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Sample records for cervical lymph node

  1. Cervical lymph nodes

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    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)

  2. Cervical lymph node diseases in children

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    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...

  3. Cervical lymph node diseases in children

    OpenAIRE

    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...

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

    Science.gov (United States)

    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

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

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    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

  6. Effects of concurrent chemoradiotherapy on cervical lymph node metastases

    International Nuclear Information System (INIS)

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

    International Nuclear Information System (INIS)

    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)

  8. Ultrasound elastography for evaluation of cervical lymph nodes

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    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.

  9. DETECTION OF SENTINEL LYMPH NODE IN EARLY CERVICAL CANCER

    Institute of Scientific and Technical Information of China (English)

    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.

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

    DEFF Research Database (Denmark)

    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....

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

    OpenAIRE

    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...

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

    OpenAIRE

    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...

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

    International Nuclear Information System (INIS)

    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

  14. 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

    International Nuclear Information System (INIS)

    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)

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

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    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.

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

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    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.

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

    Science.gov (United States)

    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

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

    International Nuclear Information System (INIS)

    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)

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

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    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.

  20. Dua-energy virtual noncontrast imaging in diagnosis of cervical metastasis lymph nodes

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    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.

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

    International Nuclear Information System (INIS)

    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)

  2. Role of protease activated receptor-2 in lymph node metastasis of uterine cervical cancers

    International Nuclear Information System (INIS)

    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

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

    International Nuclear Information System (INIS)

    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

  4. Malignant melanoma of cervical and parotid lymph nodes with an unknown primary site

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    Nasri, S.; Namazie, A; Dulguerov, Pavel; Mickel, R

    1994-01-01

    Forty-six patients with malignant melanoma metastatic to cervical or parotid lymph nodes with an unknown primary site were treated at UCLA Medical Center from 1964 through 1991. Treatment consisted of parotidectomy and/or neck dissection with or without adjuvant therapy. The initial presentation was a cervical mass in 74% and a parotid mass in 26% of patients. Metastasis distal to the head and neck nodal basins developed in 22% of patients. Involvement of more than four cervical or parotid no...

  5. Cervical Lymph Node Metastasis: Unusual Presentation of Adenoid Cystic Carcinoma - Diagnosed By FNAC

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    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.

  6. Primary Amyloidosis Involving Mediastinal and Cervical Lymph Nodes: A Case Report

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    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.

  7. Endoplasmic reticulum aminopeptidase 2 is highly expressed in papillary thyroid microcarcinoma with cervical lymph node metastasis

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    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.

  8. Metastatic characteristics of lymph node in cervical region and radiotherapy target volume after dissection of thoracic esophageal carcinoma

    International Nuclear Information System (INIS)

    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)

  9. Role of Sentinel Lymph Node in Early Stage of Uterine Cervical Cancer

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    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.

  10. ROLE OF SONOGRAPHY IN EVALUATION OF CERVICAL LYMPH NODES AND COMPARISON WITH THEIR CYTOLOGICAL FINDINGS

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    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

  11. Sentinel lymph node mapping in early stage of endometrial and cervical cancers

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    Tajossadat Allameh

    2015-01-01

    Full Text Available Background: The sentinel lymph node (SLN is defined as the first chain node in the lymphatic basin that receives primary lymphatic flow. If the SLN is negative for metastatic disease, then other nodes are expected to be disease-free. SLN techniques have been extensively applied in the staging and treatment of many tumors, including melanoma, breast and vulvar cancers. This study aims to evaluate our technique in SLN mapping in early stage endometrial and cervical cancers. Materials and Methods: We scheduled a cross-sectional pilot study for patients undergoing staging surgery for endometrial and cervical cancer from November 2012 to February 2014 in Beheshti and Sadoughi Hospitals. Our SLN mapping technique included 1 h preoperative or intraoperative injection of 4 ml of 1% methylene blue dye in the tumor site. At the time of surgery, blue lymph nodes were removed and labeled as SLNs. Then systematic lymph node dissection was completed, and all of the nodes were sent for pathologic examination concerning metastatic involvement. All of the sentinel nodes were first stained with hematoxylin and eosin and examined. Those negative in this study were then stained with immunohistochemistry using anti-keratin antibody. Descriptive statistics, sensitivity, negative predictive values (NPV, false negative (FN and detection rates were calculated. Results: Twenty-three patients including 62% endometrial and 38% cervical cancers enrolled in the study. Median of SLN count in the endometrial and cervical cancers was 3 and 2, respectively. Among endometrial and cervical cancers, detection rate of metastatic disease was 80% and 87.5%, respectively. The FN rate for this technique was 0 and the sensitivity and NPV are 100% for both endometrial and cervical cancers. Conclusion: Considering the lower risk of metastases in early stage of both endometrial and cervical cancers, SLN technique allows for confident and accurate staging of cancer.

  12. Thermochemoradiotherapy using superselective intra-arterial infusionfor N3 cervical lymph node metastases of tongue cancer

    Directory of Open Access Journals (Sweden)

    Hiroaki Nishiguchi

    2013-01-01

    Full Text Available A case of squamous cell carcinoma of the tongue with advanced N3 cervical lymph node metastases in an 80-year-old female is reported. The patient was treated with a combination of radiotherapy (2 Gy/day, total 60 Gy, superselective intra-arterial chemotherapy via a superficial temporal artery and a femoral artery (docetaxel, total 124 mg; cisplatin, total 135 mg, and four sessions of hyperthermia for cervical lymph node metastases. The tumor responded well to therapy, and 18-fluorodeoxyglucose uptake in both primary and neck lesions disappeared on positron emission tomography-computed tomography. The patient has shown no clinical or radiological evidence of local recurrence or distant metastases 6 years after the end of treatment. Advanced oral cancer patients with N3 cervical lymph node metastases are particularly difficult to treat and have a poor prognosis. This method of thermochemoradiotherapy seems a promising modality for patients with N3 cervical lymph node metastases of oral cancer.

  13. CONSIDERATIONS ON ANATOMY AND PHYSIOLOGY OF LYMPH VESSELS OF UPPER AERO DIGESTIVE ORGANS AND CERVICAL SATELLITE LYMPH NODE GROUP.

    Science.gov (United States)

    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

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

    International Nuclear Information System (INIS)

    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)

  15. Anatomic Distribution of Fluorodeoxyglucose-Avid Para-aortic Lymph Nodes in Patients With Cervical Cancer

    International Nuclear Information System (INIS)

    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

  16. Clinical study of 28 cases of cervical lymph node metastasis from an unknown primary carcinoma

    International Nuclear Information System (INIS)

    From 1989 to 2005, 28 patients-20 men and 8 women-with cervical lymph node metastasis from an unknown primary carcinoma were treated and studied retrospectively. In histological diagnosis, open biopsy was conducted in 11 patients and non-open biopsy (fine needle aspiration (FNA) or frozen section diagnosis during surgery) in 17. Blind biopsy under general anesthesia was conducted in 10 patients, showing one primary tumor in the nasopharynx. Tonsillectomy for diagnosis was not done. In region of maximum-size lymph node metastasis, the upper cervical region accounted for 22 cases (79%). The N stage of cervical lymph nodes was as follows: N2a in 4, N2b in 14, N2c in 3, and N3 in 7. The histopathological diagnosis of cervical lymph node was as follows: squamous cell carcinoma in 21, adenocarcinoma in 3, mucoepidermoid carcinoma in 2, and others in 2. Therapy was as follows: only neck dissection in 7, neck dissection with postoperative radiation therapy in 13, and irradiation and chemotherapy in 8. All patients treated with irradiation and chemotherapy had been judged to be inoperable. Seven patients were found to have a subsequent primary tumor. Primary tumor sites were as follows: tonsils in 3 and upper gingiva, base of tongue, lung, and nasopharynx in 1 each. Fluorodeoxyglucose-positron emission tomography (FDG-PET) was conducted in 7 patients but revealed no primary tumor. Overall 5-year survival in this study was 46%. We should pay particular attention to the tonsils for detecting primary tumors in patients with cervical metastasis from an unknown primary carcinoma. (author)

  17. ROLE OF FNAC IN THE EVALUATION OF CERVICAL LYMPH NODES: A HOSPITAL BASED STUDY

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    Jyoti Priyadarshini

    2015-07-01

    Full Text Available Background : Cervical Lymphadenopathy is one of the commonest clinical presentation in all ages. They are frequently involved in regional and systemic diseases ranging from infection , inflammation , immune related and neoplastic conditions. Fine needle aspiration cytology to assess the cytomorphology of Lymph nodes is regularly done by Pathologists. FNAC helps to diagnose multiple lesions avoiding biopsy. It is a simple and rapid diagnostic test , econ omic , primary investigation with minimal trauma easily carried out in OPD. Objective : To study the role of FNAC in evaluation of cervical Lymphadenopathy MATERIAL AND METHOD: This retrospective study was conducted from records of 6 years from Jan.2005 - Dec. 2010. All patients who presented with enlarged cervical lymph node/nodes were included in the study. Written informed consent was obtained from all patients. Total 1195 cases of cervical lymphadenopathy were studied. Hypocellular and acellular smears were discarded. FNAC was done with 22 - 24 gauge disposable needle using 20 ml. syringe. The smears were dried and stained with MGG. RESULTS: Total 1195 cases of cervical lymphadenopathy were studied. Maximum number of cases were 21 - 30 years age group. Males were more than the females. Patients below 15 years constituted 32.5 % cases. Maximum cases reported were of Tubercular lymphadenitis followed by Reactive Lymphadenitis. Squamous cell carcinoma was the commonest metastatis.02 cases were discarded due to hypoce llularity and non - availability of clinical details. CONCLUSION: FNAC is first line diagnostic , cost effective and easy procedure yielding quick and mostly definite results. Biopsy now follows FNAC.

  18. Sentinel Lymph Node Biopsy

    Science.gov (United States)

    ... 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 ...

  19. Lymph node biopsy

    Science.gov (United States)

    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 ...

  20. Applicability of Preoperative Nuclear Morphometry to Evaluating Risk for Cervical Lymph Node Metastasis in Oral Squamous Cell Carcinoma

    OpenAIRE

    KARINO, MASAAKI; Nakatani, Eiji; HIDESHIMA, Katsumi; Nariai, Yoshiki; Tsunematsu, Kohji; Ohira, Koichiro; Kanno, Takahiro; Asahina, Izumi; Kagimura, Tatsuo; Sekine, Joji

    2014-01-01

    Background We previously reported the utility of preoperative nuclear morphometry for evaluating risk for cervical lymph node metastases in tongue squamous cell carcinoma. The risk for lymph node metastasis in oral squamous cell carcinoma, however, is known to differ depending on the anatomical site of the primary tumor, such as the tongue, gingiva, mouth floor, and buccal mucosa. In this study, we evaluated the applicability of this morphometric technique to evaluating the risk for cervical ...

  1. Testicular choriocarcinoma: diagnosed on cervical lymph node biopsy.

    Science.gov (United States)

    Abbasi, Nadeem Zia; Zahur, Zainab; Sheikh, Abdul Samad; Khan, Amjad Aziz; Ahmed, Fayyaz; Memon, Khalid Hussain; Ali, Furqan; Jeilani, Asif; Fatima, Tetheer; Khan, Kamran; Gul, Attia

    2013-12-01

    Choriocarcinoma is a very rare germinal testicular tumour and in literature its incidence has been reported to be 0.3% of all germinal testicular tumours. An important tumour marker is serum beta-hCG which not only helps in establishing diagnosis but also in assessing response to chemotherapy. In this study we present a case of testicular choriocarcinoma, who presented with abdominal pain, cough, generalized weakness and left sided cervical mass. Incisional biopsy of cervical mass was performed. Histopathology revealed metastatic choriocarcinoma. Serum beta-hCG levels were 1227 ng/mL. Patient received intravenous cycles of PEB (cisPlatin, Etoposide, Bleomycin) chemotherapy but he had progressive disease both radiologically and on tumour marker monitoring. He was planned for salvage chemotherapy but was lost to follow up there after. It is concluded that in males, choriocarcinoma carries a very dismal prognosis and a very poor response to chemotherapy and radiotherapy; surgery has no role in the management. PMID:24397105

  2. Individualized IMRT treatment approach for cervical lymph node metastases of unknown primary

    Energy Technology Data Exchange (ETDEWEB)

    Janssen, S.; Glanzmann, C.; Studer, G. [University Hospital Zurich, Department of Radiation Oncology, Zurich (Switzerland); Huber, G. [University Hospital Zurich, Department of Otorhinolaryngology, Head and Neck Surgery, Zurich (Switzerland)

    2014-04-15

    The goal of the present study was to evaluate the outcome of risk-adapted planning treatment volumes (PTVs) in patients with cervical lymph node metastases of unknown primary cancer (UPC) treated with intensity-modulated radiotherapy (IMRT). Between January 2006 and November 2012, 28 patients with cervical lymph node metastases of UPC were treated in our institution with IMRT either postoperatively (n=20) or as definitive treatment (n=8). Nodal involvement distributed as follows: N1 (n=2), N2a (8), N2b (10), N2c (4), and N3 (4). Systemic therapy with cisplatin or cetuximab was added concomitantly in 20 of 28 patients (71%). Radiotherapy using simultaneously integrated boost (SIB-IMRT) was carried out with 2.0 or 2.11 Gy single doses up to 66/70 Gy. Mean/median follow-up was 31.6/30.5 months (range 3-78 months). In all, 15 of 28 patients were treated with unilateral SIB-IMRT (54%). An elective PTV to the contralateral oropharynx and contralateral level II-III lymph nodes was carried out in 8 patients with PET-CT suspected but not histologically proven involvement, recurrences or former tumor of the oropharynx. More extended treatment fields were reserved for patients with N2c or bilaterally N3 status (n=5). The 3-year overall survival, mucosal control, neck control and distant metastasis-free survival rates were 76, 100, 93, and 88%, respectively. No patient suffered from a locoregional recurrence. Two patients treated with radiotherapy alone had persistent nodal disease. No grade II or higher late sequel has been observed. Our single center approach to treat patients with cervical lymph node metastases of UPC with individualized, risk-adapted SIB-IMRT resulted in high locoregional tumor control and was well tolerated. (orig.)

  3. Value of diffusion-weighted MR imaging in the differentiation between benign and malignant cervical lymph nodes

    International Nuclear Information System (INIS)

    Purpose: To evaluate echo-planar diffusion-weighted MR imaging (DWI) in the differentiation between benign and malignant cervical lymph nodes. Materials and methods: 35 consecutive patients with 55 enlarged (>10 mm) cervical lymph nodes underwent MR imaging at 1.5-T. DWI was performed using a single-shot echo-planar (SSEPI) MR imaging sequence with b values (b: diffusion factor) of 0, 500 and 1000 s/mm2. Apparent diffusion coefficient (ADC) maps were reconstructed for all patients and ADC values were calculated for each lymph node. Imaging results were correlated with histopathologic findings after neck dissection or surgical biopsy, findings in PET/CT or imaging follow-up. Mann-Whitney test was used for statistical analysis and a receiver operating characteristic (ROC) curve analysis was performed. Results: Cervical lymph node enlargement was secondary to metastases from squamous cell carcinomas [n = 25], non-Hodgkin's lymphoma [n = 6], reactive lymphadenitis [n = 20], cat scratch lymphadenitis [n = 2] and sarcoidosis [n = 2]. The mean ADC values (x10-3 mm2/s) were 0.78 ± 0.09 for metastatic lymph nodes, 0.64 ± 0.09 for lymphomatous nodes and 1.24 ± 0.16 for benign cervical lymph nodes. ADC values of malignant lymph nodes were significantly lower than ADC values of benign lymph nodes. 94.3% of lesions were correctly classified as benign or malignant using a threshold ADC value of 1.02 x 10-3 mm2/s. Conclusion: According to our first experience, DWI using a SSEPI sequence allows reliable differentiation between benign and malignant cervical lymph nodes.

  4. The value of sentinel lymph node detection with radionuclide in cervical cancer

    International Nuclear Information System (INIS)

    Objective: investigate the feasibility of sentinel lymph node (SLN) detection after radio-nuclide injection as well as the significance of lymphoscintigraphical guidance in rapid search for SLNs in surgery in cervical cancer patients. Methods: 10-12 h before surgery, 20 patients with cervical cancer of International Federation of Gynecology and Obstetrics (FIGO) stage Ib or IIa underwent instant or delayed lymphoscintigraphy and positioning tomography after intracervical injection of 99Tcm-sulphur colloid (SC). In surgery, a hand-held γ ray detection probe was used to find the 'hot spot'. Besides, 4 ml blue dye was injected around the cervical lesion and the blue sentinel lymph nodes (BSLN) were recorded. Then the conventional pelvic node exsection and node biopsy were performed. The mutual relation between the two methods and the pathological results were analyzed. Results: Combining the two methods we detected all the SLNs in the 20 patients, the detection rate reached 100% while the false negative rate was 0%. γ-detection rate was 92.5% (49/53) whereas blue dye detection rate was 88.7%(47/53); the complete congruence of the two methods reached 75%(15/20). In 13 patients, lymphoscintigraphy showed the same SLNs region as γ-detection did, the rate was 65%(13/20). Conclusions: Radio-nuclide could be used to detect SLNs in cervical cancer, and the detection rate would be raised if it is combined with blue dye injection. Presurgical lymphoscintigraphy is likely to direct positioning SLNs rapidly in surgery. (authors)

  5. Change of sonographic findings on cervical lymph nodes before and after preoperative radiotherapy

    Energy Technology Data Exchange (ETDEWEB)

    Chikui, Toru; Yuasa, Kenji; Tokumori, Kenji; Kanda, Shigenobu [Department of Oral and Maxillofacial Radiology, Graduate School of Dental Science, 3-1-1 Maidashi Higashi-ku, 812-8582, Fukuoka (Japan); Kunitake, Naonobu; Nakamura, Katsumasa [Department of Clinical Radiology, Graduate School of Medical Science, Kyushu University, Fukuoka (Japan); Nagata, Tetsuji [First Department of Oral and Maxillofacial Surgery, Graduate School of Dental Science, Kyushu University, Fukuoka (Japan); Hiraki, Akimitsu [Second Department of Oral and Maxillofacial Surgery, Graduate School of Dental Science, Kyushu University, Fukuoka (Japan)

    2004-07-01

    The aim of this study was to assess the changes in the power Doppler sonographic findings in patients with oral cancer undergoing chemotherapy and radiotherapy. We performed US examinations on 187 cervical lymph nodes (71 metastatic and 116 reactive nodes) excised from 52 patients before and after preoperative therapy. On Power Doppler images, we calculated the vascular index (VI) and evaluated the vascular pattern. We also assessed the diagnostic power using receiver operating characteristic (ROC) curve analysis. Irradiation caused an increase of the VI and better visualization of the vessels within the lymph node in the reactive nodes; however, in the metastatic nodes, the VI was not significantly different between that before and after irradiation. When the reader observed the images before irradiation, the area under an ROC curve (Az values) observed by B-mode sonography were closely similar to those obtained by B-mode plus power Doppler sonography. With both images before and after irradiation, the Az value obtained by B-mode plus power Doppler sonography was higher than that by B-mode sonography alone. After irradiation, the enhanced Doppler signals contributed to a better visualization of the vessels and a better detection of any vascular abnormalities. (orig.)

  6. Assessment of occult cervical lymph node metastasis in primary squamous cell carcinoma of the head and neck by computed tomography

    International Nuclear Information System (INIS)

    To determine the frequency of occult (node negative) cervical lymph node metastasis in primary head and neck squamous cell carcinoma, using contrast enhanced computed tomography (CT). Study Design: Cross sectional descriptive study. Place and Duration of Study: Study was conducted in Department of Radiology, Combined Military Hospital Rawalpindi. Duration of the study was 06 months i.e. from 19th February 2011 to 19th August 2011. Patients and Methods: A total of 141 cases, fulfilling the inclusion criteria, reporting to the radiology department, were included in the study after seeking written informed consent. All patients underwent contrast enhanced CT scan of the neck from base of skull to root of neck using Asteion Whole Body X-ray CT Scanner (Model TSX-021A). Images were evaluated for the presence or absence of cervical lymph node metastasis according to the cervical lymph node metastatic criteria at each level of the neck. Results: Of the 141 patients with clinically no head and neck squamous cell carcinoma, 45.4% were found to have lymph node metastases. Frequency of occult metastases in squamous cell carcinoma of oral cavity was 47.6%, oropharynx 23.5%, larynx 33.3% and hypopharynx 78.6%. Conclusion: In clinically node negative neck, the risk of lymph node metastases is significantly high in patients of head and neck squamous cell carcinoma in our population. All patients presenting with node negative neck should undergo CT scans for early detection of occult metastasis. (author)

  7. The Number of Positive Pelvic Lymph Nodes and Multiple Groups of Pelvic Lymph Node Metastasis Influence Prognosis in Stage IA-IIB Cervical Squamous Cell Carcinoma

    Directory of Open Access Journals (Sweden)

    Yu Liu

    2015-01-01

    Full Text Available Background: Pelvic lymph node metastasis (LNM is an important prognostic factor in cervical cancer. Cervical squamous cell carcinoma accounts for approximately 75-80% of all cervical cancers. Analyses of the effects of the number of positive lymph nodes (LNs, unilateral versus bilateral pelvic LNM and a single group versus multiple groups of pelvic LNM on survival and recurrence of cervical squamous cell carcinoma are still lacking. The study aimed to analyze the effects of the number of positive pelvic LNs and a single group versus multiple groups of pelvic LNM on survival and recurrence. Methods: We performed a retrospective review of 296 patients diagnosed with Stage IA-IIB cervical squamous cell carcinoma who received extensive/sub-extensive hysterectomy with pelvic lymphadenectomy/pelvic LN sampling at Peking University People′s Hospital from November 2004 to July 2013. Ten clinicopathological variables were evaluated as risk factors for pelvic LNM: Age at diagnosis, gravidity, clinical stage, histological grade, tumor diameter, lymph-vascular space involvement (LVSI, depth of cervical stromal invasion, uterine invasion, parametrial invasion, and neoadjuvant chemotherapy. Results: The incidence of pelvic LNM was 20.27% (60/296 cases. Pelvic LNM (P = 0.00 was significantly correlated with recurrence. Pelvic LNM (P = 0.00, the number of positive pelvic LNs (P = 0.04 and a single group versus multiple groups of pelvic LNM (P = 0.03 had a significant influence on survival. Multivariate analysis revealed that LVSI (P = 0.00, depth of cervical stromal invasion (P = 0.00 and parametrial invasion (P = 0.03 were independently associated with pelvic LNM. Conclusions: Patients with pelvic LNM had a higher recurrence rate and poor survival outcomes. Furthermore, more than 2 positive pelvic LNs and multiple groups of pelvic LNM appeared to identify patients with worse survival outcomes in node-positive IA-IIB cervical squamous cell carcinoma. LVSI

  8. Sentinel lymph node detection with 99mTc-sulphur colloid in cervical cancer patients

    International Nuclear Information System (INIS)

    Background: Cervical cancer gets the highest incidence in female reproductive system and is ranked secondary in mortality rate of Chinese female tumors. Lymphatic metastasis is the uppermost mode, so the conventional surgery performed in early stage patients is radical hysterectomy along with pelvic lymph nodes dissection. However, the latter is often ccompanied with some disadvantages and a series of intercurrent diseases such as prolonged surgery time, increased blood loss, vessel and nerve damage, lymph cyst with infection, pelvic conglutination, lymphedema of thighs or legs. Since sentinel lymph node (SLN) stands important in clinical value, we refer to the experience we've got in breast cancer for investigating the feasibility of SLNs detection in cervical cancer after radionuclide injection as well as the guidance significance of lymphoscintigraphy in rapid search for SLNs in surgery. Methods: Millennium VG ECT/CT manufactured by GE Company and 99Tcm -sulphur colloid (99Tcm -SC) produced by CIS-US Company were used in the study. Between April and November 2003, 20 patients with cervical cancer FIGO (International Federation of Gynecology and Obstetrics) stage Ib or IIa underwent SLNs radionuclide dection. 10-12 hour before surgery, 148 Mbq/2 ml 99Tcm -SC were injected into the cervical tissue around the tumor at 3 and 9 o'clock evenly about 0.5 cm deep. Then the patients underwent instant lymphoscintigraphy, positioning tomography and a delayed imaging. In surgery, a hand-held γ-ray detector probe was used to find the hot spots' . Besides, 4ml blue dye was injected evenly through the same places as the nuclide did and the blue sentinel lymph nodes (BSLNs) were recorded. Then the conventional pelvic nodes dissection and histological check up of the nodes were performed. Comparing the difference between the two Methods, analyzing the relation between the 'hot spots' and BSLNS, and checking the histological results. Results In the study we found 53 SLNs

  9. 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

    International Nuclear Information System (INIS)

    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

  10. Sentinel lymph node detection in early stage cervical cancer with combined radioisotope and blue dyemethod

    International Nuclear Information System (INIS)

    Objective: The aim of this study was to investigate the feasibility and clinical value of detecting sentinel lymph node (SLN) with combined radioisotope and blue dye method in early stage cervical cancer. Methods: Between March 2005 and April 2006, 50 patients with cervical cancer, who were staged I b and II a by International Federation of Gynecology and Obstetrics (FIGO), underwent SLN detection with preoperative lymphoscintigraphy. A dose of 148 MBq (4 x 10-4 L) 99Tcm-sulfur colloid (SC) was injected into the uterine cervix at 3 and 9 o'clock position with lymphoscintigraphy taken at 15-60 min after injection. Intraoperative detection of 'hot spot' lymph nodes was performed with a handheld gamma probe (γ-detection). During operation, 2-4 ml metend blue dye (BD-detection) was injected into the uterine cervix at the same positions. All patients underwent hysterectomy and pelvic lymphadenectomy. The spatial and pathological relationships of the SLN samples were compared between the two methods. SPSS 13.0 was used for statistical analysis. Results: The detection rate of SLN with combined radioisotope and blue dye was 96.0% (48/50). γ-detection alone was 92.0% (46/50) and BD-detection alone was 70.0% (35/50, χ2=4.92, P2=5.06, P=0.021). Conclusion: Combined radioisotope and blue dye technique is a feasible and valuable tool to detect pelvic SLN in patients with early uterine cervical malignancy. (authors)

  11. Cervical lymph node metastases from unknown primary tumours. Results from a national survey by the Danish Society for Head and Neck Oncology

    DEFF Research Database (Denmark)

    Grau, Cai; Johansen, L V; Jakobsen, J;

    2000-01-01

    The management of patients with cervical lymph node metastases from unknown primary tumours is a major challenge in oncology. This study presents data collected from all five oncology centres in Denmark.......The management of patients with cervical lymph node metastases from unknown primary tumours is a major challenge in oncology. This study presents data collected from all five oncology centres in Denmark....

