis in regional lymph nodes after neoadjuvant radiochemotherapy and consecutive surgery as an independent prognostic marker. Staining for intranodal lymphangiogenesis and methods of intravital imaging of lymphangiogenesis and lymphatic flow may be a useful strategy to predict long-term outcome in rectal cancer patients. Furthermore, addition of VEGF-blocking agents to standardized neoadjuvant treatment schemes might be indicated in advanced rectal cancer.

  15. Detection of Melanoma Metastases in Resected Human Lymph Nodes by Noninvasive Multispectral Photoacoustic Imaging

    Gerrit Cornelis Langhout

    2014-01-01

    Full Text Available Objective. Sentinel node biopsy in patients with cutaneous melanoma improves staging, provides prognostic information, and leads to an increased survival in node-positive patients. However, frozen section analysis of the sentinel node is not reliable and definitive histopathology evaluation requires days, preventing intraoperative decision-making and immediate therapy. Photoacoustic imaging can evaluate intact lymph nodes, but specificity can be hampered by other absorbers such as hemoglobin. Near infrared multispectral photoacoustic imaging is a new approach that has the potential to selectively detect melanin. The purpose of the present study is to examine the potential of multispectral photoacoustic imaging to identify melanoma metastasis in human lymph nodes. Methods. Three metastatic and nine benign lymph nodes from eight melanoma patients were scanned ex vivo using a Vevo LAZR© multispectral photoacoustic imager and were spectrally analyzed per pixel. The results were compared to histopathology as gold standard. Results. The nodal volume could be scanned within 20 minutes. An unmixing procedure was proposed to identify melanoma metastases with multispectral photoacoustic imaging. Ultrasound overlay enabled anatomical correlation. The penetration depth of the photoacoustic signal was up to 2 cm. Conclusion. Multispectral three-dimensional photoacoustic imaging allowed for selective identification of melanoma metastases in human lymph nodes.

  16. Surgical resection of a solitary para-aortic lymph node metastasis from hepatocellular carcinoma

    Junji Ueda; Hiroshi Yoshida; Yasuhiro Mamada; Nobuhiko Taniai; Sho Mineta; Masato Yoshioka; Youichi Kawano

    2012-01-01

    Lymph node (LN) metastases from hepatocellular carcinoma (HCC) are considered uncommon.We describe the surgical resection of a solitary para-aortic LN metastasis from HCC.A 65-year-old Japanese man with B-type liver cirrhosis was admitted for the evaluation of a liver tumor.He had already undergone radiofrequency ablation,transcatheter arterial chemoemboliza tion,and percutaneous ethanol injection therapy for HCC.Despite treatment,viable regions remained in segments 4 and 8.We performed a right paramedian sectionectomy with partial resection of the left paramedian section of the liver.Six months later,serum concentrations of alpha-fetoprotein (189 ng/mL) and PIVKA-2 (507 mAU/mL) increased.Enhanced computed tomography of the abdomen revealed a tumor (20 mm in diameter) on the right side of the abdominal aorta.Fluorine-18 fluorodeoxyglucose positron emission tomography revealed an increased standard uptake value.There was no evidence of recurrence in other regions.Esophagogastroduodenoscopy and colonoscopy revealed no malignant tumor in the gastrointestinal tract.Para-aortic LN metastasis from HCC was thus diagnosed.We performed lymphadenectomy.Histopathological examination revealed that the tumor was largely necrotic,with poorly differentiated HCC on its surface,which confirmed the suspected diagnosis.After 6 mo tumor marker levels were normal,with no evidence of recurrence.Our experience suggests that a solitary para-aortic LN metastasis from HCC can be treated surgically.

  17. Cross-sectional study examining Salmonella enterica carriage in subiliac lymph nodes of cull and feedlot cattle at harvest

    Bovine peripheral lymph nodes, including subiliac lymph nodes, have been identified as a potential source of human exposure to Salmonella enterica when trim containing these nodes is incorporated into ground beef. In order to gain a better understanding of the burden of S. enterica in subiliac lymp...

  18. Computed tomographic appearance of the abdominal lymphadenopathy due to tuberculosis

    CT appearances of two cases of abdominal tuberculous lymphadenopathy were reported. Enlarged lymph nodes with thick, irregular enhanced rim are characteristic findings of tuberculous lymphadenopathy. Non-enhanded center of the tuberculous lymph nodes is compatible with caseous necrosis. With CT tuberculous lymph nodes could be differentiated from lymph nodous and metastatic lymph nodes which show no contrast enhancement or thin rim-like enhancement. (author)

  19. Differential Motion Between Mediastinal Lymph Nodes and Primary Tumor in Radically Irradiated Lung Cancer Patients

    Schaake, Eva E. [Department of Thoracic Oncology, The Netherlands Cancer Institute, Amsterdam (Netherlands); Department of Radiation Oncology, The Netherlands Cancer Institute, Amsterdam (Netherlands); Rossi, Maddalena M.G. [Department of Radiation Oncology, The Netherlands Cancer Institute, Amsterdam (Netherlands); Buikhuisen, Wieneke A.; Burgers, Jacobus A. [Department of Thoracic Oncology, The Netherlands Cancer Institute, Amsterdam (Netherlands); Smit, Adrianus A.J. [Department of Pulmonary Disease, Onze Lieve Vrouwe Gasthuis, Amsterdam (Netherlands); Belderbos, José S.A. [Department of Radiation Oncology, The Netherlands Cancer Institute, Amsterdam (Netherlands); Sonke, Jan-Jakob, E-mail: j.sonke@nki.nl [Department of Radiation Oncology, The Netherlands Cancer Institute, Amsterdam (Netherlands)

    2014-11-15

    Purpose/Objective: In patients with locally advanced lung cancer, planning target volume margins for mediastinal lymph nodes and tumor after a correction protocol based on bony anatomy registration typically range from 1 to 1.5 cm. Detailed information about lymph node motion variability and differential motion with the primary tumor, however, is lacking from large series. In this study, lymph node and tumor position variability were analyzed in detail and correlated to the main carina to evaluate possible margin reduction. Methods and Materials: Small gold fiducial markers (0.35 × 5 mm) were placed in the mediastinal lymph nodes of 51 patients with non-small cell lung cancer during routine diagnostic esophageal or bronchial endoscopic ultrasonography. Four-dimensional (4D) planning computed tomographic (CT) and daily 4D cone beam (CB) CT scans were acquired before and during radical radiation therapy (66 Gy in 24 fractions). Each CBCT was registered in 3-dimensions (bony anatomy) and 4D (tumor, marker, and carina) to the planning CT scan. Subsequently, systematic and random residual misalignments of the time-averaged lymph node and tumor position relative to the bony anatomy and carina were determined. Additionally, tumor and lymph node respiratory amplitude variability was quantified. Finally, required margins were quantified by use of a recipe for dual targets. Results: Relative to the bony anatomy, systematic and random errors ranged from 0.16 to 0.32 cm for the markers and from 0.15 to 0.33 cm for the tumor, but despite similar ranges there was limited correlation (0.17-0.71) owing to differential motion. A large variability in lymph node amplitude between patients was observed, with an average motion of 0.56 cm in the cranial-caudal direction. Margins could be reduced by 10% (left-right), 27% (cranial-caudal), and 10% (anteroposterior) for the lymph nodes and −2%, 15%, and 7% for the tumor if an online carina registration protocol replaced a

  20. Differential Motion Between Mediastinal Lymph Nodes and Primary Tumor in Radically Irradiated Lung Cancer Patients

    Purpose/Objective: In patients with locally advanced lung cancer, planning target volume margins for mediastinal lymph nodes and tumor after a correction protocol based on bony anatomy registration typically range from 1 to 1.5 cm. Detailed information about lymph node motion variability and differential motion with the primary tumor, however, is lacking from large series. In this study, lymph node and tumor position variability were analyzed in detail and correlated to the main carina to evaluate possible margin reduction. Methods and Materials: Small gold fiducial markers (0.35 × 5 mm) were placed in the mediastinal lymph nodes of 51 patients with non-small cell lung cancer during routine diagnostic esophageal or bronchial endoscopic ultrasonography. Four-dimensional (4D) planning computed tomographic (CT) and daily 4D cone beam (CB) CT scans were acquired before and during radical radiation therapy (66 Gy in 24 fractions). Each CBCT was registered in 3-dimensions (bony anatomy) and 4D (tumor, marker, and carina) to the planning CT scan. Subsequently, systematic and random residual misalignments of the time-averaged lymph node and tumor position relative to the bony anatomy and carina were determined. Additionally, tumor and lymph node respiratory amplitude variability was quantified. Finally, required margins were quantified by use of a recipe for dual targets. Results: Relative to the bony anatomy, systematic and random errors ranged from 0.16 to 0.32 cm for the markers and from 0.15 to 0.33 cm for the tumor, but despite similar ranges there was limited correlation (0.17-0.71) owing to differential motion. A large variability in lymph node amplitude between patients was observed, with an average motion of 0.56 cm in the cranial-caudal direction. Margins could be reduced by 10% (left-right), 27% (cranial-caudal), and 10% (anteroposterior) for the lymph nodes and −2%, 15%, and 7% for the tumor if an online carina registration protocol replaced a

  1. Number of negative lymph nodes can predict survival of breast cancer patients with four or more positive lymph nodes after postmastectomy radiotherapy

    This study was conducted to assess the prognostic value of the number of negative lymph nodes (NLNs) in breast cancer patients with four or more positive lymph nodes after postmastectomy radiotherapy (PMRT). This retrospective study examined 605 breast cancer patients with four or more positive lymph nodes who underwent mastectomy. A total of 371 patients underwent PMRT. The prognostic value of the NLN count in patients with and without PMRT was analyzed. The log-rank test was used to compare survival curves, and Cox regression analysis was performed to identify prognostic factors. The median follow-up was 54 months, and the overall 8-year locoregional recurrence-free survival (LRFS), distant metastasis-free survival (DMFS), disease-free survival (DFS), and overall survival (OS) were 79.8%, 50.0%, 46.8%, and 57.9%, respectively. The optimal cut-off points for NLN count was 12. Univariate analysis showed that the number of NLNs, lymph node ratio (LNR) and pN stage predicted the LRFS of non-PMRT patients (p < 0.05 for all). Multivariate analysis showed that the number of NLNs was an independent prognostic factor affecting the LRFS, patients with a higher number of NLNs had a better LRFS (hazard ratio = 0.132, 95% confidence interval = 0.032-0.547, p =0.005). LNR and pN stage had no effect on LRFS. PMRT improved the LRFS (p < 0.001), DMFS (p = 0.018), DFS (p = 0.001), and OS (p = 0.008) of patients with 12 or fewer NLNs, but it did not any effect on survival of patients with more than 12 NLNs. PMRT improved the regional lymph node recurrence-free survival (p < 0.001) but not the chest wall recurrence-free survival (p = 0.221) in patients with 12 or fewer NLNs. The number of NLNs can predict the survival of breast cancer patients with four or more positive lymph nodes after PMRT. The online version of this article (doi:10.1186/s13014-014-0284-5) contains supplementary material, which is available to authorized users

  2. Ductal carcinoma in situ and sentinel lymph node metastasis in breast cancer

    Makita Masujiro

    2010-01-01

    Full Text Available Abstract Background The impact of sentinel lymph node biopsy on breast cancer mimicking ductal carcinoma in situ (DCIS is a matter of debate. Methods We studied the rate of occurrence of sentinel lymph node metastasis in 255 breast cancer patients with pure DCIS showing no invasive components on routine pathological examination. We compared this to the rate of occurrence in 177 patients with predominant intraductal-component (IDC breast cancers containing invasive foci equal to or less than 0.5 cm in size. Results Most of the clinical and pathological baseline characteristics were the same between the two groups. However, peritumoral lymphatic permeation occurred less often in the pure DCIS group than in the IDC-predominant invasive-lesion group (1.2% vs. 6.8%, p = 0.002. One patient (0.39% with pure DCIS had two sentinel lymph nodes positive for metastasis. This rate was significantly lower than that in patients with IDC-predominant invasive lesions (6.2%; p Conclusions Because the rate of sentinel lymph node metastasis in pure DCIS is very low, sentinel lymph node biopsy can safely be omitted.

  3. FDG PET/MR for lymph node staging in head and neck cancer

    Objective: To assess the diagnostic value of PET/MR (positron emission tomography/magnetic resonance imaging) with FDG (18F-fluorodeoxyglucose) for lymph node staging in head and neck cancer. Materials and methods: This prospective study was approved by the local ethics committee; all patients signed informed consent. Thirty-eight patients with squamous cell carcinoma of the head and neck region underwent a PET scan on a conventional scanner and a subsequent PET/MR on a whole-body hybrid system after a single intravenous injection of FDG. The accuracy of PET, MR and PET/MR for lymph node metastases were compared using receiver operating characteristic (ROC) analysis. Histology served as the reference standard. Results: Metastatic disease was confirmed in 16 (42.1%) of 38 patients and 38 (9.7%) of 391 dissected lymph node levels. There were no significant differences between PET/MR, MR and PET and MR (p > 0.05) regarding accuracy for cervical metastatic disease. Based on lymph node levels, sensitivity and specificity for metastatic involvement were 65.8% and 97.2% for MR, 86.8% and 97.0% for PET and 89.5% and 95.2% for PET/MR. Conclusions: In head and neck cancer, FDG PET/MR does not significantly improve accuracy for cervical lymph node metastases in comparison to MR or PET

  4. ZEB1 Expression in Endometrial Biopsy Predicts Lymph Node Metastases in Patient with Endometrial Cancer

    Feng, Gang; Wang, Xiangming; Cao, Xiaozhi; Shen, Lijuan; Zhu, Jiansheng

    2014-01-01

    Purpose. The purpose of this study was to analyze the expression of zinc-finger E-box-binding homeobox 1 (ZEB1) in endometrial biopsy and its correlation with preoperative characteristics, including lymph node metastases in patient with endometrial cancer. Methods. Using quantitative RT-PCR, ZEB1 expressions in endometrial biopsy from 452 patients were measured. The relationship between ZEB1 expression and preoperative characteristics was analyzed. Results. ZEB1 expressions were significantly associated with subtype, grade, myometrial invasion, and lymph node metastases. Lymph node metastases could be identified with a sensitivity of 57.8% at specificity of 74.1% by ZEB1 expression in endometrial biopsy. Based on combination of preoperative characteristics and ZEB1 expression, lymph node metastases could be identified with a sensitivity of 62.1% at specificity of 96.2% prior to hysterectomy. Conclusion. ZEB1 expression in endometrial biopsy could help physicians to better predict the lymph node metastasis in patients with endometrial cancer prior to hysterectomy. PMID:25544793

  5. ZEB1 Expression in Endometrial Biopsy Predicts Lymph Node Metastases in Patient with Endometrial Cancer

    Gang Feng

    2014-01-01

    Full Text Available Purpose. The purpose of this study was to analyze the expression of zinc-finger E-box-binding homeobox 1 (ZEB1 in endometrial biopsy and its correlation with preoperative characteristics, including lymph node metastases in patient with endometrial cancer. Methods. Using quantitative RT-PCR, ZEB1 expressions in endometrial biopsy from 452 patients were measured. The relationship between ZEB1 expression and preoperative characteristics was analyzed. Results. ZEB1 expressions were significantly associated with subtype, grade, myometrial invasion, and lymph node metastases. Lymph node metastases could be identified with a sensitivity of 57.8% at specificity of 74.1% by ZEB1 expression in endometrial biopsy. Based on combination of preoperative characteristics and ZEB1 expression, lymph node metastases could be identified with a sensitivity of 62.1% at specificity of 96.2% prior to hysterectomy. Conclusion. ZEB1 expression in endometrial biopsy could help physicians to better predict the lymph node metastasis in patients with endometrial cancer prior to hysterectomy.