  12. Cervical Lymph Nodes as a Selective Niche for Brucella during Oral Infections.

    Science.gov (United States)

    von Bargen, Kristine; Gagnaire, Aurélie; Arce-Gorvel, Vilma; de Bovis, Béatrice; Baudimont, Fannie; Chasson, Lionel; Bosilkovski, Mile; Papadopoulos, Alexia; Martirosyan, Anna; Henri, Sandrine; Mège, Jean-Louis; Malissen, Bernard; Gorvel, Jean-Pierre

    2014-01-01

    Cervical lymph nodes (CLN) are the first lymph nodes encountered by material taking the oral route. To study their role in orally acquired infections, we analyzed 307 patients of up to 14 years treated in the university clinic of Skopje, Macedonia, for brucellosis, a zoonotic bacterial disease frequently acquired by ingestion of contaminated dairy products. From these children, 36% had lymphadenopathy. Among orally infected children, lymphadenopathy with CLN being the only lymph nodes affected was significantly more frequent as compared to those infected by contact with animals (83% vs. 63%), suggesting a possible involvement of CLN during orally acquired human brucellosis. Using a murine model where bacteria are delivered into the oral cavity, we show that Brucella quickly and selectively colonize the CLN where they proliferate and persist over long periods of time for up to 50 days post-infection. A similar efficient though less specific drainage to CLN was found for Brucella, Salmonella typhimurium and fluorescent microspheres delivered by gavage, a pathway likely representing a mixed infection mode of intragastric and oral infection, suggesting a central pathway of drained material. Microspheres as well as bacteria drained to CLN predominately reside in cells expressing CD68 and no or low levels of CD11c. Even though no systemic response could be detected, Brucella induced a locally restricted inflammatory reaction with increased expression levels of interferon γ, interleukin (IL)-6, IL-12, granzyme B and a delayed induction of Nos2. Inflammation led to pronounced lymphadenopathy, infiltration of macrophages/monocytes expressing high levels of major histocompatibility complex II and to formation of epitheloid granulomas. Together, these results highlight the role of CLN in oral infections as both, an initial and efficient trap for bacterial invaders and as possible reservoir for chronic pathogens. They likewise cast a new light on the significance of oral

  13. Comparative study of three sonoelastographic scores for differentiation between benign and malignant cervical lymph nodes

    Energy Technology Data Exchange (ETDEWEB)

    Lenghel, Lavinia Manuela, E-mail: pop.lavinia@umfcluj.ro [Iuliu Hatieganu University of Medicine and Pharmacy, Department of Radiology, Clinicilor Street, No. 3-5, 400006 Cluj-Napoca (Romania); Botar Jid, Carolina, E-mail: cbotar@umfcluj.ro [Iuliu Hatieganu University of Medicine and Pharmacy, Department of Radiology, Clinicilor Street, No. 3-5, 400006 Cluj-Napoca (Romania); Bolboaca, Sorana D., E-mail: sbolboaca@umfcluj.ro [Iuliu Hatieganu University of Medicine and Pharmacy, Department of Medical Informatics and Biostatistics, Louis Pasteur Street, No. 6, 400349 Cluj-Napoca (Romania); Ciortea, Cristiana, E-mail: cristianaciortea@yahoo.com [Cluj District University Emergency, Department of Radiology, Clinicilor Street, No. 3-5, 400006 Cluj-Napoca (Romania); Vasilescu, Dan, E-mail: vasilescu.dan@umfcluj.ro [Iuliu Hatieganu University of Medicine and Pharmacy, Department of Radiology, Clinicilor Street, No. 3-5, 400006 Cluj-Napoca (Romania); Baciut, Grigore, E-mail: gbaciut@umfcluj.ro [Iuliu Hatieganu University of Medicine and Pharmacy, Department of Cranio-Maxillo-Facial Surgery, Cardinal Iuliu Hossu Street, No. 37, 400029 Cluj-Napoca (Romania); Dudea, Sorin M., E-mail: sdudea@umfcluj.ro [Iuliu Hatieganu University of Medicine and Pharmacy, Department of Radiology, Clinicilor Street, No. 3-5, 400006 Cluj-Napoca (Romania)

    2015-06-15

    Highlights: • We compared three sonoelastographic scoring systems for neck lymphnode assessment. • We proposed a six pattern scoring system of the elastographic images. • No significant differences were found in the diagnostic value of the assessed scores. - Abstract: Purpose: The aim of the study was to explore the diagnostic value of three different sonoelastographic scoring systems (labeled S1–S3) for the differentiation between benign and malignant cervical lymph nodes. Materials and method: The authors propose a six pattern scoring system of the elastographic images with pattern 1 – representing purely soft nodes, pattern 2 – predominantly soft nodes, pattern 3 – predominantly soft nodes with focal had area, pattern 4 – predominantly hard node, pattern 5 – entirely hard node and pattern 6 – node with necrosis. The sonoelastographic images of 50 benign and 70 malignant lymph nodes were assessed. The area under the ROC curve (AUROC) for the differentiation between benign vs. malignant and benign vs. metastatic nodes were analyzed for the three scoring systems. Results: When all the malignant lymph nodes were considered, the S1 score showed an AUROC = 0.873 (95%CI [0.805–0.918], where CI = confidence interval; p < 0.001), sensibility (Se) = 58.57%, and specificity (Sp) = 96%. For S2 score the AUROC was 0.890 (95%CI [0.824–0.933], p < 0.001), Se = 92.86%, and Sp = 72%. For S3 score, the AUROC was 0.852 (95%CI [0.778–0.902], p < 0.001), Se = 64.29%, and Sp = 94%). When lymphomatous nodes were excluded, for S1 the AUROC was 0.884 (95%CI [0.809–0.932], p < 0.001), Se = 64%, and Sp = 96%. For S2 the AUROC was 0.894 (95%CI [0.818–0.939], p < 0.001), Se = 92%, and Sp = 72%. For S3, the AUROC was 0.856 (95%CI [0.771–0.911], p < 0.001), Se = 66%, and Sp = 94%. In the S3 scoring system, setting the benign vs. malignant cut off at pattern 3 increases the sensibility (41–65%) with minimal loss of specificity (96–94%). From the gray

  14. Comparative study of three sonoelastographic scores for differentiation between benign and malignant cervical lymph nodes

    International Nuclear Information System (INIS)

    Highlights: • We compared three sonoelastographic scoring systems for neck lymphnode assessment. • We proposed a six pattern scoring system of the elastographic images. • No significant differences were found in the diagnostic value of the assessed scores. - Abstract: Purpose: The aim of the study was to explore the diagnostic value of three different sonoelastographic scoring systems (labeled S1–S3) for the differentiation between benign and malignant cervical lymph nodes. Materials and method: The authors propose a six pattern scoring system of the elastographic images with pattern 1 – representing purely soft nodes, pattern 2 – predominantly soft nodes, pattern 3 – predominantly soft nodes with focal had area, pattern 4 – predominantly hard node, pattern 5 – entirely hard node and pattern 6 – node with necrosis. The sonoelastographic images of 50 benign and 70 malignant lymph nodes were assessed. The area under the ROC curve (AUROC) for the differentiation between benign vs. malignant and benign vs. metastatic nodes were analyzed for the three scoring systems. Results: When all the malignant lymph nodes were considered, the S1 score showed an AUROC = 0.873 (95%CI [0.805–0.918], where CI = confidence interval; p < 0.001), sensibility (Se) = 58.57%, and specificity (Sp) = 96%. For S2 score the AUROC was 0.890 (95%CI [0.824–0.933], p < 0.001), Se = 92.86%, and Sp = 72%. For S3 score, the AUROC was 0.852 (95%CI [0.778–0.902], p < 0.001), Se = 64.29%, and Sp = 94%). When lymphomatous nodes were excluded, for S1 the AUROC was 0.884 (95%CI [0.809–0.932], p < 0.001), Se = 64%, and Sp = 96%. For S2 the AUROC was 0.894 (95%CI [0.818–0.939], p < 0.001), Se = 92%, and Sp = 72%. For S3, the AUROC was 0.856 (95%CI [0.771–0.911], p < 0.001), Se = 66%, and Sp = 94%. In the S3 scoring system, setting the benign vs. malignant cut off at pattern 3 increases the sensibility (41–65%) with minimal loss of specificity (96–94%). From the gray

  15. Automatic FDG-PET-based tumor and metastatic lymph node segmentation in cervical cancer

    Science.gov (United States)

    Arbonès, Dídac R.; Jensen, Henrik G.; Loft, Annika; Munck af Rosenschöld, Per; Hansen, Anders Elias; Igel, Christian; Darkner, Sune

    2014-03-01

    Treatment of cervical cancer, one of the three most commonly diagnosed cancers worldwide, often relies on delineations of the tumour and metastases based on PET imaging using the contrast agent 18F-Fluorodeoxyglucose (FDG). We present a robust automatic algorithm for segmenting the gross tumour volume (GTV) and metastatic lymph nodes in such images. As the cervix is located next to the bladder and FDG is washed out through the urine, the PET-positive GTV and the bladder cannot be easily separated. Our processing pipeline starts with a histogram-based region of interest detection followed by level set segmentation. After that, morphological image operations combined with clustering, region growing, and nearest neighbour labelling allow to remove the bladder and to identify the tumour and metastatic lymph nodes. The proposed method was applied to 125 patients and no failure could be detected by visual inspection. We compared our segmentations with results from manual delineations of corresponding MR and CT images, showing that the detected GTV lays at least 97.5% within the MR/CT delineations. We conclude that the algorithm has a very high potential for substituting the tedious manual delineation of PET positive areas.

  16. Sentinel lymph node identification in patients with early stage cervical cancer undergoing radical hysterectomy and pelvic lymphadenectomy

    Institute of Scientific and Technical Information of China (English)

    李斌; 章文华; 刘琳; 吴令英; 张蓉; 李宁

    2004-01-01

    Background In general, sentinel lymph node (SLN) can reflect the whole state of the entire drainage area. The present study evaluated the clinical significance of sentinel lymph node identification in the treatment of early stage cervical cancer.Methods Twenty-eight patients with early stage (Ia-Iia) cervical cancer undergoing radical hysterectomy and pelvic lymphadenectomy were included in this study. At two locations 8 hours before operation, 0.4 ml 37 Mbq technicium-99 labeled dextran was injected intracervically. After that, preoperative lymphoscintigraphy was performed to detect SLNs. During the operation, lymph nodes were detected ex vivo by a γ-counter to identify SLNs. The samples of SLNs and non-SLNs were used for pathological examination separately and compared with the final results. Results SLNs were identified in 27 of 28 (96.4%) patients. A total of 123 SLNs were identified from 814 nodes. Six patients had altogether 11 positive lymph nodes, which were all SLNs. No patient had false-negative sentinel node. Conclusion SLNs can successfully predict the lymphatic metastasis in patients with cervical cancer. The clinical validity of this technique should be evaluated prospectively.

  17. A Parapharyngeal Soft Tissue Chordoma Presenting with Synchronous Cervical Lymph Node Metastasis: An Unusual Presentation.

    Science.gov (United States)

    Khurram, S A; Biswas, D; Fernando, M

    2016-09-01

    A 63 year old male presented with a three month history of dysphagia, neck swelling and an oropharyngeal swelling on examination. Initial fine needle aspiration cytology and magnetic resonance imaging (done at a peripheral hospital) suggested a salivary gland neoplasm with lymph node metastasis. An infra-temporal approach was employed to excise the tumour mass and a modified radical neck dissection undertaken to remove the cervical metastasis. Histopathological examination with immunohistochemistry confirmed this to be a soft tissue chordoma. To the best of our knowledge, this is the first documented report of an extra-axial soft tissue chordoma presenting with synchronous metastatic disease. Though rare, this adds to the list of differential diagnoses for complex parapharyngeal lesions. A multidisciplinary approach between head and neck surgery, histopathology, radiology and sarcoma teams is paramount for arriving at the correct diagnosis and to deliver optimal treatment. PMID:26984125

  18. Proposed revision of CT-based cervical and thoracic lymph node levels for esophageal cancer in UICC 7th version

    International Nuclear Information System (INIS)

    Background and purpose: To propose revisions of CT-based cervical and thoracic lymph node levels for esophageal cancer in UICC 7th version. Material and methods: One hundred and forty-nine patients who underwent surgery were analyzed retrospectively for hypothesis validation, 338 patients who underwent definitive radiotherapy to evaluate the feasibility in clinical work, and 121 patients from another independent cohort for external evaluation. We redefined Level VI in the RTOG consensus guideline of CT-based cervical lymph node levels, and established a new Level 1 in the IASLC guideline of CT-based thoracic lymph node levels. We also shrunk Level 3p. Lymph nodes were assigned into different levels by three criteria. Results: We encountered stratification problems in 63 patients by JSED criteria and in 24 patients by RTOG criteria. Multivariate analysis showed that nodal status was independently associated with OS in the three cohorts (p < 0.001). No significant difference was found between the Level 1 only group and the mediastinal nodes only group (p > 0.05). Conclusions: The proposed hypothesis clearly defined the boundary area between the cervical and thoracic parts, brought more convenience for stratification, better predicted patients’ OS and provided information for both pre-treatment evaluation and multidisciplinary treatment planning

  19. Characterization of long non-coding RNA expression profiles in lymph node metastasis of early-stage cervical cancer.

    Science.gov (United States)

    Shang, Chunliang; Zhu, Wenhui; Liu, Tianyu; Wang, Wei; Huang, Guangxin; Huang, Jiaming; Zhao, Peizhen; Zhao, Yunhe; Yao, Shuzhong

    2016-06-01

    Pelvic lymph node metastasis (PLNM) is an independent prognostic parameter and determines the treatment strategies of cervical cancer. Increasing evidence indicates that long non-coding RNAs (lncRNAs) play a crucial role in the process of tumor biological functions. This study aimed to mine lymph node metastasis-associated lncRNAs and investigate their potential pathophysiological mechanism in cervical cancer lymph node metastasis. We applied the lncRNA-mining approach to identify lncRNA transcripts represented on Affymetrix human genome U133 plus 2.0 microarrays from Gene Expression Omnibus (GEO) and then by validation in clinical specimens. The biological role and molecular mechanism of these lncRNAs were predicted by bioinformatic analysis. Subsequently, a receiver operating characteristic (ROC) curve and survival curve were conducted to evaluate the diagnostic and prognostic value of candidate lncRNAs. In total, 234 differentially expressed lncRNAs were identified to significantly associate with pelvic lymph node metastasis in early-stage cervical cancer. Our qRT-PCR results were consistent with the mining analysis (Pprocess of lymph node metastasis. The ROC curves demonstrated satisfactory discrimination power of MIR100HG and AC024560.2 with areas under the curve of 0.801 and 0.837, respectively. Survival curve also indicated that patients with high MIR100HG expression had a tendency of poor prognosis. This is the first study to successfully mine the lncRNA expression patterns in PLNM of early-stage cervical cancer. MIR100HG and AC024560.2 may be a potential biomarkers of PLNM and these lncRNAs may provide broader perspective for combating cervical cancer metastasis. PMID:27035672

  20. Up-to-date opportunities of cervical lymph nodes ultrasound investigation in patients, suffering from oral cavity cancer

    Directory of Open Access Journals (Sweden)

    Yu. V. Alymov

    2016-01-01

    Full Text Available Background. Incidence of oral cancer in Russia is 4.52 and mortality – 2.44. Head and neck cancer is characterized by the high risk of development of metastases in regional lymph nodes. Lymph nodes status exerts influence on the treatment plan and appears to be the major predictive factor. Regional metastases result into two-fold decrease of five-year survival. Therefore, evaluation and treatment of metastatic lymph nodes is of prime importance. Objective. The aim of this manuscript was to illustrate and summarize publications devoted to modern methods of ultrasound evaluation of cervical lymph node status in patients with squamous cell carcinoma of the oral cavity. Results. Numerous studies have demonstrated, that standard ultrasound investigation (in B-mode is characterized by high sensitivity and specificity (specificity varies from 71.0 to 96.4 %, and specificity – from 46.6 to 91.0 %, according to different studies. In addition, ultrasound efficiency exceeds that of CT. Accuracy of ultrasound as the method of cervical lymph node investigation has increased after implementation of such methods, as elastography and elastometry (this techniques allow to achieve sensitivity of 98.1 % and specificity of 100 %. 

  1. FDG uptake heterogeneity in FIGO IIb cervical carcinoma does not predict pelvic lymph node involvement

    International Nuclear Information System (INIS)

    Many types of cancer are located and assessed via positron emission tomography (PET) using the 18F-fluorodeoxyglucose (FDG) radiotracer of glucose uptake. There is rapidly increasing interest in exploiting the intra-tumor heterogeneity observed in these FDG-PET images as an indicator of disease outcome. If this image heterogeneity is of genuine prognostic value, then it either correlates to known prognostic factors, such as tumor stage, or it indicates some as yet unknown tumor quality. Therefore, the first step in demonstrating the clinical usefulness of image heterogeneity is to explore the dependence of image heterogeneity metrics upon established prognostic indicators and other clinically interesting factors. If it is shown that image heterogeneity is merely a surrogate for other important tumor properties or variations in patient populations, then the theoretical value of quantified biological heterogeneity may not yet translate into the clinic given current imaging technology. We explore the relation between pelvic lymph node status at diagnosis and the visually evident uptake heterogeneity often observed in 18F-fluorodeoxyglucose positron emission tomography (FDG-PET) images of cervical carcinomas. We retrospectively studied the FDG-PET images of 47 node negative and 38 node positive patients, each having FIGO stage IIb tumors with squamous cell histology. Imaged tumors were segmented using 40% of the maximum tumor uptake as the tumor-defining threshold and then converted into sets of three-dimensional coordinates. We employed the sphericity, extent, Shannon entropy (S) and the accrued deviation from smoothest gradients (ζ) as image heterogeneity metrics. We analyze these metrics within tumor volume strata via: the Kolmogorov-Smirnov test, principal component analysis and contingency tables. We found no statistically significant difference between the positive and negative lymph node groups for any one metric or plausible combinations thereof. Additionally

  2. EGFR and HER2 expression in primary cervical cancers and corresponding lymph node metastases: Implications for targeted radiotherapy

    International Nuclear Information System (INIS)

    Proteins overexpressed on the surface of tumor cells can be selectively targeted. Epidermal growth factor receptor (EGFR) and human epidermal growth factor receptor 2 (HER2) are among the most often targeted proteins. The level and stability of expression in both primary tumors and corresponding metastases is crucial in the assessment of a receptor as target for imaging in nuclear medicine and for various forms of therapy. So far, the expression of EGFR and HER2 has only been determined in primary cervical cancers, and we have not found published data regarding the receptor status in corresponding metastatic lesions. The goal of this study was to evaluate whether any of these receptors are suitable as target for clinical diagnosis and therapy. Expression of EGFR and HER2 was investigated immunohistochemically in both lymph node metastases and corresponding primary cervical cancers (n = 53). HER2 and EGFR expression was scored using HercepTest criteria (0, 1+, 2+ or 3+). EGFR overexpression (2+ or 3+) was found in 64% (35/53) of the primary cervical tumors and 60% (32/53) of the corresponding lymph node metastases. There was a good concordance between the primary tumors and the paired metastases regarding EGFR expression. Only four patients who had 2+ or 3+ in the primary tumors changed to 0 or 1+ in lymph node metastases, and another two cases changed the other way around. None of the primary tumors or the lymph node metastases expressed HER2 protein. The EGFR expression seems to be common and stable during cervical cancer metastasis, which is encouraging for testing of EGFR targeted radiotherapy. HER2 appears to be of poor interest as a potential target in the treatment of cervical cancer

  3. Cervical lymph node hyperplasia on [{sup 18}F]-fluorodeoxyglucose positron emission tomography/computed tomography scan after treatment of children and adolescents with malignant lymphoma

    Energy Technology Data Exchange (ETDEWEB)

    Hu, Ying-Ying, E-mail: huyy@sysucc.org.cn; Zhang, Xu, E-mail: zhangxu2@sysucc.org.cn; Long, Wen, E-mail: longwen2@sysucc.org.cn; Lin, Xiao-Ping, E-mail: linxp@sysucc.org.cn; Zhang, Ya-Rui, E-mail: zhangyr@sysucc.org.cn; Li, Yuan-Hua, E-mail: liyh@sysucc.org.cn; Xiao, Zi-Zheng, E-mail: xiaozzh@sysucc.org.cn; Zheng, Rong-Liang, E-mail: zhengrl@sysucc.org.cn; Liang, Pei-Yan, E-mail: liangpy@sysucc.org.cn; Fan, Wei, E-mail: fanwei@sysucc.org.cn

    2015-07-15

    Highlights: • Cervical lymph node hyperplasia is a benign processes. • Lymph node hyperplasia found in treated children and adolescents with lymphoma. • We define imaging manifestations of cervical lymph node hyperplasia in PET/CT. • Awareness of lymph node hyperplasia avoid invasive procedures and over-treatment. - Abstract: Purpose: To define imaging manifestations and clinical prognosis of cervical lymph node hyperplasia using [{sup 18}F]-fluorodeoxyglucose positron emission tomography/computed tomography (FDG PET/CT) scanning after treatment of children and adolescents with malignant lymphoma. Methods: Children and adolescent patients with malignant lymphoma who had high FDG uptake in their cervical lymph nodes via PET/CT after treatment, which was not due to tumor recurrence or residue, were retrospectively analyzed. Results: Twenty-seven patients with a median age of 12 years were included; 11 had Hodgkin's disease and 16 had non-Hodgkin's lymphoma. The time from PET/CT scan to completion of therapy was 1–36 months, 85.2% (23/27) of which took place within 12 months. Three patients had confirmed lymph node follicular hyperplasia by biopsy, while all 27 patients achieved disease-free survival during the follow-up period. The maximum standardized uptake values (SUV{sub max}) of cervical lymph nodes were 2.2–16.2 and the maximum short axis ranged from 0.3 to 1.2 cm. Cervical lymph node hyperplasia was noted in neck levels I–V, and neck level II bilaterally had the highest incidence (100%). Bilateral cervical lymph node hyperplasia was symmetrical in terms of both the SUV{sub max} and affected locations. Thymic hyperplasia and nasopharyngeal lymphoid hyperplasia were both observed in 24 patients (88.9%). There was no relationship in terms of the SUV{sub max} between cervical lymph nodes and thymic tissue, cervical nodes or nasopharyngeal lymphoid tissue. Conclusion: Cervical lymph node hyperplasia with high FDG uptake on PET/CT scans found

  4. Cervical lymph node hyperplasia on [18F]-fluorodeoxyglucose positron emission tomography/computed tomography scan after treatment of children and adolescents with malignant lymphoma

    International Nuclear Information System (INIS)

    Highlights: • Cervical lymph node hyperplasia is a benign processes. • Lymph node hyperplasia found in treated children and adolescents with lymphoma. • We define imaging manifestations of cervical lymph node hyperplasia in PET/CT. • Awareness of lymph node hyperplasia avoid invasive procedures and over-treatment. - Abstract: Purpose: To define imaging manifestations and clinical prognosis of cervical lymph node hyperplasia using [18F]-fluorodeoxyglucose positron emission tomography/computed tomography (FDG PET/CT) scanning after treatment of children and adolescents with malignant lymphoma. Methods: Children and adolescent patients with malignant lymphoma who had high FDG uptake in their cervical lymph nodes via PET/CT after treatment, which was not due to tumor recurrence or residue, were retrospectively analyzed. Results: Twenty-seven patients with a median age of 12 years were included; 11 had Hodgkin's disease and 16 had non-Hodgkin's lymphoma. The time from PET/CT scan to completion of therapy was 1–36 months, 85.2% (23/27) of which took place within 12 months. Three patients had confirmed lymph node follicular hyperplasia by biopsy, while all 27 patients achieved disease-free survival during the follow-up period. The maximum standardized uptake values (SUVmax) of cervical lymph nodes were 2.2–16.2 and the maximum short axis ranged from 0.3 to 1.2 cm. Cervical lymph node hyperplasia was noted in neck levels I–V, and neck level II bilaterally had the highest incidence (100%). Bilateral cervical lymph node hyperplasia was symmetrical in terms of both the SUVmax and affected locations. Thymic hyperplasia and nasopharyngeal lymphoid hyperplasia were both observed in 24 patients (88.9%). There was no relationship in terms of the SUVmax between cervical lymph nodes and thymic tissue, cervical nodes or nasopharyngeal lymphoid tissue. Conclusion: Cervical lymph node hyperplasia with high FDG uptake on PET/CT scans found after treating children

  5. Applicability of preoperative nuclear morphometry to evaluating risk for cervical lymph node metastasis in oral squamous cell carcinoma.

    Directory of Open Access Journals (Sweden)

    Masaaki Karino

    Full Text Available BACKGROUND: We previously reported the utility of preoperative nuclear morphometry for evaluating risk for cervical lymph node metastases in tongue squamous cell carcinoma. The risk for lymph node metastasis in oral squamous cell carcinoma, however, is known to differ depending on the anatomical site of the primary tumor, such as the tongue, gingiva, mouth floor, and buccal mucosa. In this study, we evaluated the applicability of this morphometric technique to evaluating the risk for cervical lymph node metastasis in oral squamous cell carcinoma. METHODS: A digital image system was used to measure the mean nuclear area, mean nuclear perimeter, nuclear circular rate, ratio of nuclear length to width (aspect ratio, and nuclear area coefficient of variation (NACV. Relationships between these parameters and nodal status were evaluated by t-test and logistic regression analysis. RESULTS: Eighty-eight cases of squamous cell carcinoma (52 of the tongue, 25 of the gingiva, 4 of the buccal mucosa, and 7 of the mouth floor were included: 46 with positive node classification and 42 with negative node classification. Nuclear area and perimeter were significantly larger in node-positive cases than in node-negative cases; however, there were no significant differences in circular rate, aspect ratio, or NACV. We derived two risk models based on the results of multivariate analysis: Model 1, which identified age and mean nuclear area and Model 2, which identified age and mean nuclear perimeter. It should be noted that primary tumor site was not associated the pN-positive status. There were no significant differences in pathological nodal status by aspect ratio, NACV, or primary tumor site. CONCLUSION: Our method of preoperative nuclear morphometry may contribute valuable information to evaluations of the risk for lymph node metastasis in oral squamous cell carcinoma.

  6. Efficacy of concurrent chemoradiotherapy with superselective intra-arterial docetaxel-nedaplatin for metastatic cervical lymph nodes in oral cancers

    International Nuclear Information System (INIS)

    The purpose of this study was to evaluate the efficacy of concurrent chemoradiation with intra-arterial docetaxel-nedaplatin infusion to metastatic cervical lymph nodes in oral cancers. Sixteen patients with advanced oral cancer accompanied by cervical lymph node metastasis were treated between 2003 and 2009 at Hirosaki University Hospital. A total of 66 Gy of external beam irradiation concurrent with 2 to 3 courses of intra-arterial chemotherapy infusion via the femoral artery with a combination of docetaxel (40 mg/m2) and nedaplatin (80 mg/m2) was conducted. Amongst the 16 patients, 6 received a total anticancer drug delivery to the primary tumor and 10 received a partial delivery to the nodal disease. The feeding artery to the nodal disease was the facial artery in 3 patients and the occipital artery in 3 patients. The remaining 4 patients received anticancer drug infusion to the external carotid artery with arterial redistribution technique where embolization was applied in order to achieve an antitumor effect due to a high local concentration. Treatment effect was evaluated by computed tomography (CT), magnetic resonance imaging and positron emission tomography-CT (PET-CT). Metastatic cervical lymph nodes disappeared in 15 out of the 16 patients (93.8%) post-treatment. Neck dissection was performed for the patient with residual nodal disease. One patient had neck recurrence at level V in ipsilateral neck. The three-year overall survival rate was 74.6% with a median follow-up duration of 27 months. Intra-arterial docetaxel-nedaplatin infusion concurrent with radiotherapy is an effective treatment not only for primary disease but also for metastatic cervical lymph nodes. (author)

  7. Carbon-ion radiotherapy for marginal lymph node recurrences of cervical cancer after definitive radiotherapy: a case report

    International Nuclear Information System (INIS)

    Recurrences of cervical cancer after definitive radiotherapy often occur at common iliac or para-aortic lymph nodes as marginal lymph node recurrences. Patients with these recurrences have a chance of long-term survival by optimal re-treatment with radiotherapy. However, the re-irradiation often overlaps the initial and the secondary radiotherapy fields and can result in increased normal tissue toxicities in the bowels or the stomach. Carbon-ion radiotherapy, a form of particle beam radiotherapy using accelerated carbon ions, offers more conformal and sharp dose distribution than X-ray radiotherapy. Therefore, this approach enables the delivery of high radiation doses to the target while sparing its surrounding normal tissues. Marginal lymph node recurrences in common iliac lymph nodes after radiotherapy were treated successfully by carbon-ion radiotherapy in two patients. These two patients were initially treated with a combination of external beam radiotherapy and intracavitary and interstitial brachytherapy. However, the diseases recurred in the lymph nodes near the border of the initial radiotherapy fields after 22 months and 23 months. Because re-irradiation with X-ray radiotherapy may deliver high doses to a section of the bowels, carbon-ion radiotherapy was selected to treat the lymph node recurrences. A total dose of 48 Gy (RBE) in 12 fractions over 3 weeks was given to the lymph node recurrences, and the tumors disappeared completely with no severe acute toxicities. The two patients showed no evidence of disease for 75 months and 63 months after the initial radiotherapy and for 50 months and 37 months after the carbon-ion radiotherapy, respectively. No severe late adverse effects are observed in these patients. The two presented cases suggest that the highly conformal dose distribution of carbon-ion radiotherapy may be beneficial in the treatment of marginal lymph node recurrences after radiotherapy. In addition, the higher biological effect of carbon

  8. Primary nodular lymphocyte predominant Hodgkin lymphoma of the palate: A rare incidence which was also associated with progressive transformation of germinal centres of cervical lymph node

    International Nuclear Information System (INIS)

    Primary manifestation of nodular lymphocyte predominant Hodgkin lymphoma in oral cavity is very rare. We are describing such a case which was associated with progressive transformation of germinal centres in a cervical lymph node

  9. Is diffusion-weighted MRI useful for differentiation of small non-necrotic cervical lymph nodes in patients with head and neck malignancies?

    Energy Technology Data Exchange (ETDEWEB)

    Lim, Hyun Kyung; Lee, Jeong Hyun; Beak, Hye Jin; Kim, Nam Kug; Lee, Ha Young; Park, Jee Won; Kim, Sang Yoon; Cho, Kyung Ja; Baek, Jung Hwan [Asan Medical Center, University of Ulsan College of Medicine, Seoul (Korea, Republic of)

    2014-12-15

    To evaluate the usefulness of measuring the apparent diffusion coefficient (ADC) in diffusion-weighted magnetic resonance imaging to distinguish benign from small, non-necrotic metastatic cervical lymph nodes in patients with head and neck cancers. Twenty-six consecutive patients with head and neck cancer underwent diffusion-weighted imaging (b value, 0 and 800 s/mm{sup 2}) preoperatively between January 2009 and December 2010. Two readers independently measured the ADC values of each cervical lymph node with a minimum-axial diameter of > or = 5 mm but < 11 mm using manually drawn regions of interest. Necrotic lymph nodes were excluded. Mean ADC values were compared between benign and metastatic lymph nodes after correlating the pathology. A total of 116 lymph nodes (91 benign and 25 metastatic) from 25 patients were included. Metastatic lymph nodes (mean +/- standard deviation [SD], 7.4 +/- 1.6 mm) were larger than benign lymph nodes (mean +/- SD, 6.6 +/- 1.4 mm) (p = 0.018). Mean ADC values for reader 1 were 1.17 +/- 0.31 x 10-3 mm{sup 2}/s for benign and 1.25 +/- 0.76 x 10-3 mm{sup 2}/s for metastatic lymph nodes. Mean ADC values for reader 2 were 1.21 +/- 0.46 x 10-3 mm{sup 2}/s for benign and 1.14 +/- 0.34 x 10-3 mm{sup 2}/s for metastatic lymph nodes. Mean ADC values between benign and metastatic lymph nodes were not significantly different (p = 0.594 for reader 1, 0.463 for reader 2). Measuring mean ADC does not allow differentiating benign from metastatic cervical lymph nodes in patients with head and neck cancer and non-necrotic, small lymph nodes.

  10. Neurovascular Invasion and Histological Grade Serve as the Risk Factors of Cervical Lymph Node Metastases in Early Tongue Squamous Cell Carcinoma.

    Science.gov (United States)

    Wu, Kailiu; Yang, Xi; Li, Liwen; Ruan, Min; Liu, Wei; Lu, Wei; Zhang, Chenping; Li, Siyi

    2016-07-01

    The objectives of this study were to analyze the regional characteristics of the cervical lymph node metastasis and to investigate the factors associated with the risk of lymph node involvement. One hundred seventy-one patients suffering from early primary squamous cell carcinoma (SCC) of the tongue (cT1-2N0) were enrolled. Gender, age, growth site, T stage, histological grade, and neurovascular invasion were statistically analyzed by K-M survival analysis and Cox multivariate analysis to evaluate the relationship between the factors and the neck lymph node metastasis. Of the 171 cases divided into the neck dissection group and observation group, 40 ended up with lymph node metastasis, of which 17 were metastasized to level I, 27 to level II, 10 to level III, 2 to level IV, and 1 to level V. Histological grade and neurovascular invasion were significantly associated with lymph node involvement in univariate and multivariate analyses. Age distribution was found to be significantly associated with the lymph node metastasis in multivariate analysis. The metastasis of early tongue SCC has a certain regularity at different sites. Age was not a critical risk factor for cervical lymph node metastasis after surgery. Tumor size was suspected to exert a negative effect on metastasis by influencing tumor invasion. Histological grade and neurovascular invasion were significantly associated with the risk of cervical lymph node metastasis of early tongue SCC. PMID:25911199

  11. Proteomic biomarkers predicting lymph node involvement in serum of cervical cancer patients. Limitations of SELDI-TOF MS

    Directory of Open Access Journals (Sweden)

    Van Gorp Toon

    2012-06-01

    Full Text Available Abstract Background Lymph node status is not part of the staging system for cervical cancer, but provides important information for prognosis and treatment. We investigated whether lymph node status can be predicted with proteomic profiling. Material & methods Serum samples of 60 cervical cancer patients (FIGO I/II were obtained before primary treatment. Samples were run through a HPLC depletion column, eliminating the 14 most abundant proteins ubiquitously present in serum. Unbound fractions were concentrated with spin filters. Fractions were spotted onto CM10 and IMAC30 surfaces and analyzed with surface-enhanced laser desorption time of flight (SELDI-TOF mass spectrometry (MS. Unsupervised peak detection and peak clustering was performed using MASDA software. Leave-one-out (LOO validation for weighted Least Squares Support Vector Machines (LSSVM was used for prediction of lymph node involvement. Other outcomes were histological type, lymphvascular space involvement (LVSI and recurrent disease. Results LSSVM models were able to determine LN status with a LOO area under the receiver operating characteristics curve (AUC of 0.95, based on peaks with m/z values 2,698.9, 3,953.2, and 15,254.8. Furthermore, we were able to predict LVSI (AUC 0.81, to predict recurrence (AUC 0.92, and to differentiate between squamous carcinomas and adenocarcinomas (AUC 0.88, between squamous and adenosquamous carcinomas (AUC 0.85, and between adenocarcinomas and adenosquamous carcinomas (AUC 0.94. Conclusions Potential markers related with lymph node involvement were detected, and protein/peptide profiling support differentiation between various subtypes of cervical cancer. However, identification of the potential biomarkers was hampered by the technical limitations of SELDI-TOF MS.