  6. The effect of intraarterial high-dose cisplatin on lymph nodes in oral and oropharyngeal cancer

    A F Kovács

    2012-01-01

    Full Text Available Aim of Study: To assess the effect of strictly local treatment [intraarterial chemotherapy (iaCHT with high-dose cisplatin and parallel neutralization] in the primary oral and oropharyngeal cancer (OOSCC on the dependent cervical lymph nodes. Patients and Methods: Seventeen consecutive patients with OOSCC and clinically positive necks underwent a prospective blinded comparison of two pre-surgical fluor18-deoxyglucose (FDG-positron emission tomography (PET examinations: baseline examination 1 week before and follow-up examination 3 weeks after iaCHT. Maximal standardized uptake (SUVmax values of lymph nodes were measured and compared with each other and histopathology. Results: The SUVmax value of the primary and all neck lymph nodes with uptake decreased significantly. Twelve/17 patients having metastases revealed significant decrease (P = 0.03, and benign lymph nodes showed non-significant decrease of the SUVmax. All neck lymph nodes with uptake and nodal metastases showed a significant reduction (P = 0.004 of standard uptake values (SUV. Conclusion: A regional effect of intraarterial cisplatin is proven. To date, it is not clear whether this is due to decreasing inflammatory reaction or a translymphatic anti-neoplastic effect.

  7. Immunohistochemical consistency between primary tumors and lymph node metastases of gastric neuroendocrine carcinoma

    Uchiyama Chieko

    2012-06-01

    Full Text Available Abstract Background Gastric neuroendocrine carcinoma (G-NEC is a rare, highly malignant tumor that exhibits aggressive growth leading to vascular invasion, distant metastasis and extremely poor prognosis. We studied the clinicopathological findings of seven patients at our institute to better under this disease. Methods Seven cases of G-NEC were identified among 1,027 cases of gastric carcinoma that underwent gastrectomy at Kansai Rousai Hospital between 2002 and 2010. We studied the pathological and immunohistochemical features of gastric neuroendocrine carcinomas at both the primary site and metastatic lymph nodes. Results The mean patient age was 73 years (range 63 to 86 years. There were no females in this series. The final staging was Stage I in one case, Stage II in two, Stage III in two and Stage IV in two. A total of 31 metastatic lymph nodes were found in these patients. This study revealed that the ratio of neuroendocrine cells was similar between the primary and metastatic sites, which tended to show the same expression patterns of neuroendocrine markers. Conclusions Metastatic lymph nodes showed heterogeneous immunohistochemical expression patterns similar to the primary sites. G-NEC is far advanced at diagnosis and rapidly reaches the lymph nodes retaining its heterogeneity, carrying a worse prognosis than common gastric cancer. Mini abstract G-NEC grows rapidly and metastasizes to the lymph nodes, retaining its pathological and immunohistochemical heterogeneity even at the metastatic sites.

  8. Preliminary experiences with sentinel lymph node detection in cases of vulvar malignancy

    Zambo, Katalin; Schmidt, Erzsebet; Dehghani, Babak [Department of Nuclear Medicine, University of Pecs, Faculty of Medicine (Hungary); Hartmann, Tamas; Bodis, Jozsef [Department of Obstetrics and Gynecology, County Teaching Hospital, University of Pecs, Faculty of Health Sciences (Hungary); Kornya, Laszlo [Department of Obstetrics and Gynecology, Peterfy Sandor Hospital, Budapest (Hungary); Tinneberg, Hans Rudolf [Department of Obstetrics and Gynecology, City Hospital Bielefeld (Germany)

    2002-09-01

    Lymph node status is the most important prognostic factor in vulvar malignancy. The aim of this pilot study was to explore the clinical significance of radionuclide lymphoscintigraphy in the management of vulvar neoplasms. Eight patients with squamous cell carcinoma and two patients with malignant melanoma of the vulva were studied with 100 MBq technetium-99m nanocolloid (Sentiscint, OSSKI, Budapest) 1 day before surgery. The location of the sentinel lymph node was checked by a single-head gamma camera-computer system (MB 9200, Mediso, Budapest). Vulvectomy with bilateral inguinofemoral lymphadenectomy was performed in each case. At lymphadenectomy, the sentinel lymph node was separately removed and histologically studied. Three of the ten patients had positive sentinel lymph nodes (micrometastasis). Five months later one of them had local recurrence of the vulvar cancer, and another had inguinal recurrence of the tumour 6 months postoperatively; the third patient was operated on only recently. Our preliminary results are impressive and suggest that lymphoscintigraphy is an easy and reliable method for detection of the sentinel lymph node in vulvar malignancy. (orig.)

  9. Lymphotoxin, but not TNF, is required for prion invasion of lymph nodes.

    O'Connor, Tracy; Frei, Nathalie; Sponarova, Jana; Schwarz, Petra; Heikenwalder, Mathias; Aguzzi, Adriano

    2012-01-01

    Neuroinvasion and subsequent destruction of the central nervous system by prions are typically preceded by a colonization phase in lymphoid organs. An important compartment harboring prions in lymphoid tissue is the follicular dendritic cell (FDC), which requires both tumor necrosis factor receptor 1 (TNFR1) and lymphotoxin β receptor (LTβR) signaling for maintenance. However, prions are still detected in TNFR1⁻/⁻ lymph nodes despite the absence of mature FDCs. Here we show that TNFR1-independent prion accumulation in lymph nodes depends on LTβR signaling. Loss of LTβR signaling, but not of TNFR1, was concurrent with the dedifferentiation of high endothelial venules (HEVs) required for lymphocyte entry into lymph nodes. Using luminescent conjugated polymers for histochemical PrP(Sc) detection, we identified PrP(Sc) deposits associated with HEVs in TNFR1⁻/⁻ lymph nodes. Hence, prions may enter lymph nodes by HEVs and accumulate or replicate in the absence of mature FDCs. PMID:22912582

  10. Lymphotoxin, but not TNF, is required for prion invasion of lymph nodes.

    Tracy O'Connor

    Full Text Available Neuroinvasion and subsequent destruction of the central nervous system by prions are typically preceded by a colonization phase in lymphoid organs. An important compartment harboring prions in lymphoid tissue is the follicular dendritic cell (FDC, which requires both tumor necrosis factor receptor 1 (TNFR1 and lymphotoxin β receptor (LTβR signaling for maintenance. However, prions are still detected in TNFR1⁻/⁻ lymph nodes despite the absence of mature FDCs. Here we show that TNFR1-independent prion accumulation in lymph nodes depends on LTβR signaling. Loss of LTβR signaling, but not of TNFR1, was concurrent with the dedifferentiation of high endothelial venules (HEVs required for lymphocyte entry into lymph nodes. Using luminescent conjugated polymers for histochemical PrP(Sc detection, we identified PrP(Sc deposits associated with HEVs in TNFR1⁻/⁻ lymph nodes. Hence, prions may enter lymph nodes by HEVs and accumulate or replicate in the absence of mature FDCs.

  11. Diagnosis of pelvic lymph node metastasis in prostate cancer using single optical fiber probe.

    Denkçeken, Tuba; Canpolat, Murat; Baykara, Mehmet; Başsorgun, İbrahim; Aktaş-Samur, Anıl

    2016-09-01

    Elastic light single-scattering spectroscopy system (ELSSS) is a biomedical tool which is used for detection of cancerous tissues ex-vivo. ELSSS spectra depend primarily on the size of scatterers in the tissue and are not directly related to changes in the absorption which are caused by variations of the biological macromolecules. In the present study, we aimed to detect metastasis in the pelvic lymph node by using combination of Principal Components Analysis (PCA) and Linear Discriminant Analysis (LDA). Single-scattering spectra in the 450-750nm wavelength regions were obtained from the total of 83 reactive lymph node and 12 metastatic lymph node samples from 10 prostatic cancer patients. The ELSSS spectral data were compared against the "gold standard" histopathology results. Data analyses were done via using PCA, followed by LDA. Receiver Operating Characteristic (ROC) curve analysis was employed for differentiating performance. The classification based on discriminant score provided sensitivity of 100% and specificity of 96.4%, in differentiating non-metastatic (reactive) from metastatic pelvic lymph nodes, with a Positive Predictive Value (PPV) of 0.8, a Negative Predictive Value (NPV) of 0.99 and the area under the ROC curve (AUC) of 0.99, respectively. In this study, it was shown that ELSSS system can accurately distinguish reactive and metastatic pelvic lymph nodes of prostate cancer with high PPV and NPV. It can be concluded that diagnostic accuracy of ELSSS system allows detecting metastatic tissues during operation. PMID:26526175

  12. Minute ampullary carcinoid tumor with lymph node metastases: a case report and review of literature

    Sakano Shigeru

    2009-01-01

    Full Text Available Abstract Background Carcinoid tumors are usually considered to have a low degree of malignancy and show slow progression. One of the factors indicating the malignancy of these tumors is their size, and small ampullary carcinoid tumors have been sometimes treated by endoscopic resection. Case presentation We report a case of a 63-year-old woman with a minute ampullary carcinoid tumor that was 7 mm in diameter, but was associated with 2 peripancreatic lymph node metastases. Mild elevation of liver enzymes was found at her regular medical check-up. Computed tomography (CT revealed a markedly dilated common bile duct (CBD and two enlarged peripancreatic lymph nodes. Endoscopy showed that the ampulla was slightly enlarged by a submucosal tumor. The biopsy specimen revealed tumor cells that showed monotonous proliferation suggestive of a carcinoid tumor. She underwent a pylorus-preserving whipple resection with lymph node dissection. The resected lesion was a small submucosal tumor (7 mm in diameter at the ampulla, with metastasis to 2 peripancreatic lymph nodes, and it was diagnosed as a malignant carcinoid tumor. Conclusion Recently there have been some reports of endoscopic ampullectomy for small carcinoid tumors. However, this case suggests that attention should be paid to the possibility of lymph node metastases as well as that of regional infiltration of the tumor even for minute ampullary carcinoid tumors to provide the best chance for cure.

  13. Role of protease activated receptor-2 in lymph node metastasis of uterine cervical cancers

    Protease activated receptor-2 (PAR-2) has been implicated in cellular proliferation, invasion and metastasis in various tumors. Lymph node metastasis is an important patient prognostic factor for uterine cervical cancers. This prompted us to study the role of PAR-2 in lymph node metastasis of uterine cervical cancers. Thirty patients underwent surgery for uterine cervical cancers. PAR-2 histoscores and mRNA levels were determined by immunohistochemistry and real-time reverse transcription-polymerase chain reaction, respectively. Patient prognosis was analyzed with a 48-month survival rate. PAR-2 histoscores and mRNA levels significantly (P < 0.05) increased in 12 of 30 metastatic lymph node lesions from the corresponding primary tumor. The 48-month survival rate of the 12 patients with increased PAR-2 levels in metastatic lymph nodes was 42%, while the rate of the other 18 patients with no change in PAR-2 levels was 82%, regardless of histopathological type. PAR-2 might work on lymph node metastasis of uterine cervical cancers, and is considered to be a novel prognostic indicator for uterine cervical cancers

  14. FDG PET/MR for lymph node staging in head and neck cancer

    Platzek, Ivan, E-mail: ivan.platzek@uniklinikum-dresden.de [Dresden University Hospital, Department of Radiology, Fetscherstr. 74, 01307 Dresden (Germany); Beuthien-Baumann, Bettina, E-mail: bettina.beuthien-baumann3@uniklinikum-dresden.de [Dresden University Hospital, Department of Nuclear Medicine, Fetscherstr. 74, 01307 Dresden (Germany); Schneider, Matthias, E-mail: m.schneider@mkgdresden.de [Dresden University Hospital, Department of Oral and Maxillofacial Surgery, Fetscherstr. 74, 01307 Dresden (Germany); Gudziol, Volker, E-mail: volker.gudziol@uniklinikum-dresden.de [Dresden University Hospital, Department of Otolaryngology, Fetscherstr. 74, 01307 Dresden (Germany); Kitzler, Hagen H., E-mail: hagen.kitzler@uniklinikum-dresden.de [Dresden University Hospital, Department of Neuroradiology, Fetscherstr. 74, 01307 Dresden (Germany); Maus, Jens, E-mail: j.maus@hzdr.de [Helmholtz-Zentrum Dresden-Rossendorf, Institute of Radiopharmaceutical Cancer Research, Bautzner Landstr. 400, 01328 Dresden (Germany); Schramm, Georg, E-mail: g.schramm@hzdr.de [Helmholtz-Zentrum Dresden-Rossendorf, Institute of Radiopharmaceutical Cancer Research, Bautzner Landstr. 400, 01328 Dresden (Germany); Popp, Manuel, E-mail: manuel.popp@praxisklinik-dresden.de [Dresden University Hospital, Department of Nuclear Medicine, Fetscherstr. 74, 01307 Dresden (Germany); Laniado, Michael, E-mail: michael.laniado@uniklinikum-dresden.de [Dresden University Hospital, Department of Radiology, Fetscherstr. 74, 01307 Dresden (Germany); Kotzerke, Jörg, E-mail: Joerg.Kotzerke@uniklinikum-dresden.de [Dresden University Hospital, Department of Nuclear Medicine, Fetscherstr. 74, 01307 Dresden (Germany); Hoff, Jörg van den, E-mail: j.van_den_hoff@hzdr.de [Helmholtz-Zentrum Dresden-Rossendorf, Institute of Radiopharmaceutical Cancer Research, Bautzner Landstr. 400, 01328 Dresden (Germany)

    2014-07-15

    Objective: To assess the diagnostic value of PET/MR (positron emission tomography/magnetic resonance imaging) with FDG (18F-fluorodeoxyglucose) for lymph node staging in head and neck cancer. Materials and methods: This prospective study was approved by the local ethics committee; all patients signed informed consent. Thirty-eight patients with squamous cell carcinoma of the head and neck region underwent a PET scan on a conventional scanner and a subsequent PET/MR on a whole-body hybrid system after a single intravenous injection of FDG. The accuracy of PET, MR and PET/MR for lymph node metastases were compared using receiver operating characteristic (ROC) analysis. Histology served as the reference standard. Results: Metastatic disease was confirmed in 16 (42.1%) of 38 patients and 38 (9.7%) of 391 dissected lymph node levels. There were no significant differences between PET/MR, MR and PET and MR (p > 0.05) regarding accuracy for cervical metastatic disease. Based on lymph node levels, sensitivity and specificity for metastatic involvement were 65.8% and 97.2% for MR, 86.8% and 97.0% for PET and 89.5% and 95.2% for PET/MR. Conclusions: In head and neck cancer, FDG PET/MR does not significantly improve accuracy for cervical lymph node metastases in comparison to MR or PET.