  12. 18F-FDG PET /CT for the detection of primary malignancy in patients with cervical lymph node metastatses from unknown origin

    Institute of Scientific and Technical Information of China (English)

    宋建华

    2014-01-01

    Objective To investigate the value of18F-FDG PET/CT for the detection of primary malignancy in patients with cervical lymph node metastases from unknown origin.Methods Seventy-eight patients(48 males,30 females,average age(56.4±14.7)years)who were diagnosed as cervical lymph node metastases from unknown origin by fine needle aspiration underwent18F-FDG PET/CT from 2007 to 2012.ROI was drawn with SUVmaxcalculated.The distribution of the lymph nodes was classified according

  13. Simultaneous occurrence of Hodgkin's disease and tubercular lymphadenitis in the same cervical lymph node: a rare presentation.

    Science.gov (United States)

    Mahajan, Kunal; Gupta, Gunjan; Singh, Davinder Pal; Mahajan, Aditi

    2016-01-01

    Concomitant presentation of tuberculosis (TB) and lymphoma is a rare entity. A primary malignancy such as Hodgkin's disease (HD) may cause suppression of the cell-mediated immunity, which predisposes to a concomitant TB infection. We report a case of an 18-year-old man, who presented with fever and was found to have pallor, generalised lymphadenopathy, hepatosplenomegaly, ascites and pedal oedema. Ultrasound of the abdomen revealed enlarged lymph nodes in the para-aortic and peripancreatic region. On chest contrast-enhanced CT, calcified mediastinal lymph nodes were seen. A surgical biopsy of a cervical lymph node was performed, which revealed caseous necrosis surrounded by epithelioid cells along with diffuse nodal architectural effacement by large atypical lymphoid cells. Numerous Reed Sternberg cells were also seen. Immunohistochemistry confirmed diagnosis of Hodgkin's lymphoma. The same lymph node came out to be positive for mycobacterium TB on polymerised chain reaction. The patient was given antitubercular therapy concomitantly with chemotherapy for HD, and improved with treatment. PMID:26740271

  14. Occult cervical lymph node metastases in 100 consecutive patients with cN0 tongue cancer

    Institute of Scientific and Technical Information of China (English)

    JIN Wu-long; YE Wei-min; ZHENG Jia-wei; ZHOU Liang; ZHU Han-guang; ZHANG Zhi-yuan; TIAN Jie

    2008-01-01

    Background Squamous cell carcinoma (SCC) of the tongue is one of the most common cancers in the oral and maxillofacial region. To provide clinical evidence for selective neck dissection in management of cN0 patients by analyzing the characteristics and correlation of factors of occult cervical lymph node metastases (OCLNM) in patients with SCC of the tongue.Methods From 2002 to 2006, 100 consecutive patients with SCC of the tongue were reviewed by analyzing the characteristics of OCLNM, diameter of the tumor, T classifications, depth of invasion, forms of growth, pathological grade and degree of differentiation.Results The rate of OCLNM in 100 patients with SCC of the tongue was 22%. The most common region with OCLNM was level Ⅱ in the ipsilateral neck, followed by levels Ⅰ and Ⅲ. There were 51.61% (16/31) of OCLNM in level Ⅱ and 87.10% (27/31) of OCLNM in levels Ⅰ-Ⅲ. There was no significant correlation between the diameter of tumor and OCLNM (P >0.05). OCLNM was statistically significantly correlated with the depth of invasion, forms of growth, pathological grade and degree of differentiation (P <0.05). The rate of occult metastases increased with the increased pathological grade,the decreased degree of differentiation and the increased depth of invasion.Conclusions The most common regions with OCLNM in cN0 patients with SCC of the tongue were levels Ⅰ-Ⅲ in the ipsilateral neck. Supraomohyoid neck dissection should be the elective treatment to the neck in patients with cN0 SCC of the tongue by consideration of the clinical and pathological factors for the depth of invasion, forms of growth, pathological grade, and degree of differentiation.

  15. Sentinel lymph node biopsy as guidance for radical trachelectomy in young patients with early stage cervical cancer

    International Nuclear Information System (INIS)

    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

  16. Repeat CT-scan assessment of lymph node motion in locally advanced cervical cancer patients

    Energy Technology Data Exchange (ETDEWEB)

    Bondar, Luiza; Velema, Laura; Mens, Jan Willem; Heijmen, Ben; Hoogeman, Mischa [Erasmus Medical Center Cancer Institute, Department of Radiation Oncology, 3008 AE, Rotterdam (Netherlands); Zwijnenburg, Ellen [Radboud University Medical Center, Department of Radiation Oncology, Nijmegen (Netherlands)

    2014-12-15

    In cervical cancer patients the nodal clinical target volume (CTV, defined using the major pelvic blood vessels and enlarged lymph nodes) is assumed to move synchronously with the bony anatomy. The aim of this study was to verify this assumption by investigating the motion of the major pelvic blood vessels and enlarged lymph nodes visible in CT scans. For 13 patients treated in prone position, four variable bladder-filling CT scans per patient, acquired at planning and after 40 Gy, were selected from an available dataset of 9-10 CT scans. The bladder, rectum, and the nodal-vessels structure containing the iliac vessels and all visible enlarged nodes were delineated in each selected CT scan. Two online patient setup correction protocols were simulated. The first corrected bony anatomy translations and the second corrected translations and rotations. The efficacy of each correction was calculated as the overlap between the nodal-vessels structure in the reference and repeat CT scans. The motion magnitude between delineated structures was quantified using nonrigid registration. Translational corrections resulted in an average overlap of 58 ± 13% and in a range of motion between 9.9 and 27.3 mm. Translational and rotational corrections significantly improved the overlap (64 ± 13%, p value = 0.007) and moderately reduced the range of motion to 7.6-23.8 mm (p value = 0.03). Bladder filling changes significantly correlated with the nodal-vessels motion (p < 0.001). The motion of the nodal-vessels was large, nonrigid, patient-specific, and only moderately synchronous with the bony anatomy. This study highlights the need for caution when reducing the CTV-to-PTV (PTV planning target volume) margin of the nodal CTV for highly conformal radiation techniques. (orig.) [German] Bei Zervixkarzinompatientinnen wird davon ausgegangen, dass das nodale klinische Zielvolumen (CTV, definiert anhand der grossen Blutgefaesse des Beckens und vergroesserter Lymphknoten) sich synchron mit

  17. Differential diagnosis of metastasis from non-metastatic lymph nodes in cervical cancers: pilot study of diffusion weighted imaging with background suppression at 3T magnetic resonance

    Institute of Scientific and Technical Information of China (English)

    YU Shen-ping; HE Li; LIU Bo; ZHUANG Xiao-zhao; LIU Ming-juan; HU Xiao-shu

    2010-01-01

    Background Diffusion weighted imaging with background suppression (DWIBS) is potentially useful in detecting metastatic lymph nodes. This study aimed to evaluate the efficacy of DWIBS at 3T magnetic resonance (MR) for diagnosing metastatic lymph nodes in cervical cancer.Methods This retrospective study included 25 patients with cervical cancer who underwent MR examination and were treated by hysterectomy and lymphadenectomy. The metastatic and non-metastatic lymph nodes were histologically proven by operation. Apparent diffusion coefficient (ADC) values, long-axis diameters, short-axis diameters, ratio of short- to long-axis diameters of all the identifiable lymph nodes were measured and compared.Results Twenty-five primary tumor lesions, 17 metastatic lymph nodes and 140 non-metastatic lymph nodes were pathologically confirmed in 25 cases with cervical cancer. The difference of ADC values between primary tumor lesions,metastatic and non-metastatic lymph nodes were statistically significant (F=7.93, P=0.001). There was no statistically significant difference between primary tumor lesions of cervical cancer and metastatic lymph nodes (t=-0.75, P=-0.456),and the difference between primary tumor lesions and non-metastatic lymph nodes was statistically significant (t =4.68, P<0.001). The ADC values, long-axis diameters, short-axis diameters, ratio of short- to long-axis diameters of metastatic and non-metastatic lymph nodes were (0.86±0.36)×10-3 mm2/s vs. (1.12±0.34)×10-3 mm2/s, (1.51±0.41) cm vs.(1.19±0.36) cm, (1.16±0.35) cm vs. (0.77±0.22) cm, 0.78±0.17 vs. 0.68±0.19 respectively, and statistically significant difference existed between two groups.Conclusions DWIBS at 3T MR has the distinct advantages in detecting pelvic lymph nodes of cervical cancer.Quantitative measurement of ADC values could reflect the degree of restriction of diffusion of metastatic and non-metastatic lymph nodes. The combination of size and ADC value would be useful in the

  18. 18F-FDG PET/CT for the detection of primary malignancy in patients with cervical lymph node metastases from unknown origin

    International Nuclear Information System (INIS)

    Objective: To investigate the value of 18F-FDG PET/CT for the detection of primary malignancy in patients with cervical lymph node metastases from unknown origin. Methods Seventy-eight patients (48 males, 30 females, average age (56.4± 14.7) years) who were diagnosed as cervical lymph node metastases from unknown origin by fine needle aspiration underwent 18F-FDG PET/CT from 2007 to 2012. ROI was drawn with SUVmax calculated. The distribution of the lymph nodes was classified according to the standard levels Ⅰ to Ⅵ, as well as the retropharyngeal and supraclavicular stations. The short axis of lymph node was defined as the lesion size. The final diagnosis was confirmed by pathology and clinical follow-up. Data collection and interpretation included identification of primary malignancy, pathologic types of primary tumors, distribution, size and SUVmax of the metastatic lymph nodes. One-way analysis of variance and linear correlation analysis were used for data analysis. Results: In 78 subjects, 75 were diagnosed as having malignant and 3 as benign lymph nodes by excisional biopsy. 18F-FDG PET/CT detected primary malignancy in 56 cases (71.8%, 56/78). In these 56 cases, 57.1% (32/56) had head and neck cancer with metastatic lymph nodes mainly distributed in levels Ⅱ, Ⅲ and Ⅳ (90.6%, 29/32). The remaining 24/56 (42.9%) patients had primary malignancy of the trunk with metastatic lymph nodes primarily involving supraclavicular fossa (95.8%, 23/24). There was no statistical difference in size and SUVmax of lymph node among different primary locations or pathological types (F=0.037-2.413, all P>0.05). Conclusion: 18F-FDG PET/CT may play an important role in the detection of primary cancers for patients with metastatic cervical lymph nodes from unknown origin. (authors)

  19. Cervical lymph node metastasis in adenoid cystic carcinoma of oral cavity and oropharynx: A collective international review.

    Science.gov (United States)

    Suárez, Carlos; Barnes, Leon; Silver, Carl E; Rodrigo, Juan P; Shah, Jatin P; Triantafyllou, Asterios; Rinaldo, Alessandra; Cardesa, Antonio; Pitman, Karen T; Kowalski, Luiz P; Robbins, K Thomas; Hellquist, Henrik; Medina, Jesus E; de Bree, Remco; Takes, Robert P; Coca-Pelaz, Andrés; Bradley, Patrick J; Gnepp, Douglas R; Teymoortash, Afshin; Strojan, Primož; Mendenhall, William M; Eloy, Jean Anderson; Bishop, Justin A; Devaney, Kenneth O; Thompson, Lester D R; Hamoir, Marc; Slootweg, Pieter J; Vander Poorten, Vincent; Williams, Michelle D; Wenig, Bruce M; Skálová, Alena; Ferlito, Alfio

    2016-10-01

    The purpose of this study was to suggest general guidelines in the management of the N0 neck of oral cavity and oropharyngeal adenoid cystic carcinoma (AdCC) in order to improve the survival of these patients and/or reduce the risk of neck recurrences. The incidence of cervical node metastasis at diagnosis of head and neck AdCC is variable, and ranges between 3% and 16%. Metastasis to the cervical lymph nodes of intraoral and oropharyngeal AdCC varies from 2% to 43%, with the lower rates pertaining to palatal AdCC and the higher rates to base of the tongue. Neck node recurrence may happen after treatment in 0-14% of AdCC, is highly dependent on the extent of the treatment and is very rare in patients who have been treated with therapeutic or elective neck dissections, or elective neck irradiation. Lymph node involvement with or without extracapsular extension in AdCC has been shown in most reports to be independently associated with decreased overall and cause-specific survival, probably because lymph node involvement is a risk factor for subsequent distant metastasis. The overall rate of occult neck metastasis in patients with head and neck AdCC ranges from 15% to 44%, but occult neck metastasis from oral cavity and/or oropharynx seems to occur more frequently than from other locations, such as the sinonasal tract and major salivary glands. Nevertheless, the benefit of elective neck dissection (END) in AdCC is not comparable to that of squamous cell carcinoma, because the main cause of failure is not related to neck or local recurrence, but rather, to distant failure. Therefore, END should be considered in patients with a cN0 neck with AdCC in some high risk oral and oropharyngeal locations when postoperative RT is not planned, or the rare AdCC-high grade transformation. PMID:27017314

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

    International Nuclear Information System (INIS)

    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

  1. Correlation of Point B and Lymph Node Dose in 3D-Planned High-Dose-Rate Cervical Cancer Brachytherapy

    International Nuclear Information System (INIS)

    Purpose: To compare high dose rate (HDR) point B to pelvic lymph node dose using three-dimensional-planned brachytherapy for cervical cancer. Methods and Materials: Patients with FIGO Stage IB-IIIB cervical cancer received 70 tandem HDR applications using CT-based treatment planning. The obturator, external, and internal iliac lymph nodes (LN) were contoured. Per fraction (PF) and combined fraction (CF) right (R), left (L), and bilateral (Bil) nodal doses were analyzed. Point B dose was compared with LN dose-volume histogram (DVH) parameters by paired t test and Pearson correlation coefficients. Results: Mean PF and CF doses to point B were R 1.40 Gy ± 0.14 (CF: 7 Gy), L 1.43 ± 0.15 (CF: 7.15 Gy), and Bil 1.41 ± 0.15 (CF: 7.05 Gy). The correlation coefficients between point B and the D100, D90, D50, D2cc, D1cc, and D0.1cc LN were all less than 0.7. Only the D2cc to the obturator and the D0.1cc to the external iliac nodes were not significantly different from the point B dose. Significant differences between R and L nodal DVHs were seen, likely related to tandem deviation from irregular tumor anatomy. Conclusions: With HDR brachytherapy for cervical cancer, per fraction nodal dose approximates a dose equivalent to teletherapy. Point B is a poor surrogate for dose to specific nodal groups. Three-dimensional defined nodal contours during brachytherapy provide a more accurate reflection of delivered dose and should be part of comprehensive planning of the total dose to the pelvic nodes, particularly when there is evidence of pathologic involvement.

  2. Central cervical lymph node in papillary thyroid cancer. Is it necessary?

    Directory of Open Access Journals (Sweden)

    Pardal-Refoyo JL

    2013-04-01

    Full Text Available We comment on the article published by Mehta and Nathan in The Laryngoscope on the indication of the central compartment node dissection (CND in the treatment of papillary thyroid cancer (PTC. Metastatic nodal involvement implies greater risk of death in patients older than 45 years. The CND increases the risk of transient RLN palsy and transient hypoparathyroidism so the risk-benefit balance favors only perform thyroidectomy. Conducting thyroidectomy CND alongside showed no statistically significant decrease in the nodal relapse. The decision on the level of indication of CND in PTC is not definitive. To demonstrate the value of CND would require a large sample (5,840 patients and 20$ million. Detection of BRAF gene mutation in predicting preoperative FNA extrathyroidal invasion and occult metastases in lymph nodes stations. These patients are 2.8 times more likely to have occult nodal metastases. All patients with histologically confirmed PTC should undergo preoperative investigation of metastatic nodes. Thyroid ultrasound can hinder viewing of the central compartment so that it is useful to detect the BRAF mutation. The groups most at risk of lymph node involvement are: tumor size greater than 1 cm, extrathyroidal invasion and the BRAF mutation positive preoperative FNA. In case you can not determine the BRAF mutation on FNAB, the VCC can be performed in patients with PTC in local stage T3 / T4, with tumor size> 4 cm or extrathyroidal as these factors have been confirmed risk the presence of occult nodal metastases in other studies.

  3. Lymph node culture

    Science.gov (United States)

    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 ...

  4. Langerhans cell histiocytosis of the thyroid with multiple cervical lymph node involvement accompanying metastatic thyroid papillary carcinoma.

    Science.gov (United States)

    Ceyran, A Bahar; Senol, Serkan; Bayraktar, Barış; Ozkanlı, Seyma; Cinel, Z Leyla; Aydın, Abdullah

    2014-01-01

    A 37-year-old male case was admitted with goiter. Ultrasonography of thyroid showed a 5 cm cystic nodule in the left lobe with a 1.5 cm solid component. Fine needle aspiration biopsy revealed atypia of undetermined significance or follicular lesion. The patient was operated on. The pathological diagnosis was reported as papillary thyroid carcinoma. The immunohistochemical examination showed multiple foci of Langerhans cell histiocytosis involving both lobes. The patient died due to cardiac arrest with respiratory causes in the early postoperative period. Langerhans cell histiocytosis is a rare primary condition which involves abnormal clonal proliferation of Langerhans cells in various tissues and organs. Thyroid involvement is infrequently seen. Although the etiology is unknown, genetic components may be linked to the disease. It is also associated with a family history of thyroid disease. Papillary thyroid carcinoma is the most common malignant epithelial tumor of the thyroid gland. Langerhans cell histiocytosis presenting with papillary thyroid carcinoma is rare. The privilege of our case is langerhans cell histiocytosis of the thyroid with multiple cervical lymph node involvement accompanying cervical lymph node metastatic thyroid papillary carcinoma. PMID:25349760

  5. Immunoglobulin G4-related disease of the orbital cavity, cervical lymph nodes and greater auricular nerve: case report.

    Science.gov (United States)

    Wong, Wai Keat; Morton, Randall P

    2016-01-01

    IgG4-related disease (IgG4-RD) is a novel clinicopathological entity characterised by elevated tissue levels of IgG4-positive plasma cells. It can present in almost every organ systems. We present a case of a 48year-old man with recurrent intra-orbital and cervical lymph node swelling and found to have greater auricular nerve involvement intraoperatively during open surgical biopsy. Histopathological evaluation of biopsied specimens from these lesions yielded IgG4-positive plasma cell infiltration on immunohistochemistry. Key pathological features such as prominent lymphoplasmacytic population, storiform fibrosis and obliterative phlebitis were also seen. A diagnosis of IgG4-RD was made. Oral prednisone therapy ameliorated the symptoms and patient remained in remission at followup. Literature review indicated that IgG4-RD is a rare condition that seldom occurs concurrently in the orbital cavity, cervical lymph nodes and involving the greater auricular nerve. The condition may often masquerade as malignancy or infection due to formation of tumefactive lesions but tend to respond favourably to glucocorticoid or immunosuppressants. The differential diagnosis of unusual mass lesions in these locations should include IgG4-RD. The otolaryngologist, as well as other health professionals, should be familiar with this novel disease to ensure timely diagnosis and treatment. PMID:27178504

  6. Tumor size interpretation for predicting cervical lymph node metastasis using a differentiated thyroid cancer risk model

    OpenAIRE

    Qu, Ning; Shi, Rong-liang; Yang,Shu-wen; Ma,Ben; Lu, Zhong-Wu; Wen, Duo; Sun, Guo-hua; Wang, Yu; Ji, Qing-Hai

    2016-01-01

    Rong-liang Shi,1–3,* Ning Qu,1,2,* Shu-wen Yang,1,2 Ben Ma,1,2 Zhong-wu Lu,1,2 Duo Wen,1,2 Guo-hua Sun,1,2 Yu Wang,1,2 Qing-hai Ji1,2 1Department of Head and Neck Surgery, Fudan University Shanghai Cancer Center, 2Department of Oncology, Shanghai Medical College, Fudan University, 3Department of General Surgery, Minhang Hospital, Fudan University, Shanghai, People’s Republic of China *These authors contributed equally to this work Abstract: Lymph node metastasi...

  7. Daily concurrent preoperative chemoradiotherapy using superselective intra-arterial infusion via superficial temporal artery for advanced oral cancer. Histological evaluation of metastatic cervical lymph nodes

    International Nuclear Information System (INIS)

    Superselective intra-arterial chemotherapy via a superficial temporal artery has become feasible for daily concurrent radiotherapy and chemotherapy in patients with oral cancer. In this study, histopathological effects on metastatic cervical lymph nodes in cases of advanced oral cancer using superselective intra-arterial chemoradiotherapy were evaluated. Thirty-seven oral cancer patients with cervical lymph node metastasis were treated with preoperative chemoradiotherapy using superselective intra-arterial infusion via the superficial temporal artery. The treatment consisted of superselective intra-arterial infusions (docetaxel, total 60 mg/m2; cisplatin, total 100-150 mg/m2) and concurrent radiotherapy (total 40-60 Gy) for 4-6 weeks, followed by surgery. In cases in which the catheter was inserted into the facial artery, grade III or IV (Oboshi-Shimosato classification) in the cervical lymph node metastasis was obtained in 20 (83.3%) of 24 patients. And, forty-six (88.5%) of 52 metastatic lymph nodes showed grade III or IV. This method was an effective regimen for oral cancer with cervical lymph node metastasis. (author)

  8. Is extended-field concurrent chemoradiation an option for radiologic negative paraaortic lymph node, locally advanced cervical cancer?

    International Nuclear Information System (INIS)

    The aim was to evaluate whether extended-field concurrent chemoradiation (EF-CCRT) leads to results better than those obtained by standard whole-pelvis concurrent chemoradiation (WP-CCRT) in locally advanced cervical cancer with radiologic negative paraaortic lymph nodes (PALNs). A total of 102 patients with histopathologically proven squamous cell carcinoma, adenocarcinoma, or adenosquamous cell carcinoma, and radiologic negative PALN locally advanced cervical cancer, stage IIB-IVA, were accrued between July 2007 and April 2008 and were randomly assigned to WP-CCRT (50 patients) or EF-CCRT (52 patients), followed by high-dose rate brachytherapy. Data regarding the safety profile, response rates, and occurrence of local, PALN, or distant failure were recorded. During a median follow-up time of 60 months (18–66), 74/102 patients completed the treatment protocol and were analyzed. Overall PALN, distant-metastasis control, disease-free survival, and overall survival rates were 97.1%, 86.9%, 80.3%, and 72.4% in EF-CCRT respectively in comparison with WP-CCRT (82.1%,74.7%, 69.1%, and 60.4%), with P-values of 0.02, 0.03, 0.03 and 0.04 respectively. No difference in acute toxicity profile was seen between the groups, and late toxicities were mild and minimal. Prophylactic EF-CCRT can be a reasonable option in patients with locally advanced cervical cancer with radiologic positive pelvic lymph nodes and radiologic negative PALN

  9. Pulmonary Langerhans cell histiocytosis with cervical lymph node involvement, and coexistence with pulmonary tuberculosis and right pneumothorax: a case report and review of literature.

    Science.gov (United States)

    Gao, Limin; Li, Huifang; Li, Gandi; Liu, Weiping; Li, Jinnan; Zhang, Wenyan

    2015-01-01

    We report an uncommon 22-year-old male Pulmonary Langerhans Cell Histiocytosis (PLCH) case which co-existed with pulmonary tuberculosis (TB). Unlike the common PLCH cases, this PLCH case has cervical lymph node involvement and right pneumothorax. The diagnosis was established by the imaging of lung and the biopsies of the lung and left neck lymph node. Imaging of the chest showed characteristic small nodules and thin-walled cysts and right pneumothorax. The LCH cells in the lung and left neck lymph node were characterized by large convoluted nuclei with cerebriform indentations of the nuclear envelope and longitudinal grooves. The nuclei contained small eosinophilic nucleoli and moderate amount cytoplasm. Immunohistochemically, the histiocytoid cells were positive for Langerin, CD1a and S-100. Acid-fast bacilli were found in sputum and lung biopsy tissue. To the best of our knowledge, this is the first case of PLCH with cervical lymph node involvement, and coexisted with pulmonary tuberculosis, right pneumothorax. A contribution of this case and review three of the five cases of PLCH with extrapulmonary involvement to lymph nodes resolved spontaneously after smoking cessation constitute a novel addition that it is inappropriate to regard pulmonary/nodal LCH as multi-organ or disseminated disease, and the treatment methods are the same whether the PLCH patient with lymph node involvement or not. PMID:25973117

  10. The usefulness of MRI and PET imaging for the detection of parametrial involvement and lymph node metastasis in patients with cervical cancer

    International Nuclear Information System (INIS)

    The purpose of this study is to elucidate the usefulness of magnetic resonance imaging (MRI) and positron emission tomography (PET) for the detection of parametrial involvement and lymph node metastasis in patients with cervical cancer. Thirty-six patients with cervical cancer were retrospectively enrolled. MRI and PET scans were performed for all patients within a week before radical surgery. The criterion for malignancy on MRI was >1 cm short axis diameter of the suspected lymph node. On PET, only fluorodeoxyglucose (FDG) uptake was significantly higher than the background and, if this FDG uptake showed on at least two consecutive axial slices, then the lesion was considered as a malignancy. We compared the extent of tumor on the surgical findings with the International Federation of Gynecology and Obstetrics (FIGO) staging, MRI and PET scans. The accuracy of FIGO and MRI staging was 67 and 84.4%, respectively. The accuracy for detecting pelvic lymph node metastasis was better for PET than for MRI (78 versus 67%, respectively). All FDG uptake lymph nodes were confirmed as metastatic lymph nodes by pathological evaluation; this included five lymph nodes <1 cm in diameter. MRI provides an improved evaluation of local tumor extension, but PET is more useful for the evaluation of pelvic lymph nodes than MRI; however, PET still misses microscopic disease. Further studies are necessary to evaluate the usefulness of PET/computed tomography (CT) for the accuracy of the disease extension and the cost-effectiveness of MRI, PET or PET/CT in patients with cervical cancer. (author)

  11. Sono-elastography for differentiating benign and malignant cervical lymph nodes: A systematic review and meta-analysis

    Directory of Open Access Journals (Sweden)

    Mahsa Ghajarzadeh

    2014-01-01

    Full Text Available We did this systematic review to determine diagnostic accuracy of sono-elastography in evaluating cervical lymph nodes (LNs. A highly sensitive search for sono-elastography and LNs was performed in MEDLINE, Cochrane Library, ACP Journal Club, EMBASE, Health Technology assessment, and ISI web of knowledge for studies published prior to December 2012. SPSS version 18 (SPSS Inc., Chicago, IL, USA used for descriptive analysis and meta-disk version 1.4 applied for meta-analysis. Forest plots for pooled estimates and summery of receiver operating characteristic plots for different cut-offs were produced. The literature and manual search yielded 69 articles, of which 10 were eligible to include. A total of 578 individuals with a total number of 936 cervical LNs was evaluated (502 malignant and 434 benign. The summary sensitivity of the scoring and strain ratio (SR measurements for the differentiation of benign and malignant LNs were 0.76 (95% CI: 0.71-0.8 and 0.83 (95% CI: 0.78-0.87. The summary specificities were 0.8 (95% confidence interval [CI]: 0.75-0.84 and 0.84 (95% CI: 0.79-0.88, respectively. Area under the curve for scoring system was 0.86 (standard error [SE] = 0.03 and 0.95 (SE = 0.02 for SR measurement. Sono-elastograohy has high accuracy in differentiating benign and malignant cervical LNs.

  12. Assessment of radiation doses to the para-aortic, pelvic, and inguinal lymph nodes delivered by image-guided adaptive brachytherapy in locally advanced cervical cancer

    DEFF Research Database (Denmark)

    Mohamed, Sandy M I; Aagaard, Torben; Fokdal, Lars U; Pedersen, Erik Morre; Lindegaard, Jacob C; Tanderup, Kari

    2015-01-01

    PURPOSE: This study evaluated the dose delivered to lymph nodes (LNs) by brachytherapy (BT) and the effect of BT image-guided optimization on the LN dose. METHODS AND MATERIALS: Twenty-five patients with locally advanced cervical cancer were retrospectively analyzed, 16 patients of them had LN...

  13. The accuracy of ultrasonography in the preoperative diagnosis of cervical lymph node metastasis in patients with papillary thyroid carcinoma: A meta-analysis

    International Nuclear Information System (INIS)

    Background: Ultrasonography has been proposed to enhance preoperative assessment of cervical lymph node status in patients with papillary thyroid carcinoma (PTC). Management is most controversial for patients with a clinically negative (cN0) neck. We aimed to evaluate the diagnostic properties of ultrasonography in the detection of cervical lymph node metastasis in patients with PTC. Materials and methods: Studies evaluating the diagnostic accuracy of Ultrasonography in the diagnosis of cervical lymph node metastasis in patients with PTC were systematically searched for in the MEDLINE, EMBASE, Cancerlit and Cochrane Library and other database from January 1995 to November 2010. Two reviewers independently abstracted data including research design, sample size, imaging technique and technical characteristics, method of image interpretation. By patient-based and region- or node-based data analyses, we determined pooled sensitivities and specificities across studies, and constructed summary receiver operating characteristic curves, and area under summary receiver operating characteristic curves were calculated. Results: The pooled patient-based sensitivity for ultrasonography was 0.72 (95% CI, 0.46–0.88), specificity was 0.98 (95% CI, 0.84–1.00), and the area under the curve (AUC) was 0.94 (95% CI, 0.92–0.0.96). The pooled region- or node-based sensitivity for ultrasonography was 0.63 (95% CI, 0.47–0.76), specificity was 0.93 (95% CI, 0.73–0.99), and the AUC was 0.81 (95% CI, 0.77–0.84). For lesion-based analysis, the subgroup of lateral compartment lymph node involvement was found to have the highest sensitivity (0.72, 95% CI 0.68–0.75) and specificity (0.97, 95% CI 0.93–0.99) among the studies (p 2 = 0.0196, p = 0.7915; region- or node-based: R2 = 0.3835, p = 0.1381). Conclusions: We conclude that preoperative ultrasonography is a good technique for the preoperative lymph node staging of PTC and is helpful for detecting metastatic cervical lymph

  14. Computed tomography of cervical and retropharyngeal lymph nodes: normal anatomy, variants of normal, and applications in staging head and neck cancer. Part 1. Normal anatomy

    International Nuclear Information System (INIS)

    The retropharyngeal and cervical lymph-node-bearing areas in 30 patients were examined with computed tomography (CT) to determine the range of normal variation in these nodal groups. The data agree with those in the pathologic, anatomic, and surgical literature, and indicate that CT can very precisely determine the size and gross morphology of normal nodes in the retropharyngeal region and the neck. This should have important applications in the management of patients with head and neck cancer

  15. Comparison between CT and histopathological findings of cervical lymph node metastases in the oral squamous cell carcinoma

    International Nuclear Information System (INIS)

    The purpose of this study is to clarify the relationship between the findings of contrast-enhanced CT scans and the histopathological findings of regional lymph nodes obtained from a complete extirpation of oral squamous cell carcinoma. Twenty-seven pairs of contrast-enhanced CT scans and histopathological specimens of 27 oral squamous cell carcinoma used in this study were obtained at Kyushu Dental College Hospital between 1987 and 1999. The primary site of the 27 tumor consists of the tongue (13 cases), the mandibular gingiva (6 cases), the maxillary gingiva (4 cases), the floor of the oral cavity (3 cases), and the buccal mucosa (1 case). The results obtained were as follows: Of the 27 cases, 11 (41%) were proven to be positive lymph nodes metastatic cases histopathologically. Metastatic lymph nodes were predominantly detected in both the submandibular regions and the superior internal jugular chains (95%). The length and the ratio of the short and long axes of the metastatic lymph nodes were larger than those of the non-metastatic lymph nodes. Many of the metastatic lymph nodes revealed a low density in their central area and were also accompanied by a thin ring enhancement. Non-metastatic lymph nodes, affected by inflammation, often revealed a heterogeneous density. The ring enhancement was predominantly seen in the metastatic lymph nodes (45%), which were filled with a well-differentiated tumor cell. In the metastatic lymph nodes, which were filled with moderately-differentiated tumor cells, were seen heterogeneous density, but a ring enhancement was not seen. In the metastatic lymph nodes, it was difficult to decide the metastasis by contrast CT scan, if the tumor extension degree was not predominant. The ring enhancement was caused by the dilatation of the capsular vessels, but not by the extra capsular spread of the tumor cells. (author)

  16. Pulmonary Langerhans cell histiocytosis with cervical lymph node involvement, and coexistence with pulmonary tuberculosis and right pneumothorax: a case report and review of literature

    OpenAIRE

    Gao, Limin; Li, Huifang; LI, GANDI; Liu, Weiping; Li, Jinnan; Zhang, Wenyan

    2015-01-01

    We report an uncommon 22-year-old male Pulmonary Langerhans Cell Histiocytosis (PLCH) case which co-existed with pulmonary tuberculosis (TB). Unlike the common PLCH cases, this PLCH case has cervical lymph node involvement and right pneumothorax. The diagnosis was established by the imaging of lung and the biopsies of the lung and left neck lymph node. Imaging of the chest showed characteristic small nodules and thin-walled cysts and right pneumothorax. The LCH cells in the lung and left neck...