  15. [Lymphatic afferents and efferents of lymph nodes of the Barety's space. Anatomic review in adults].

    Riquet, M; Debesse, B; Zouaoui, A; Hidden, G

    1990-06-01

    Lymph nodes of the Barety's space (LNLB) often involved in lung diseases are known under various names for a long time ago by pathologists. Our study involves 360 cadavers of adult subjects. The injection of a dye was performed by direct catheterization of a pulmonary segment. L.N.L.B. were directly or indirectly coloured (inter connected ganglionary network) more often from the lobes of the right lung, but from the lobes of the left lung too. From L.N.L.B. the lymphatic flow discharges in the venous confluent of the neck in the right side; in 1/4 of the cases a mediastinal efferent joints the left venous confluent too. From the lower lymph nodes of the space efferents can go to lymph nodes which are located right along the arch of the azygos vein (and then to the thoracic duct) and in the left side the group of left suprabronchial lymph nodes (then either to the thoracic duct in the mediastinum, or to the recurrent chain to the neck). At last, it seems that inside the lymph nodes themselves, lymphatic flows exist, the topography and the nature of which change according to the area interested by the injection. PMID:2289035

  16. Influence of dexamethasone on mesenteric lymph node of rats with severe acute pancreatitis

    Xi-Ping Zhang; Hong-Miao Xu; Yi-Yu Jiang; Shuo Yu; Yang Cai; Bei Lu; Qi Xie; Tong-Fa Ju

    2008-01-01

    AIM: To study the influence and mechanisms of dexamethasone on mesenteric lymph node of rats with severe acute pancreatitis (SAP).METHODS: The SAP rats were assigned to model, treated or sham-operated groups. The mortality, pathological changes of mesenteric lymph nodes, expression levels of NF-κB, P-selectin, Bax, Bcl-2 and caspase-3 protein and changes in apoptotic indexes in lymph nodes were observed at 3, 6 and 12 h after operation. The blood levels of endotoxin, superoxide dismutase (SOD), malondialdehyde (MDA), and endothelin-1 (ET-1) in blood were determined.RESULTS: SOD content, expression of Bax protein and apoptotic index were significantly higher in the treated group than in the model group at different time points (P < 0.05 or P < 0.01). Other blood-detecting indexes and histopathological scores of mesenteric lymph nodes were lower in the treated than in the model group (P < 0.05, P < 0.01 or P < 0.01). NF-κB protein expression was negative in all groups. Comparing P-selectin and caspase-3 expression levels among all three groups, there was no marked difference between the model and treated group.CONCLUSION: Dexamethasone can protect mesenteric lymph nodes. The mechanism may be by reducing the content of inflammatory mediators in the blood and inducing lymphocyte apoptosis.

  17. Relationship Between Lymph Node Metastases and Pathological Stage in Bladder Cancer

    Muhammet Özcan

    2012-09-01

    Full Text Available Aim: The aim of our study was to review the relationship between pathological stage and lymph node metastasis in patients who underwent radical cystectomy for bladder cancer. Material and Method: One hundred twenty-five patients who underwent radical cystectomy for bladder cancer between March 2005 and January 2012 were evaluated. Pathological evaluation and clinical features were retrospectively analyzed. Results: Mean age of 125 patients were 61.7 years (38-88 who underwent radical cystectomy. Seven (%5.6 patients were female and 118 (%94.4 were male. The median number of yielded lymph node (LN was 16 (2-81 and median number of  positive  LN was  2 (1-29 who had metastatic LN. Twenty four patients had no tumour (pT0. Two patients had pT0 disease but had lymph node metastasis (pT0N1. One of them had neoadjuvant chemotherapy (NACT. Median lymph node density (LND (positive LN/ total LN ratio was 0.14(0,03-1. Patients’ pathological results are summarized on table 1. Discussion: Although lymph node metastases seem to occur in patients with T2b or higher stages, it can be detected in patients with pT0 disease.

  18. Observation of the Primo Vessel Approaching the Axillary Lymph Node with the Fluorescent Dye, DiI

    Su Youn Park

    2014-01-01

    Full Text Available The primo vascular system (PVS floating in lymph fluid has mostly been observed in large caliber ducts around the caudal vena cava and the thoracic duct of rabbits, rats, and mice. But the PVS has not been traced up to the lymph nodes. It has not been established whether the PVS leaves the lymph vessel through the lymph vessel wall or it enters the lymph nodes. Therefore, observing the PVS entering a lymph node, for example, the axillary node, is desirable. In the current work, we traced the PVS approaching up to the surface of axillary node of a rat. The method used for this study was based upon a method that was recently developed to detect the PVS in the lymph duct from the inguinal to the axillary nodes in the skin of a rat by injecting Alcian blue into the inguinal node. However, the Alcian blue blurred near the lymph nodes and tracing the PVS up to the lymph nodes has not been possible. The current method clearly showed the PVS approaching the axillary node.

  19. Can high frequency ultrasound predict metastatic lymph nodes in patients with invasive breast cancer?

    Purpose: Use high frequency ultrasound to predict the presence of metastatic axillary lymph nodes, with a high specificity and positive predictive value, in patients with invasive breast cancer. The clinical aim is to improve the surgical management and possible survival rate of groups of patients who would not normally have conventional axillary dissections. Materials and methods: The ipsilateral and contralateral axillas of 42 consecutive patients with invasive breast cancer were scanned prior to treatment using a B-mode frequency of 13 MHz and a Doppler frequency of 7 MHz. The presence or absence of an echogenic centre for each lymph node detected was recorded, measurements were also taken to determine the L/S (long axis/short axis) ratio of the node and the widest and narrowest part of the cortex. Power Doppler was also used to determine vascularity. The contralateral axilla was used as a control for each patient. Results: In this study of patients with invasive breast cancer, where ipsilateral lymph nodes had a cortical bulge of ≥3 mm and/or at least two lymph nodes had absent echogenic centres, all had disease spread to the axillary lymph nodes (10 patients). Sensitivity and specificity were 52.6% and 100%, respectively, positive and negative predictive values were 100% and 71.9%, respectively, the P-value was 0.001 and the Kappa score was 0.55. Conclusion: This would indicate that high frequency ultrasound could be used to accurately predict metastatic lymph nodes in a proportion of patients with invasive breast cancer, which may alter patient management

  20. Comparison between 18F-Fluorodeoxyglucose Positron Emission Tomography and Sentinel Lymph Node Biopsy for Regional Lymph Nodal Staging in Patients with Melanoma: A Review of the Literature

    Aim. to compare 18F-Fluorodeoxyglucose positron emission tomography (FDG-PET) to sentinel lymph node biopsy (SLNB) for regional lymph nodal staging in patients with melanoma. Methods. We performed a literature review discussing original articles which compared FDG-PET to SLNB for regional lymph nodal staging in patients with melanoma. Results and Conclusions. There is consensus in the literature that FDG-PET cannot replace SLNB for regional lymph nodal staging in patients with melanoma

  1. A Lymph Node Staging System for Gastric Cancer: A Hybrid Type Based on Topographic and Numeric Systems

    Choi, Yoon Young; An, Ji Yeong; Katai, Hitoshi; Seto, Yasuyuki; Fukagawa, Takeo; OKUMURA, YASUHIRO; Kim, Dong Wook; Kim, Hyoung-Il; Cheong, Jae-Ho; Hyung, Woo Jin; Noh, Sung Hoon

    2016-01-01

    Although changing a lymph node staging system from an anatomically based system to a numerically based system in gastric cancer offers better prognostic performance, several problems can arise: it does not offer information on the anatomical extent of disease and cannot represent the extent of lymph node dissection. The purpose of this study was to discover an alternative lymph node staging system for gastric cancer. Data from 6025 patients who underwent gastrectomy for primary gastric cancer...

  2. Molecular Investigation of Lymph Nodes in Colon Cancer Patients Using One-Step Nucleic Acid Amplification (OSNA)

    Güller, Ulrich; Zettl, Andreas; Worni, Mathias; Langer, Igor; Cabalzar-Wondberg, Daniela; Viehl, Carsten T; Demartines, Nicolas; Zuber, Markus

    2012-01-01

    BACKGROUND A new diagnostic system, called one-step nucleic acid amplification (OSNA), has recently been designed to detect cytokeratin 19 mRNA as a surrogate for lymph node metastases. The objective of this prospective investigation was to compare the performance of OSNA with both standard hematoxylin and eosin (H&E) analysis and intensive histopathology in the detection of colon cancer lymph node metastases. METHODS In total, 313 lymph nodes from 22 consecutive patients with stage I, II, an...

  3. Cytoplasmic CXCR4 expression in breast cancer: induction by nitric oxide and correlation with lymph node metastasis and poor prognosis

    Kodama Rieko; Nakahara Masaaki; Yoshidome Katsuhide; Tsujimoto Masahiko; Yasuoka Hironao; Sanke Tokio; Nakamura Yasushi

    2008-01-01

    Abstract Background Lymph nodes constitute the first site of metastasis for most malignancies, and the extent of lymph node involvement is a major criterion for evaluating patient prognosis. The CXC chemokine receptor 4 (CXCR4) has been shown to play an important role in lymph node metastasis. Nitric oxide (NO) may also contribute to induction of metastatic ability in human cancers. Methods CXCR4 expression was analyzed in primary human breast carcinoma with long-term follow-up. The relations...

  4. Endoscopic and endobronchial ultrasonography according to the proposed lymph node map definition in the seventh edition of the tumor, node, metastasis classification for lung cancer.

    Tournoy, Kurt G; Annema, Jouke T; Krasnik, Mark; Herth, Felix J F; van Meerbeeck, Jan P

    2009-12-01

    Accurate assessment of lymph node involvement is a critical step in patients with non-small cell lung cancer in the absence of distant metastases. The International Association for the Study of Lung Cancer has proposed a new lymph node map, which provides precise anatomic definitions for all intrathoracic lymph nodes. Transoesophageal endoscopic ultrasound with fine-needle aspiration and endobronchial ultrasound with transbronchial needle aspiration are two minimally invasive techniques that are increasingly implemented in the staging of non-small cell lung cancer. Therefore, recognition of the proposed anatomic borders by these techniques is very relevant for an accurate clinical staging. We here discuss the reach and limits of endoscopic ultrasound in the precise delineation and approach of the intrathoracic lymph nodes according to the new lymph node map for the seventh edition of the tumor, node, metastasis classification for lung cancer. PMID:19884852

  5. Evaluation of mediastinal lymph node metastasis in lung cancer: factors influencing the diagnostic accuracy of CT

    The purpose of this paper is to evaluate factors influencing the CT assessment of mediastinal lymph node metastasis in patients with non-small cell lung cancer. CT scans of 198 patients who had undergone thoracotomy and mediastinal lymph node dissection for non-small cell lung cancer were retrospectively evaluated using a size criterion of ≥ 10mm in the short axis. To evaluate the accuracy of CT in diagnosing lymph node metastasis on a nodal station-by-station basis, CT and pathological results were correlated. Analysis included a comparison of the sensitivity and specificity of CT according to 1) cell type of tumor, squamous cell carcinoma versus adenocarcinoma (excluding bronchioloalveolar cell carcinoma); 2) histologic differentiation; 3) tumor size ; 4) central and peripheral location of the tumor; 5) the presence or absence of obstructive pneumonitis and /or atelectasis; 6) the presence or absence of prior granulomatous disease. In the CT assessment of mediastinal lymph node metastasis the cell type of adenocarcinoma adversely affected sensitivity, with a high frequency of normal-sized metastatic nodes. Obstructive pneumonitis caused by central tumor adversely affected specificity with the frequent occurrence of hyperplastic nodes. (author). 16 refs., 2 figs

  6. Role of Sentinel Lymph Node in Early Stage of Uterine Cervical Cancer

    Mihaela Mădălina Gavrilescu

    2014-07-01

    Full Text Available Cervical cancer is currently the second most common form of neoplasia worldwide and third in the female population. Dissemination can occur directly (isthmus, parametrium, vagina, urinary bladder and/or rectum, through the lymphatic system (parametrium, internal iliac, external iliac, common iliac, obturator lymph nodes and rarely in the inferior gluteus, superior gluteus, superior rectum, sacrum, aortic lymph nodes and through the circulatory system (lung, mediastinum, bones, liver. The risk of pelvic lymph nodes invasion in stage IB (FIGO is 9-17%. The standard surgical treatment, for stages IA2-IIA, is radical hysterectomy with pelvic lymphadenectomy. The risk of intraoperative (vessel or nerve damage or postoperative complications (lymphedema is not negligible. The sentinel node concept refers to the first lymph node in which the cancerous lymphatic drainage takes place. This idea has radically changed the therapeutic approach in the treatment of breast cancer and melanoma. In cervical cancers, this technique is 92% accurate with only an 8% false negative rate. Currently, the sentinel node protocol is not included in the standard treatment for cervical cancer because certain issues need to be addressed (the sensitivity of the frozen section examination, the pathologist’s subjectivity, the uniformity of the protocol, the surgical experience, the size of the tumor.