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

    International Nuclear Information System (INIS)

    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.)

  18. Evaluation of cervical lymph node metastasis in thyroid cancer patients using real-time CT navigated ultrasonography: preliminary study

    Energy Technology Data Exchange (ETDEWEB)

    Na, Dae Kwon; Choi, Yoon Jung; Choi, Seon Hyeong; Kook, Shin Ho; Park, Hee Jin [Dept. of Radiology, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul (Korea, Republic of)

    2015-01-15

    To evaluate the diagnostic accuracy of real-time neck computed tomography (CT)-guided ultrasonography (US) in detecting cervical neck lymph node metastasis (LNM) in patients with papillary thyroid cancer (PTC). We retrospectively reviewed data from 176 patients (mean age, 43 years; range, 23 to 74 years) with surgically confirmed PTC who underwent preoperative US, neck CT, and neck CTguided US. We then compared the sensitivities and diagnostic accuracies of each of the three above modalities in detecting cervical LNM. Preoperative US showed 17.3% sensitivity and 58.5% diagnostic accuracy in detecting central LNM compared with 64.3% sensitivity and 89.2% diagnostic accuracy in detecting lateral neck LNM. Neck CT showed 23.5% sensitivity and 55.7% diagnostic accuracy in detecting central LNM and 71.4% sensitivity with 90.9% diagnostic accuracy in detecting lateral neck LNM. CT-guided US exhibited 37.0% sensitivity and 63.1% diagnostic accuracy in detecting central LNM compared with 92.9% sensitivity and 96.0% diagnostic accuracy in detecting lateral LNM. CT-guided US showed higher diagnostic accuracy with superior sensitivity in detecting central and lateral LNM than did US (P<0.001, P=0.011) and CT (P=0.026, P=0.063). Neck CT-guided US is a more accurate technique with higher sensitivity for detecting cervical LNM than either US or CT alone. Therefore, our data indicate that neck CT-guided US is an especially useful technique in preoperative examinations.

  19. High-dose Extended-Field Irradiation and High-Dose-Rate Brachytherapy With Concurrent Chemotherapy for Cervical Cancer With Positive Para-Aortic Lymph Nodes

    International Nuclear Information System (INIS)

    Purpose: To determine the efficacy and toxicity of extended-field radiotherapy (RT) with concurrent platinum-based chemotherapy in patients with uterine cervical carcinoma and positive para-aortic nodes. Methods and Materials: We retrospectively reviewed the results for 33 women with Stage IB-IVB cervical cancer. Each patient had received 59.4 Gy, including a three-dimensional conformal boost to the para-aortic lymph nodes and 41.4-50.4 Gy of external beam radiotherapy to the pelvis. Each patient also underwent six or seven applications of high-dose-rate brachytherapy (median, 5 Gy to point A at each session). Results: The median follow-up period of surviving patients was 39 months. The most common acute toxicity was hematologic, observed in 23 women. Severe acute and late gastrointestinal toxicity was observed in 3 and 4 patients, respectively. More than three-quarters of patients showed a complete response, encompassing the primary mass, metastatic pelvic, and para-aortic lymph nodes. Of the 33 women, 15 had no evidence of disease, 6 had persistent disease, 4 developed in-field failures, and 6 developed distant failures. The 5-year overall and disease-free survival rate was 47% and 42%, respectively. Conclusion: Concurrent chemoradiotherapy with extended-field radiotherapy is feasible in women with uterine cervical carcinoma and positive para-aortic lymph nodes, with acceptable late morbidity and a high survival rate, although it was accompanied by substantial acute toxicity.

  20. Treatment of cervical lymph node metastasis from an unknown primary tumor, with a review of the literature

    International Nuclear Information System (INIS)

    Background: The results of treatment at the Free University Hospital of 44 patients with cervical lymph node metastasis of an unknown primary tumor were reviewed in order to establish an optimal treatment policy and to look for prognostic parameters. These results were compared with results of other treatment policies known from the literature. Patients and Method: Thirty-three out of the 44 patients received a treatment with curative intent; 22 cases received a unilateral neck dissection and postoperative radiotherapy, 7 were irradiated after an excisional biopsy and 4 received radical radiotherapy alone. Results: For the whole group 5- and 10-year overall survival was 50% and 44%, respectively, and for the group treated with curative intent 68% and 56%, respectively. Disease-free survival at 5 and 10 years after treatment for the whole group was 48% and 32%, respectively, and for the group treated with curative intent 63% and 37%, respectively. Conclusions: Multivariate analysis showed only treatment with intent and histology as significant independent prognostic factors for the whole group. For the patients treated with curative intent no significant influences of variables were found. (orig.)

  1. MR analysis of nasopharyngeal carcinoma: correlation of the pattern of tumor extent at the primary site with the distribution of metastasized cervical lymph nodes. Preliminary results

    International Nuclear Information System (INIS)

    The purpose of this study was to correlate the pattern of tumor extent of nasopharyngeal carcinoma at the primary site on magnetic resonance (MR) imaging with the distribution of cervical lymph node metastasis. MR images of 32 patients with biopsy-proven nasopharyngeal carcinoma were reviewed and classified into five patterns of tumor extent in correlation with the distribution of cervical lymphadenopathy. The assessment of cervical lymph node metastasis was done on the basis of the computed tomography (CT) findings. The tumor volume was also correlated with the occurrence of contralateral lymphadenopathy. Of the 32 patients, five (16 %) presented as type 1, tumor limited to the nasopharyngeal mucosa; 12 (38 %) as type 2 a, tumor which had invaded either lateral side but did not extend over the roof of nasopharynx; three (9 %) as type 2 b, tumor which had invaded bilaterally across the midline but did not extend over the roof of nasopharynx; three (9 %) as type 2 c, tumor which had invaded mainly the skull base but did not cross the midline; and nine (28 %) as type 3, tumor which had extended anteriorly to the nasal cavity without invasion. Twenty-five patients (78 %) demonstrated cervical lymphadenopathy. Patients with type 1, type 2 b and type 3 spread had frequent bilateral cervical lymphadenopathy; those with type 2 a had only ipsilateral lymphadenopathy. There was statistical significance (P < 0.005) regarding the existence of contralateral lymphadenopathy with midline tumors as well as the absence of contralateral cervical lymphadenopathy with non-midline tumors. This study therefore suggests that the distribution of metastasized lymph nodes depends on the pattern of tumor extent at the primary site. (orig.)

  2. Patterns and variability of tumor oxygenation in human soft tissue sarcomas, cervical carcinomas, and lymph node metastases

    International Nuclear Information System (INIS)

    Purpose: The validity of tumor pO2 measurement as a predictive outcome assay depends upon demonstrating that intrapatient pO2 variation is less than interpatient variation. No consensus exists regarding the appropriate distance between individual measurements. This distance could affect the calculation of the hypoxic fraction (% pO2s 2 heterogeneity in three different sets of patients. Materials and Methods: Fifteen patients with soft tissue sarcoma, nine patients with cervical carcinoma, and eight patients with squamous carcinoma metastatic to lymph nodes underwent pretreatment polarographic pO2 measurements. Two grossly distinct sites were studied in each tumor, and 2-3 linear tracks were measured at each site. Track lengths varied from 20-36 mm. Distance between measured points was either 0.7-0.8 mm or 0.4 mm. Mean pO2, median pO2, and hypoxic fraction were calculated for each track. Data for each patient were also averaged across all tracks obtained for that patient. Track-specific data were used to evaluate intrapatient variation. The range of average values for each patient was used to assess interpatient heterogeneity. The ratio of these measures provided an assessment of within- vs. between-patient heterogeneity. Results: The median number of pO2 measurements/patient was 200 (range: 88-356). The average length of hypoxic regions varied from 4.5-5.6 mm. Median tumor pO2s for the cervix, lymph node, and sarcoma patients were 4.5 mm Hg, 12.6 mm Hg, and 18.0 mm Hg, respectively (p = 0.07). Median hypoxic fractions were 0.61, 0.36, and 0.31, respectively (p = 0.07). Intrapatient heterogeneity was less than interpatient heterogeneity for all parameters in all patients, except for mean pO2 for the cervix patients measured at 0.7-mm increments (1.51). Assessment of oxygenation was not affected by the distance between samples. Conclusions: Heterogeneity of tumor oxygenation within tumors is less than that between tumors. Both 0.4 mm and 0.7-0.8 mm sampling

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

    OpenAIRE

    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...

  4. Preoperative Prediction of Cervical Lymph Node Metastasis Using Primary Tumor SUVmax on 18F-FDG PET/CT in Patients with Papillary Thyroid Carcinoma

    OpenAIRE

    Jung, Ji-hoon; Kim, Choon-Young; Son, Seung Hyun; Kim, Do-Hoon; Jeong, Shin Young; Lee, Sang-Woo; Lee, Jaetae; Ahn, Byeong-Cheol

    2015-01-01

    Objectives The aim of the current study was to evaluate the value of preoperative 18F-FDG (FDG) PET/CT in predicting cervical lymph node (LN) metastasis in patients with papillary thyroid carcinoma (PTC). Methods One hundred and ninety-three newly diagnosed PTC patients (M: F = 25:168, age = 46.8 ± 12.2) who had undergone pretreatment FDG PET/CT and had neck node dissection were included in this study. The FDG avidity of the primary tumor and the SUVmax of the primary tumor (pSUVmax) were ana...

  5. Thermochemoradiation Therapy Using Superselective Intra-arterial Infusion via Superficial Temporal and Occipital Arteries for Oral Cancer With N3 Cervical Lymph Node Metastases

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    Mitsudo, Kenji, E-mail: mitsudo@yokohama-cu.ac.jp [Department of Oral and Maxillofacial Surgery, Yokohama City University Graduate School of Medicine, Yokohama (Japan); Koizumi, Toshiyuki; Iida, Masaki; Iwai, Toshinori; Oguri, Senri [Department of Oral and Maxillofacial Surgery, Yokohama City University Graduate School of Medicine, Yokohama (Japan); Yamamoto, Noriyuki [Department of Oral and Maxillofacial Surgery, Nagoya University Graduate School of Medicine, Nagoya (Japan); Itoh, Yoshiyuki [Department of Radiology, Nagoya University Graduate School of Medicine, Nagoya (Japan); Kioi, Mitomu; Hirota, Makoto; Tohnai, Iwai [Department of Oral and Maxillofacial Surgery, Yokohama City University Graduate School of Medicine, Yokohama (Japan)

    2012-08-01

    Purpose: To evaluate the therapeutic results and histopathological effects of treatment with thermochemoradiation therapy using superselective intra-arterial infusion via the superficial temporal and occipital arteries for N3 cervical lymph node metastases of advanced oral cancer. Methods and Materials: Between April 2005 and September 2010, 9 patients with N3 cervical lymph node metastases of oral squamous cell carcinoma underwent thermochemoradiation therapy using superselective intra-arterial infusion with docetaxel (DOC) and cisplatin (CDDP). Treatment consisted of hyperthermia (2-8 sessions), superselective intra-arterial infusions (DOC, total 40-60 mg/m{sup 2}; CDDP, total 100-150 mg/m{sup 2}) and daily concurrent radiation therapy (total, 40-60 Gy) for 4-6 weeks. Results: Six of 9 patients underwent neck dissection 5-8 weeks after treatment. In four of these 6 patients, all metastatic lymph nodes, including those at N3, were grade 3 (non-viable tumor cells present) or grade 4 (no tumor cells present) tumors, as classified by the system by Shimosato et al (Shimosato et al Jpn J Clin Oncol 1971;1:19-35). In 2 of these 6 patients, the metastatic lymph nodes were grade 2b (destruction of tumor structures with a small amount of residual viable tumor cells). The other 3 patients did not undergo neck dissection due to distant metastasis after completion of thermochemoradiation therapy (n=2) and refusal (n=1). The patient who refused neck dissection underwent biopsy of the N3 lymph node and primary sites and showed grade 3 cancer. During follow-up, 5 patients were alive without disease, and 4 patients died due to pulmonary metastasis (n=3) and noncancer-related causes (n=1). Five-year survival and locoregional control rates were 51% and 88%, respectively. Conclusions: Thermochemoradiation therapy using intra-arterial infusion provided good histopathologic effects and locoregional control rates in patients with N3 metastatic lymph nodes. However, patients with N3

  6. Thermochemoradiation Therapy Using Superselective Intra-arterial Infusion via Superficial Temporal and Occipital Arteries for Oral Cancer With N3 Cervical Lymph Node Metastases

    International Nuclear Information System (INIS)

    Purpose: To evaluate the therapeutic results and histopathological effects of treatment with thermochemoradiation therapy using superselective intra-arterial infusion via the superficial temporal and occipital arteries for N3 cervical lymph node metastases of advanced oral cancer. Methods and Materials: Between April 2005 and September 2010, 9 patients with N3 cervical lymph node metastases of oral squamous cell carcinoma underwent thermochemoradiation therapy using superselective intra-arterial infusion with docetaxel (DOC) and cisplatin (CDDP). Treatment consisted of hyperthermia (2-8 sessions), superselective intra-arterial infusions (DOC, total 40-60 mg/m2; CDDP, total 100-150 mg/m2) and daily concurrent radiation therapy (total, 40-60 Gy) for 4-6 weeks. Results: Six of 9 patients underwent neck dissection 5-8 weeks after treatment. In four of these 6 patients, all metastatic lymph nodes, including those at N3, were grade 3 (non-viable tumor cells present) or grade 4 (no tumor cells present) tumors, as classified by the system by Shimosato et al (Shimosato et al Jpn J Clin Oncol 1971;1:19-35). In 2 of these 6 patients, the metastatic lymph nodes were grade 2b (destruction of tumor structures with a small amount of residual viable tumor cells). The other 3 patients did not undergo neck dissection due to distant metastasis after completion of thermochemoradiation therapy (n=2) and refusal (n=1). The patient who refused neck dissection underwent biopsy of the N3 lymph node and primary sites and showed grade 3 cancer. During follow-up, 5 patients were alive without disease, and 4 patients died due to pulmonary metastasis (n=3) and noncancer-related causes (n=1). Five-year survival and locoregional control rates were 51% and 88%, respectively. Conclusions: Thermochemoradiation therapy using intra-arterial infusion provided good histopathologic effects and locoregional control rates in patients with N3 metastatic lymph nodes. However, patients with N3 metastatic

  7. Cervical Lymph Node Metastases From Unknown Primary Cancer: A Single-Institution Experience With Intensity-Modulated Radiotherapy

    Energy Technology Data Exchange (ETDEWEB)

    Villeneuve, Hugo, E-mail: hugo.villeneuve@umontreal.ca [Department of Radiation Oncology, Centre hospitalier de l' Universite de Montreal, Montreal, QC (Canada); Despres, Philippe; Fortin, Bernard; Filion, Edith; Donath, David [Department of Radiation Oncology, Centre hospitalier de l' Universite de Montreal, Montreal, QC (Canada); Soulieres, Denis [Department of Medical Oncology, Centre hospitalier de l' Universite de Montreal, Montreal, QC (Canada); Guertin, Louis; Ayad, Tarek; Christopoulos, Apostolos [Department of Head and Neck Surgery, Centre hospitalier de l' Universite de Montreal, Montreal, QC (Canada); Nguyen-Tan, Phuc Felix [Department of Radiation Oncology, Centre hospitalier de l' Universite de Montreal, Montreal, QC (Canada)

    2012-04-01

    Purpose: To determine the effectiveness and rate of complications of intensity-modulated radiotherapy (IMRT) in the treatment of cervical lymph node metastases from unknown primary cancer. Methods and Materials: Between February 2005 and November 2008, 25 patients with an unknown primary cancer underwent IMRT, with a median radiation dose of 70 Gy. The bilateral neck and ipsilateral putative pharyngeal mucosa were included in the target volume. All patients had squamous cell carcinoma, except for 1 patient who had adenosquamous differentiation. They were all treated with curative intent. Of the 25 included patients, 20 were men and 5 were women, with a median age of 54 years. Of these patients, 3 had Stage III, 18 had Stage IVa, and 4 had Stage IVb. Of the 25 patients, 18 (72%) received platinum-based chemotherapy in a combined-modality setting. Neck dissection was reserved for residual disease after definitive IMRT. Overall survival, disease-free survival, and locoregional control were calculated using the Kaplan-Meier method. Results: With a median follow-up of 38 months, the overall survival, disease-free survival, and locoregional control rates were all 100% at 3 years. No occurrence of primary cancer was observed during the follow-up period. The reported rates of xerostomia reduced with the interval from the completion of treatment. Nine patients (36%) reported Grade 2 or greater xerostomia at 6 months, and only 2 (8%) of them reported the same grade of salivary function toxicity after 24 months of follow-up. Conclusion: In our institution, IMRT for unknown primary cancer has provided good overall and disease-free survival in all the patients with an acceptable rate of complications. IMRT allowed us to address the bilateral neck and ipsilateral putative pharyngeal mucosa with minimal late salivary function toxicity. The use of concurrent chemotherapy and IMRT for more advanced disease led to good clinical results with reasonable toxicities.

  8. 颈淋巴结穿刺细胞学检查对颈淋巴结转移的诊断价值%Clinical value of aspiration cytology of cervical lymph node in the diagnosis of cervical lymph node metastasis

    Institute of Scientific and Technical Information of China (English)

    刘新梅

    2016-01-01

    Objective To investigate the clinical value of aspiration cytology of cervical lymph node in the diagnosis of cervical lymph node metastasis.Methods 80 cases of thyroid cancer with cervical lymph node metastasis admitted in our hospital from January 2003 to February 2015 were randomly selected.All patients were treated with fine needle aspiration cytology of cervical lymph node;the results were observed and recorded, and then compared with the routine postoperative pathological diagnosis results for analysis.Results After 80 patients received fine needle aspiration cytology of cervical lymph node, 74 cases were diagnosed as metastasis of cervical lymph node of thyroid cancer, with the positive rate of 92.50%;and the sensitivity of aspiration cytology of cervical lymph node was higher than that of slide cytological examination (85.19% vs.33.33%), with statistically significant difference (P<0.05).Conclusion Aspiration cytology of cervical lymph node can provide accurate preoperative diagnosis for thyroid cancer patients with cervical lymph node metastasis, which is helpful for the decision of the surgical plan and the successful development of the treatment.%目的 探讨采用颈淋巴结穿刺细胞学检查进行颈淋巴结转移诊断的临床价值.方法 随机选取本院2003年1月至2015年2月收治的甲状腺癌颈淋巴结转移患者80例,所有患者均接受颈淋巴结细针穿刺细胞学检查,对患者的细胞学检查结果进行观察记录,并同术后常规病理诊断结果进行对比分析.结果 80例患者经颈淋巴结穿刺细胞学检查,其中74例患者诊断为存在甲状腺癌颈淋巴结转移,阳性率为92.50%;颈淋巴结穿刺细胞学检查的灵敏度(85.19%)明显高于甲状腺切片细胞学检查结果(33.33%),差异有统计学意义(P<0.05).结论 颈淋巴结穿刺细胞学检查可对甲状腺癌合并颈淋巴结转移患者进行准确的术前诊断,有助于手术方案的制定和治疗的

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

    International Nuclear Information System (INIS)

    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.

  10. Response analysis of the results of radiotherapy for cervical lymph node metastasis in squamous cell carcinoma of the head and neck

    Energy Technology Data Exchange (ETDEWEB)

    Kita, Midori; Okawa, Tomohiko; Ikeda, Michio (Tokyo Women' s Medical Coll. (Japan))

    1989-06-01

    Seventy-three patients with squamous cell carcinoma of the head and neck were treated with radiotherapy from 1968 until 1985. The 135 metastatic cervical lymph nodes were given radiation doses exceeding TDF 65 (40 Gy/20 fr/4 weeks). The data was analyzed retrospectively to evaluate the factors affecting radiation response and control. At 1 month following radiotherapy, the complete response (CR) rate was 102/135, partial response (PR) was 23/135,while 6/135 registered no change (NC), and 4/135 exhibited progressive disease (PD). The CR rate for nodes near the primary site was 65/68 for nasopharynx, 12/15 oropharynx 13/21, for hypopharynx, 0/7 for tongue, 8/17 for larynx, and 4/7 for maxillary sinus, respectively. The CR rate was 81/98 for lymph nodes up to 3 cm compared to 21/37 for larger nodes. In nasopharyngeal carcinoma, the CR rate for nodes up to 3 cm was 30/30 at dose levels over TDF 65; however, for larger nodes, it was 4/7 at TDF 65-99 and 10/10 at TDF 100 or above. In other carcinomas, the CR rate for nodes up to 3 cm was 13/23 at 65-99 and 17/24 at TDF 100 or above; however, for larger nodes, it was 0/2 at TDF 65-99 and 7/18 at TDF 100 or above. In moderately and well differentiated carcinomas, the CR rate was related to TDF. In follow-up studies, 8 of 102 CR nodes recurred and were accompanied by primary and/or distant disease; 5 out of 23 PR nodes changed to CR 2-12 months after treatment. The 2-year CR rate for nasopharyngeal carcinoma nodes was 19/28 and 15/42 in the other nodes. The data suggests that, for patients with metastatic lymph nodes from squamous cell carcinoma of the head and neck, radiotherapy was effective and useful in curing nodes up to 3 cm, irrespective of the primary site or histological grade. However, with the excretion of nasopharyngeal carcinoma, multimodal treatment should be considered for nodes larger than 3 cm.

  11. A consensus-based guideline defining the clinical target volume for pelvic lymph nodes in external beam radiotherapy for uterine cervical cancer

    International Nuclear Information System (INIS)

    The objective of this study was to develop a consensus-based guideline as well as an atlas defining pelvic nodal clinical target volumes in external beam radiotherapy for uterine cervical cancer. A working subgroup to establish the consensus-based guideline on clinical target volumes for uterine cervical cancer was formulated by the Radiation Therapy Study Group of the Japan Clinical Oncology Group in July 2008. The working subgroup consisted of seven radiation oncologists. The process resulting in the consensus included a comparison of contouring on CT images among the members, reviewing of published textbooks and the relevant literature and a distribution analysis of metastatic nodes on computed tomography/magnetic resonance imaging of actual patients. The working subgroup defined the pelvic nodal clinical target volumes for cervical cancer and developed an associated atlas. As a basic criterion, the lymph node clinical target volume was defined as the area encompassed by a 7 mm margin around the applicable pelvic vessels. Modifications were made in each nodal area to cover adjacent adipose tissues at risk of microscopic nodal metastases. Although the bones and muscles were excluded, the bowel was not routinely excluded in the definition. Each of the following pelvic node regions was defined: common iliac, external iliac, internal iliac, obturator and presacral. Anatomical structures bordering each lymph node region were defined for six directions; anterior, posterior, lateral, medial, cranial and caudal. Drafts of the definition and the atlas were reviewed by members of the JCOG Gynecologic Cancer Study Group (GCSG). We developed a consensus-based guideline defining the pelvic node clinical target volumes that included an atlas. The guideline will be continuously updated to reflect the ongoing changes in the field. (author)

  12. B3GNT3 Expression Is a Novel Marker Correlated with Pelvic Lymph Node Metastasis and Poor Clinical Outcome in Early-Stage Cervical Cancer.

    Directory of Open Access Journals (Sweden)

    Weijing Zhang

    Full Text Available The β1,3-N-acetylglucosaminyltransferase-3 gene (B3GNT3 encodes a member of the B3GNT family that functions as the backbone structure of dimeric sialyl-Lewis A and is involved in L-selectin ligand biosynthesis, lymphocyte homing and lymphocyte trafficking. B3GNT3 has been implicated as an important element in the development of certain cancers. However, the characteristics of B3GNT3 in the development and progression of cancer remain largely unknown. Thus, our study aimed to investigate the expression pattern and the prognostic value of B3GNT3 in patients with early-stage cervical cancer.The mRNA and protein levels of B3GNT3 expression were examined in eight cervical cancer cell lines and ten paired cervical cancer tumors, using real-time PCR and western blotting, respectively. Immunohistochemistry (IHC was used to analyze B3GNT3 protein expression in paraffin-embedded tissues from 196 early-stage cervical cancer patients. Statistical analyses were applied to evaluate the association between B3GNT3 expression scores and clinical parameters, as well as patient survival.B3GNT3 expression was significantly upregulated in cervical cancer cell lines and lesions compared with normal cells and adjacent noncancerous cervical tissues. In the 196 cases of tested early-stage cervical cancer samples, the B3GNT3 protein level was positively correlated with high risk TYPES of human papillomavirus (HPV infection (P = 0.026, FIGO stage (P < 0.001, tumor size (P = 0.025, tumor recurrence (P = 0.004, vital status (P < 0.001, concurrent chemotherapy and radiotherapy (P = 0.016, lymphovascular space involvement (P = 0.003 and most importantly, lymph node metastasis (P = 0.003. Patients with high B3GNT3 expression had a shorter overall survival (OS and disease-free survival (DFS compared with those with low expression of this protein. Multivariate analysis suggested that B3GNT3 expression is an independent prognostic indicator for cervical cancer patients.Our study

  13. Mesenteric lymph node cavitation syndrome

    Institute of Scientific and Technical Information of China (English)

    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...

  14. An easy irradiation technique (partial half-beam) to reduce renal dose in radiotherapy of cervical cancer including paraaortic lymph nodes

    International Nuclear Information System (INIS)

    Purpose: for radiation treatment of patients with cervical cancer and a high risk for paraaortic lymph node involvement, an easy three-dimensional (3-D) conformal irradiation technique (partial half-beam [PHB]) for protection of organs at risk, especially of renal tissue, was developed. Patients and methods: in five consecutive female patients a computed tomography scan was performed. Dose-volume histograms of the renal tissue and other organs at risk were analyzed for PHB, three other 3-D conformal techniques, and an intensity-modulated radiotherapy (IMRT) technique. Results: the PHB technique reduced the renal volume and volumes of other organs at risk exposed to radiation doses when comparing all patients to the other 3-D conformal techniques. With use of the IMRT technique more renal tissue volume received very low radiation doses (≤ 6.8 Gy) whereas the D10 was lower than with the PHB technique. Conclusion: in female patients with cervical cancer and high risk for paraaortic lymph node involvement, the use of the PHB technique is recommended to reduce renal radiation exposure, if no IMRT technique should be applied. The PHB technique is very easily and fast applicable. (orig.)

  15. The Role of Pretreatment FDG-PET in Treating Cervical Cancer Patients With Enlarged Pelvic Lymph Node(s) Shown on MRI: A Phase 3 Randomized Trial With Long-Term Follow-Up

    International Nuclear Information System (INIS)

    Purpose: This report is the second analysis of a prospective randomized trial to investigate the impact of 18F-fluorodeoxyglucose positron emission tomography (FDG-PET) on cervical cancer patients with enlarged pelvic lymph nodes identified by magnetic resonance imaging. Methods and Materials: Patients with newly diagnosed cervical cancer with enlarged pelvic lymph nodes but free of enlarged para-aortic lymph nodes (PALN) were eligible. Patients were randomized to receive either pretreatment FDG-PET (PET arm) or not (control arm). The whole pelvis was the standard irradiation field for all patients except those with FDG-avid extrapelvic findings. Results: In all, 129 patients were enrolled. Pretreatment PET detected extrapelvic metastases in 7 patients. No new patient experienced treatment failure during the additional 4-year follow-up period. There were no significant differences between the PET arm and the control arm regarding overall survival, disease-free survival, and freedom from extrapelvic metastasis. In the control arm, 8 of 10 patients with PALN relapse had limited extrapelvic nodal failures; their 5-year disease-specific survival was 34.3%. By contrast, only 1 of 5 patients with PALN relapse in the PET arm experienced such limited failures; their 5-year survival rate was 0%. Conclusions: Although the pretreatment detection of PALN did not translate into survival benefit, it indeed decreased the need for extended-field concurrent chemoradiation therapy

  16. The Role of Pretreatment FDG-PET in Treating Cervical Cancer Patients With Enlarged Pelvic Lymph Node(s) Shown on MRI: A Phase 3 Randomized Trial With Long-Term Follow-Up

    Energy Technology Data Exchange (ETDEWEB)

    Lin, Shinn-Yn [Department of Radiation Oncology, Chang Gung Memorial Hospital and Chang Gung University, Taoyuan, Taiwan (China); Department of Medical Imaging and Radiological Sciences, College of Medicine, Chang Gung University, Taiwan (China); Institute of Epidemiology and Preventive Medicine, College of Public Health, National Taiwan University, Taiwan (China); Tsai, Chien-Sheng [Department of Medical Imaging and Radiological Sciences, College of Medicine, Chang Gung University, Taiwan (China); Department of Radiation Oncology, Chang Gung Memorial Hospital, Keelung, Taiwan (China); Chang, Yu-Chen [Department of Medical Imaging and Radiological Sciences, College of Medicine, Chang Gung University, Taiwan (China); Molecular Imaging Center and Department of Nuclear Medicine, Chang Gung Memorial Hospital and Chang Gung University, Taoyuan, Taiwan (China); Ng, Koon-Kwan [Department of Medical Imaging and Intervention, Chang Gung Memorial Hospital, Keelung, Taiwan (China); Chang, Ting-Chang [Department of Obstetrics and Gynecology, Chang Gung Memorial Hospital and Chang Gung University, Taoyuan, Taiwan (China); Kao, Wei-Heng [Department of Radiation Oncology, Chang Gung Memorial Hospital and Chang Gung University, Taoyuan, Taiwan (China); Lai, Chyong-Huey [Department of Obstetrics and Gynecology, Chang Gung Memorial Hospital and Chang Gung University, Taoyuan, Taiwan (China); Hong, Ji-Hong, E-mail: jihong@adm.cgmh.org.tw [Department of Radiation Oncology, Chang Gung Memorial Hospital and Chang Gung University, Taoyuan, Taiwan (China); Department of Medical Imaging and Radiological Sciences, College of Medicine, Chang Gung University, Taiwan (China); Institute for Radiological Research, Chang Gung University and Chang Gung Memorial Hospital, Taiwan (China)

    2015-07-01

    Purpose: This report is the second analysis of a prospective randomized trial to investigate the impact of {sup 18}F-fluorodeoxyglucose positron emission tomography (FDG-PET) on cervical cancer patients with enlarged pelvic lymph nodes identified by magnetic resonance imaging. Methods and Materials: Patients with newly diagnosed cervical cancer with enlarged pelvic lymph nodes but free of enlarged para-aortic lymph nodes (PALN) were eligible. Patients were randomized to receive either pretreatment FDG-PET (PET arm) or not (control arm). The whole pelvis was the standard irradiation field for all patients except those with FDG-avid extrapelvic findings. Results: In all, 129 patients were enrolled. Pretreatment PET detected extrapelvic metastases in 7 patients. No new patient experienced treatment failure during the additional 4-year follow-up period. There were no significant differences between the PET arm and the control arm regarding overall survival, disease-free survival, and freedom from extrapelvic metastasis. In the control arm, 8 of 10 patients with PALN relapse had limited extrapelvic nodal failures; their 5-year disease-specific survival was 34.3%. By contrast, only 1 of 5 patients with PALN relapse in the PET arm experienced such limited failures; their 5-year survival rate was 0%. Conclusions: Although the pretreatment detection of PALN did not translate into survival benefit, it indeed decreased the need for extended-field concurrent chemoradiation therapy.