  7. Relationship of apical lymph node involvement to survival in resected colon carcinoma.

    Malassagne, B; Valleur, P; Serra, J; Sarnacki, S; Galian, A; Hoang, C; Hautefeuille, P

    1993-07-01

    In a prospective study of 197 patients with resected colon carcinoma treated between 1974 and 1985, we explored the relationships between pathologic parameters, and the effect of the latter on survival, to identify the parameter whose systematic measurement would improve the predictive capacity of pathologic staging. Prognostic characteristics were studied by univariate analysis. The results showed significant relationships between the location and number of lymph nodes involved, blood vessel invasion, depth of tumor penetration, and metastases. The five-year survival rates were 45 percent and 17 percent (P < 0.001) for patients without and with apical lymph node involvement, respectively, and 44 percent and 6 percent (P < 0.05) for those with four or less nodes involved and more than four involved, respectively. Among the patients treated by incomplete resection, the respective survival rates of those resected for metastases and of those resected for apical lymph node involvement did not differ significantly. We conclude that the involvement of apical lymph nodes has a significant effect on prognosis and suggest systematic pathologic examination of these nodes to allow simpler and more reproducible selection of patients for treatment by incomplete resection who are at high risk of disease-related death. PMID:8394236

  8. Evaluation of mediastinal lymph node metastasis in lung cancer: factors influencing the diagnostic accuracy of CT

    Choe, Du Hwan; Lee, Tae Hyun; Kim, Kie Hwan; Chin, Soo Yil; Zo, Jae Ill; Cho, Kyung Ja [Korea Cancer Center Hospital, Seoul (Korea, Republic of)

    1998-03-01

    The purpose of this paper is to evaluate factors influencing the CT assessment of mediastinal lymph node metastasis in patients with non-small cell lung cancer. CT scans of 198 patients who had undergone thoracotomy and mediastinal lymph node dissection for non-small cell lung cancer were retrospectively evaluated using a size criterion of {>=} 10mm in the short axis. To evaluate the accuracy of CT in diagnosing lymph node metastasis on a nodal station-by-station basis, CT and pathological results were correlated. Analysis included a comparison of the sensitivity and specificity of CT according to 1) cell type of tumor, squamous cell carcinoma versus adenocarcinoma (excluding bronchioloalveolar cell carcinoma); 2) histologic differentiation; 3) tumor size ; 4) central and peripheral location of the tumor; 5) the presence or absence of obstructive pneumonitis and /or atelectasis; 6) the presence or absence of prior granulomatous disease. In the CT assessment of mediastinal lymph node metastasis the cell type of adenocarcinoma adversely affected sensitivity, with a high frequency of normal-sized metastatic nodes. Obstructive pneumonitis caused by central tumor adversely affected specificity with the frequent occurrence of hyperplastic nodes. (author). 16 refs., 2 figs.

  9. Drug concentrations in axillary lymph nodes after lymphatic chemotherapy on patients with breast cancer

    Lymph node status is one of the decisive prognostic factors in breast cancer. Chemotherapy targeting regional lymphatic tissues has emerged as a promising therapy for the treatment of malignancies with a high tendency to disseminate lymphatically. The present study determined the drug concentrations in axillary lymph nodes after lymphatic chemotherapy (LC) in patients with breast cancer and compared the results with those receiving intravenous chemotherapy (VC) to investigate whether LC could improve the accumulation of anticancer drug in regional lymph nodes. Sixty patients with breast carcinoma confirmed by preoperative puncture-biopsy were divided into two groups at random. The LC group (n = 30) received a subcutaneous injection of 4 ml of carboplatin-activated carbon suspension, containing 20 mg of carboplatin, adjacent to the primary tumour. The VC group (n = 30) received an intravenous administration of an equal dose of aqueous carboplatin. At 1, 12, 24, 36 and 48 hours after administration, modified radical mammectomies were performed on 12 patients at each time point, with 6 from each group. Axillary lymph nodes were removed for pathological examination. The platinum concentrations in nodes were determined by Zeeman atomic absorption spectrometry. A total of 275 axillary lymph nodes were resected, with 154 in the LC group and 121 in the VC group. Of the 275 lymph nodes, 136 (49.5%) from 23 patients (38.3%) had histopathologically detected metastases. At 1, 12, 24, 36 and 48 hours after injection, the carboplatin concentrations in the LC group were 11.82 ± 3.50, 23.58 ± 7.34, 18.22 ± 4.93, 16.70 ± 5.15 and 14.62 ± 4.29 μg/g (means ± SD), respectively, whereas those in the VC group were 0.06 ± 0.02, 0.11 ± 0.05, 0.10 ± 0.02, 0.05 ± 0.02 and 0 μg/g, respectively. Significant differences were found in each corresponding comparison (P < 0.001). Lymph node metastasis was uncorrelated with drug concentration (P > 0.05). LC can effectively and

  10. Rule of lymph node metastasis and proper target of postoperative radiotherapy for thoracic esophageal carcinoma

    Objective: To analyze the rule of lymph node metastasis in thoracic esophageal carcinoma, and to study the proper radiation target. Methods: From September 1986 to December 1997,549 patients with esophageal carcinoma who had undergone radical resection were divided into surgery alone group (S,275 patients) or surgery plus radiotherapy group(S + R,274 patients). Radiotherapy was begun 3 to 4 weeks after operation. The radiation target included both supra-clavicular areas and the entire mediastinum. The total dose was 50 Gy in 25 fractions over 5 weeks for the supra-clavicular areas and 60 Gy in 30 fractions over 6 weeks for the entire mediastinum. Results: The 5-year overall survival of patients with lymph node metastasis in one anatomic site and two anatomic sites was 31.5% and 13.9% (P=0.013), respectively. For patients with > 2 positive nodes metastasis receiving surgery alone, the corresponding 5-year survival was 24.8% and 4.9% (P=0.046), respectively. The median number of dissected lymph nodes of the upper-, middle-and lower-segment esophageal carcinoma was 13, 17 and 20, respectively. The rate of metastatic lymph node in the para-esophagus region was the highest(61.5%-64.9%), which was not different among the different primary sites (P=0.922). The anastomotic stoma recurrence rate of the upper-segment esophageal carcinoma was higher than that of the middle- or lower-segment carcinomas (16.7%, 3.1%, and 7.7%, χ2=9.02,P<0.05). Conclusions: For the thoracic esophageal carcinoma, the number of anatomic sites of lymph node metastasis is an important factor affecting the survival. The lower rate of lymph node metastasis of the upper segment esophageal carcinoma may be corrected with the less lymph node dissected. The rate of lymph node metastasis in para-esophageal region is not related with the lesion segment. The anastomotic stoma is an important radiotherapy target for upper segment esophageal carcinoma. (authors)

  11. Role of postoperative radiotherapy for celiac lymph node metastasis from gastric cancer: analysis on 63 patients

    Objective: To evaluate the role of postoperative radiotherapy for celiac lymph node (LN) metastasis from gastric cancer in the past 6 years. Methods: Sixty-three patients with abdominal LN metastasis after curative resection for gastric cancer were retrospectively analyzed. Clinical characteristics was colleeted including age, gender, status of primary tumor of stomach (size, location and grade), and the number of LN dissected and involved. Of the 63 patients, 36 received local external beam radiotherapy (EBRT) as salvage therapy and were classified as the EBRT group. The irradiation target was local-regional LN. The radiation dose ranged from 40 to 60 Gy in daily 1.8-2.0 Gy fractions, 5 times weekly. The other 27 patients who received chemotherapy were classified as the non-EBRT group. The Kaplan-Meier method was used to evaluate the survival rates, and the Cox regression model was used to identify the predictors of prognosis. Results: After EBRT, complete response and partial response were observed in 31% and 58% of patients, respectively. The clinical obstruction symptoms induced by LN pressure in 18 patients were completely relieved after EBRT. The median survival was 339 clays for the EBRT group and 136 days for the non- EBRT group, the survival rate at 1 and 2 years for patients treated with EBRT vs. without EBRT was 40% vs. 17% and 20% vs. 6%, respectively (P=0.004). Multivariate analysis showed that the level of relative risk (RR) in the EBRT group was reduced to 0.299 (P=0.002). The incidence of death resulting from LN-related complications was lower in the EBRT group. The main cause of death in both groups was distant metastasis. The gastro-intestinal toxicities were the most common side effects during and after EBRT. The RTOG grade 0,1,2 and 3 toxicities were found in 7,17,11 and 1 patients, respectively. No hematologic and hepatic toxicities were observed. Conclusions: Postoperative lymph node metastasis from gastric cancer is sensitive to external beam

  12. Cervical Lymph Node Metastasis: Unusual Presentation of Adenoid Cystic Carcinoma - Diagnosed By FNAC

    Archana Buch

    2015-01-01

    Full Text Available Adenoid cystic carcinoma (ACC is a rare neoplasm that usually arises from minor salivary glands. It is characteristically locally infiltrative, exhibiting perineural invasion, has a tendency for local recurrence and prolonged clinical course. A 60 year old male, chronic smoker presented with swelling of the left cervical lymph node since two months. Examination revealed a solitary firm, non tender, non mobile left cervical swelling measuring 2 x 1 cm. Fine Needle Aspiration Cytology (FNAC was done from the cervical lymph node. The diagnosis of metastatic deposits of ACC was given. Detail examination of the oral cavity revealed a small swelling at the floor of the mouth. Biopsy of the swelling confirmed ACC on histopathological examination. An unusual feature of adenoid cystic carcinoma is the low incidence of metastases to regional lymph nodes. The case is presented to highlight its unusual presentation and utility of FNAC in rapid diagnosis.

  13. [Excision of colorectal cancers: what can be expected of lymph node excision?].

    Pol, B; Brandone, J M; Le Treut, Y P; Bricot, R

    1989-01-01

    We report a series of 413 patients with colo-rectal adenocarcinoma. 328 had a curative resection and 277 of them had elective lymphadenectomy; 51 had no lymphadenectomy because of either age or poor general status. Operative morbidity and mortality were not increased by lymphadenectomy. Survival was related to the lymph node involvement: 70.6% 5 year survival in patients without lymph node metastases, 49.3% 5 year survival in patients with lymph node metastases (P less than 0.001). However lymphadenectomy did not affect the survival rate of the patients. We conclude that lymphadenectomy had no deleterious effect. However, its real benefit on long term survival must be evaluated in further prospective randomised studies. PMID:2930148

  14. Supra- and infra-clavicular lymph node irradiation in breast cancer patients: State of the art

    Radiation therapy plays an essential role in the treatment of invasive breast cancer. However, prophylactic treatment of supra- and infra-clavicular lymph nodes is not consensual, with different treatment depending on the centres and practitioners. Clinical indications for radiotherapy of the supra- and infra-clavicular lymph nodes are often the subject of a consensus. Nevertheless, radiotherapy induces some toxicity. Various techniques have been developed. To date, conformal radiotherapy allows an accurate assessment of doses to target volumes and organs at risk, but at the cost of a sometime complex delineation. This article reviews the literature on radiation of supra- and infra-clavicular lymph nodes, with a special focus on technical aspects in delineation and its potential toxicity. (authors)

  15. Primary Amyloidosis Involving Mediastinal and Cervical Lymph Nodes: A Case Report

    Mun, Sugn Hee; Jung, Kyung Jae [Dept. of Radiology, Catholioc University of Daegu School of Medicine, Daegu (Korea, Republic of)

    2011-08-15

    Amyloidosis is a rare disease characterized by the accumulation of an insoluble protein called 'amyloid' in various soft tissues and organs. Primary localized amyloidosis involving the mediastinal and cervical lymph nodes is extremely rare. A 68-year-old man was hospitalized a few days ago for recent cerebral infarction and was diagnosed with primary localized amyloidosis manifesting as mediastinal and cervical lymphadenopathy with calcification. In this review, we report a case of primary localized amyloidosis involving the mediastinal and cervical lymph nodes along with its computed tomography findings. Amyloidosis should be considered as part of the differential diagnosis when the lymph nodes show low central attenuation and various types of calcification.

  16. Hilar lymph-node metastasis of bronchogenic carcinoma. Evaluation with ultrafast incremental dynamic CT (IDCT)

    Eighty patients with bronchogenic carcinoma were studied with ultrafast IDCT using a 3 mm collimation. Nineteen contiguous images encompassing pulmonary hilum were obtained in a single breath-hold with an injection of contrast material at the rate of 3 ml/sec. Subsequent to the preliminary analysis of the peribronchovascular interstitium in 22 patients with normal hilum, the presence or absence of hilar lymph node metastases was judged in 151 hilar lymph nodes of 80 patients on the basis of convex interface of the interstitium into adjacent lung. The interfaces between the normal interstitium and adjacent lung demonstrated concave or linear appearances in 97.2%. Sensitivity, specificity, and accuracy of ultrafast IDCT in the diagnosis of hilar lymph node metastasis were 91.4%, 87.9%, and 88.7%, respectively. (author)

  17. Endoplasmic reticulum aminopeptidase 2 is highly expressed in papillary thyroid microcarcinoma with cervical lymph node metastasis

    Woo Young Kim

    2015-01-01

    Full Text Available Background: The cervical lymph node metastasis (CLNM of papillary thyroid microcarcinoma (PTMC is not uncommon. However, prophylactic cervical lymph node dissection in all PTMC is debatable. Molecular markers of predicting CLNM would help to decide to either do or not do cervical lymph node dissection which might increase morbidities. Aims: We aimed to characterize gene expression profiles and molecular markers of CLNM in PTMC. Settings and Design: The thyroid frozen tissues were obtained with from six PTMC patients, who underwent total thyroidectomy. Methods: We performed oligonucleotide microarray analysis with three PTMCs with CLNM and three without CLNM. Real-time quantitative reverse transcription-polymerase chain reaction was used to validate the gene. Statistical Analysis Used: We used linear models for microarray data. Results: We identified 12 differentially expressed gene, and most one is endoplasmic reticulum aminopeptidase 2 (ERAP2. Conclusion: ERAP2 might be associated with CLNM in PTMC.