  17. Establishment of cervical lymph node metastasis model of squamous cell carcinoma in the oral cavity in mice

    Institute of Scientific and Technical Information of China (English)

    SUN Rui; ZHANG Jian-gang; GUO Chuan-bin

    2008-01-01

    Background Oral squamous cell carcinoma (OSCC) is the most prevalent malignant tumor in the head and neck region,comprising more than 90% of all oral malignancies. A feasible approach for an animal model to study OSCC lymph node metastasis was established and biological behaviors of three oral squamous cell carcinoma cell lines were compared.Methods After implanting three kinds of call lines (GDC185, Tca8113, Tca83) into three different anatomical sites in nude mice, namely the tongue, floor of the mouth, and axillary fossa, we observed the tumorigenicity and the metastatic capacity, which was confirmed by histopathology under a surgical microscope.Results The animal model injected with GDC185 cells into the floor of the mouth had the highest rate of neck lymph node metastasis (55.6%) and the call lines had significantly different biological behaviors.Conclusions Nude mice injected with GDC185 cells into the floor of the mouth could be used as a feasible animal model to study neck metastasis of oral squamous cell carcinoma.

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

    International Nuclear Information System (INIS)

    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

  19. Lymph node imaging: Basic principles

    International Nuclear Information System (INIS)

    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

  20. Selective Changes in the Immune Profile of Tumor-Draining Lymph Nodes After Different Neoadjuvant Chemoradiation Regimens for Locally Advanced Cervical Cancer

    International Nuclear Information System (INIS)

    Purpose: To assess how neoadjuvant chemoradiation regimens modulate the immune system state in tumor-draining lymph nodes (TDLN), in the setting of advanced cervical cancer. Methods and Materials: Tumor-draining lymph nodes of patients undergoing chemotherapy only (nonirradiated, NI-TDLN) and chemoradiation with lower-dose (39.6 Gy, LD-TDLN) and higher-dose radiation (50 Gy, HD-TDLN) were analyzed by multicolor flow cytometry. Results: Enlarging our previous data, LD-TDLN showed features overall indicative of an enhanced antitumor response as compared with NI-TDLN, namely a significant Th1 and Tc1 polarization and a lower amount of the potent CD4+Foxp3+CD25high regulatory T cell (Treg) subset identified by neuropilin-1 expression. Conversely, compared with NI-TDLN, HD-TDLN showed features overall indicative of an impaired antitumor response, namely a significantly inverted CD4/CD8 cell ratio, a higher Nrp1+Treg frequency, and a higher frequency of CCR4+Treg, a Treg subset facilitated in migrating out from TDLN to suppress the immune response against distant cancer cells. Moreover, the Th1 and Tc1 polarization induced by LD radiation was lost, and there was an unfavorable tolerogenic/immunogenic dendritic cell ratio compared with LD-TDLN. Conclusions: Even minor differences in radiation dose in neoadjuvant regimens for locally advanced cervical cancer are crucial for determining the balance between a tolerogenic and an efficacious antitumor immune response in TDLN. Because most of the anticancer immune response takes place in TDLN, the present findings also emphasize the importance of chemoradiation protocols in the context of immunotherapeutic trials.

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

    Institute of Scientific and Technical Information of China (English)

    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.

  2. Elective ilioingunial lymph node irradiation

    Energy Technology Data Exchange (ETDEWEB)

    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.

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

    International Nuclear Information System (INIS)

    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

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

    Energy Technology Data Exchange (ETDEWEB)

    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.

  5. Sentinel lymph node concept in oral cancer

    International Nuclear Information System (INIS)

    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. The first experience of using 99mTc-Al2O3-based radiopharmaceutical for the detection of sentinel lymph nodes in cervical cancer patients

    Science.gov (United States)

    Sinilkin, I. G.; Chernov, V. I.; Lyapunov, A. Yu.; Medvedeva, A. A.; Zelchan, R. V.; Chernyshova, A. L.; Kolomiets, L. A.

    2016-08-01

    The purpose of the study was to evaluate the feasibility of using 99mTc-Al2O3-based radiopharmaceutical, a novel molecular imaging agent for sentinel lymph node detection in patients with invasive cervical cancer. The study included 23 cervical cancer patients (T1aNxMx-T2bNxMx) treated at the Tomsk Cancer Research Institute. In the 18 hours before surgery, 80 MBq of the 99mTc-Al2O3 in peritumoral injected, followed by single-photon emission computed tomography (SPECT) of the pelvis and intraoperative SLN identification. Twenty-seven SLNs were detected by SPECT, and 34 SLNs were identified by intraoperative gamma probe. The total number of identified SLNs per patient ranged from 1 to 3 (the mean number of SLNs was 1.4 per patient). The most common site for SLN detection was the external iliac region (57.2%), followed by the internal iliac (14%), obturator (14%), presacral and retrosacral regions (14%), and the parametrial region (1%). Sensitivity in detecting SLNs was 100% for intraoperative SLN identification and 79% for SPECT image.

  7. The use of 99mTc-Al2O3 for detection of sentinel lymph nodes in cervical cancer patients

    Science.gov (United States)

    Sinilkin, I. G.; Chernov, V. I.; Lyapunov, A. Yu; Medvedeva, A. A.; Zelchan, R. V.; Chernyshova, A. L.; Kolomiets, L. A.

    2016-06-01

    The purpose of the study was to evaluate the feasibility of using 99mTc-Al2O3- based radiopharmaceutical, a novel molecular imaging agent for sentinel lymph node detection in patients with invasive cervical cancer. The study included 23 cervical cancer patients (TlaNxMx- T2bNxMx) treated at the Tomsk Cancer Research Institute. At 18 hours before surgery, 80 MBq of the 99mTc-Al2O3 were injected peritumorally, followed by single-photon emission computed tomography (SPECT) of the pelvis and intraoperative SLN identification. Twenty-seven SLNs were detected by SPECT, and 34 SLNs were identified by intraoperative gamma probe. The total number of identified SLNs per patient ranged from 1 to 3(the mean number of SLNs was 1.4 per patient). The most common site for SLN detection was the external iliac region (57.2%), followed by the internal iliac, obturator, presacral and retrosacral regions (they amounted to 14%, respectively),and the parametrial region (1%). Sensitivity in detecting SLNs was 100% for intraoperative SLN identification and 79% for SPECT image.

  8. Diagnostic efficacy of diffusion-weighted MRI for pre-operative assessment of myometrial and cervical invasion and pelvic lymph node metastasis in endometrial carcinoma

    International Nuclear Information System (INIS)

    To determine the diagnostic accuracy of diffusion-weighted magnetic resonance imaging (DW-MRI) for the pre-operative assessment of patients with endometrial carcinoma and to assess myometrial and cervical invasion as well as pelvic lymph node metastasis. Fifty-eight women who underwent surgery for histopathologically confirmed endometrial carcinoma were included in the current study. Prior to surgery, patients were evaluated using pelvic DW-MRI and gadolinium-enhanced T1-weighted imaging (Gd-T1WI). Gd-T1WI was evaluated together with T2-weighted images. DW-MR images were obtained in the axial plane using echo-planar spin-echo pulse sequences with different b factors. Endometrial carcinomas were observed as areas of increased intensity on DW-MRI images, and their intensity was compared with the surrounding hypo-intense myometrium. Pre-operative DW-MRI and Gd-T1WI results were compared with post-operative histopathological findings that served as reference standards. The sensitivity, specificity, positive (PPV) and negative predictive values (NPV), and diagnostic accuracy of DW-MRI for differentiation between superficial myometrial invasion and deep myometrial invasion were 85%, 89%, 81%, 92% and 88%, respectively. The sensitivity, specificity and diagnostic accuracy rates were 82%, 91% and 89.6% for cervical invasion and 100%, 96% and 96.5% for pelvic lymph node metastasis, respectively. The sensitivity, specificity, PPV and NPV, and diagnostic accuracy of Gd-T1WI for differentiation between superficial myometrial invasion and deep myometrial invasion were 85%, 81.5%, 71%, 91% and 83%, respectively. The sensitivity, specificity and diagnostic accuracy were 73%, 89% and 86% for cervical invasion, respectively. These findings suggest that DW-MRI may be a good diagnostic tool with high sensitivity and specificity for assessing myometrial invasion and detecting tumour extension. We suggest that DW-MRI should be considered as a routine part of the pre-operative pelvic

  9. Sentinel lymph node biopsy in oral cancer

    DEFF Research Database (Denmark)

    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...

  10. Extended field chemoradiation for cervical cancer patients with histologically proven para-aortic lymph node metastases after laparoscopic lymphadenectomy

    International Nuclear Information System (INIS)

    The purpose of this work was to evaluate the use of extended-field chemoradiation (EFRT) with concomitant chemotherapy in patients with histologically confirmed para-aortic metastases after laparoscopic para-aortic and pelvic lymphadenectomy (LAE) with regard to oncologic results and treatment-related toxicity. A total of 44 women with squamous cell carcinoma (82 %) and adenocarcinoma (18 %) of the cervix in FIGO stages IIA (n = 3), IIB (n = 29); IIIB (n = 9), and IVA (n = 3) and histologically proven para-aortic metastases underwent EFRT and chemotherapy. Laparoscopic LAE was performed in 40 patients. Patients underwent chemoradiation with conventional fractionation of 1.8-50.4 Gy to the para-aortic and pelvic region. In addition, MRI-guided brachytherapy was performed to the cervix with 5-6 single doses of 5 Gy for a total dose of 25-30 Gy. The mean number of harvested lymph nodes was 17 in the pelvic as well as para-aortic regions, respectively. Laparoscopic intervention did not delay chemoradiation. Follow-up was 6-76 months (mean 25.1 months). There was no grade 4 or 5 acute radiation toxicity. In all, 8, 4, and 11 % grade 1, 2, and 3 gastrointestinal late toxicities and 7, 11, and 19 % grade 1, 2 and 3 genitourinary late toxicities were recorded. Despite the excellent locoregional (pelvic) control rates of 89.1 and 82.8 % after 2 and 5 years, respectively, the overall survival rates were 68.4 and 54.1 % after 2 and 5 years, respectively. Of the 44 patients, 43 remained tumor free in the para-aortic region. In patients with proven para-aortic disease, excellent pelvic and para-aortic control could be achieved by laparoscopic LAE followed by EFRT. More than half of the patients were long-term survivors. The high risk of distant metastases should be addressed by further improving systemic treatment. (orig.)

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

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    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

  12. Use of diffusion-weighted magnetic resonance imaging in cervical lymph node metastasis from nasopharyngeal carcinoma receiving intensity modulated radiation therapy

    International Nuclear Information System (INIS)

    Objective: To investigate the value of diffusion-weighted magnetic resonance imaging (DWI) and apparent diffusion coefficients (ADC) in detecting metastatic lymph nodes from nasopharyngeal carcinoma (NPC), and predicting the response of these nodes to concurrent chemoradiation (CRT). Methods: Eighteen patients with pathologically proven NPC received conventional magnetic resonance imaging (MRI) and DWI before treatment,weekly during treatment, and one month after treatment.DWI was performed using a single-shot echo-planar (SSEPI) MR imaging sequence with b values of 0 and 1500 s/mm2. ADC maps were reconstructed for all patients and ADC values were calculated for each lymph node and tongue muscle. Totally fifty-two morphologically abnormal lymph nodes were analyzed. The ADC values of the metastatic lymph nodes before treatment were compared between those with the short axis ≥10 mm (n=32) and those with the short axis <10 mm (n=20), and the dynamic changes in ADC values of the lymph nodes before, during, and after therapy were observed and recorded. Results: The average ADC of the 32 lymph nodes with the short axis ≥ 10 mm was (0.71±0.12)×10-3mm/s, not significantly different from that of the 20 lymph nodes with the short axis < 10 mm [(0.73±0.16)×10-3mm/s, t=1.11, P=0.27]. The average ADC values of these lymph nodes before treatment was significantly lower than that of the tongue muscle (t=19.35, P<0.0001). During CRT, the ADC values of the lymph nodes increased gradually,with the most evident change in the first two weeks before reaching a relatively flat plateau thereafter. The ADC value of the residual lymph nodes after CRT was significantly higher than that before treatment (t=12.72, P<0.0001), however, not statistically significant different from that of the normal tongue muscle (t=0.34, P=0.73). Conclusions: DWI plays an important role in diagnosing the metastatic lymph nodes from NPC and is feasible for observation of the early response of the lymph

  13. Postoperative low-pelvic irradiation for stage I-IIA cervical cancer patients with risk factors other than pelvic lymph node metastasis

    International Nuclear Information System (INIS)

    Purpose: To retrospectively investigate whether postoperative low-pelvic radiotherapy (RT) is an appropriate treatment for node-negative, high-risk Stage I-IIA cervical cancer patients. Methods and Materials: A total of 228 Stage I-IIA cervical cancer patients treated by radical surgery and postoperative RT were included in this study. All patients had histopathologically negative pelvic node metastasis, but at least one of the following risk factors: parametrial involvement, positive or close resection margins, invasion depth two-thirds or greater cervical stromal thickness. Seventy-nine patients (35%) received 30-50 Gy (median 44) to whole pelvis and a boost dose to the low pelvis (whole-pelvic RT group); the other 149 patients (65%) received low-pelvic RT only (low-pelvic RT group). For both groups, the total external RT dose to the low pelvis ranged from 40 to 60 Gy (median 50). The potential factors associated with survival, small bowel (gastrointestinal) complications, and leg lymphedema were analyzed, and patients who had a relapse in the upper pelvis were identified. Results: The 5-year overall and disease-specific survival rate was 84% and 86%, respectively. After multivariate analysis, only bulky tumor (≥4 cm) and non-squamous cell carcinoma were significantly associated with survival. Parametrial involvement, lymph-vascular invasion, ≤50.4 Gy to the low pelvis, positive or close margins, and low-pelvic RT alone did not significantly affect survival. Grade I-V small bowel complications occurred in 33 patients (15%). Whole pelvic RT and >50.4 Gy to the low pelvis, but not old age and treatment technique (AP-PA vs. box), were significantly associated with gastrointestinal complications. Three patients (2%) in the low-pelvic RT group and 6 patients (8%) in the whole-pelvic RT group were found to have Grade III or higher small bowel complications (p=0.023). Thirty-one percent of patients developed lymphedema of the leg. A dose to the low pelvis >50.4 Gy

  14. Preoperative PET/CT FDG standardized uptake value of pelvic lymph nodes as a significant prognostic factor in patients with uterine cervical cancer

    Energy Technology Data Exchange (ETDEWEB)

    Chung, Hyun Hoon [Seoul National University College of Medicine, Department of Obstetrics and Gynecology, Cancer Research Institute, Seoul (Korea, Republic of); Seoul National University College of Medicine, Department of Obstetrics and Gynecology, Seoul (Korea, Republic of); Cheon, Gi Jeong; Kang, Keon Wook [Seoul National University College of Medicine, Department of Nuclear Medicine, Seoul (Korea, Republic of); Kim, Jae Weon; Park, Noh-Hyun [Seoul National University College of Medicine, Department of Obstetrics and Gynecology, Cancer Research Institute, Seoul (Korea, Republic of); Song, Yong Sang [Seoul National University College of Medicine, Department of Obstetrics and Gynecology, Cancer Research Institute, Seoul (Korea, Republic of); Seoul National University, WCU Biomodulation Major, Department of Agricultural Biotechnology, College of Agriculture and Life Sciences, Seoul (Korea, Republic of)

    2014-04-15

    Using integrated PET/CT, we evaluated the prognostic relevance in uterine cervical cancer of preoperative pelvic lymph node (LN) [{sup 18}F]FDG uptake. Patients with FIGO stage IB to IIA uterine cervical cancer were imaged with FDG PET/CT before radical surgery. We used Cox proportional hazards regression to examine the relationship between recurrence and the FDG maximum standardized uptake value (SUV{sub max}) in the pelvic LN (SUV{sub LN}) on PET/CT. Clinical data, treatment modalities, and results in 130 eligible patients were reviewed. The median postsurgical follow-up was 34 months (range 6 to 109 months). Receiver operating characteristic analysis identified SUV{sub LN} 2.36 as the most significant cut-off value for predicting recurrence. SUV{sub LN} was correlated with SUV{sub tumour} (P = 0.002), primary tumour size (P = 0.004), and parametrial invasion (P = 0.013). Univariate analyses showed significant associations between recurrence and SUV{sub LN} (P = 0.001), SUV{sub tumour} (P = 0.007), pelvic LN metastasis (P = 0.002), parametrial invasion (P < 0.001), primary tumour size (P = 0.007), suspected LN metastasis on MRI (P = 0.024), and FIGO stage (P = 0.026). Multivariate analysis identified SUV{sub LN} (P = 0.013, hazard ratio, HR, 4.447, 95 % confidence interval, CI, 1.379 - 14.343) and parametrial invasion (P = 0.013, HR 6.728, 95 % CI 1.497 - 30.235) as independent risk factors for recurrence. Patients with SUV{sub LN} ≥2.36 and SUV{sub LN} <2.36 differed significantly in terms of recurrence (HR 15.20, P < 0.001). Preoperative pelvic LN FDG uptake showed a strong significant association with uterine cervical cancer recurrence. (orig.)

  15. Targeted Delivery of Immunomodulators to Lymph Nodes

    OpenAIRE

    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.

    Science.gov (United States)

    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

    Directory of Open Access Journals (Sweden)

    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. Transforming Growth Factor β1 Could Influence Thyroid Nodule Elasticity and Also Improve Cervical Lymph Node Metastasis in Papillary Thyroid Carcinoma.

    Science.gov (United States)

    Li, Yi; Wang, Yan; Wu, Qiong; Hu, Bing

    2015-11-01

    Ultrasound elastography has been a very useful tool in predicting the risk of malignant thyroid tumor for several years. The objective of this study was to determine if there is a correlation between strain ratio (SR), collagen deposition and transforming growth factor β1 (TGF-β1) expression in different types of thyroid nodules and if TGF-β1 is related to cervical lymph node metastasis. 102 nodules from 81 patients who underwent thyroid resection surgery in our hospital were retrospectively studied. All of these patients had undergone ultrasound elastography scanning before surgery. Masson staining and immunohistochemical staining were used to evaluate the ratio of expression of collagen deposition and TGF-β1. There was a significant difference between benign and malignant thyroid nodules in SR (8.913 ± 11.021 vs. 1.732 ± 0.727, p = 0.000), collagen content (0.371 ± 0.125 vs. 0.208 ± 0.057, p = 0.000) and TGF-β1 expression (0.336 ± 0.093 vs. 0.178 ± 0.071, p = 0.000). A cutoff of 2.99 for SR measurement was selected for the highest Youden index for predicting malignant thyroid nodules, which yielded 87.88% sensitivity, 100% specificity, 100% positive predictive value, 83.72% negative predictive value and 92.15% accuracy. Expression of collagen and TGF-β1 was positively correlated with SR measurements (coefficient = 0.839 for collagen and 0.855 for TGF-β1, p = 0.000). Among 61 nodules with papillary thyroid carcinoma, the average SR for the metastasis group was higher than that for the non-metastasis group (10.955 ± 13.805 and 7.852 ± 7.931, respectively), but without statistical significance (p = 0.287). Collagen deposition was significantly higher in the metastasis group than in the non-metastasis group (0.421 ± 0.091 vs. 0.353 ± 0.118, p = 0.011). TGF-β1 expression was also significantly higher in the metastasis group than in the non-metastasis group (0.378 ± 0.0.69 vs. 0.328 ± 0.091, p = 0.016). To conclude, TGF-β1 may contribute to thyroid

  19. Computed tomography versus magnetic resonance imaging for diagnosing cervical lymph node metastasis of head and neck cancer: a systematic review and meta-analysis

    Directory of Open Access Journals (Sweden)

    Sun J

    2015-06-01

    Full Text Available J Sun,1 B Li,2 CJ Li,1 Y Li,1 F Su,3 QH Gao,4 FL Wu,4 T Yu,5 L Wu,6 LJ Li11Department of Head and Neck Oncology, West China Hospital of Stomatology, State Key Laboratory of Oral Diseases, Sichuan University, Chengdu, People’s Republic of China; 2West China School of Stomatology, State Key Laboratory of Oral Diseases, Sichuan University, Chengdu, People’s Republic of China; 3Department of stomatology, Tianjin University of Traditional Chinese Medicine, Tianjin, People’s Republic of China; 4Department of Oral and Maxillofacial Surgery, State Key Laboratory of Oral Diseases, West China Hospital of Stomatology, Sichuan University, Chengdu, People’s Republic of China; 5Department of Head and Neck Oncology Surgery, Sichuan Cancer Hospital, Chengdu, People’s Republic of China; 6Center for Clinical and Translational Science, Mayo Clinic, Rochester, MN, USAAbstract: Computed tomography (CT and magnetic resonance imaging (MRI are common imaging methods to detect cervical lymph node metastasis of head and neck cancer. We aimed to assess the diagnostic efficacy of CT and MRI in detecting cervical lymph node metastasis, and to establish unified diagnostic criteria via systematic review and meta-analysis. A systematic literature search in five databases until January 2014 was carried out. All retrieved studies were reviewed and eligible studies were qualitatively summarized. Besides pooling the sensitivity (SEN and specificity (SPE data of CT and MRI, summary receiver operating characteristic curves were generated. A total of 63 studies including 3,029 participants were involved. The pooled results of meta-analysis showed that CT had a higher SEN (0.77 [95% confidence interval {CI} 0.73–0.87] than MRI (0.72 [95% CI 0.70–0.74] when node was considered as unit of analysis (P<0.05; MRI had a higher SPE (0.81 [95% CI 0.80–0.82] than CT (0.72 [95% CI 0.69–0.74] when neck level was considered as unit of analysis (P<0.05 and MRI had a higher area

  20. Extended field chemoradiation for cervical cancer patients with histologically proven para-aortic lymph node metastases after laparoscopic lymphadenectomy

    Energy Technology Data Exchange (ETDEWEB)

    Marnitz, Simone; Schram, Johanna; Budach, Volker [Charite University Medicine, Department of Radiation Oncology, Berlin (Germany); Sackerer, Irina [Technische Universitaet Muenchen, Department of Radiation Oncology, Muenchen (Germany); Vercellino, Giuseppe Filiberto [University Medicine Berlin, Department of Gynecology, Campus Benjamin Franklin, Berlin (Germany); Sehouli, Jalid [University Medicine Berlin, Department of Gynecology, Campus Benjamin Franklin and Virchow, Berlin (Germany); Koehler, Christhardt [ASKLEPIOS Clinic Hamburg-Harburg, Department of Specialized Surgical and Oncologic Gynecology, Hamburg (Germany)

    2015-05-01

    The purpose of this work was to evaluate the use of extended-field chemoradiation (EFRT) with concomitant chemotherapy in patients with histologically confirmed para-aortic metastases after laparoscopic para-aortic and pelvic lymphadenectomy (LAE) with regard to oncologic results and treatment-related toxicity. A total of 44 women with squamous cell carcinoma (82 %) and adenocarcinoma (18 %) of the cervix in FIGO stages IIA (n = 3), IIB (n = 29); IIIB (n = 9), and IVA (n = 3) and histologically proven para-aortic metastases underwent EFRT and chemotherapy. Laparoscopic LAE was performed in 40 patients. Patients underwent chemoradiation with conventional fractionation of 1.8-50.4 Gy to the para-aortic and pelvic region. In addition, MRI-guided brachytherapy was performed to the cervix with 5-6 single doses of 5 Gy for a total dose of 25-30 Gy. The mean number of harvested lymph nodes was 17 in the pelvic as well as para-aortic regions, respectively. Laparoscopic intervention did not delay chemoradiation. Follow-up was 6-76 months (mean 25.1 months). There was no grade 4 or 5 acute radiation toxicity. In all, 8, 4, and 11 % grade 1, 2, and 3 gastrointestinal late toxicities and 7, 11, and 19 % grade 1, 2 and 3 genitourinary late toxicities were recorded. Despite the excellent locoregional (pelvic) control rates of 89.1 and 82.8 % after 2 and 5 years, respectively, the overall survival rates were 68.4 and 54.1 % after 2 and 5 years, respectively. Of the 44 patients, 43 remained tumor free in the para-aortic region. In patients with proven para-aortic disease, excellent pelvic and para-aortic control could be achieved by laparoscopic LAE followed by EFRT. More than half of the patients were long-term survivors. The high risk of distant metastases should be addressed by further improving systemic treatment. (orig.) [German] Ziel dieser Arbeit war es,die onkologischen Ergebnisse und die Toxizitaet der ''Extended-field''-Radiochemotherapie (EFRT) im

  1. Vascular endothelial growth factor-C expression and its relationship to pelvic lymph node status in invasive cervical cancer

    OpenAIRE

    Hashimoto, I.; Kodama, J; Seki, N; Hongo, A; Yoshinouchi, M; Okuda, H.; Kudo, T.

    2001-01-01

    Vascular endothelial growth factor-C (VEGF-C) has been implicated in lymphangiogenesis, the process of new lymphatics formation. The present study investigated VEGF-C mRNA expression in invasive cervical cancer tissue. Additionally, the association of VEGF-C mRNA with clinicopathological features was examined. VEGF-C mRNA expression was assessed by reverse transcription-polymerase chain reaction using β-action as an internal control. 75 patients presenting with invasive cervical cancer were i...

  2. Preoperative assessment of cervical lymph nodes in head and neck cancer with fluorine-18 fluorodeoxyglucose using a dual-head coincidence camera: a pilot study

    International Nuclear Information System (INIS)

    The aim of this study was to investigate whether in patients with head and neck cancer, staging is possible with fluorine-18 fluorodeoxyglucose (18F-FDG) using a dual-head positron emission tomography (PET) camera. Twenty patients (ten men, ten women; mean age: 60 years) were studied using 185 MBq (5 mCi) 18F-FDG. Two of these patients who were suspected of having recurrence in the neck were restaged 19 and 12 months, respectively, after the resection of the primary tumour. The images were visually analyzed and the results were correlated with computed tomography (CT) (n = 18), ultrasonography (n = 17) and pathological findings. With respect to the primary tumour, FDG dual-head PET and CT revealed a sensitivity of 100% and 59%, respectively (P18F-FDG with a dual-head PET camera is very sensitive in the detection of primary head and neck cancers and accurate in the preoperative assessment of lymph node metastases. The results justify a prospective study on the identification of metastases in patients with head and neck cancer. In addition, it is justified to start a study on the detection of unknown primary tumours in patients with cervical metastases. (orig.)

  3. Localized Lymph Node Light Chain Amyloidosis

    Directory of Open Access Journals (Sweden)

    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.

  4. A trial of anticancer drug injection into cervical metastatic lymph nodes. Focus on therapeutic response when combined with 60Co external radiation

    International Nuclear Information System (INIS)

    Control of metastatic lymph nodes, especially enlarged nodes with adhesion, is extremely difficult. We treated metastatic lymph nodes with adhesion by intranodal injection (INI) of anticancer agents and obtained prolonged control of metastasis. Sixteen patients with a total of 23 metastatic lymph nodes with adhesion that were not indicated for surgical removal were studied. INI of peplomycin (14.0±10.4 mg), CDDP (10.0±0 mg), CBDCA (60.0±37.3 mg), methotrexate (28.5±27.1 mg), and 5-FU (311.1±194.9 mg) was given to all, 1, 10, 7, and 8 patients, respectively. External radiation with cobalt 60 (2 Gy/time, 42.8±9.7 Gy) was given to all but 3 patients. The results obtained were as follows: Except for one patient in whom the therapeutic responses could not be evaluated, all subjects had remission of swollen lymph nodes. The remission rates ranged from 99.6% to 14.3% (average, 51.3±27.8%). In three patients, metastatic lymph nodes became small enough to be surgically removed without recurrence. Of the remaining 13 patients, 11 had no re-enlargement for at least 3 months after the end of INI. Three patients are still alive (observation periods, 57, 6, and 6 months). Eleven patients died of uncontrolled primary lesions, distant metastases, or metastatic lymph nodes despite treatment with INI and radiation. The remaining two patients died of cardiovascular disease and pneumonia. Of the 13 patients who died, 6 (37.5% of all patients) survived for 10 months or more from the start of INI, and the remaining 7 survived for about 5 months. The mean duration of survival was 11.8±13.9 months. Finally, INI controlled metastatic lymph nodes although the therapeutic response was unclear in one patient and could not be evaluated in another. In conclusion, INI is an useful treatment for large metastatic lymph nodes that adhere to surrounding tissue and cannot undergo lymphectomy. (author)

  5. Cervical lymph node metastases from thyroid cancer: does thyroglobulin and calcitonin measurement in fine needle aspirates improve the diagnostic value of cytology?

    Directory of Open Access Journals (Sweden)

    Baldini Enke

    2013-02-01

    Full Text Available Abstract Background Measurement of thyroglobulin (Tg protein in the washout of the needle used for fine needle aspiration biopsy cytology (FNAB-C has been shown to increase the sensitivity of FNAB-C in identifying cervical lymph node (CLN metastasis from well-differentiated thyroid cancer (TC. In this study, we evaluated whether routine measurement of Tg protein (FNAB-Tgp, Tg mRNA (FNAB-Tgm and calcitonin (CT mRNA (FNAB-CTm in the FNAB washout of CLN increases the accuracy of FNAB-C in the diagnosis of suspicious metastatic CLN. Methods In this prospective study 35 CLN from 28 patients were examined. Histology showed metastatic papillary TC (PTC in 26 CLN, metastatic medullary TC (MTC in 3 CLN, metastatic anaplastic TC (ATC in 3 CLN and 3 metastatic CLN from extra-thyroidal cancers. Results The overall accuracy of FNAB-C was 84.4%, reaching 95.7% when the analysis was restricted to PTC. Both FNAB-Tgp and FNAB-Tgm compared favorably with FNAB-C and shown diagnostic performances not statistically different from that of FNAB-C. However, FNAB-Tgp and FNAB-Tgm/FNAB-CTm were found useful in cases in which cytology results were inadequate or provided diagnosis inconsistent with patient's clinical parameters. Conclusions We demonstrated that FNAB-C, Tg/CT mRNA and Tg protein determination in the fine-needle washout showed similar accuracy in the diagnosis of metastatic CLN from TC. The results of this study suggest that samples for Tg protein and Tg/CT mRNA measurements from CLN suspicious for metastatic TC should be collected, but their measurements should be restricted to cases in which FNAB-C provides uninformative or inconsistent diagnosis with respect to patient's clinical parameters.

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

    OpenAIRE

    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...

  7. Induction of c-Met Proto-Oncogene by Epstein-Barr Virus Latent Membrane Protein-1 and the Correlation with Cervical Lymph Node Metastasis of Nasopharyngeal Carcinoma

    OpenAIRE

    Horikawa, Toshiyuki; Sheen, Tzung-Shiahn; Takeshita, Hajime; Sato, Hiroshi; Furukawa, Mitsuru; Yoshizaki, Tomokazu

    2001-01-01

    Nasopharyngeal carcinoma (NPC) is distinctive in head and neck carcinomas for its close association with Epstein-Barr virus and its highly metastatic nature. Up-regulation of cell motility is essential for enhancement of metastatic potential. The expression of c-Met proto-oncogene, a high-affinity receptor for hepatocyte growth factor/scatter factor, has been reported to correlate with metastatic ability of the tumor cell. We observed close association of c-Met expression with cervical lymph ...

  8. Intravital Microscopy of the Inguinal Lymph Node

    OpenAIRE

    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...

  9. Enhancement characteristics of retroperitoneal lymphomatous lymph nodes

    Energy Technology Data Exchange (ETDEWEB)

    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

  10. 双源CT双能量虚拟平扫技术在颈部淋巴结病变中的应用价值%Preliminary application of dualenergy virtual noncontrast of dualsource CT for cervical lymph nodes diseases

    Institute of Scientific and Technical Information of China (English)

    贾晓霞; 江杰; 邓亚敏; 杨亚英

    2012-01-01

    Objective To investigate the clinical applied value of dual-energy virtual non-contrast( VNC) of dual-source CT for the cervical lymph nodes. Methods 48 cases with pathological diagnosis of cervical lymph nodes underwent conventional non-contrast (CNC)and dual-energy enhanced scanning. VNC images were obtained through dual energy post-processing software. Mean CT values, signal to noise ratio(SNR) , image quality, lesion's detectability and radiation dose were comparatively analysed between routine non-contrast and VNC. Results CT attenuations of the cervical lymph nodes between CNC and VNC images were not significantly different(P>0. 05). The image noise of VNC images was significantly lower than that of CNC, while the SNR of VNC images was significantly higher than that of CNC(P0. 05). The necrosis of the cervical lymph nodes could be detected by both CNC and VNC , and the difference was not statistically significant between them (P>0. 05 ) . The radiation dose of VNC was lower than that of VNC(P0.05);虚拟平扫图像噪声明显低于常规平扫,而信号噪声比明显高于常规平扫(P0.05);虚拟平扫及常规平扫对颈部肿大淋巴结内坏死均可见显示;双能量扫描模式较常规扫描模式的总辐射剂量小(P<0.05).结论 在颈部肿大淋巴结检查中,1次双能量增强扫描可获得增强图像和VNC图像,而VNC图像基本不影响病灶的观察同时显著降低了辐射剂量,具有潜在的临床应用价值.

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

    Science.gov (United States)

    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

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

    International Nuclear Information System (INIS)

    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

  13. Sentinel node biopsy as an indicator for pelvic nodes dissection in early stage cervical cancer.

    OpenAIRE

    Rhim, Chae-Chun; Park, Jong-Sup; Bae, Seog-Nyeon; Namkoong, Sung-Eun

    2002-01-01

    The purpose of this study was to investigate the feasibility of sentinel node frozen biopsy to minimize the extensive pelvic lymph nodes dissection in early stage cervical cancer patients on the basis that the risk of skip metastasis to the paraaortic area is negligible. Twenty-six patients with early stage cervical cancer were enrolled in this study. Technetium-99m colloid albumin (Tc(99m)) was injected intradermally around the tumor for allowing preoperative lymphoscintigraphy and intraoper...

  14. Metabolic Response of Lymph Nodes Immediately After RT Is Related With Survival Outcome of Patients With Pelvic Node-Positive Cervical Cancer Using Consecutive [{sup 18}F]fluorodeoxyglucose-Positron Emission Tomography/Computed Tomography

    Energy Technology Data Exchange (ETDEWEB)

    Yoon, Mee Sun; Ahn, Sung-Ja; Nah, Byung-Sik; Chung, Woong-Ki [Department of Radiation Oncology, Chonnam National University Medical School, Gwangju (Korea, Republic of); Song, Ho-Chun; Yoo, Su Woong [Department of Nuclear Medicine, Chonnam National University Medical School, Gwangju (Korea, Republic of); Song, Ju-Young; Jeong, Jae-Uk [Department of Radiation Oncology, Chonnam National University Medical School, Gwangju (Korea, Republic of); Nam, Taek-Keun, E-mail: tknam@chonnam.ac.kr [Department of Radiation Oncology, Chonnam National University Medical School, Gwangju (Korea, Republic of)

    2012-11-15

    Purpose: To evaluate the metabolic response of uterine cervix and pelvic lymph nodes (LNs) using consecutive {sup 18}F-fluorodeoxyglucose-positron emission tomography/computed tomography (PET/CT) immediately after RT and to correlate survival outcome with the metabolic response. Methods and Materials: We retrospectively reviewed 48 patients with cervical cancer who had positive pelvic LNs by preradiation therapy (pre-RT) PET/CT. All patients underwent PET/CT scans immediately after RT (inter-RT PET/CT) after median 63 Gy to the gross LNs. The metabolic response of the LNs was assessed quantitatively and semiquantitatively by measurement of the maximal standardized uptake value (SUV{sub max}). Results: Classifying the metabolic response of all nodal lesions, 37 patients (77%) had LNs with complete metabolic response on the inter-RT PET/CT (LNCMRi), and 11 patients had a non-LNCMRi, including 4 patients with progressive metabolic disease. The overall 3-year survival rates were 83% for the patients with LNCMRi and 73% for the non-LNCMRi group (P=.038). The disease-free survival for patients with LNCMRi were significantly better than that for the non-LNCMRi group (71% vs 18%, respectively, P<.001). The 3-year distant metastasis-free survival rates were 79% for the patients with LNCMRi and 27% for the non-LNCMRi group (P<.001). There were no statistically significant differences in overall survival (76% vs 86%, respectively, P=.954) and disease-free survival rates (58% vs 61%, respectively, P=.818) between the CMR of primary cervical tumor and the non-CMR groups. Conclusions: The results showed a significant correlation between survival outcome and the interim metabolic response of pelvic LNs. CMR of nodal lesion on inter-RT PET/CT had excellent overall survival, disease-free survival and distant metastasis-free survival rates. This suggested that PET/CT immediately after RT can be a useful tool for the evaluation of the interim response of the LNs and identify a subset

  15. CT双能量虚拟平扫在颈部肿大淋巴结的诊断价值%Application of Dua-energy Virtual Non-contrast Imaging in Evaluating Enlarged Cervical Lymph Nodes

    Institute of Scientific and Technical Information of China (English)

    石梦昀; 杨斌; 边莉; 杨亚英; 赵卫

    2013-01-01

    Purpose To investigate the value of dual-source CT with dual-energy virtual non-contrast imaging in the diagnosis of cervical lymph node disease. Materials and Methods The dual-energy scan data of 126 lymph nodes from 50 patients confirmed pathologically were reviewed. The difference of average CT value, signal to noise ratio, contrast to noise ratio, image subjective assessment and lesion detectability between virtual non-contrast imaging and conventional non-contrast scan were analyzed. The radiation dose of virtual non-contrast imaging and real non-contrast imaging of cervical lymph node were also compared. Results ①The consistency of virtual plain scan combined with dual-energy contrast imaging in the diagnosis of six typical pathological types were all satisfactory (Kappa>0.7, P0.05).③ Compared with conventional enhanced scan, dual-energy phases reduced radiation dose by about 19%. Conclusion Dual-energy virtual non-contrast imaging combined with contrast imaging can provide clear images in the diagnosis of enlarged cervical lymph nodes and reduce radiation dose of subjects, thus can be expected to replace real scan.%目的:探讨双源CT虚拟平扫技术在颈部淋巴结病变中的诊断价值。资料与方法经病理证实的50例患者共126枚颈部肿大淋巴结,均行双能量扫描,比较淋巴结虚拟平扫和常规平扫图像的CT值、信噪比、对比噪声比、图像主观评价、病变显示、常规扫描与双能量扫描的辐射剂量等。结果①虚拟平扫结合双能量增强扫描对颈部肿大淋巴结6种典型病变的检出率一致性均较好(Kappa>0.7, P0.05)。③双能量二期扫描较常规三期扫描降低有效辐射剂量约19%。结论双源CT虚拟平扫结合增强扫描可以清晰地显示并诊断颈部肿大淋巴结,同时可以降低受检者的辐射剂量,有望取代真实平扫。

  16. Sentinel lymph node biopsy: clinical relevance

    International Nuclear Information System (INIS)

    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

  17. Mesenchymal cell differentiation during lymph node organogenesis

    OpenAIRE

    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 ...

  18. SOME ASPECTS OF THE ANATOMY OF AXILLARY LYMPH NODES

    OpenAIRE

    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.

  19. SOME ASPECTS OF THE ANATOMY OF AXILLARY LYMPH NODES

    Directory of Open Access Journals (Sweden)

    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.

  20. Duodenal and Other Gastrointestinal Toxicity in Cervical and Endometrial Cancer Treated With Extended-Field Intensity Modulated Radiation Therapy to Paraaortic Lymph Nodes

    International Nuclear Information System (INIS)

    Purpose: To characterize the rates of acute and late duodenal and other gastrointestinal (GI) toxicities among patients treated for cervical and endometrial cancers with extended-field intensity modulated radiation therapy (EF-IMRT) to the paraaortic nodes and to analyze dose-volume relationships of GI toxicities. Methods and Materials: Fifty-three patients with endometrial or cervical cancer underwent EF-IMRT to the paraaortic nodes, of whom 46 met the inclusion criteria for GI toxicity and 45 for duodenal toxicity analysis. The median prescribed dose to the paraaortic nodes was 54 Gy (range, 41.4-65 Gy). The 4 duodenal segments, whole duodenum, small bowel loops, peritoneum, and peritoneum plus retroperitoneal segments of colon were contoured retrospectively, and dosimetric analysis was performed to identify dose-volume relationships to grade ≥3 acute (<90 day) and late (≥90 day) GI toxicity. Results: Only 3/46 patients (6.5%) experienced acute grade ≥3 GI toxicity and 3/46 patients (6.5%) experienced late grade ≥3 GI toxicity. The median dose administered to these 6 patients was 50.4 Gy. One of 12 patients who received 63 to 65 Gy at the level of the renal hilum experienced grade 3 GI toxicity. Dosimetric analysis of patients with and without toxicity revealed no differences between the mean absolute or fractional volumes at any 5-Gy interval between 5 Gy and the maximum dose. None of the patients experienced duodenal toxicity. Conclusions: Treatment of paraaortic nodes with IMRT is associated with low rates of GI toxicities and no duodenal-specific toxicity, including patients treated with concurrent chemotherapy. This technique may allow sufficient dose sparing of the bowel to enable safe dose escalation to at least 65 Gy

  1. Duodenal and Other Gastrointestinal Toxicity in Cervical and Endometrial Cancer Treated With Extended-Field Intensity Modulated Radiation Therapy to Paraaortic Lymph Nodes

    Energy Technology Data Exchange (ETDEWEB)

    Poorvu, Philip D. [Department of Radiation Oncology, Brigham and Women' s Hospital and Dana-Farber Cancer Institute, Harvard Medical School, Boston, Massachusetts (United States); Sadow, Cheryl A. [Department of Radiology, Brigham and Women' s Hospital, and Harvard Medical School, Boston, Massachusetts (United States); Townamchai, Kanokpis; Damato, Antonio L. [Department of Radiation Oncology, Brigham and Women' s Hospital and Dana-Farber Cancer Institute, Harvard Medical School, Boston, Massachusetts (United States); Viswanathan, Akila N., E-mail: aviswanathan@lroc.harvard.edu [Department of Radiation Oncology, Brigham and Women' s Hospital and Dana-Farber Cancer Institute, Harvard Medical School, Boston, Massachusetts (United States)

    2013-04-01

    Purpose: To characterize the rates of acute and late duodenal and other gastrointestinal (GI) toxicities among patients treated for cervical and endometrial cancers with extended-field intensity modulated radiation therapy (EF-IMRT) to the paraaortic nodes and to analyze dose-volume relationships of GI toxicities. Methods and Materials: Fifty-three patients with endometrial or cervical cancer underwent EF-IMRT to the paraaortic nodes, of whom 46 met the inclusion criteria for GI toxicity and 45 for duodenal toxicity analysis. The median prescribed dose to the paraaortic nodes was 54 Gy (range, 41.4-65 Gy). The 4 duodenal segments, whole duodenum, small bowel loops, peritoneum, and peritoneum plus retroperitoneal segments of colon were contoured retrospectively, and dosimetric analysis was performed to identify dose-volume relationships to grade ≥3 acute (<90 day) and late (≥90 day) GI toxicity. Results: Only 3/46 patients (6.5%) experienced acute grade ≥3 GI toxicity and 3/46 patients (6.5%) experienced late grade ≥3 GI toxicity. The median dose administered to these 6 patients was 50.4 Gy. One of 12 patients who received 63 to 65 Gy at the level of the renal hilum experienced grade 3 GI toxicity. Dosimetric analysis of patients with and without toxicity revealed no differences between the mean absolute or fractional volumes at any 5-Gy interval between 5 Gy and the maximum dose. None of the patients experienced duodenal toxicity. Conclusions: Treatment of paraaortic nodes with IMRT is associated with low rates of GI toxicities and no duodenal-specific toxicity, including patients treated with concurrent chemotherapy. This technique may allow sufficient dose sparing of the bowel to enable safe dose escalation to at least 65 Gy.

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

    International Nuclear Information System (INIS)

    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)

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

    Directory of Open Access Journals (Sweden)

    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.

  4. Inguinal lymph node metastasis of colon cancer

    Directory of Open Access Journals (Sweden)

    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.

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

    OpenAIRE

    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...

  6. Lymph Node Metastases and Prognosis in Penile Cancer

    Institute of Scientific and Technical Information of China (English)

    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.

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

    Science.gov (United States)

    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

  8. Treatment outcomes of extended-field radiation therapy and the effect of concurrent chemotherapy on uterine cervical cancer with para-aortic lymph node metastasis

    International Nuclear Information System (INIS)

    To review the clinical outcomes of extended-field radiation therapy (EFRT) and to analyze prognostic factors significant for survival in patients receiving EFRT for uterine cervical carcinoma with para-aortic node (PAN) metastasis. We retrospectively reviewed 90 patients with stage IB-IVA cervical cancer and PAN metastasis between 1987 and 2012. Median age was 50 (range, 24–77). Patients received median 70.2 Gy (range, 56–93) to point A and median 50.4 Gy (range, 45–60.4) to PAN over median 69 elapsed days (range, 43–182). Forty-six patients (51.1%) received concurrent chemotherapy. Survival was calculated using the Kaplan–Meier method. We analyzed prognostic factors for overall actuarial survival (OS) and progression-free survival (PFS) using a Cox regression method. The median follow-up period for surviving patients was 55 months (range, 3–252). Seventy patients (77.8%) had complete remission. Forty-six patients experienced treatment failure as follows: 11 patients (12.2%) as local recurrence, 19 (21%) as regional recurrence and 33 (36.7%) as distant metastasis. The 5-yr OS and PFS were 62.6% and 43.9%, respectively. Treatment response was the only statistically independent prognostic factors for OS (p= 0.04) and PFS (p< 0.001) on multivariate analysis. Grade 3 or 4 hematologic gastrointestinal and urogenital toxicities were observed in about 10% of patients. Our institutional experiences showed that EFRT was an effective treatment for cervical cancer patients with PAN metastasis. The addition of chemotherapy to EFRT seems to have uncertain survival benefit with higher hematologic toxicity. The online version of this article (doi:10.1186/s13014-014-0320-5) contains supplementary material, which is available to authorized users

  9. Popliteal lymph node metastasis of tibial osteoblastic osteosarcoma

    Directory of Open Access Journals (Sweden)

    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.

  10. The lymph node in chronic lymphocytic leukemia.

    Science.gov (United States)

    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

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

    International Nuclear Information System (INIS)

    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

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

    Science.gov (United States)

    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

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

    Institute of Scientific and Technical Information of China (English)

    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.

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

    OpenAIRE

    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 ...

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

    OpenAIRE

    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...

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

    Energy Technology Data Exchange (ETDEWEB)

    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.)

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

    OpenAIRE

    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...

  18. Concomitant Mycobacterium avium infection and Hodgkin's disease in a lymph node from an HIV-negative child.

    Science.gov (United States)

    de Armas, Yaxsier; Capó, Virginia; González, Ida; Mederos, Lilian; Díaz, Raúl; de Waard, Jacobus H; Rodríguez, Alberto; García, Yarmila; Cabanas, Ricardo

    2011-03-01

    We report a case of an immunocompetent child with simultaneously an infection with Mycobacterium avium and Hodgkin's disease in a cervical lymph node. A positive PCR result for M. avium on a biopsy of the lymph node directed the definitive diagnosis for both etiologies and avoided a possible dissemination of this infection after chemotherapy was started. PMID:20467849

  19. CT on the distribution of peripancreatic lymph nodes

    International Nuclear Information System (INIS)

    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)

  20. CT on the distribution of peripancreatic lymph nodes

    Energy Technology Data Exchange (ETDEWEB)

    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.

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

    International Nuclear Information System (INIS)

    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)

  2. HISTOPATHOLOGICAL CHARACTERISTICS OF LYMPH NODE SINUS CONTAINING BLOOD

    Institute of Scientific and Technical Information of China (English)

    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.

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

    Directory of Open Access Journals (Sweden)

    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.

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

    OpenAIRE

    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...

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

    OpenAIRE

    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...

  6. Cytological evaluation of enlarged lymph nodes in metastatic disease: A hospital-based assessment

    Directory of Open Access Journals (Sweden)

    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.

  7. Intraoperative rapid detection of micrometastasis in sentinel lymph nodes of oral malignant tumors

    International Nuclear Information System (INIS)

    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)

  8. Greater auricular nerve masquerading as lymph node.

    Science.gov (United States)

    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

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

    International Nuclear Information System (INIS)

    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)

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

    Science.gov (United States)

    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

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

    Institute of Scientific and Technical Information of China (English)

    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.

  12. Lymph Node Metastasis of Gastric Cancer

    Energy Technology Data Exchange (ETDEWEB)

    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.

  13. Lymph Node Metastasis of Gastric Cancer

    International Nuclear Information System (INIS)

    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

  14. Nanoparticle Transport from Mouse Vagina to Adjacent Lymph Nodes

    OpenAIRE

    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,...

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

    International Nuclear Information System (INIS)

    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)

  16. Modeling lymphocyte homing and encounters in lymph nodes

    OpenAIRE

    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...

  17. The Role of 3 Tesla Diffusion-Weighted Imaging in the Differential Diagnosis of Benign versus Malignant Cervical Lymph Nodes in Patients with Head and Neck Squamous Cell Carcinoma

    OpenAIRE

    Flavio Barchetti; Nicola Pranno; Guglielmo Giraldi; Alessandro Sartori; Silvia Gigli; Giovanni Barchetti; Luigi Lo Mele; Luigi Tonino Marsella

    2014-01-01

    Objective. The aim of this study was to validate the role of diffusion-weighted imaging (DWI) at 3 Tesla in the differential diagnosis between benign and malignant laterocervical lymph nodes in patients with head and neck squamous cell carcinoma (HNSCC). Materials and Methods. Before undergoing surgery, 80 patients, with biopsy proven HNSCC, underwent a magnetic resonance exam. Sensitivity (Se) and specificity (Spe) of conventional criteria and DWI in detecting laterocervical lymph node metas...

  18. Sentinel lymph nodes in cancer of the oral cavity

    DEFF Research Database (Denmark)

    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...

  19. Lymphocyte migration into syngeneic implanted lymph nodes

    International Nuclear Information System (INIS)

    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

  20. Endoscopic ultrasound: Elastographic lymph node evaluation.

    Science.gov (United States)

    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

  1. Sentinel lymph node detection in oropharynx and oral cavity

    International Nuclear Information System (INIS)

    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)

  2. Assessment of lymph node involvement in colorectal cancer

    OpenAIRE

    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...

  3. FDG PET/MR for lymph node staging in head and neck cancer

    International Nuclear Information System (INIS)

    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. FDG PET/MR for lymph node staging in head and neck cancer

    Energy Technology Data Exchange (ETDEWEB)

    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.

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

    Science.gov (United States)

    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

  6. Sentinel lymph node biopsy in breast cancer and melanoma

    NARCIS (Netherlands)

    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

  7. A case report of giant retroperitoneal lymph node hyperplasia

    Energy Technology Data Exchange (ETDEWEB)

    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.

  8. A case report of giant retroperitoneal lymph node hyperplasia

    International Nuclear Information System (INIS)

    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

  9. Sentinel lymph nodes in cancer of the oral cavity

    DEFF Research Database (Denmark)

    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...

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

    OpenAIRE

    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...

  11. Papillary carcinoma arising in a thyroglossal duct cyst with associated microcarcinoma of the thyroid and without cervical lymph node metastasis: a case report

    OpenAIRE

    Kandogan Tolga; Erkan Nazif; Vardar Enver

    2008-01-01

    Abstract Introduction This is a case report of a 44-year-old woman with papillary carcinoma of a thyroglossal duct cyst. Case presentation A 44 year-old woman presented to the otolaryngology outpatient clinic with an asymptomatic anterior midline neck mass. A cervical ultrasound showed a lesion which appeared to be a thyroglossal duct cyst and surgical resection using Sistrunk's procedure was performed. The histopathologic diagnosis showed papillary carcinoma evolving from a thyroglossal duct...

  12. Effects of transuranics on pulmonary lymph nodes of rodents

    International Nuclear Information System (INIS)

    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

  13. The Role of 3 Tesla Diffusion-Weighted Imaging in the Differential Diagnosis of Benign versus Malignant Cervical Lymph Nodes in Patients with Head and Neck Squamous Cell Carcinoma

    Directory of Open Access Journals (Sweden)

    Flavio Barchetti

    2014-01-01

    Full Text Available Objective. The aim of this study was to validate the role of diffusion-weighted imaging (DWI at 3 Tesla in the differential diagnosis between benign and malignant laterocervical lymph nodes in patients with head and neck squamous cell carcinoma (HNSCC. Materials and Methods. Before undergoing surgery, 80 patients, with biopsy proven HNSCC, underwent a magnetic resonance exam. Sensitivity (Se and specificity (Spe of conventional criteria and DWI in detecting laterocervical lymph node metastases were calculated. Histological results from neck dissection were used as standard of reference. Results. In the 239 histologically proven metastatic lymphadenopathies, the mean apparent diffusion coefficient (ADC value was 0.903 × 10−3 mm2/sec. In the 412 pathologically confirmed benign lymph nodes, an average ADC value of 1.650 × 10−3 mm2/sec was found. For differentiating between benign versus metastatic lymph nodes, DWI showed Se of 97% and Spe of 93%, whereas morphological criteria displayed Se of 61% and Spe of 98%. DWI showed an area under the ROC curve (AUC of 0.964, while morphological criteria displayed an AUC of 0.715. Conclusions. In a DWI negative neck for malignant lymph nodes, the planned dissection could be converted to a wait-and-scan policy, whereas DWI positive neck would support the decision to perform a neck dissection.

  14. The Role of 3 Tesla Diffusion-Weighted Imaging in the Differential Diagnosis of Benign versus Malignant Cervical Lymph Nodes in Patients with Head and Neck Squamous Cell Carcinoma

    Science.gov (United States)

    Pranno, Nicola; Sartori, Alessandro; Gigli, Silvia; Lo Mele, Luigi; Marsella, Luigi Tonino

    2014-01-01

    Objective. The aim of this study was to validate the role of diffusion-weighted imaging (DWI) at 3 Tesla in the differential diagnosis between benign and malignant laterocervical lymph nodes in patients with head and neck squamous cell carcinoma (HNSCC). Materials and Methods. Before undergoing surgery, 80 patients, with biopsy proven HNSCC, underwent a magnetic resonance exam. Sensitivity (Se) and specificity (Spe) of conventional criteria and DWI in detecting laterocervical lymph node metastases were calculated. Histological results from neck dissection were used as standard of reference. Results. In the 239 histologically proven metastatic lymphadenopathies, the mean apparent diffusion coefficient (ADC) value was 0.903 × 10−3 mm2/sec. In the 412 pathologically confirmed benign lymph nodes, an average ADC value of 1.650 × 10−3 mm2/sec was found. For differentiating between benign versus metastatic lymph nodes, DWI showed Se of 97% and Spe of 93%, whereas morphological criteria displayed Se of 61% and Spe of 98%. DWI showed an area under the ROC curve (AUC) of 0.964, while morphological criteria displayed an AUC of 0.715. Conclusions. In a DWI negative neck for malignant lymph nodes, the planned dissection could be converted to a wait-and-scan policy, whereas DWI positive neck would support the decision to perform a neck dissection. PMID:25003115

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

    Directory of Open Access Journals (Sweden)

    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.

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

    Science.gov (United States)

    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

  17. Management of squamous cell carcinoma in cervical lymph nodes in the clinical absence of primary lesion by combined surgery and irradiation

    International Nuclear Information System (INIS)

    Sixty-three patients who had either previously treated primary tumors or unknown primary tumors and developed metastatic cervical adenopathy in their previously untreated necks received the combination of surgery and megavoltage irradiation. Within two years, 12 patients died of intercurrent disease, nine patients died with distant metastastases only, and five patients had disease recur at a primary site. The remaining 37 patients were evaluable for control of neck disease; 26 patients had previous treatment to a primary head and neck cancer that was under control at the time cervical adenopathy was treated; and 11 patients had an unknown primary tumor that was believed to be in the head and neck area. The combination of pre- or postoperative irradiation and surgery controlled neck disease in 86% of the evaluable patients. Because of the extent of neck disease, these patients would have been at a high risk of failure in the treated area if only a single modality of treatment were uognostic variables, in addition to treatment, were pretreatment performance status and pretreatment CEA level. The toxic reactions related to the treatment are discussed

  18. The management of squamous cell carcinoma in cervical lymph nodes in the clinical absence of a primary lesion by combined surgery and irradiation

    International Nuclear Information System (INIS)

    Sixty-three patients who had either previously treated primary tumors or unknown primary tumors and developed metastatic cervical adenopathy in their previously untreated necks received the combination of surgery and megavoltage irradiation. Within two years, 12 patients died of intercurrent disease, nine patients died with distant metastases only, and five patients had disease recur at a primary site. The remaining 37 patients were evaluable for control of neck disease; 26 patients had previous treatment to a primary head and neck cancer that was under control at the time cervical adenopathy was treated; and 11 patients had an unknown primary tumor that was believed to be in the head and neck area. The combination of pre- or postoperative irradiation and surgery controlled neck disease in 86% of the evaluable patients. Because of the extent of neck disease, these patients would have been at a high risk of failure in the treated area if only a single modality of treatment were used. Analysis of the data shows an association of extranodal connective tissue involvement with both a decreased rate of control within the treated area and distant metastases

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

    OpenAIRE

    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...

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

    Energy Technology Data Exchange (ETDEWEB)

    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

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

    Science.gov (United States)

    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

  2. Risk factors for lower limb lymphedema after lymph node dissection in patients with ovarian and uterine carcinoma

    OpenAIRE

    Tada, Harue; Teramukai, Satoshi; Fukushima, Masanori; Sasaki, Hiroshi

    2009-01-01

    Background Lymph node dissection has proven prognostic benefits for patients with ovarian or uterine carcinoma; however, one of the complications associated with this procedure is lymphedema. We aimed to identify the factors that are associated with the occurrence of lymphedema after lymph node dissection for the treatment of ovarian or uterine carcinoma. Methods A total of 694 patients with histologically confirmed ovarian (135 patients) or uterine cancer (258 with cervical cancer, 301 with ...

  3. Risk factors for lower limb lymphedema after lymph node dissection in patients with ovarian and uterine carcinoma.

    OpenAIRE

    Tada, Harue; Teramukai, Satoshi; Fukushima, Masanori; Sasaki, Hiroshi

    2009-01-01

    [Background]Lymph node dissection has proven prognostic benefits for patients with ovarian or uterine carcinoma; however, one of the complications associated with this procedure is lymphedema. We aimed to identify the factors that are associated with the occurrence of lymphedema after lymph node dissection for the treatment of ovarian or uterine carcinoma. [Methods]A total of 694 patients with histologically confirmed ovarian (135 patients) or uterine cancer (258 with cervical cancer, 301 wit...

  4. Risk factors for lower limb lymphedema after lymph node dissection in patients with ovarian and uterine carcinoma

    OpenAIRE

    Fukushima Masanori; Teramukai Satoshi; Tada Harue; Sasaki Hiroshi

    2009-01-01

    Abstract Background Lymph node dissection has proven prognostic benefits for patients with ovarian or uterine carcinoma; however, one of the complications associated with this procedure is lymphedema. We aimed to identify the factors that are associated with the occurrence of lymphedema after lymph node dissection for the treatment of ovarian or uterine carcinoma. Methods A total of 694 patients with histologically confirmed ovarian (135 patients) or uterine cancer (258 with cervical cancer, ...

  5. Assessment of lymph node involvement in colorectal cancer.

    Science.gov (United States)

    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. Inappropriate cervical injection of radiotracer for sentinel node mapping in a uterine cervix cancer patient: importance of lymphoscintigraphy and blue dye injection

    Directory of Open Access Journals (Sweden)

    Sima Kadkhodayan

    2014-10-01

    Full Text Available Herein, we report a case of sentinel lymph node mapping in a uterine cervix cancer patient, referring to the nuclear medicine department of our institute. Lymphoscintigraphy images showed inappropriate intra‐cervical injection of radiotracer. Blue dye technique was applied for sentinel lymph node mapping, using intra‐cervical injection of methylene blue. Two blue/cold sentinel lymph nodes, with no pathological involvement, were intra‐operatively identified, and the patient was spared pelvic lymph node dissection. The present case underscores the importance of lymphoscintigraphy imaging in sentinel lymph node mapping and demonstrates the added value of blue dye injection in selected patients. It is suggested that preoperative lymphoscintigraphy imaging be considered as an integral part of sentinel lymph node mapping in surgical oncology. Detailed results of lymphoscintigraphy images should be provided for surgeons prior to surgery, and in case the sentinel lymph nodes are not visualized, use of blue dye for sentinel node mapping should be encouraged.