  18. Sentinel-lymph node procedure in breast, uterine cervix, prostate, vulva and penile cancers: Practical methodology

    The nodal status is the strongest prognostic factor in early stage cancers. The sentinel-lymph node (S.L.N.) is defined as the first draining lymph node of an organ; the lymph node status is determined by the histological results of S.L.N.. The lymphadenectomy, with high morbidity, is realised only in case of metastatic S.L.N.. The S.L.N. identification, in most of cases, is performed using the combination of blue dye and radiocolloid 99mTc injections. The purpose of this article is to give some practical details about the S.L.N. isotopic procedure in breast cancer, vulva and penile cancer, uterine cervix and prostate cancer. (author)

  19. ROLE OF SONOGRAPHY IN EVALUATION OF CERVICAL LYMPH NODES AND COMPARISON WITH THEIR CYTOLOGICAL FINDINGS

    Sikarwar

    2015-02-01

    Full Text Available This study was conducted in department of radio - diagnosis, G.R. Medical College, Gwalior for period of one year (October 2013 - September 2014. Ultrasound evaluation of cervical lymph - nodes was done using high frequency (7.5 - MHz linear transducer in 100 p atients. Various Parameters such as size, shape (L/S ratio, hilar echogenicity, micro calcification, color flow pattern and R.I. (resistive index were applied to assess the lymph nodes. Fine needle aspiration cytology of these lymph nodes was done under ultrasound guidance and sent for cytological evaluation. Finally results of ultrasound and cytology compared. In this study ultrasound examination of total 100 patients with subsequent F.N.A.C of cervical lymph node was done. Out of 100 pt 74 were having b enign and 26 were having malignant etiology. In this study we found size criterion has sensitivity of 84.6%, specificity 67.5% PPV 47.8% NPV 92.5%.L/S ratio criterion has sensitivity 88.6%, specificity 75.6%, PPV 56.1%, and NPV 94.9%. Hilar echogenicity cr iterion has sensitivity 76%, specificity 82.4%, PPV 60.6%, NPV 91.9%. Using micro - calcification criterion we got sensitivity of 30.7%, specificity 97.2%, PPV 80%, NPV 80%. Peripheral vascularity criterion has sensitivity of 84.6%, specificity 70.2%, PPV 50 %and NPV 92.8%. Finally R.I. value has sensitivity 92.3% specificity 71.6% PPV 53% and NPV 96.3%. AIMS AND OBJECTIVES: Sonographic examination of cervical lymph nodes. To do FNAC of cervical lymph nodes. Comparison of ultrasound findings of cervical lymph node with Cytological findings. To assess sensitivity, specificity, positive predictive value, and negative predictive value of ultrasound in diagnosing malignant and benign nature of cervical lymph node. The aim of this study is to evaluate the role of u ltrasound in differentiation of normal/reactive nodes from malignant one. MATERIAL AND METHODS: This is a prospective study conducted in department of radio diagnosis, G

  20. Solitary pancreatic lymph node metastasis from carcinoma of the breast: case report

    Scambia Giovanni

    2010-05-01

    Full Text Available Abstract Background We report the first case of isolated pancreatic lymph node recurrence in a locally advanced breast cancer patient. Case A 41-year old woman underwent radical mastectomy according to Madden and removal of axillary lymph nodes for multicentric infiltrating ductal carcinoma pathologically staged as pT2N2M0. After six years from primary diagnosis, and four years from the diagnosis of lung recurrence, she developed an isolated metastatic lesion to pancreatic lymph node. After surgical excision of metastasis, hormone therapy with Exemestane was begun. At 16 months of follow-up, the patient appears free of disease. Conclusion Because metastatization to visceral organ carries a very unfavorable prognosis, we think that the clinical significance of the elevation of CA 15.3 serum levels in the early detection of recurrence and in monitoring metastatic disease during follow-up, should be not underestimated.

  1. Artificial neural networks as classification and diagnostic tools for lymph node-negative breast cancers

    Eswari J, Satya; Chandrakar, Neha [National Institute of Technology Raipur, Raipur (India)

    2016-04-15

    Artificial neural networks (ANNs) can be used to develop a technique to classify lymph node negative breast cancer that is prone to distant metastases based on gene expression signatures. The neural network used is a multilayered feed forward network that employs back propagation algorithm. Once trained with DNA microarraybased gene expression profiles of genes that were predictive of distant metastasis recurrence of lymph node negative breast cancer, the ANNs became capable of correctly classifying all samples and recognizing the genes most appropriate to the classification. To test the ability of the trained ANN models in recognizing lymph node negative breast cancer, we analyzed additional idle samples that were not used beforehand for the training procedure and obtained the correctly classified result in the validation set. For more substantial result, bootstrapping of training and testing dataset was performed as external validation. This study illustrates the potential application of ANN for breast tumor diagnosis and the identification of candidate targets in patients for therapy.

  2. Histological and immunohistochemical studies of the structure of lymph nodes in Kilis goats.

    Bozkurt, Y A; Kuş, S; Kozlu, T; Başak, F

    2014-08-01

    Ten healthy adult Kilis goat mesenteric lymph nodes were used to examine the general structure of lymph nodes, lymphocytes, plasma cells, reticular cells and reticular fibers using histological methods. We also detected T lymphocytes using anti-CD3 [SP7], anti-CD4 [74-12-4], mouse anti-bovine CD4 [CC30] and mouse anti-bovine CD8 [CC63] monoclonal antibodies (mAb); and B lymphocytes using anti-CD79a [HM57] mAb, macrophages using anti-macrophage [MAC387] mAb and follicular dendritic cells using anti-S100 polyclonal antibody (pAb). The distribution of these cells also was studied. Although the primer antibodies we used for CD3, CD8, CD79a, MAC387 and S100 worked well, the primer antibodies for CD4 were ineffective for paraffin embedded goat lymph nodes. PMID:24588598

  3. The diagnostic value of lymph node biopsy to detect Castleman’s disease

    Prashilla Soma

    2014-09-01

    Full Text Available HIV is not indicated in the aetiology of Castleman’s disease. However, it impacts on the prevalence and natural history of this disease and significantly on the disease progression. Castleman’s disease is a uni- or multicentric disease of the lymph node with or without polyclonal proliferation of B-cells. It is a morphologically distinct form of lymph node hyperplasia and is characterised by significant architectural changes in all lymphatic compartments. Histopathologically, the disease is classified into two major subtypes: the hyaline-vascular type and the plasma-cell type. A mixed type is also identified, as there are frequent transitions between the types. The diagnosis of Castleman’s disease needs to be made histologically. Treatment modalities include surgery, which is curative for unicentric disease, and systemic therapy, which is needed for multicentric disease. This case highlights the diagnostic value of lymph node excision biopsy in HIV-infected patients. 

  4. Erroneous interpretations in CT in malignant lymph node diseases of the pelvis and abdomen

    In the presence of a retroperitoneal mass with loss of normal aortic and caval contours no distinction can be made by CT between metastases or malignant lymphoma and primary sarcoma or retroperitoneal fibrosis if a primary tumour is not known. A false diagnose is quite possible if intestinal loops or vessels are considered as enlarged lymph nodes. These pitfalls can be avoided by intravenous application of contrast medium and by filling of all intestinal loops with orally administered contrast medium, in special cases even via a gastric tube. Pitfalls in post-therapeutic changes, like haematoma, scar tissue or lymphocele, are confounded with tumour recurrence of recent metastases and are give false-positive results in follow-up examinations. If no regression of lymph node enlargement after therapy is observed, a distinction between active metastases and nodal induration is impossible. False-negative results are due to metastatic, but not enlarged lymph nodes and cannot be avoided by CT. (orig.)

  5. Ljubljana nomograms for predicting the likelihood of non-sentinel lymph node metastases in breast cancer patients with a positive sentinel lymph node

    Perhavec, Andraž; Perme, Maja Pohar; Hočevar, Marko; Besić, Nikola; Žgajnar, Janez

    2009-01-01

    Abstract Several tools for predicting the likelihood of non-sentinel lymph node (non-SLN) involvement in SLN-positive breast cancer patients have been created so far. The aim of our study was to create and validate different nomograms for predicting the likelihood of non-SLN involvement that would be applicable in different institutions and that would also include the results of the preoperative US examination of the axilla. From January 2000 to January 2009, 534 breast cancer pati...

  6. Anatomic Distribution of Fluorodeoxyglucose-Avid Para-aortic Lymph Nodes in Patients With Cervical Cancer

    Purpose: Conformal treatment of para-aortic lymph nodes (PAN) in cervical cancer allows dose escalation and reduces normal tissue toxicity. Currently, data documenting the precise location of involved PAN are lacking. We define the spatial distribution of this high-risk nodal volume by analyzing fluorodeoxyglucose (FDG)-avid lymph nodes (LNs) on positron emission tomography/computed tomography (PET/CT) scans in patients with cervical cancer. Methods and Materials: We identified 72 PANs on pretreatment PET/CT of 30 patients with newly diagnosed stage IB-IVA cervical cancer treated with definitive chemoradiation. LNs were classified as left-lateral para-aortic (LPA), aortocaval (AC), or right paracaval (RPC). Distances from the LN center to the closest vessel and adjacent vertebral body were calculated. Using deformable image registration, nodes were mapped to a template computed tomogram to provide a visual impression of nodal frequencies and anatomic distribution. Results: We identified 72 PET-positive para-aortic lymph nodes (37 LPA, 32 AC, 3 RPC). All RPC lymph nodes were in the inferior third of the para-aortic region. The mean distance from aorta for all lymph nodes was 8.3 mm (range, 3-17 mm), and from the inferior vena cava was 5.6 mm (range, 2-10 mm). Of the 72 lymph nodes, 60% were in the inferior third, 36% were in the middle third, and 4% were in the upper third of the para-aortic region. In all, 29 of 30 patients also had FDG-avid pelvic lymph nodes. Conclusions: A total of 96% of PET positive nodes were adjacent to the aorta; PET positive nodes to the right of the IVC were rare and were all located distally, within 3 cm of the aortic bifurcation. Our findings suggest that circumferential margins around the vessels do not accurately define the nodal region at risk. Instead, the anatomical extent of the nodal basin should be contoured on each axial image to provide optimal coverage of the para-aortic nodal compartment

  7. Contraindications of sentinel lymph node biopsy: Áre there any really?

    Zografos George

    2007-01-01

    Full Text Available Abstract Background One of the most exciting and talked about new surgical techniques in breast cancer surgery is the sentinel lymph node biopsy. It is an alternative procedure to standard axillary lymph node dissection, which makes possible less invasive surgery and side effects for patients with early breast cancer that wouldn't benefit further from axillary lymph node clearance. Sentinel lymph node biopsy helps to accurately evaluate the status of the axilla and the extent of disease, but also determines appropriate adjuvant treatment and long-term follow-up. However, like all surgical procedures, the sentinel lymph node biopsy is not appropriate for each and every patient. Methods In this article we review the absolute and relative contraindications of the procedure in respect to clinically positive axilla, neoadjuvant therapy, tumor size, multicentric and multifocal disease, in situ carcinoma, pregnancy, age, body-mass index, allergies to dye and/or radio colloid and prior breast and/or axillary surgery. Results Certain conditions involving host factors and tumor biologic characteristics may have a negative impact on the success rate and accuracy of the procedure. The overall fraction of patients unsuitable or with multiple risk factors that may compromise the success of the sentinel lymph node biopsy, is very small. Nevertheless, these patients need to be successfully identified, appropriately advised and cautioned, and so do the surgeons that perform the procedure. Conclusion When performed by an experienced multi-disciplinary team, the SLNB is a highly effective and accurate alternative to standard level I and II axillary clearance in the vast majority of patients with early breast cancer.

  8. SERPINE2 is a possible candidate promotor for lymph node metastasis in testicular cancer

    Testicular germ cell tumors (TGCTs) commonly metastasize to the lymph node or lung. However, it remains unclear which genes are associated with TGCT metastasis. The aim of this study was to identify gene(s) that promoted human TGCT metastasis. We intraperitoneally administered conditioned medium (CM) from JKT-1, a cell-line from a human testicular seminoma, or JKT-HM, a JKT-1 cell sub-line with high metastatic potential, into mice with JKT-1 xenografts. Administration of CM from JKT-HM significantly promoted lymph node metastasis. A cDNA microarray analysis showed that JKT-HM cells highly expressed the Serpine peptidase inhibitor, clade E, member 2 (SERPINE2), which encodes a secreted protein. Administration of CM from SERPINE2-silenced JKT-HM cells inhibited lymph node metastasis in the xenograft model, compared with administration of CM from JKT-HM cells. There was no significant difference in xenograft volume. Moreover, administration of CM from SERPINE2-over-expressing JKT-1 was likely to promote lymph node metastasis in the xenograft model. There was no difference in the in vitro proliferation or migration of JKT-1 cells cultured with CM from JKT-HM cells, compared to that with CM from JKT-1. There was no promotion of proliferation or lymphangiogenesis in the xenografts, as measured by Ki-67 and LYVE-1 immunohistochemistry, respectively. Although we could not clarify how SERPINE2 promoted lymph node metastasis, it may be a promoter in the development of lymph node metastasis in the human seminoma cells in a mouse xenograft model.