  7. MR imaging of lymph nodes using gadofluorine M. Feasibility in a swine model at 1.5 amd 3T

    International Nuclear Information System (INIS)

    Purpose: To investigate the potential of Gadofluorine M for targeted lymph node imaging in a human size animal model and on a clinical MR scanner at 1.5 and 3 T. Materials and Methods: Pelvic and cervical lymph nodes in a swine model were investigated prior to and 24 hours after intravenous administration of 50 μmol/kg body weight Gadofluorine M, an experimental contrast agent. MR imaging was carried out on clinical 1.5 T and 3 T whole-body MR systems using clinically available coils and T 1-weighted sequences. The signal-to-noise ratio (SNR) and contrast-to-noise ratio (CNR) with respect to the surrounding tissue were assessed and compared using the Student's t-test. The Gd concentration in the lymph nodes (n = 43) was measured post mortem by Inductively Coupled Plasma-Atomic Emission Spectroscopy (ICP-AES). Results: Gadofluorine M allowed for high signal and high contrast visualization of lymph nodes in all stations on post-contrast images with a significantly increased SNR and CNR (SNR pelvic lymph nodes post vs. pre: 46 ± 7 vs. 14 ± 3, SNR cervical lymph nodes post vs. pre: 105 ± 64 vs. 32 ± 21; CNR pelvic lymph node vs. muscle post vs. pre 28 ± 5 vs. 0.2 ± 0.5, CNR cervical lymph node vs. muscle post vs. pre 76 ± 53 vs. 11 ± 15, p < 0.05 for all comparisons). The SNR and CNR in the pelvis were further improved using 3 T compared to 1.5 T scanners (SNR lymph nodes 3 T vs. 1.5 T 84 ± 6 vs. 46 ± 7, CNR lymph node vs. muscle 3 T vs. 1.5 T 53 ± 9 vs. 28 5 respectively, p < 0.05). A high concentration of Gd in the lymph nodes was found (149 ± 25 mmol Gd/L). Conclusion: Gadofluorine M accumulates in the lymph nodes and allows for selective targeted high contrast MR imaging of lymph node tissue in a large animal model using clinically available MR imaging techniques. 3 T further improves SNR and CNR compared to 1.5 T. (orig.)

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

    OpenAIRE

    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

    International Nuclear Information System (INIS)

    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. Detection of cervical lymph node metastasis in head and neck cancer patients with clinically N0 neck—a meta-analysis comparing different imaging modalities

    International Nuclear Information System (INIS)

    How to properly manage clinically negative neck of head and neck cancer patients is a controversial topic. Research is now directed toward finding a method sensitive enough to bring the risk of occult metastases below 20%. The aim of this review was to compare the diagnostic accuracy of different imaging modalities, including CT, MRI, PET and US, in clinically N0 head and neck cancer patients. For this systematic review and meta-analysis, PubMed and the Cochrane Database were searched for relevant original articles published up to May 2011. Inclusion criteria were as follows: articles were reported in English; CT, MRI, PET or US were performed to identify cervical metastases in clinically N0 head and neck squamous cell carcinoma; and data were sufficient for the calculation of true-positive or false-negative values. A bivariate random effect model was used to obtain pooled sensitivity and specificity. The positive and negative test probability of neck metastasis was generated based on Bayesian theory and collected data for different pre-test possibilities. Of the 168 identified relevant articles, 7 studies fulfilled all inclusion criteria for CT, 6 studies for MRI, 11 studies for PET and 8 studies for US. There was no difference in sensitivity and specificity among these imaging modalities, except CT was superior to US in specificity. The pooled estimates for sensitivity were 52% (95% confidence interval [CI], 39% ~ 65%), 65% (34 ~ 87%) 66% (47 ~ 80%), and 66% (45 ~ 77%), on a per-neck basis for CT, MRI, PET and US, respectively. The pooled estimates for specificity were 93% (87% ~ 97%), 81% (64 ~ 91%), 87% (77 ~ 93%), and 78% (71 ~ 83%) for CT, MRI, PET and US, respectively. With pre-examination nodal metastasis probabilities set at 10%, 20% and 30%, the post-exam probabilities of positive nodal metastasis rates were 47%, 66% and 77% for CT; 27%, 46% and 59% for MRI; 36%, 56% and 69% for PET; and 25%, 42% and 56% for US, respectively. Negative nodal metastasis

  11. CT manifestations of lymph node metastasis of thyroid carcinoma

    International Nuclear Information System (INIS)

    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

    International Nuclear Information System (INIS)

    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. The effect of intraarterial high-dose cisplatin on lymph nodes in oral and oropharyngeal cancer

    Directory of Open Access Journals (Sweden)

    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.

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

    OpenAIRE

    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.

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

    Directory of Open Access Journals (Sweden)

    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.

  16. Lymph node metastases - diagnosis by lymphography and CT

    International Nuclear Information System (INIS)

    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.)

  17. A level III sentinel lymph node in breast cancer

    Directory of Open Access Journals (Sweden)

    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

    Institute of Scientific and Technical Information of China (English)

    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

    OpenAIRE

    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

    OpenAIRE

    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

    OpenAIRE

    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

    OpenAIRE

    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. Analysis of Retrospective Study on Color Doppler Ultrasound for Thyroid Carcinoma and Cervical Lymph Node Metastasis Diagnostic%彩超对甲状腺癌颈部淋巴结转移诊断分析的回顾性研究

    Institute of Scientific and Technical Information of China (English)

    徐云

    2014-01-01

    目的:研究分析临床面对甲状腺癌颈部淋巴结转移患者时,对其实施彩超诊断的临床意义。方法:随机抽取近期内笔者所在医院收治的45例甲状腺癌颈部淋巴结转移患者的临床超声诊断资料,根据资料分析总结患者淋巴结转移的特点。结果:本组45例淋巴结转移患者经术后病理证实,合计发生269枚转移性淋巴结、161枚反应增生性淋巴结;在淋巴结的纵横比、门部高回声消失率、内部点状高回声率、囊性变发生率及周边型血流信号的出现率方面比较,转移性淋巴结的发生率显著高于反应增生性淋巴结的发生率(P<0.05)。结论:彩超检查可以较为明确地对甲状腺癌颈部的淋巴结转移类型进行鉴别,这对辅助临床对患者实施治疗具有至关重要的意义,值得临床推广应用。%Objective:To study the clinical analysis in the face of cervical lymph node metastasis of thyroid carcinoma patients,given its clinical significance of color Doppler ultrasound diagnosis.Method:We randomly selected 45 cases of cervical lymph node metastasis of thyroid carcinoma in our hospital in the recent clinical ultrasound diagnosis of patient data,according to the characteristics of data analysis in patients with lymph node metastasis.Result:In this group,45 cases of lymph node metastasis patients confirmed by pathology examination after operation,total 269 pieces of metastatic lymph nodes,161 pieces hyperplasia lymph node;In the lymph nodes of the aspect ratio,the door high echo disappearance rate,internal punctate hyperechoic rate,cystic change rate and peripheral blood flow signal rate a few more,the incidence of metastatic lymph nodes was significantly higher than the incidence of hyperplastic lymph node reaction(P<0.05).Conclusion:Color Doppler ultrasound can identify transfer type node more clear for thyroid cancer neck lymph,the auxiliary clinical treatment has vital significance to

  4. Lymph node imaging by ultrarapid 3D angiography

    International Nuclear Information System (INIS)

    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.)

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

    International Nuclear Information System (INIS)

    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

  6. 子宫颈癌患者血清、盆腔淋巴结HPV检测及其相关性探讨%The detection and association of HPV in serum and pelvic lymph nodes derived from patients with cervical carcinoma

    Institute of Scientific and Technical Information of China (English)

    杨滨; 姜囡; 杨帆

    2011-01-01

    Objective: To investigate the associations and clinical significance of human papillomavirus ( HPV)DNA and HPV subtypes in primary lesions,serum and paraffin embedded pelvic lymph nodes of cervical carcinoma.Methods : Sixteen primary tumors , peripheral blood and paraffin embedded pelvic lymph nodes were collected from patients with cervical carcinoma who underwent radical hysterectomy and pelvic lymph nodes dissections.PCR was employed to examine HPV DNA and subtypes in the above specimens.Results: Among the 16 primary tumon and serum , we detected 8 HPV DNA positive samples ( 8/16.50% ).13 of 16 (13/16, 81.25% ) paraffin embedded pelvic lymph nodes were showed HPV DNA positive,60 lymph nodes were positive among the total 133 excisional lymph nodes ( 60/133 , 45.1% ) , and the subtypes were almost identical with that in their corresponding primary tumors.Remarkably, we found that in embedded pelvic lymph nodea was higher 45.1% ( 60/133) than the lymph node metastasis rate detected by pathological diagnosia1.5% ( 2/133) .Notably , 6 patients( 6/16 ,37.5% ) were observed HPV DNA positive of primary tumors, serum and paraffin embedded pelvic lymph nodes;2 palients(2/16,12.5% )were observed HPV DNA positive of primary tumors and paraffin embedded pelvic lymph nodea, while the serum was negatjye; 1 patient( 1/16, 6.25% ) was observed HPV DNA positive of paraffin embedded pelvic lymph nodes and serum, while the primary tumors were negative;no patient was obsewed HPV DNA positive of primary tumors and senun ,but paraffin embedded pelvie lymph nodes were negative.The subtypes of HPV DNA positives were identical within the same patients.Conclusion: HPV DNA detective rate in serum uncorrelated with clinical stage.Compared with traditional pathology method, detection of HPV in pelvic lymph nodes may improve the detection rate of lymph node metastasis in cervical carcinoma, and the HPV DNA detection rate correlate with differentiated degree of the primary

  7. Recently Identified Biomarkers That Promote Lymph Node Metastasis in Head and Neck Squamous Cell Carcinoma

    OpenAIRE

    Weed, Scott A.; Walk, Elyse L.

    2011-01-01

    Head and neck squamous cell carcinoma (HNSCC) is a heterogeneous cancer that arises in the upper aerodigestive tract. Despite advances in knowledge and treatment of this disease, the five-year survival rate after diagnosis of advanced (stage 3 and 4) HNSCC remains approximately 50%. One reason for the large degree of mortality associated with late stage HNSCC is the intrinsic ability of tumor cells to undergo locoregional invasion. Lymph nodes in the cervical region are the primary sites of m...

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

    Directory of Open Access Journals (Sweden)

    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.

  9. Morphology of draining lymph nodes after local immune stimulation with C. parvum: comparison of pelvic nodes in carcinoma of cervix and popliteal and inguinal nodes of guinea-pig.

    OpenAIRE

    Mignot, M. H.; Lens, J.W.; Stolk, J. G.; Oort, J.; Veldhuizen, R.W.; Dijkhuizen, G. H.; Drexhage, H. A.

    1982-01-01

    Morphological changes are described in pelvic lymph nodes excised 10 days after C. parvum (CP) treatment of patients with cervical carcinoma. Guinea-pig popliteal and inguinal lymph nodes were investigated from Days 1 to 10 after an injection of 70 micrograms CP into the footpad. Eosinophils were detected from the first few hours after stimulation, initially in the marginal sinus, then in the medullary sinuses and subsequently in the efferent lymphatics. From Day 2 to Day 6, histiocyte accumu...

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

    International Nuclear Information System (INIS)

    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)

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

    DEFF Research Database (Denmark)

    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...

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

    Energy Technology Data Exchange (ETDEWEB)

    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.

  13. Management of Regional Lymph Nodes in Localized Vulvar Carcinoma

    International Nuclear Information System (INIS)

    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

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

    OpenAIRE

    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...

  15. Enhancing regional lymph nodes from endoscopic ultrasound images

    Science.gov (United States)

    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.

  16. Fludeoxyglucose F 18 PET Scan, CT Scan, and Ferumoxtran-10 MRI Scan Before Chemotherapy and Radiation Therapy in Finding Lymph Node Metastasis in Patients With Locally Advanced Cervical Cancer or High-Risk Endometrial Cancer

    Science.gov (United States)

    2015-11-09

    Cervical Adenocarcinoma; Cervical Adenosquamous Cell Carcinoma; Cervical Small Cell Carcinoma; Cervical Squamous Cell Carcinoma; Endometrial Clear Cell Carcinoma; Endometrial Papillary Serous Carcinoma; Stage I Endometrial Carcinoma; Stage IB Cervical Cancer; Stage II Endometrial Carcinoma; Stage IIA Cervical Cancer; Stage IIB Cervical Cancer; Stage III Cervical Cancer; Stage III Endometrial Carcinoma; Stage IVA Cervical Cancer

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

    Energy Technology Data Exchange (ETDEWEB)

    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.

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

    International Nuclear Information System (INIS)

    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

  19. Pathological axillary lymph nodes detected at mammographic screening

    International Nuclear Information System (INIS)

    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

  20. Contemporary management of lymph node metastases from an unknown primary to the neck : I. A review of diagnostic approaches

    NARCIS (Netherlands)

    Strojan, Primoz; Ferlito, Alfio; Medina, Jesus E.; Woolgar, Julia A.; Rinaldo, Alessandra; Robbins, K. Thomas; Fagan, Johannes J.; Mendenhall, William M.; Paleri, Vinidh; Silver, Carl E.; Olsen, Kerry D.; Corry, June; Suarez, Carlos; Rodrigo, Juan P.; Langendijk, Johannes A.; Devaney, Kenneth O.; Kowalski, Luiz P.; Hartl, Dana M.; Haigentz, Missak; Werner, Jochen A.; Pellitteri, Phillip K.; de Bree, Remco; Wolf, Gregory T.; Takes, Robert P.; Genden, Eric M.; Hinni, Michael L.; Mondin, Vanni; Shaha, Ashok R.; Barnes, Leon

    2013-01-01

    In an era of advanced diagnostics, metastasis to cervical lymph nodes from an occult primary tumor is a rare clinical entity and accounts for approximately 3% of head and neck malignancies. Histologically, two thirds of cases are squamous cell carcinomas (SCCs), with other tissue types less common i

  1. Contemporary management of lymph node metastases from an unknown primary to the neck: II. a review of therapeutic options

    NARCIS (Netherlands)

    Strojan, P.; Ferlito, A.; Langendijk, J.A.; Corry, J.; Woolgar, J.A.; Rinaldo, A.; Silver, C.E.; Paleri, V.; Fagan, J.J.; Pellitteri, P.K.; Haigentz Jr., M.; Suarez, C.; Robbins, K.T.; Rodrigo, J.P.; Olsen, K.D.; Hinni, M.L.; Werner, J.A.; Mondin, V.; Kowalski, L.P.; Devaney, K.O.; Bree, R. de; Takes, R.P.; Wolf, G.T.; Shaha, A.R.; Genden, E.M.; Barnes, L.

    2013-01-01

    Although uncommon, cancer of an unknown primary (CUP) metastatic to cervical lymph nodes poses a range of dilemmas relating to optimal treatment. The ideal resolution would be a properly designed prospective randomized trial, but it is unlikely that this will ever be conducted in this group of patie

  2. Contemporary management of lymph node metastases from an unknown primary to the neck: I. A review of diagnostic approaches

    NARCIS (Netherlands)

    Strojan, P.; Ferlito, A.; Medina, J.E.; Woolgar, J.A.; Rinaldo, A.; Robbins, K.T.; Fagan, J.J.; Mendenhall, W.M.; Paleri, V.; Silver, C.E.; Olsen, K.D.; Corry, J.; Suarez, C.; Rodrigo, J.P.; Langendijk, J.A.; Devaney, K.O.; Kowalski, L.P.; Hartl, D.M.; Haigentz Jr., M.; Werner, J.A.; Pellitteri, P.K.; Bree, R. de; Wolf, G.T.; Takes, R.P.; Genden, E.M.; Hinni, M.L.; Mondin, V.; Shaha, A.R.; Barnes, L.

    2013-01-01

    In an era of advanced diagnostics, metastasis to cervical lymph nodes from an occult primary tumor is a rare clinical entity and accounts for approximately 3% of head and neck malignancies. Histologically, two thirds of cases are squamous cell carcinomas (SCCs), with other tissue types less common i

  3. Contemporary management of lymph node metastases from an unknown primary to the neck : II. A review of therapeutic options

    NARCIS (Netherlands)

    Strojan, Primoz; Ferlito, Alfio; Langendijk, Johannes A.; Corry, June; Woolgar, Julia A.; Rinaldo, Alessandra; Silver, Carl E.; Paleri, Vinidh; Fagan, Johannes J.; Pellitteri, Phillip K.; Haigentz, Missak; Suarez, Carlos; Robbins, K. Thomas; Rodrigo, Juan P.; Olsen, Kerry D.; Hinni, Michael L.; Werner, Jochen A.; Mondin, Vanni; Kowalski, Luiz P.; Devaney, Kenneth O.; de Bree, Remco; Takes, Robert P.; Wolf, Gregory T.; Shaha, Ashok R.; Genden, Eric M.; Barnes, Leon

    2013-01-01

    Although uncommon, cancer of an unknown primary (CUP) metastatic to cervical lymph nodes poses a range of dilemmas relating to optimal treatment. The ideal resolution would be a properly designed prospective randomized trial, but it is unlikely that this will ever be conducted in this group of patie

  4. Predictors of Regional Lymph Node Recurrence after Initial Thyroidectomy in Patients with Thyroid Cancer

    Directory of Open Access Journals (Sweden)

    Amirsina Sharifi

    2016-01-01

    Full Text Available Background. Regional lymph node recurrence (RLNR is common in patients with thyroid cancer but clinicopathological predictors are unclear. We aimed to clarify these predictors and identify patients who would benefit from prophylactic lymph node dissection the most. Method. 343 patients with different types of thyroid cancer were analyzed retrospectively. All patients underwent total thyroidectomy between 2007 and 2013. Results. The median ± interquartile range of patients’ age was 40 ± 25 years. 245 (71.4% patients were female. Regarding the risk of regional lymph node recurrence, we found that male gender, age ≥45 years, non-PTC (i.e., medullary, follicular, and anaplastic types histopathology, T3 (i.e., tumor size >4 cm in the greatest dimension limited to the thyroid or any tumor with minimal extrathyroid extension, stage IVa, and isolated cervical lymphadenopathy as initial manifestation (ICL are significant risk factors. T3 (p < 0.001; odds ratio = 156.41, 95% CI [55.72–439.1] and ICL (p < 0.001; odds ratio = 77.79, 95% CI [31.55–191.81] were the strongest predictors of regional lymph node recurrence. Conclusion. We found easily achievable risk factors for RLNR in thyroid cancers patients. We suggested that patients with specific clinicopathological features like male gender, age ≥45 years, larger tumor size, and extrathyroidal extension be considered as prophylactic lymphadenectomy candidates.

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

    Science.gov (United States)

    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

  6. Angiosarcoma of the Thyroid and Regional Lymph Node Metastasis

    Directory of Open Access Journals (Sweden)

    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.

  7. Accuracy of abdominal lymph node scintigraphy in tumor diagnostics

    International Nuclear Information System (INIS)

    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.)

  8. Robotic Salvage Lymph Node Dissection After Radical Prostatectomy

    Directory of Open Access Journals (Sweden)

    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.

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

    Energy Technology Data Exchange (ETDEWEB)

    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.

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

    International Nuclear Information System (INIS)

    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.)

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

    OpenAIRE

    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 ...

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

    Directory of Open Access Journals (Sweden)

    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.

  13. Guillain-Barré Syndrome in a Patient after Bilateral Thyroidectomy plus Bilateral Cervical Lymph Node Dissection:One Case Report and Literature Review%双侧甲状腺切除加双侧颈部淋巴结清扫术后引发吉兰-巴雷综合征一例报告并文献复习

    Institute of Scientific and Technical Information of China (English)

    赵红; 王苏平; 宋品; 李莉; 刘赞华; 李淑敏

    2015-01-01

    Guillain-Barré syndrome( GBS)is clinically rare as a postoperative complication occurs after bilateral thyroidectomy plus bilateral cervical lymph node dissection,and missed diagnosis often occurs at its early stage. The article presents the diagnosis and treatment of GBS as postoperative complication in a patient with thyroid cancer concurrent with parathyroid tumor after bilateral thyroidectomy plus bilateral cervical lymph node dissection. The relevant literature is also reviewed. Surgical operations could induce GBS. More attention should be paid to the diagnosis and treatment of postoperative GBS,preventing its missed diagnosis and misdiagnosis.%双侧甲状腺切除加双侧颈部淋巴结清扫术后并发吉兰-巴雷综合征( Guillain-Barré syndrome,GBS)的病例在临床上较为少见,且GBS发病早期易被漏诊。本文报道了1例甲状腺癌伴甲状旁腺腺瘤患者,行双侧甲状腺切除加双侧颈部淋巴结清扫术后并发GBS的临床诊治经过,并复习相关文献。提示外科手术可以为GBS的诱因,临床医生应警惕术后GBS的发生,避免漏诊和误诊。

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

    Institute of Scientific and Technical Information of China (English)

    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.

  15. Evaluation of FDG-PET in the diagnosis of neck lymph node swelling on children

    International Nuclear Information System (INIS)

    Usefulness and limitation of fluorodeoxyglucose (FDG)-position emission tomography (PET) examination were evaluated in children with cervical lymph node tumors. Subjects were 14 pediatric patients (3 months to 18FDG concentration/18FDG dose/body wt.), and on other clinical findings involving the process, lymph node biopsy and surgery. For diagnosing the malignant tumor, sensitivity of PET was found to be 100% at SUV=4 or 10, but specificity, 78% at SUV 10 and 22% at 4. Thus the FDG distribution in the tumor was not always an indication of the presence of malignant one; however, it surely indicated the presence of lesion necessary for treatment. Clinical, ultrasonographic, CT and MRI findings together with PET were thought important for precise diagnosis. (R.T.)

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

    International Nuclear Information System (INIS)

    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)

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

    International Nuclear Information System (INIS)

    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.)

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

    Energy Technology Data Exchange (ETDEWEB)

    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.

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

    Science.gov (United States)

    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

  20. The impact of postoperative supraclavicular radiotherapy on tracheoesophageal groove lymph node metastasis in esophageal carcinoma

    International Nuclear Information System (INIS)

    Objective: To evaluate the prognostic factors of tracheoesophageal groove lymph node (TEGLN) metastasis in postoperative esophageal carcinoma. Methods: From January 1996 to December 1997, 101 postoperative cervical and thoracic esophageal carcinoma patients proved absence from tracheoesophageal groove lymph node (TEGIAN) metastasis before and after operation by physical examination and computer tomography examination were entered into this study. The patients were divided into three groups according to the treatment of supraclavicular region: no prophylactic radiotherapy (group A-, 30 patients); prophylactic radiotherapy with local dose < 45 Gy (Group B-, 71 patients); and prophylactic radiotherapy with local dose ≥45 Gy (Group C-, 19 patients). Radiotherapy was delivered by cobalt- 60 or 6 MV X-ray with the prescribed dose normalized to the point of tracheoesophageal groove, i. e, 5 cm in depth. The tracheoesophageal groove lymph node metastasis after treatment was observed. Results: The incidence of tracheoesophageal groove lymph node metastasis was 20% (6/30), 9.6% (5/71) and 0% (0/19) in groups A, B and C. Univariate analysis showed that there was significant difference of TEGLN metastasis between groups A and C only (P=0.039), but higher dose to supraclavicular region tended to lower the incidence of TEGLN metastasis. Multivariate analysis showed that only prophylactic radiotherapy to the supraclavicular region was independent prognostic factor for TEGLN metastasis (P=0.037). Gender, primary tumor site and pathological stage had no significant impact on TEGLN metastasis. Conclusions: Postoperative prophylactic supraclavicular region irradiation can lower the incidence of tracheoesophageal groove lymph node metastasis in esophageal carcinoma. Radiotherapy dose should not be less than 45 Gy and should be routinely normalized to a point 5 cm deep in the tracheoesophageal groove. (authors)

  1. Salmonella Persistence within the Peripheral Lymph Nodes of Cattle following Experimental Inoculation.

    Science.gov (United States)

    Edrington, T S; Loneragan, G H; Genovese, K J; Hanson, D L; Nisbet, D J

    2016-06-01

    Utilizing a transdermal method of inoculation developed in our laboratory, the duration of infection of Salmonella in the peripheral lymph nodes of steers was examined. Thirty-six Holstein steers (mean body weight of 137 kg) were inoculated with Salmonella Montevideo (day 0) on each lower leg and both sides of the back and abdomen. Calves were euthanized beginning at 6 h and subsequently on each of days 1, 2, 4, 7, 9, 11, 14, and 21 postinoculation (four animals each time). The subiliac, popliteal, and superficial cervical (prescapular) lymph nodes were collected and cultured (quantitatively and qualitatively) for the challenge strain of Salmonella. The challenge strain was detected via direct culture within the lymph nodes at 6 h postinoculation and on each subsequent necropsy date. Salmonella levels in lymph node were 0.8 to 1.8 log CFU/g. Lymph nodes were generally positive after enrichment culture throughout the experiment. Salmonella elimination appeared to begin approximately 14 days postinoculation. However, elimination was not completed by day 21; therefore, a second experiment was conducted identical to the first except that the time from inoculation to necropsy was extended. Salmonella was recovered via direct culture on each of the necropsy days, and results in general were similar to those of experiment I, except that on days 20, 24, and 28 isolates from serogroups C2 and E1 were identified in addition to the inoculation strain C1 in multiple animals. The data from both experiments indicate that after a single inoculation event, Salmonella would be completely cleared by approximately 28 days. Further research with expanded times between inoculation and necropsy is required for verification. PMID:27296609

  2. LCP nanoparticle for tumor and lymph node metastasis imaging

    Science.gov (United States)

    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

  3. Effectiveness of postoperative radiotherapy in patients with small oral and oropharyngeal squamous cell carcinoma and concomitant ipsilateral singular cervical lymph node metastasis (pN1). A meta-analysis

    Energy Technology Data Exchange (ETDEWEB)

    Moergel, Maximilian; Meurer, Philipp; Al-Nawas, Bilal [Mainz Univ. Medical Center, Mainz (Germany). Dept. of Oral and Maxillofacial Surgery; Ingel, Katharina [Mainz Univ. Medical Center, Mainz (DE). Inst. of Medical Biostatistics, Epidemiology and Informatics (IMBEI); Wendt, Thomas G. [Jena Univ. Medical Center, Jena (Germany). Dept. of Radiation Oncology

    2011-06-15

    The positive effect of radiation therapy for patients with advanced oropharyngeal squamous cell carcinoma (OSCC) has been substantially verified. The present work investigated whether a meta-analysis of current data is able to evaluate the effectiveness of postoperative radiotherapy (PORT) in patients with small OSCC (pT1, pT2) and a single ipsilateral lymph node metastasis (pN1). The meta-analysis comprises randomized and non-randomized studies. High-risk tumors were excluded and defined by size {>=} pT3/pT4, lymph node involvement {>=} pN2, or presence of additional histological risk factors, e.g., involved positive resection margins, extra nodal spread of the disease, or lymphangiosis carcinomatosa. The primary outcome analyzed mortality between the different treatment arms. Only one prospective randomized clinical trial and six retrospective observational studies were adequate for evaluation. Descriptive analysis revealed a marginally higher mortality in the irradiation group (44% vs. 34%). In contrast, a forest plot presentation of two of seven studies with and without events in the control and therapy arms presented an advantage for the irradiation group with the limitation of large heterogeneity and a lack of statistical significance. Present data are poor and exhibit limited internal and external validity; thus, direct comparison was not possible with the eligible studies. Therefore, a meta-analysis of present data may not serve as the basis for a general treatment recommendation but underlines the need of prospective, randomized, controlled clinical trials. (orig.)

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

    Directory of Open Access Journals (Sweden)

    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.

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

    International Nuclear Information System (INIS)

    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)

  6. Pelvic Lymph Node Status Assessed by 18F-Fluorodeoxyglucose Positron Emission Tomography Predicts Low-Risk Group for Distant Recurrence in Locally Advanced Cervical Cancer: A Prospective Study

    International Nuclear Information System (INIS)

    Purpose: To develop a prediction model to identify a low-risk group for distant recurrence in patients with locally advanced cervical cancer treated by concurrent chemoradiation. Methods and Materials: Prospectively, 62 patients with locally advanced cervical cancer were recruited as a training cohort. Clinical variables and parameters obtained from positron emission tomography (PET) and magnetic resonance imaging were analyzed by logistic regression. For the test set, 54 patients were recruited independently. To identify the low-risk group, negative likelihood ratio (LR) less than 0.2 was set to be a cutoff. Results: Among the training cohort, multivariate logistic analysis revealed that advanced International Federation of Gynecology and Obstetrics (FIGO) stage and a high serum squamous cancer cell (SCC) antigen level were significant risk factors (p = 0.015 and 0.025, respectively). Using the two parameters, criteria to determine a low-risk subset for distant recurrence were postulated: (1) FIGO Stage IIB or less and (2) pretreatment SCC < 2.4 (Model A). Positive pelvic node on PET completely predicted all cases with distant recurrence and thus was considered as another prediction model (Model B). In the test cohort, although Model A did not showed diagnostic performance, Model B completely predicted all cases with distant recurrence and showed a sensitivity of 100% with negative LR of 0. Across the training and test cohort (n = 116), the false negative rate was 0 (95% confidence interval 0%-7.6%). Conclusions: Positive pelvic node on PET is a useful marker in prediction of distant recurrence in patients with locally advanced cervical cancer who are treated with concurrent chemoradiation.

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

    OpenAIRE

    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...