  9. Endoscopic ultrasound elastography for evaluation of lymph nodes and pancreatic masses: A multicenter study

    Marc Giovannini; Botelberge Thomas; Bories Erwan; Pesenti Christian; Caillol Fabrice; Esterni Benjamin; Monges Geneviève; Arcidiacono Paolo; Deprez Pierre; Yeung Robert; Schimdt Walter; Schrader Hanz; Szymanski Carl; Dietrich Christoph; Eisendrath Pierre; Van Laethem Jean-Luc; Devière Jacques; Vilmann Peter; Saftoiu Andrian

    2009-01-01

    AIM: To evaluate the ability of endoscopic ultrasound (EUS) elastography to distinguish benign from malignant pancreatic masses and lymph nodes. METHODS: A multicenter study was conducted and included 222 patients who underwent EUS examination with assessment of a pancreatic mass ( n = 121) or lymph node ( n = 101). The classification as benign or malignant, based on the real time elastography pattern, was compared with the classification based on the B-mode EUS images and with the final diagnosis obtained by EUS-guided fine needle aspiration (EUSFNA) and/or by surgical pathology. An interobserver study was performed. RESULTS: The sensitivity and specificity of EUS elastography to differentiate benign from malignant pancreatic lesions are 92.3% and 80.0%, respectively, compared to 92.3% and 68.9%, respectively, for the conventional B-mode images. The sensitivity and specificity of EUS elastography to differentiate benign from malignant lymph nodes was 91.8% and 82.5%, respectively, compared to 78.6% and 50.0%, respectively, for the B-mode images. The kappa coefficient was 0.785 for the pancreatic masses and 0.657 for the lymph nodes. CONCLUSION: EUS elastography is superior compared to conventional B-mode imaging and appears to be able to distinguish benign from malignant pancreatic masses and lymph nodes with a high sensitivity, specificity and accuracy. It might be reserved as a second line examination to help characterise pancreatic masses after negative EUS-FNA and might increase the yield of EUS-FNA for lymph nodes.

  10. SERPINE2 is a possible candidate promotor for lymph node metastasis in testicular cancer

    Nagahara, Akira; Nakayama, Masashi; Oka, Daizo; Tsuchiya, Mutsumi; Kawashima, Atsunari; Mukai, Masatoshi; Nakai, Yasutomo; Takayama, Hitoshi [Department of Urology, Osaka University Graduate School of Medicine, 2-2 Yamadaoka, Suita-City, Osaka 565-0871 (Japan); Nishimura, Kazuo [Department of Urology, Osaka Medical Center for Cancer and Cardiovascular Diseases, 1-3-3 Nakamachi, Higashinari-ku, Osaka, 537-8511 (Japan); Jo, Yoshimasa; Nagai, Atsushi [Department of Urology, Kawasaki Medical University, 577 Matsushima, Kurashiki-City, Okayama 701-0192 (Japan); Okuyama, Akihiko [Department of Urology, Osaka University Graduate School of Medicine, 2-2 Yamadaoka, Suita-City, Osaka 565-0871 (Japan); Nonomura, Norio, E-mail: nono@uro.med.osaka-u.ac.jp [Department of Urology, Osaka University Graduate School of Medicine, 2-2 Yamadaoka, Suita-City, Osaka 565-0871 (Japan)

    2010-01-22

    Testicular germ cell tumors (TGCTs) commonly metastasize to the lymph node or lung. However, it remains unclear which genes are associated with TGCT metastasis. The aim of this study was to identify gene(s) that promoted human TGCT metastasis. We intraperitoneally administered conditioned medium (CM) from JKT-1, a cell-line from a human testicular seminoma, or JKT-HM, a JKT-1 cell sub-line with high metastatic potential, into mice with JKT-1 xenografts. Administration of CM from JKT-HM significantly promoted lymph node metastasis. A cDNA microarray analysis showed that JKT-HM cells highly expressed the Serpine peptidase inhibitor, clade E, member 2 (SERPINE2), which encodes a secreted protein. Administration of CM from SERPINE2-silenced JKT-HM cells inhibited lymph node metastasis in the xenograft model, compared with administration of CM from JKT-HM cells. There was no significant difference in xenograft volume. Moreover, administration of CM from SERPINE2-over-expressing JKT-1 was likely to promote lymph node metastasis in the xenograft model. There was no difference in the in vitro proliferation or migration of JKT-1 cells cultured with CM from JKT-HM cells, compared to that with CM from JKT-1. There was no promotion of proliferation or lymphangiogenesis in the xenografts, as measured by Ki-67 and LYVE-1 immunohistochemistry, respectively. Although we could not clarify how SERPINE2 promoted lymph node metastasis, it may be a promoter in the development of lymph node metastasis in the human seminoma cells in a mouse xenograft model.

  11. EFFECT OF PREOPERATIVE CHEMOTHERAPY ON METASTASIZED LYMPH NODES IN PATIENTS WITH ADVANCED ESOPHAGEAL CARCINOMA

    2001-01-01

    Objective To investigate the effect and clinical value of preoperative chemotherapy on the treatment of metastasized lymph nodes in patients with advanced esophageal carcinoma. Methods We studied the pathological results of primary lesions and lymph nodes of 97 patients with advanced esophageal cancer between 1996 and 1999,62patients were treated by preoperative chemotherapy and 35 patients were treated by surgery only. Results The metastasized rate and degree of mediastinum in preoperative group were 16. 1% and 4.7% ,whereas 65.7% and 34.2% in the surgery only group (P<0. 05);That of abdomen in preoperative group were 25.8% and 6.6% ,whereas 48. 6%and 12.0% in the surgery only group (P<0.05). Conclusion Preparative chemotherapy is effective not only against the primary lesions but also the metastasized lymph nodes. The lower complete response rate of the metastasized lymph may account for the unsatisfied long-term results. Whole resection of primary lesions and lymph nodes are still very important for a better prognosis even for patients who have a good response for the preoperative chemotherapy.

  12. Transcript analysis of a goat mesenteric lymph node by deep next-generation sequencing.

    E, G X; Zhao, Y J; Na, R S; Huang, Y F

    2016-01-01

    Deep RNA sequencing (RNA-seq) provides a practical and inexpensive alternative for exploring genomic data in non-model organisms. The functional annotation of non-model mammalian genomes, such as that of goats, is still poor compared to that of humans and mice. In the current study, we performed a whole transcriptome analysis of an intestinal mucous membrane lymph node to comprehensively characterize the transcript catalogue of this tissue in a goat. Using an Illumina HiSeq 4000 sequencing platform, 9.692 GB of raw reads were acquired. A total of 57,526 lymph transcripts were obtained, and the majority of these were mapped to known transcriptional units (42.67%). A comparison of the mRNA expression of the mesenteric lymph nodes during the juvenile and post-adolescent stages revealed 8949 transcripts that were differentially expressed, including 6174 known genes. In addition, we functionally classified these transcripts using Gene Ontology (GO) and the Kyoto Encyclopedia of Genes and Genomes (KEGG) terms. A total of 6174 known genes were assigned to 64 GO terms, and 3782 genes were assigned to 303 KEGG pathways, including some related to immunity. Our results reveal the complex transcriptome profile of the lymph node and suggest that the immune system is immature in the mesenteric lymph nodes of juvenile goats. PMID:27173308

  13. Power Doppler ultrasound of breast cancer: Correlation with histologic microvessel density and lymph node metastasis

    Kim, Eun Kyung; Lee, Yong Hee; Son, Hong Ju; Oh, Ki Keun; Chung, Hyun Cheol; Lee, Kyong Sik [Yonsei University College of Medicine, Seoul (Korea, Republic of)

    2000-12-15

    To evaluate how breast cancer vascularity detected by power Doppler sonography correlates with microvessel density(MVD) and lymph node involvement. Power Doppler US was performed on 47 patients with pathologically diagnosed invasive ductal carcinoma. According to the presense or absence of vessels, power Doppler findings were categorized regarding total tumors and tumors less than 2 cm. MVD was assessed immunohistochemically using polyclonal antisera against factor VIII. Tumor vascularity was correlated with MVD and lymph node involvement. Among 47 infiltrating ductal carcinomas, 35 (74.5%) cases were vascular and 12 (25.5%) cases were avascular on power Doppler US. The mean MVD of the vascular and avascular carcinomas did not show any statistical difference. However, lymph mode involvement showed significant statistical difference between the two groups (51.4% versus 25.0%, p=0.036), even though in cancers less than 2 cm (40% versus 22.2%, p=0.047). Breast cancer vascularity detected by power Doppler sonography was not correlated with MVD but correlated with lymph node involvement. So we suggest that power Doppler sonography may be useful for predicting lymph node metastasis.

  14. Primo Vascular System in the Lymph Vessel from the Inguinal to the Axillary Nodes

    Seung Hwan Lee; Kyoung-Hee Bae; Geum Ock Kim; Min Ho Nam; Young Bok Choi; Hee-Min Kwon; Yeonhee Ryu; Kwang-Sup Soh

    2013-01-01

    The primo vascular system (PVS) in a lymph system was observed mostly in large caliber ducts around the caudal vena cava of rabbits, rats, and mice. This required a severe surgery with laparectomy and massive removal of fat tissues in the abdomen to expose the lymph vessel. In the current brief report, we presented a new method to evade these shortcomings by observing the PVS in a less large caliber duct in the skin, that is, the lymph vessel from the inguinal to the axillary nodes. The Alcia...

  15. Adjuvant oil induces waves of arthritogenic lymph node cells prior to arthritis onset.

    Holm, Barbro; Lorentzen, J C; Bucht, A

    2004-01-01

    A single intradermal injection of the adjuvant-oil squalene induces T cell mediated arthritis in DA rats. The chain of events leading from nonspecific provocation of the immune system to arthritis is largely unknown. Previous studies have demonstrated that lymph node (LN) cells are of pathogenic importance, i.e. cells from LNs draining the injection site can transfer arthritis to naïve DA rats. Recently we have demonstrated cellular uptake of adjuvant oil in draining lymph nodes but also that...

  16. FDG uptake in axillary lymph nodes after vaccination against pandemic (H1N1)

    Panagiotidis, Emmanouil; Exarhos, Demetrios; Housianakou, Irene; Bournazos, Apostolos; Datseris, Ioannis [General Hospital, PET/CT Unit, Athens (Greece)

    2010-05-15

    To alert the imaging community to potential false positive findings related to current immunization programmes against H1N1 influenza virus. We reviewed 10 patients referred for positron emission tomography/computed tomography (PET/CT) who had undergone recent vaccination. All studies showed{sup 18}F-fluorodeoxyglucose (FDG) uptake in the draining axillary lymph nodes close to the vaccination site, while low-dose CT revealed lymph nodes ranged between 0.5 cm and 1.2 cm at the same site. This potential pitfall in PET/CT should be borne in mind during current vaccination programmes. (orig.)

  17. Prolonged lymphatic leak after retroperitoneal lymph node dissection: a case report

    Browne Katherine M

    2009-08-01

    Full Text Available Abstract Introduction Persistent lymphatic drainage following retroperitoneal lymph node dissection for testicular tumor is an uncommon complication. Case presentation We describe a 21-year old man of Caucasian origin who had metastatic non-seminomatous germ cell tumor of the testis, and underwent retroperitoneal lymph node dissection, nephrectomy and partial inferior vena cava excision for a residual mass. The patient subsequently developed persistent lymphatic drainage causing foot drop that eventually responded to conservative medical and surgical measures. Conclusion This postoperative condition usually responds well to conservative measures but has the potential for serious morbidity if it is not managed appropriately.

  18. FDG uptake in axillary lymph nodes after vaccination against pandemic (H1N1)

    To alert the imaging community to potential false positive findings related to current immunization programmes against H1N1 influenza virus. We reviewed 10 patients referred for positron emission tomography/computed tomography (PET/CT) who had undergone recent vaccination. All studies showed18F-fluorodeoxyglucose (FDG) uptake in the draining axillary lymph nodes close to the vaccination site, while low-dose CT revealed lymph nodes ranged between 0.5 cm and 1.2 cm at the same site. This potential pitfall in PET/CT should be borne in mind during current vaccination programmes. (orig.)

  19. Calculated methods for table diagnosis of lung cancer metastases to regional lymph nodes

    The literary data and the author's material (132 patients with peripheral lung cancer and 112 patients with central lung cancer) are used to develop a technique for calculated table diagnosis of lung cancer metastases to regional lymph nodes. The results of table diagnostics are compared with therapeutic and computer diagnostics. The above technique improves the diagnostics of lung cancer metastases to regional lymph nodes by 20%. However, the results of table diagnostics of metastases are somewhat worse (2.8-4.4 %) than those of computer diagnosis. 5 refs.; 3 tabs

  20. Computed tomography in the diagnosis of lymph nodes metastases of testicular tumors

    40 patients with malignant testicular tumors were studied by lymphography and computed tomography in order to detect metastatic lymph nodes. With a 100% specifity and 88% sensitivity CT offered better results than lymphangiography (95% specifity and 55% sensitivity). Most false-negatives in lymphangiogram were caused by failure of contrast medium to reach the higher lumbar levels. Therefore we consider CT a better suited method for the evaluation of lymph nodes in malignant testicular tumors. If CT is normal, lymphangiography should be performed in order to rule out small metastases, which cannot be detected by CT. (orig.)

  1. Ultrasmall superparamagnetic iron oxide enhanced MR imaging for lymph node metastases

    Russell, Mai [Department of Radiology, University of Washington, 1959 NE Pacific Street, Seattle, WA 98195 (United States); Anzai, Yoshimi [Department of Radiology, University of Washington, 1959 NE Pacific Street, Seattle, WA 98195 (United States)], E-mail: anzai@u.washington.edu

    2007-12-15

    The presence of a lymph node metastasis is one of the most important factors influencing therapeutic planning and prognosis in patients with malignancy. For example, a single nodal metastasis approximately halves the survival rate in patients with head and neck cancer, regardless of the location or size of the primary tumor. Currently used imaging techniques such as CT or conventional MRI are unreliable in detecting involved nodes accurately. There are few new techniques that have proven to be of value in nodal staging, and one such technique is ultrasmall superparamagnetic iron oxide (USPIO) contrast agents for MRI. Administered intravenously, USPIO are phagocytosed by macrophages within lymph nodes. Homogeneous uptake of iron oxide particles in normal lymph node shortens the T2 and T2*, turning these nodes dark on post contrast images whereas malignant nodes, lacking the normal physiologic uptake, remain hyperintense on T2- and T2*-weighted images. These differences in signal intensity between normal and metastatic nodes are easily detected visually, leading to high sensitivity and specificity regardless of size or morphological features. This article will review the physiologic properties of USPIO, the technical considerations for imaging using USPIO agent, the results of various clinical trials, and other experimental agents, as well asthe future directions.

  2. Ultrasmall superparamagnetic iron oxide enhanced MR imaging for lymph node metastases

    The presence of a lymph node metastasis is one of the most important factors influencing therapeutic planning and prognosis in patients with malignancy. For example, a single nodal metastasis approximately halves the survival rate in patients with head and neck cancer, regardless of the location or size of the primary tumor. Currently used imaging techniques such as CT or conventional MRI are unreliable in detecting involved nodes accurately. There are few new techniques that have proven to be of value in nodal staging, and one such technique is ultrasmall superparamagnetic iron oxide (USPIO) contrast agents for MRI. Administered intravenously, USPIO are phagocytosed by macrophages within lymph nodes. Homogeneous uptake of iron oxide particles in normal lymph node shortens the T2 and T2*, turning these nodes dark on post contrast images whereas malignant nodes, lacking the normal physiologic uptake, remain hyperintense on T2- and T2*-weighted images. These differences in signal intensity between normal and metastatic nodes are easily detected visually, leading to high sensitivity and specificity regardless of size or morphological features. This article will review the physiologic properties of USPIO, the technical considerations for imaging using USPIO agent, the results of various clinical trials, and other experimental agents, as well asthe future directions

  3. Axillary lymph node core biopsy for breast cancer metastases — How many needle passes are enough?

    Aim: To determine the diagnostic yield of each of three core passes when sampling abnormal lymph nodes in patients presenting with breast cancer. Materials and methods: All patients suspected of having breast cancer had axillary ultrasound as part of initial assessment. Radiologically abnormal nodes (cortical thickness >2.3 mm or round shape) were biopsied with three passes of a 22 mm throw 14 G core biopsy needle and sent for histopathology in separate numbered pots. Data were collected prospectively, and analysis performed on the data of 55 consecutive patients who had positive nodes on at least one core biopsy needle pass. Results: Of 55 patients with a positive node on core biopsy, tumour was noted in all three cores taken in 39 (70.9%). Lymph node metastasis was detected in 45 (81.8%) first core biopsies. With the first two cores taken, positive results were detected in 53 of 55 cases (96.4%). In both cases where tumour was only found on a third core biopsy pass, no lymph node tissue was present in the first two biopsy passes. Conclusion: Two well-directed 14 G core biopsy samples from an abnormal axillary node are adequate for diagnosis of breast cancer metastasis.

  4. Axillary lymph node core biopsy for breast cancer metastases - How many needle passes are enough?

    Macaskill, E.J., E-mail: ejanemacaskill@nhs.net [Department of Breast Surgery, Ninewells Hospital and Medical School, Dundee DD1 9SY (United Kingdom); Purdie, C.A.; Jordan, L.B. [Department of Pathology, Ninewells Hospital and Medical School, Dundee DD1 9SY (United Kingdom); Mclean, D.; Whelehan, P. [Department of Breast Imaging, Ninewells Hospital and Medical School, Dundee DD1 9SY (United Kingdom); Brown, D.C. [Department of Breast Surgery, Ninewells Hospital and Medical School, Dundee DD1 9SY (United Kingdom); Evans, A. [Department of Breast Imaging, Ninewells Hospital and Medical School, Dundee DD1 9SY (United Kingdom)

    2012-05-15

    Aim: To determine the diagnostic yield of each of three core passes when sampling abnormal lymph nodes in patients presenting with breast cancer. Materials and methods: All patients suspected of having breast cancer had axillary ultrasound as part of initial assessment. Radiologically abnormal nodes (cortical thickness >2.3 mm or round shape) were biopsied with three passes of a 22 mm throw 14 G core biopsy needle and sent for histopathology in separate numbered pots. Data were collected prospectively, and analysis performed on the data of 55 consecutive patients who had positive nodes on at least one core biopsy needle pass. Results: Of 55 patients with a positive node on core biopsy, tumour was noted in all three cores taken in 39 (70.9%). Lymph node metastasis was detected in 45 (81.8%) first core biopsies. With the first two cores taken, positive results were detected in 53 of 55 cases (96.4%). In both cases where tumour was only found on a third core biopsy pass, no lymph node tissue was present in the first two biopsy passes. Conclusion: Two well-directed 14 G core biopsy samples from an abnormal axillary node are adequate for diagnosis of breast cancer metastasis.

  5. Sentinel lymph nodes detection with an imaging system using Patent Blue V dye as fluorescent tracer

    Tellier, F.; Steibel, J.; Chabrier, R.; Rodier, J. F.; Pourroy, G.; Poulet, P.

    2013-03-01

    Sentinel lymph node biopsy is the gold standard to detect metastatic invasion from primary breast cancer. This method can help patients avoid full axillary chain dissection, thereby decreasing the risk of morbidity. We propose an alternative to the traditional isotopic method, to detect and map the sentinel lymph nodes. Indeed, Patent Blue V is the most widely used dye in clinical routine for the visual detection of sentinel lymph nodes. A Recent study has shown the possibility of increasing the fluorescence quantum yield of Patent Blue V, when it is bound to human serum albumin. In this study we present a preclinical fluorescence imaging system to detect sentinel lymph nodes labeled with this fluorescent tracer. The setup is composed of a black and white CCD camera and two laser sources. One excitation source with a laser emitting at 635 nm and a second laser at 785 nm to illuminate the region of interest. The prototype is operated via a laptop. Preliminary experiments permitted to determine the device sensitivity in the μmol.L-1 range as regards the detection of PBV fluorescence signals. We also present a preclinical evaluation performed on Lewis rats, during which the fluorescence imaging setup detected the accumulation and fixation of the fluorescent dye on different nodes through the skin.

  6. Comparison between hemosiderin and Technetium-99 in sentinel lymph node biopsy in human breast cancer

    Vasques, Paulo Henrique Diogenes; Aquino, Ranniere Gurgel Furtado de; Pinheiro, Luiz Gonzaga Porto, E-mail: luizgporto@uol.com.br [Universidade Federal do Ceara (UFC), Fortaleza, CE (Brazil). Departamento de Cirurgia; Alves, Mayara Maia [Rede Nordeste de Biotecnologia (RENORBIO/UFC), Fortaleza, CE (Brazil); Torres, Roberto Vitor Almeida; Bezerra, Jose Lucas Martins [Universidade Federal do Ceara (UFC), Fortaleza, CE (Brazil). Faculdade de Medicina; Brasileiro, Luis Porto [Faculdades INTA, Sobral, CE (Brazil). Faculdade de Medicina

    2015-11-15

    Purpose: To assess the safety and potential equivalence of the use of hemosiderin compared to the Technetium-99 in sentinel lymph node biopsy in human breast cancer. Methods: Non-random sample of 14 volunteer women diagnosed with breast cancer with primary tumors (T1/T2) and clinically tumor-free axilla were submitted to the identification of sentinel lymph node using hemosiderin obtained from autologous blood injected in the periareolar region 24h before surgery on an outpatient basis. Patients received preoperative subareolar intradermal injection of Technetium-99 in the immediate preoperative period. Patients were submitted to sentinel lymph node biopsy, with incision in the axillary fold guided by Gamma-Probe, dissection by planes until the identification of the point of maximum uptake of Technetium-99, identifying the marked nodes and their colors. All surgical specimens were sent for pathological and immunohistochemical study. Results: The results showed no evidence of side effects and/or allergic and non-allergic reactions in patients submitted to SLNB with hemosiderin. The SLN identification rate per patient was 100%. SLNB identification rate per patient with hemosiderin was the same as that of Technetium, with a concordance rate of 100% between the methods. Conclusion: Hemosiderin is a safe dye that is equivalent to Technetium in breast sentinel lymph node biopsy. (author)

  7. Comparison between hemosiderin and Technetium-99 in sentinel lymph node biopsy in human breast cancer

    Purpose: To assess the safety and potential equivalence of the use of hemosiderin compared to the Technetium-99 in sentinel lymph node biopsy in human breast cancer. Methods: Non-random sample of 14 volunteer women diagnosed with breast cancer with primary tumors (T1/T2) and clinically tumor-free axilla were submitted to the identification of sentinel lymph node using hemosiderin obtained from autologous blood injected in the periareolar region 24h before surgery on an outpatient basis. Patients received preoperative subareolar intradermal injection of Technetium-99 in the immediate preoperative period. Patients were submitted to sentinel lymph node biopsy, with incision in the axillary fold guided by Gamma-Probe, dissection by planes until the identification of the point of maximum uptake of Technetium-99, identifying the marked nodes and their colors. All surgical specimens were sent for pathological and immunohistochemical study. Results: The results showed no evidence of side effects and/or allergic and non-allergic reactions in patients submitted to SLNB with hemosiderin. The SLN identification rate per patient was 100%. SLNB identification rate per patient with hemosiderin was the same as that of Technetium, with a concordance rate of 100% between the methods. Conclusion: Hemosiderin is a safe dye that is equivalent to Technetium in breast sentinel lymph node biopsy. (author)

  8. How can sentinel navigation surgery abbreviate mediastinal lymph node dissection for lung cancer?

    Sentinel nodes (SNs) were examined for 101 patients who had peripheral type non-small cell lung cancer less than 5 cm and had undergone systemic mediastinal lymph node dissection. The surgical procedure was lobectomy in 91, pneumonectomy in 3, and segmentectomy with lymph node dissection in 7. In the CT room, the site for RI injection was marked on the skin, and the angle and depth of the needle required to reach the peritumoral region was determined. The RI was then injected in the RI room. The radioactivity in the lymph nodes was counted before dissection (in vivo counting), and after dissection that (ex vivo counting). SNs were defined as any node for which the count was ≥10 times than the background count. SN identification was finally based on ex vivo data. Of the 101 patients, SNs could be identified in 80 patients (80%). Patients whose SNs could not be identified had a significantly lower forced expiratory volume in one second/forced vital capacity (FEV1/FVC) than those with identifiable SNs (p=0.025). Twenty six patients (33%) had SN in the mediastinum, the distribution of which depended on the lobe, ie the No.4 lymph node station in the right upper lobe, the No.4 in the right middle lobe, the No.4 and 7 in the right lower lobe, the No.5 in the left upper lobe, and the No.7 in the left lower lobe. One false negative SN was detected in 25 patients with N 1 or N 2 disease (4%). In vivo and ex vivo counting showed 73% concurrence for the identification of SNs in mediastinal lymph node stations, of which rate was significantly higher than 40% in hilar lymph node stations (p1/FVC, such as those with chronic obstructive pulmonary disease. The in vivo identification of mediastinal SNs was reliable as much as the ex vivo. Therefore, the in vivo identification of SNs in the mediastinum could be useful approach to guide mediastinal lymph node sampling or dissection. (author)

  9. Technological evolution of axillary lymph nodes: Radiological visualisation in breast cancer patients

    Full text: In patients with breast cancer, detection of axillary lymph node spread has a great prognostic significance. Visualisation of lymphatic glands is attracting attention of radiologists since long. Lymphogram usually shows 4-9 lymph glands as compared to 8 to 50 identified during surgical intervention. Lymphography is a laborious and complicated process requiring specific skills. Likewise, the evaluation and interpretation of results depends upon the experience of the specialist. We evaluated 234 breast cancer patients and found that lymphograms of these patients initially detected 1-2 central axillary lymph nodes followed by others. During surgical intervention, the total number of lymphatic glands removed from these patients was 3,241 of which only 2,693 (83.1%) were seen on lymphography. On further evaluation it was found that the largest groups of lymphatic nodes were seen in the following pattern (i) central axillary (ii) subclavicular (iii) lateral, with central axillary lymph nodes being the biggest (1.5 - 2 cm) and subclavicular the smallest (0.2 - 0.5 cm). Sternal lymph nodes receive lymph from medial quadrants of the breast and / or if the axillary lymph nodes are obstructed by metastases. The results of lymphography and post-operative examination matched in 71.7-75 % of cases. False positivity was seen in 19.2 % and false negative 9.1 % instances. As this method was not sufficiently selective and specific, its relative upsurge receded backwards and was forgotten. The last decade of the twentieth century saw a sentinel node (SN) concept. In advanced countries, the possibility to detect breast cancer of up to 1 cm diameter corresponding to T1A category, when the axillary lymph nodes still are not involved in malignant growth, accounts about 50%. Hence the search of lymphatic spread vis-a-vis sentinel node detection has gained more importance. Earlier, SN detection involved colour contrast methods, which was reasonably sensitive and specific in

  10. Validation of the Memorial Sloan Kettering Cancer Center nomogram for predicting non-sentinel lymph node metastasis in sentinel lymph node-positive breast-cancer patients

    Bi X

    2015-02-01

    Full Text Available Xiang Bi,1,* Yongsheng Wang,2 Minmin Li,1,* Peng Chen,2 Zhengbo Zhou,2 Yanbing Liu,2 Tong Zhao,2 Zhaopeng Zhang,2 Chunjian Wang,2 Xiao Sun,2 Pengfei Qiu2 1School of Medicine and Life Sciences, University of Jinan-Shandong Academy of Medical Sciences, Shandong Cancer Hospital, 2Breast Cancer Center, Shandong Cancer Hospital, Jinan, People’s Republic of China *These authors contributed equally to this study Background: The main purpose of the study reported here was to validate the clinical value of the Memorial Sloan Kettering Cancer Center (MSKCC nomogram that predicts non-sentinel lymph node (SLN metastasis in SLN-positive patients with breast cancer. Methods: Data on 1,576 patients who received sentinel lymph node biopsy (SLNB at the Shandong Cancer Hospital from December 2001 to March 2014 were collected in this study, and data on 509 patients with positive SLN were analyzed to evaluate the risk factors for non-SLN metastasis. The MSKCC nomogram was used to estimate the probability of non-SLN metastasis and was compared with actual probability after grouping into deciles. A receiver-operating characteristic (ROC curve was drawn and predictive accuracy was assessed by calculating the area under the ROC curve. Results: Tumor size, histological grade, lymphovascular invasion, multifocality, number of positive SLNs, and number of negative SLNs were correlated with non-SLN metastasis (P<0.05 by univariate analysis. However, multivariate analysis showed that tumor size (P=0.039, histological grade (P=0.043, lymphovascular invasion (P=0.001, number of positive SLNs (P=0.001, and number of negative SLNs (P=0.000 were identified as independent predictors for non-SLN metastasis. The trend of actual probability in various decile groups was comparable to the predicted probability. The area under the ROC curve was 0.722. Patients with predictive values lower than 10% (97/492, 19.7% had a frequency of non-SLN metastasis of 17.5% (17/97. Conclusion: The

  11. Lymph Drainage Studied by Lymphoscintigraphy in the Arms after Sentinel Node Biopsy Compared with Axillary Lymph Node Dissection Following Conservative Breast Cancer Surgery

    Celebioglu, F.; Perbeck, L.; Frisell, J.; Groendal, E.; Svensson, L.; Danielsson, R. [Dept. of Molecular Medicine and Surgery, Karolinska Inst., Karolinska Univ Hospital Solna, Stockholm (Sweden)

    2007-07-15

    Purpose: To investigate lymphatic drainage as measured by lymphoscintigraphy in the arms of patients undergoing either sentinel lymph node biopsy (SNB) or axillary lymph node dissection (ALND). Material and Methods: From January 2001 to December 2002, 30 patients with unilateral invasive breast carcinoma underwent breast-conserving surgery with SNB and 30 patients with ALND. All patients received radiotherapy to the breast. Lymphoscintigraphy was performed, and skin circulation, skin temperature, and arm volume were measured 2-3 years after radiotherapy. Results: None of the 30 patients who underwent SNB showed any clinical manifestation of lymphedema. Of the 30 patients undergoing ALND, six (20%) had clinical lymphedema, with an arm volume that was >10% larger on the operated than on the non-operated side (P<0.01). Scintigraphically, visual analysis revealed lymphatic dysfunction in three patients, manifested as forearm dermal back flow. Two of these patients also had an increased arm volume. Quantitative analysis showed no differences between the groups, apart from a smaller amount of isotope in the axilla in the ALND group. There was no difference in skin circulation or skin temperature. Conclusion: Our study shows that lymph drainage in the operated arm compared with the non-operated arm was less affected by SNB than by ALND, and that morbidity associated with SNB was lower than with ALND. However, the results do not confirm our hypothesis that lymphoscintigraphy can reveal differences in lymph circulation that are not evident clinically in the form of manifest lymphedema. The most sensitive clinical method of assessing lymph drainage seems to be measurement of arm volume.

  12. Evaluation of the 7th AJCC TNM Staging System in Point of Lymph Node Classification

    Kim, Sung Hoo; Ha, Tae Kyung; Kwon, Sung Joon

    2011-01-01

    Purpose The 7th AJCC tumor node metastasis (TNM) staging system modified the classification of the lymph node metastasis widely compared to the 6th edition. To evaluate the prognostic predictability of the new TNM staging system, we analyzed the survival rate of the gastric cancer patients assessed by the 7th staging system. Materials and Methods Among 2,083 patients who underwent resection for gastric cancer at the department of surgery, Hanyang Medical Center from July 1992 to December 2009...

  13. Sentinel lymph node mapping and biopsy for melanoma in South Brazil

    Full text: The presence or absence of regional nodal metastases is one of the most important prognostic factors in the survival of patients with primary cutaneous melanoma. Unfortunately, the complications of lymphadenectomy can be significant. An approach that permits accurate staging of the regional nodes without complete lymphadenectomy is sentinel lymph node (SLN) biopsy. We reviewed the records of 107 patients with primary cutaneous melanoma who underwent lymphatic mapping and SLN biopsy from November 2000 to May 2003. In all patients the primary melanoma was at least 1.0 mm thick, if less than 1.0 mm, was at least Clark's level IV or ulcerated or demonstrated evidence of regression if the patient had no evidence of metastatic melanoma in regional lymph nodes and distant sites. All patients underwent preoperative lymphoscintigraphy to identify the lymphatic basin and the site of the sentinel node. All patients subsequently underwent intra-operative lymphatic mapping and selective lymph node biopsy with blue dye and hand-held gamma probe. Excised SLN were analyzed by conventional histological staining (H and E). Immuno-histochemical staining was also performed if the initial pathologic examination was negative. 107 patients (58 female) were subjected to sentinel node biopsy from November 2000 to May 2003. The primary tumor was in arm in 11.2%, legs in 29.9%, trunk in 53,3% and head and neck in 4.6% patients. 72.9% lesions were superficial spreading type and 49.5% were Clark's IV level. The sentinel node biopsy was positive in 13 (12.2%) patients. Our study thus suggests that SLN biopsy improves the accuracy of staging and provides valuable prognostic information to physicians to guide subsequent treatment decisions and facilitates early therapeutic lymph node dissection in patients having nodal metastases. (author)

  14. Axillary treatment for patients with early breast cancer and lymph node metastasis: systematic review protocol

    Goyal Amit

    2013-01-01

    Full Text Available Abstract Background For patients with early breast cancer and lymph node metastasis, axillary treatment is widely recommended. This is either surgical removal of the axillary lymph nodes, or axillary radiotherapy. The rationale for axillary treatment is that it will reduce the risk of recurrence in the axilla, and may improve survival. However, both treatments are associated with adverse effects, such as lymphedema, pain and sensory loss, and are costly to the health services and to patients. With improvements in adjuvant therapy, routine axillary treatment may no longer offer any overall advantage. Objectives To assess the short and long term benefits and adverse effects of routine axillary treatment (axillary lymph node clearance or axillary radiotherapy for patients with lymph node positive early-stage breast cancer. Methods/Design Criteria for potentially eligibility for the study will be that the participants are men and women with early breast cancer and lymph nodes with metastasis. The study compares either axillary treatment with no axillary treatment, or axillary node clearance with axillary radiotherapy, and the study is a randomized trial. Primary outcomes are axillary recurrence, disease-free and overall survival. Secondary outcomes include breast or chest wall recurrence, distant metastasis, time to axillary recurrence, axillary recurrence-free survival, arm morbidity, quality of life and health economic costs. The search strategy will include the Cochrane Central Register of Controlled Trials, MEDLINE, EMBASE and WHO International Clinical Trials Registry Platform (ICTRP search portal. Two independent reviewers will assess studies for inclusion in the review, assess study quality and extract data. Characteristics of included studies will be described. Meta-analysis will be conducted using ReVman software. Comment This review addresses an important clinical question, and results will inform clinical practice and health care policy.

  15. Lymph node metastases and elevated postoperative calcitonin: Predictors of poor survival in medullary thyroid carcinoma.

    Siironen, Päivi; Hagström, Jaana; Mäenpää, Hanna O; Louhimo, Johanna; Arola, Johanna; Haglund, Caj

    2016-03-01

    Background Total thyroidectomy is the treatment of choice for medullary thyroid carcinoma (MTC), but the extent of neck dissection is controversial. Lymph node metastases, distant metastases, and old age are known predictors of poor survival. Patients Patients treated for primary MTC at Helsinki University Hospital from 1990 to 2009 were included (n = 54). Their clinical characteristics, treatment, and outcome were analysed retrospectively, these patients were followed until death or their last follow-up date. Results At last follow-up (3.4-23 years), of 54 MTC patients, 19 (35%) were disease-free, 17 (32%) were alive with disease, and 12 (22%) had died of MTC; six patients died of unrelated causes (11%). All disease-free patients were node negative and had normal postoperative calcitonin level. Of 19 disease-free patients, only four (21%) had undergone lymph node dissection. All patients who died of MTC were Stage IV at diagnosis and died with distant metastases. Disease-specific five-and 10-year survival was 84% and 76.2%. Advanced T-stage (p = 0.004), lymph node metastases (p < 0.001), distant metastases (p < 0.001), stage (p < 0.001), and elevated postoperative calcitonin (p < 0.001) significantly associated with survival. Conclusions Lymph node metastasis and elevated postoperative calcitonin are important prognostic factors. Patients with lymph node metastasis and/or elevated postoperative calcitonin with present treatments cannot become disease-free, but most of them can live a long life with metastasis. PMID:26339947

  16. Intraoperative radioisotope sentinel lymph node mapping in non-small cell lung cancer

    Sugi, Kazuro; Sudou, Manabu [National Sanyo Hospital, Ube, Yamaguchi (Japan); Kaneda, Yoshikazu; Hamano, Kimikazu [Yamaguchi Univ., Ube (Japan). School of Medicine

    2003-05-01

    We performed intraoperative Technetium (Tc) 99m sentinel lymph node (SN) mapping in patients with clinical T1N0M0 non-small cell lung cancer (NSCLC). Twenty patients with clinical T1N0M0 NSCLC were enrolled. Before thoracotomy, the primary tumor was injected with 2 mCi Tc-99m. After dissection, scintigraphic readings of lymph nodes were obtained ex vivo with a handheld gamma counter. The migration of the Tc solution was considered successful if any node registered five times or more count comared with background values. If lymph nodes were found to have the highest or more than 50% of the highest counts and measurements were greater than five times the intrathoracic background, those nodes were classified as sentinel nodes. Four of the 20 patients did not have NSCLC and were excluded. Eleven patients (68.8%) had SNs identified. No inaccurately identified SNs were encountered. Intraoperative SN mapping with Tc-99m is an accurate way to identify the first site of potential nodal metastases of NSCLC. Several technical problems still remain unresolved in this method, however. (author)

  17. Complete lymph flow reconstruction: A free vascularized lymph node true perforator flap transfer with efferent lymphaticolymphatic anastomosis.

    Yamamoto, Takumi; Yoshimatsu, Hidehiko; Yamamoto, Nana

    2016-09-01

    Treatment of primary lower extremity lymphedema (LEL) is challenging, and lymph node transfer (LNT) can be a choice of treatment for progressive LEL. However, LNT has a risk of donor site lymphedema and possible lymph node (LN) sclerosis due to efferent lymphatic vessel (ELV) obstruction. Here, we report the first case of complete lymph flow reconstruction with true perforator LNT with efferent lymphaticolymphatic anastomosis (ELLA) for a patient with primary LEL and severe lymphosclerosis. A 49-year-old female suffered from primary progressive unilateral left LEL refractory to conservative treatments with frequent episodes of cellulitis. A true perforator LN flap was selectively harvested from the left lateral thoracic region under indocyanine green (ICG) lymphography navigation and transferred to the left groin with perforator-to-perforator anastomosis. The ELV of the transplanted LN was supermicrosurgically anastomosed to the contralateral iliac lymphatic vessel that was subcutaneously transferred to the left groin. Postoperatively, the patient experienced no episode of cellulitis with reduced degree of compression treatment, and lymphedematous volume decreased from 306 to 264 in terms of LEL index. Postoperative ICG lymphography showed evidence of reconstructed lymph flow from the left foot to the left groin and to the right inguinal LN through the transplanted LN flap and the ELLA. There were no subjective or objective findings of donor site lymphedema of the left arm or the right back and the lower extremity. True perforator LN flap with ELLA is a safe and effective treatment and has the potential to be a useful therapeutic option for primary unilateral LEL. PMID:27449876

  18. Pathways of lymph flow to and from the medulla of lymph nodes in sheep.

    Heath, T J; Spalding, H J

    1987-01-01

    Medullary sinuses are continuous with penetrating afferent lymphatics, and with the trabecular and tubular sinuses which penetrate through the cortex. Tubular sinuses are often associated with blood vessels, especially in the deep cortex, and they appear to be important in the transport of lymphocytes. The subcapsular sinus is continuous over the cortex and the medulla, although trabeculae and reticular processes appear to restrict the flow of afferent lymph to the subcapsular sinus over the ...

  19. Sentinel lymph node diagnostic in prostate carcinoma: Part I. Technique and clinical evaluation

    Aim: Evaluation of the significance of lymphoscintigraphy and intraoperative probe measurement for the identification of the sentinel lymph node (SLN) in prostate cancer. Patients and method: In 117 patients with prostate cancer scintigrams in various projections were acquired till approximately 6 hours p.i. after ultrasound guided transrectal intraprostatic injection of 99mTc-Nanocoll trademark. On the following day the SLNs were identified in the operation theatre with a gamma probe and removed. Pelvic standard lymph node dissection followed SLNE. Results: In three of 117 patients with preoperative lymphoscintigraphy no SLN was scintigraphically detectable. These three patients had antecedent transurethral resection of the prostate. In 113 of the residual 114 patients SLN could be intraoperatively localized. In the mean four SLNs per patient were removed. 28 of 117 patients had pelvic lymph node metastases. In 25 cases SLN were right-positive, in one false-negative and in one intraoperatively not detectable. In one patient we found macrometastasis of up to 4 cm diameter (one SLN was tumour positive). In 15 cases only the SLN was bearing tumour. Conclusion: The SLNE with preoperative lymphoscintigraphy and intraoperative gamma probe measurement is suitable for detecting lymph node metastasis in prostate cancer. SLNE is superior to the surgical techniques commonly used in pelvic lymphadenectomy. (orig.)

  20. T cell subpopulations in lymph nodes may not be predictive of patient outcome in colorectal cancer

    Yoon Han-Seung

    2011-08-01

    Full Text Available Abstract Background The immune response has been proposed to be an important factor in determining patient outcome in colorectal cancer (CRC. Previous studies have concentrated on characterizing T cell populations in the primary tumour where T cells with regulatory effect (Foxp3+ Tregs have been identified as both enhancing and diminishing anti-tumour immune responses. No previous studies have characterized the T cell response in the regional lymph nodes in CRC. Methods Immunohistochemistry was used to analyse CD4, CD8 or Foxp3+ T cell populations in the regional lymph nodes of patients with stage II CRC (n = 31, with (n = 13 or without (n = 18 cancer recurrence after 5 years of follow up, to determine if the priming environment for anti-tumour immunity was associated with clinical outcome. Results The proportions of CD4, CD8 or Foxp3+ cells in the lymph nodes varied widely between and within patients, and there was no association between T cell populations and cancer recurrence or other clinicopathological characteristics. Conclusions These data indicate that frequency of these T cell subsets in lymph nodes may not be a useful tool for predicting patient outcome.