  8. Abnormal position of lymph nodes in a freemartin sheep

    Directory of Open Access Journals (Sweden)

    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

  9. Problems and pitfalls in vulvar and cervical cancer sentinel node scintigraphy

    International Nuclear Information System (INIS)

    After the introduction for penile cancer, the sentinel lymph node imaging is increasingly applied in various types of cancer. After the initial learning phase, 105 patients with vulvar and 24 with cervical cancer have been investigated. In vulvar cancer all the imaged sentinel nodes were discovered by the portable probe intraoperatively. No false negative sentinel node was observed. The most critical issue is the tracer application. Performed strictly intradermally, the sentinel node shows up immediately. Concomitant use of isosulfan blue dye did not improve the results and was stopped therefore. Similarly, more superficial (intra/subendothelial) application brings up better results as compared to deeper injection in cervical cancer patients. No false negative results were seen. Apparently, an almost 100% detection is possible. Our findings clearly show that tracer application is the key for successful imaging. If not done properly, sentinel node may appear later or may even more likely be missed. (author)

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

    Energy Technology Data Exchange (ETDEWEB)

    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

    International Nuclear Information System (INIS)

    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

    DEFF Research Database (Denmark)

    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

    OpenAIRE

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

    Institute of Scientific and Technical Information of China (English)

    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

  15. Patterns of regional lymph node metastasis of nasopharyngeal carcinoma: A meta-analysis of clinical evidence

    International Nuclear Information System (INIS)

    The characteristics of cervical lymphatic metastasis in nasopharyngeal carcinoma (NPC) are not completely understood. As such, radiotherapy to the entire lymphatic of the neck bilaterally has been empirically practiced even in early stage disease, although not supported by clinical evidence. We studied the pattern and probability of nodal metastasis through a meta-analysis of published evidences, with an aim to establish an evidence-based guideline for selecting and delineation of clinical target volume of neck lymphatics for conformation radiation for NPC. A literature search yielded an initial 411 original articles, and 13 studies with 2920 NPC cases staged via MRI were included in this analysis. The occurrence of nodal metastasis was calculated and analyzed according to the respective regional nodal levels. 85% of NPC cases presented with lymphadenopathy. The most commonly involved regions include retropharyngeal (69%) and level II lymph nodes (70%). The overall probability of levels III, IV, and V nodal involvement are 45%, 11%, and 27%, respectively. Low-risk node groups included the supraclavicular, levels IA/IB and VI nodes, and parotid nodes with involvement rates at 3%, 0%, 3%, 0%, and 1%, respectively. Nodal metastases followed an orderly pattern and the probability of 'skip' metastasis between levels varied between 0.5-7.9%. Lymph node metastasis in NPC follows a predictable and orderly pattern. The rarity of metastasis in certain nodal groups and 'skip' metastasis suggest that reduced treatment volume is feasible in conformal radiotherapy for NPC

  16. Significado prognóstico do número de linfonodos no esvaziamento cervical eletivo no câncer de língua e soalho de boca Prognostic significance of the number of lymph nodes in elective neck dissection for tongue and mouth floor cancers

    Directory of Open Access Journals (Sweden)

    Ali Amar

    2012-04-01

    Full Text Available A presença de linfonodos metastáticos é aspecto relevante no tratamento do câncer na cabeça e pescoço, resultando em 50% de redução na sobrevida. OBJETIVO: Avaliar o número de linfonodos removidos no esvaziamento cervical e sua relação com o prognóstico. MÉTODOS: Estudo retrospectivo de 143 pacientes portadores de carcinoma epidermoide de língua e soalho bucal, cujo exame histológico evidenciou ausência de metástases linfonodais. Desses, 119 eram masculinos e 24 femininos, com idade média de 54 anos. Quanto ao sítio do tumor primário, 65 eram na língua e 78 no soalho bucal. A distribuição do estádio T foi de quatro T1, 84 T2, 36 T3 e 19 T4. Foram realizados 176 esvaziamentos cervicais, sendo unilateral em 110 casos e bilateral em 33. Desses, 78 radicais e 98 seletivos. Os pacientes foram separados em três grupos, de acordo com os percentis 33 e 66 do número de linfonodos ressecados. RESULTADOS: O número médio de linfonodos ressecados foi de 27, sendo 24 nos esvaziamentos seletivos e 31 nos completos. Não foram observadas diferenças estatisticamente significantes quando relacionado aos estádios T e N. CONCLUSÕES: O maior número de linfonodos dissecados no esvaziamento cervical identifica um grupo de melhor prognóstico nos casos pN0.The presence of metastatic lymph nodes is a relevant aspect in the treatment of head and neck cancer, bringing about a 50% reduction in survival. OBJECTIVE: To assess the number of lymph nodes removed in the neck dissection and their relationship with the prognosis. METHODS: A retrospective study involving 143 patients with tongue and mouth floor epidermoid carcinoma, which histological exam showed no lymph node metastases. Among those, 119 were males and 24 females, with mean age of 54 years. As to the primary tumor site, 65 were in the tongue and 78 in the mouth floor. T stage distribution was of four T1, 84 T2, 36 T3 and 19 T4. We carried out 176 neck dissections, unilateral in 110

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

    Institute of Scientific and Technical Information of China (English)

    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.

  18. Retroperitoneal pleomorphic rhabdomyosarcoma metastasizing to inguinal lymph node

    Directory of Open Access Journals (Sweden)

    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.

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

    Science.gov (United States)

    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

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

    Directory of Open Access Journals (Sweden)

    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.

  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

    OpenAIRE

    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. Recently Identified Biomarkers That Promote Lymph Node Metastasis in Head and Neck Squamous Cell Carcinoma

    Energy Technology Data Exchange (ETDEWEB)

    Walk, Elyse L.; Weed, Scott A., E-mail: sweed@hsc.wvu.edu [Department of Neurobiology and Anatomy, Program in Cancer Cell Biology, Mary Babb Randolph Cancer Center, West Virginia University, Morgantown, WV 26506 (United States)

    2011-02-22

    Head and neck squamous cell carcinoma (HNSCC) is a heterogeneous cancer that arises in the upper aerodigestive tract. Despite advances in knowledge and treatment of this disease, the five-year survival rate after diagnosis of advanced (stage 3 and 4) HNSCC remains approximately 50%. One reason for the large degree of mortality associated with late stage HNSCC is the intrinsic ability of tumor cells to undergo locoregional invasion. Lymph nodes in the cervical region are the primary sites of metastasis for HNSCC, occurring before the formation of distant metastases. The presence of lymph node metastases is strongly associated with poor patient outcome, resulting in increased consideration being given to the development and implementation of anti-invasive strategies. In this review, we focus on select proteins that have been recently identified as promoters of lymph node metastasis in HNSCC. The discussed proteins are involved in a wide range of critical cellular functions, and offer a more comprehensive understanding of the factors involved in HNSCC metastasis while additionally providing increased options for consideration in the design of future therapeutic intervention strategies.

  3. Mechanisms of cyst formation in metastatic lymph nodes of head and neck squamous cell carcinoma

    Directory of Open Access Journals (Sweden)

    Mokhtari Sepideh

    2012-01-01

    Full Text Available Abstract Cystic change in metastatic lymph nodes occurs in certain types of tumors and mostly in squamous cell carcinoma of the head and neck. In the majority of cases, psuedocystic change is the mechanism of cyst formation. However, sometimes a true cyst cavity is formed. This occurrence is unexplained and some theories are introduced to explain it. In this paper, related articles and introduced concepts are reviewed and the best conclusions of present hypotheses are provided. Cystic SCC in cervical lymph node is now considered as a typical presentation of metastatic SCC arising in the oro/nasopharynx. True cystic cavities have eosinophilic fluid content and present active transport mechanism across the epithelium; Cytokeratin7 is also expressed in the lining of these cysts, which is an accepted marker of ductal differentiation. These are all strong evidences that show salivary gland type cells are present among tumor cells. In fact, some squamous cell carcinomas, especially those arising in Waldeyer's ring, originate from minor salivary glands. The other probability is that these tumors are cancers of transitional type and arise from transformed keratinocytes, which have intrinsic property for cyst formation. These malignant cells in lymph nodes, rather than primary sites, found the opportunity to express their parental property. Virtual slides The virtual slide(s for this article can be found here: http://www.diagnosticpathology.diagnomx.eu/vs/6838476096250792.

  4. Recently Identified Biomarkers That Promote Lymph Node Metastasis in Head and Neck Squamous Cell Carcinoma

    International Nuclear Information System (INIS)

    Head and neck squamous cell carcinoma (HNSCC) is a heterogeneous cancer that arises in the upper aerodigestive tract. Despite advances in knowledge and treatment of this disease, the five-year survival rate after diagnosis of advanced (stage 3 and 4) HNSCC remains approximately 50%. One reason for the large degree of mortality associated with late stage HNSCC is the intrinsic ability of tumor cells to undergo locoregional invasion. Lymph nodes in the cervical region are the primary sites of metastasis for HNSCC, occurring before the formation of distant metastases. The presence of lymph node metastases is strongly associated with poor patient outcome, resulting in increased consideration being given to the development and implementation of anti-invasive strategies. In this review, we focus on select proteins that have been recently identified as promoters of lymph node metastasis in HNSCC. The discussed proteins are involved in a wide range of critical cellular functions, and offer a more comprehensive understanding of the factors involved in HNSCC metastasis while additionally providing increased options for consideration in the design of future therapeutic intervention strategies

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

    Energy Technology Data Exchange (ETDEWEB)

    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.

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

    International Nuclear Information System (INIS)

    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)

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

    OpenAIRE

    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...

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

    OpenAIRE

    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...

  9. SENTINEL LYMPH NODE CONCEPT IN DIFFERENTIATED THYROID CANCER

    Directory of Open Access Journals (Sweden)

    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.

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

    OpenAIRE

    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...

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

    International Nuclear Information System (INIS)

    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)

  12. Fluorescence spectroscopy using indocyanine green for lymph node mapping

    Science.gov (United States)

    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.

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

    OpenAIRE

    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...

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

    International Nuclear Information System (INIS)

    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

    International Nuclear Information System (INIS)

    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. Primary High-Grade Poorly Differentiated Angiosarcoma of an Intra-parotid Lymph Node.

    Science.gov (United States)

    Ducharne-Asuaje, Eugenia; Dorion, Dominique; Lamarre, Louis; Coindre, Jean Michel; Geha, Sameh

    2016-06-01

    Head and neck angiosarcoma is an infrequent malignant vascular tumor most commonly found in the skin and soft tissue of the head and neck. Most head and neck angiosarcomas are metastatic to cervical lymph nodes from other primitive location. We describe herein a case of primary high-grade poorly differentiated angiosarcoma arising in an intra-parotid lymph node, discuss the value of immunohistochemical stains for differential diagnosis, and review the literature concerning head and neck angiosarcoma. A 47-year-old man presented with a painless mass that had grown for a period of 6 months in the parotid area. The CT-scan revealed a left parotid lesion of 17 mm. Fine needle aspiration was considered suspicious for lymphoma or poorly differentiated carcinoma. A superficial parotidectomy was performed. On gross examination, the lesion was a well-defined, gray, homogeneous mass of 15 mm of diameter. Microscopic examination showed a normal parotid tissue and a poorly differentiated malignant neoplasm in an intra-parotid lymph node. The tumor had a pseudo-alveolar pattern, with large pleomorphic epithelioid cells, abundant eosinophilic cytoplasm, large vesicular nuclei, and one or more prominent nucleoli. Atypical mitoses were seen. Neoplastic malignant cells stained positive for Vimentin, CD31, D2-40, factor VIII, ERG, and partially for CD34. A positron emission tomography scan was made to search for a primary neoplasia, but no other tumor was localized. The diagnosis of primary high-grade, poorly differentiated, intra-parotid lymph node angiosarcoma was established. PMID:25930154

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

    International Nuclear Information System (INIS)

    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

  18. Expression of Shh and Ptch proteins in cervical carcinoma and their correlations with pelvic lymph node metastasis%Hedgehog 信号通路中 Shh、Ptch 在维吾尔族妇女宫颈癌中的表达及其关系

    Institute of Scientific and Technical Information of China (English)

    朱明癑; 陈帆; 李华; 古扎丽努尔·阿不力孜; 唐努尔

    2015-01-01

    目的:探讨 Shh、Ptch 蛋白在新疆维吾尔族妇女宫颈癌中的表达及与盆腔淋巴结转移的关系。方法采用实时荧光定量及免疫组织化学检测32例正常宫颈组织、43例中重度宫颈上皮内瘤变组织(CINⅡ~Ⅲ)和80例宫颈癌组织中 Shh、Ptch 蛋白的表达情况,分析两者在宫颈癌组织中表达的相关性及与宫颈癌盆腔淋巴结转移的关系。结果 Shh、Ptch 蛋白在宫颈癌组织的阳性表达率分别为79.0%和69.7%,在 CINⅡ~Ⅲ组织中的阳性表达率分别为82.5%和80.0%,均显著高于正常宫颈组织(0,12.5%),差异有统计学意义。宫颈癌中 Shh蛋白的表达与 Ptch 蛋白的表达呈正相关(r =0.672,P <0.05)。将宫颈癌盆腔淋巴结转移组与无转移组进行单因素比较分析,Shh 蛋白表达、Ptch 蛋白表达、组织学分化程度、脉管浸润、肌层浸润深度与宫颈癌盆腔淋巴结转移有关,进一步 Logistic 回归分析表明,Shh 蛋白表达、肌层浸润深度是宫颈癌盆腔淋巴结转移的独立危险因素。结论Shh、Ptch 蛋白异常表达可能协同参与宫颈癌的恶性进展,Shh 蛋白高表达是宫颈癌盆腔淋巴结转移的独立危险因素。%Objective To quantify the expression of Shh and Ptch proteins in cervical carcinoma and to examine their role in metastasis. Methods The expression of Shh and Ptch in 32 specimens of normal cervical tissue,43 specimens of moderate-severe cervical intraepithelial neoplasia,and 80 specimens of cervical carcinoma was measured by real-time quantitative PCR and immunohistochemistry.The correlation between Shh and Ptch proteins in cervical carcinoma was analyzed;the correlation of the 2 proteins with pelvic lymph node metastasis was also evaluated. Results The positive expression rates in cervical carcinoma and CIN II-III were 79.0% and 82.5% for Shh,and 69.7% and 80.0%for Ptch,respectively.These rates were significantly

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

    International Nuclear Information System (INIS)

    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

  20. Management of the lymph nodes in penile cancer.

    Science.gov (United States)

    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

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

    OpenAIRE

    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 ...

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

    Science.gov (United States)

    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

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

    Directory of Open Access Journals (Sweden)

    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.

  4. Neoadjuvant chemotherapy for locally advanced cervical cancer reduces surgical risks and lymph-vascular space involvement

    Institute of Scientific and Technical Information of China (English)

    Yue Wang; Guang Wang; Li-Hui Wei; Ling-Hui Huang; Jian-Liu Wang; Shi-Jun Wang; Xiao-Ping Li

    2011-01-01

    Neoadjuvant chemotherapy (NACT),which can reduce the size and therefore increase the resectability of tumors,has recently evolved as a treatment for locally advanced cervical cancer.NACT has been reported to decrease the risk of pathologic factors related to prognosis of cervical cancer.To further assess the effects of NACT on surgery and the pathologic characteristics of cervicat cancer,we reviewed 110 cases of locally advanced cervical cancer treated with radical hysterectomy with or without NACT at the People's Hospital of Peking University between January 2006 and December 2010.Of 110 patients,68 underwent platinum-based NACT prior to surgery (NACT group) and 42 underwent pdmary surgery treatment (PST group).Our results showed 48 of 68 (70.6%) patients achieved a complete response or partial response to NACT.Estimated blood loss,operation time,and number of removed lymph nodes during surgery,as well as complication rates during and after surgery were not significantly different between the NACT group and the PST group.The rates of deep stromal invasion,positive parametria,positive surgical vaginal margins,and lymph node metastasis were not significantly different between the two groups.However,the rate of lymph-vascular space involvement (LVSI) was significantly lower in the NACT group than in the PST group (P = 0.021).In addition,the response rate of NACT was significantly higher in the patients with chemotherapeutic drugs administrated via artery than via vein.Our results suggest that NACT is a safe and effective treatment for locally advanced cervical cancer and significantly decreases the rate of LVSI.

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

    OpenAIRE

    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...

  6. Indirect magnetic resonance imaging lymphography identifies lymph node metastasis in rabbit pyriform sinus VX2 carcinoma using ultra-small super-paramagnetic iron oxide.

    Directory of Open Access Journals (Sweden)

    Na Shen

    Full Text Available BACKGROUND: USPIO is a contrast agent for MRI that can generate T2W images with low signal intensities. After subcutaneous or intravenous injection of USPIO, normal lymph node tissues uptake these nano-particles, but tumor cells do not. Thus, tumor metastasis can be detected using this contrast agent. OBJECTIVE: The aim of this study was to access the feasibility of USPIO enhanced MRI for the detection of cervical lymph node metastasis in a pyriform sinus carcinoma animal model and to investigate the ability of USPIO to enhance images of cervical lymph node metastases. METHODS AND FINDINGS: Twenty New Zealand rabbits were randomly divided into tumor and inflammatory groups, and each group contained 10 rabbits. In the inflammatory group, a 0.5 ml egg yolk emulsion was injected into the sub-mandibular muscle of the rabbits to induce an inflammatory reaction in their cervical lymph nodes. In the tumor group, a VX2 tumor tissue suspension was transplanted into the pyriform sinus sub-mucosa of the rabbits using direct laryngoscope. Four weeks after the tumor or egg yolk injection, MRIs were performed before and after USPIO injection to observe the imaging enhancement features of USPIO. After that, a histo-pathological analysis was performed for all rabbits. We found the metastatic lymph nodes had no signal reduced intensity or irregular signal reduced intensity on T2-weighted image by using USPIO enhancement. In the tumor group,the sensitivity and specificity of plain MRI were 57.6% and 60.7%. The corresponding values of USPIO-enhanced MRl were 96.1% and 85.7%. (P<0.05. CONCLUSION: The features and the extent of the lymph node metastases corresponded to those observed on USPIO-enhanced MR images. USPIO-enhanced MRI is useful for the detection and estimation of lymph node metastasis in this cervical carcinoma animal model.

  7. Screening recurrence and lymph node metastases in head and neck cancer: the role of computer tomography in follow-up

    OpenAIRE

    Rivelli, V; Luebbers, H T; Weber, F. E.; Cordella, C; K.W. Grätz; Kruse, A L

    2011-01-01

    Introduction Follow-up of patients with oral cancer is being questioned with regard to financial costs and effectiveness. Therefore, the aim of the present study was to evaluate whether local recurrence and cervical lymph node metastases were first discovered clinically or by routine computer tomography. Materials and methods The records of all 317 patients that were treated for an oral cancer between 1998 and 2008 were systematically reviewed. Criteria for inclusion were tumor histology with...

  8. Rare case of axillary lymph node metastasis in papillary thyroid carcinoma detected using Iodine-131 whole-body scintigraphy and single-photon emission computed tomography/computed tomography

    International Nuclear Information System (INIS)

    Differentiated thyroid cancer is, usually, associated with an excellent prognosis and indolent course. Distant metastases are rare events at the onset of thyroid cancer. Among these presentations, metastasis to the axillary lymph nodes is even more unusual. Only few cases of papillary carcinoma with axillary nodal metastasis were previously reported in the literature. We present a 38-year-old female who underwent Iodine-131 whole-body scintigraphy, after total thyroidectomy and bilateral neck lymph node dissection for papillary carcinoma of thyroid, showed intense uptake in the remnant thyroid, lung metastasis, left cervical and left axillary lymph nodes. Excision of left axillary lymph nodes confirmed metastatic papillary carcinoma

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

    OpenAIRE

    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...

  10. [STRUCTURAL-FUNCTIONAL STATUS OF THE LYMPH TISSUE OF MICE LYMPHATIC NODES FOLLOWING THE 30-DAY FLIGHT ONBOARD SPACECRAFT BION-M1].

    Science.gov (United States)

    Bulekbaeva, L E; Demchenko, G A; Ilyin, E A; Erofeeva, L M

    2015-01-01

    The article reports the results of studying the lymph tissue of mesenteric and cervical lymphatic nodes in C57BL/6N mice after the 30-day orbital flight onboard biosatellite Bion-M1. Histological and morphometric investigations revealed changes in the ratio of the nodes structural-functional zones and microstructure. Reductions in reticular cells, plasmocytes, macrophages and blasts in the nodes point to degradation of both humoral and cellular immunity. PMID:26554128

  11. Studies of plutonium in human tracheobronchial lymph nodes

    International Nuclear Information System (INIS)

    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

  12. 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

    OpenAIRE

    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...

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

    Directory of Open Access Journals (Sweden)

    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

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

    International Nuclear Information System (INIS)

    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

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

    Institute of Scientific and Technical Information of China (English)

    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.

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

    Directory of Open Access Journals (Sweden)

    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

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

    International Nuclear Information System (INIS)

    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

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

    International Nuclear Information System (INIS)

    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)

  19. Evaluation of sonography and CT in detecting lymph node metastases in malignancies of the head and neck

    CERN Document Server

    Robatscher, P A S

    2001-01-01

    Imaging methods are, compared to anamnesis and clinical investigation, of importance in the praetherapeutic diagnosis of head and neck tumors. Sonography and CT are used routinely in staging of the primary and in staging of the cervical lymph nodes. A MRI-investigation is possible, too. The main interest is concentrated upon the status of the lymph nodes, because it takes strong influence on the therapeutic management and of course on the prognosis. Methods: each lymph node level of the 203 patients with untreated head and neck tumors will be analyzed, if the staging procedure (imaging methods and histological examination) is complete. Further two statistical hypotheses are defined: 1. Lymph nodes, which are 'probably metastatic' are classed with the 'metastatic'. 2. In the second hypothesis the 'probably metastatic' nodes are counted with the 'unsuspicious' ones. Results: The sensitivity rate of US is 66,67 % and CT 30,16 %. The difference of specifity between these two methods is small (US: 87,1 %; CT: 96,1...

  20. 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

    OpenAIRE

    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...

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

    DEFF Research Database (Denmark)

    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...

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

    Institute of Scientific and Technical Information of China (English)

    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.

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

    International Nuclear Information System (INIS)

    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.)

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

    Science.gov (United States)

    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.

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

    International Nuclear Information System (INIS)

    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.

  6. 背景抑制扩散加权成像诊断头颈部鳞癌颈部淋巴结转移的价值%Utility of diffusion-weighted imaging with background signal suppression in metastatic cervical lymph nodes

    Institute of Scientific and Technical Information of China (English)

    张赟; 梁碧玲; 谢传淼; 钟镜联; 叶瑞心

    2010-01-01

    目的 前瞻性地探讨背景抑制扩散加权成像(DWIBS)评价头颈部鳞癌颈部淋巴结转移的临床应用价值.方法 对20例经颈部淋巴结活检或手术病理证实的头颈部鳞癌患者(舌癌5例、鼻咽癌5例、喉癌3例、口底癌3例、口咽癌1例、喉咽癌1例、面颊癌1例和唇癌1例)进行颈部常规MR和DWIBS扫描,测量淋巴结的ADC值,选定鉴别转移性和良性淋巴结的最佳ADC阈值,并比较DWIBS与常规MRI显示和诊断转移性淋巴结的能力.两组均数间的比较采用独立样本t检验.结果 常规MR检查计数淋巴结共101枚,诊断转移性淋巴结58枚;常规MRI诊断淋巴结转移的敏感度为78%(47/60)、特异度为81%(44/54)、准确度为80%(91/114)、阳性预测值为82%(47/57)、阴性预测值为77%(44/57).DWIBS计数淋巴结共114枚,转移性淋巴结(60枚)的平均ADC值为(0.945±0.122)×10-3mm2/s,低于良性淋巴结(54枚)的平均ADC值(1.210±0.151)×10-3 mm2/s(t=-10.354,P<0.01).以1.090×10-3 mm2/s作为ADC阈值,诊断颈部淋巴结转移的敏感度、特异度、准确度、阳性和阴性预测值分别为88%(53/60)、80%(43/54)、84%(96/114)、83%(53/64)和86%(43/50).结论 DWIBS有助于诊断头颈部鳞癌的颈部淋巴结转移,较常规MRI可提高其检出率.%Objective To prospectively evaluate the value of diffusion-weighted imaging with background signal suppression (DWIBS) in the detection and diagnoses of metastatic cervical lymph nodes. Methods Twenty patients with head and neck squamous cell carcinomas underwent conventional MRI and DWIBS. The ADC values were measured and compared between metastatic and benign lymph nodes. The abilities of DWIBS and conventional MRI in the evaluation of metastatic cervical lymph nodes were compared. Results Conventional MRI demonstrated 101 lymph nodes, in which 58 were diagnosed as metastatic nodes. When MRI criteria were used for discrimination between metastatic and benign nodes, the obtained

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

    Energy Technology Data Exchange (ETDEWEB)

    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.

  8. The reliability of lymphoscintigraphy and gamma-detecting probe in detection of sentinel node in cervical cancer

    International Nuclear Information System (INIS)

    A complete pelvic node dissection is associated with significant morbidity in cervical cancer. The aim of the study was to assess the reliability of lymphoscintgraphy and a gamma-detecting probe for identifying sentinel node (SN) in patients with cervical cancer. On 6 ∼ 24 hours before surgery, lymphoscintigram were obtained in all 11 patients with cervical cancer following peritumoral injection of Tc-99m-labelled Antimony sulfur colloid. And an intraoperative gamma-detecting probe was used to identify SN during surgery and sentinel nodes were submitted separately to pathologic evaluation. If the sentinal node was invaded, then a complete pelvic node dissection was performed. But pelvic nodes were preserved in the cases with SN being not invaded. Localization of the SN was successful in the all cases. The sentinel node was invaded in one case. Ten cases with SN being not invaded were turned out negative for lymph node metastases. Lymphoscintigraphy and SN biopsy under gamma-detecting probe guidance proved to be an easy and reliable method for the detection of SN in cervical cancer and could be helpful in determining the extent of node dissection in cervical cancer

  9. The reliability of lymphoscintigraphy and gamma-detecting probe in detection of sentinel node in cervical cancer

    Energy Technology Data Exchange (ETDEWEB)

    Chung, Y. A.; Rhim, C. C.; Yoo, I. R.; Kim, S. H.; Park, Y. H.; Lee, S. Y.; Chung, S. K.; Namkoong, S. E. [College of Medicine, The Catholic Univ. of Korea, Seoul (Korea, Republic of)

    2001-07-01

    A complete pelvic node dissection is associated with significant morbidity in cervical cancer. The aim of the study was to assess the reliability of lymphoscintgraphy and a gamma-detecting probe for identifying sentinel node (SN) in patients with cervical cancer. On 6 {approx} 24 hours before surgery, lymphoscintigram were obtained in all 11 patients with cervical cancer following peritumoral injection of Tc-99m-labelled Antimony sulfur colloid. And an intraoperative gamma-detecting probe was used to identify SN during surgery and sentinel nodes were submitted separately to pathologic evaluation. If the sentinal node was invaded, then a complete pelvic node dissection was performed. But pelvic nodes were preserved in the cases with SN being not invaded. Localization of the SN was successful in the all cases. The sentinel node was invaded in one case. Ten cases with SN being not invaded were turned out negative for lymph node metastases. Lymphoscintigraphy and SN biopsy under gamma-detecting probe guidance proved to be an easy and reliable method for the detection of SN in cervical cancer and could be helpful in determining the extent of node dissection in cervical cancer.

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

    Science.gov (United States)

    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

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

    Science.gov (United States)

    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

  12. Impact of sentinel lymph node management in malignant melanoma

    International Nuclear Information System (INIS)

    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.)

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

    Energy Technology Data Exchange (ETDEWEB)

    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.)

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

    Science.gov (United States)

    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

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

    Science.gov (United States)

    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

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

    OpenAIRE

    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...

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

    OpenAIRE

    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....

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

    OpenAIRE

    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...

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

    OpenAIRE

    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...

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

    International Nuclear Information System (INIS)

    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.)

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

    International Nuclear Information System (INIS)

    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.)

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

    DEFF Research Database (Denmark)

    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...

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

    Energy Technology Data Exchange (ETDEWEB)

    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).

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

    International Nuclear Information System (INIS)

    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)

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

    Energy Technology Data Exchange (ETDEWEB)

    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)

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

    OpenAIRE

    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...

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

    Directory of Open Access Journals (Sweden)

    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.

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

    OpenAIRE

    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...

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

    OpenAIRE

    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...

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

    OpenAIRE

    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 ...

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

    OpenAIRE

    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...

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

    OpenAIRE

    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...

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

    OpenAIRE

    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...

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

    OpenAIRE

    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...

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

    OpenAIRE

    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...

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

    OpenAIRE

    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 ...

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

    OpenAIRE

    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...

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

    OpenAIRE

    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...

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

    Directory of Open Access Journals (Sweden)

    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.

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

    International Nuclear Information System (INIS)

    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

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

    OpenAIRE

    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...

  2. Node-positive cervical cancer: impact of pelvic irradiation and patterns of failure

    International Nuclear Information System (INIS)

    Purpose: The roles of postoperative pelvic and prophylactic paraaortic irradiation in pelvic node positive cervical cancer are currently controversial. A retrospective study was undertaken to examine the effect of pelvic irradiation on pelvic control and survival and to analyze the patterns of recurrence to determine whether indications exist for prophylactic paraaortic irradiation. Methods and Materials: From 1964 to 1991, 143 cases of FIGO Stage I and II cervical cancer undergoing exploratory laparotomy, pelvic lymph node dissection, and radical hysterectomy had positive pelvic lymph nodes. Postoperatively, 108 cases were treated with whole pelvic irradiation while 35 patients were observed. Prophylactic paraaortic irradiation was not given. Results: Patients who received postoperative whole pelvic irradiation compared with those treated with radical hysterectomy alone had a significantly improved pelvic control rate, disease-free survival (DFS), and overall survival. The 5-year actuarial pelvic control rate was 78% vs. 45% (p = <0.0001), respectively. The 5-year actuarial DFS was 65% vs. 41% (p = 0.0004). The 5-year actuarial overall survival was 58% vs. 46% (p 0.02). In multivariate analysis, pelvic irradiation continued to show a positive effect on DFS (p = 0.0001) and overall survival (p = 0.0035). Lymphatic invasion and the total number of positive lymph nodes were the only other independent predictors of overall survival and DFS. The actuarial 5-year pelvic, paraaortic, and distant failure rates were 30%, 10%, and 28%, respectively. An isolated first recurrence in the paraaortic nodes occurred in only three cases. Conclusion: Postoperative pelvic irradiation significantly improves pelvic control, DFS, and overall survival, and should be used in patients with early stage cervical cancer and pathologically proven pelvic nodal metastases. The low incidence of isolated paraaortic nodal failure calls into question the value of routine prophylactic paraaortic

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

    Science.gov (United States)

    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

  4. A Prognostic Index for Predicting Lymph Node Metastasis in Minor Salivary Gland Cancer

    International Nuclear Information System (INIS)

    Purpose: Large studies examining the clinical and pathological factors associated with nodal metastasis in minor salivary gland cancer are lacking in the literature. Methods and Materials: Using the Surveillance, Epidemiology, and End Results (SEER) database, we identified 2,667 minor salivary gland cancers with known lymph node status from 1988 to 2004. Univariate and multivariate analyses were conducted to identify factors associated with the use of neck dissection, the use of external beam radiation therapy, and the presence of cervical lymph node metastases. Results: Four hundred twenty-six (16.0%) patients had neck nodal involvement. Factors associated with neck nodal involvement on univariate analysis included increasing age, male sex, increasing tumor size, high tumor grade, T3-T4 stage, adenocarcinoma or mucoepidermoid carcinomas, and pharyngeal site of primary malignancy. On multivariate analysis, four statistically significant factors were identified, including male sex, T3-T4 stage, pharyngeal site of primary malignancy, and high-grade adenocarcinoma or high-grade mucoepidermoid carcinomas. The proportions (and 95% confidence intervals) of patients with lymph node involvement for those with 0, 1, 2, 3, and 4 of these prognostic factors were 0.02 (0.01-0.03), 0.09 (0.07-0.11), 0.17 (0.14-0.21), 0.41 (0.33-0.49), and 0.70 (0.54-0.85), respectively. Grade was a significant predictor of metastasis for adenocarcinoma and mucoepidermoid carcinoma but not for adenoid cystic carcinoma. Conclusions: A prognostic index using the four clinicopathological factors listed here can effectively differentiate patients into risk groups of nodal metastasis. The precision of this index is subject to the limitations of SEER data and should be validated in further clinical studies.

  5. Correlation of histological risk assessment/ scoring system with lymph node metastasis and recurrence/progression of disease in oral squamous cell carcinoma

    International Nuclear Information System (INIS)

    Objective: To correlate the scoring system using histopathologic parameters; worst pattern of invasion (WPOI), lymphocytic host response (LHR) and peri-neural invasion (PNI), with disease recurrence, overall survival and cervical lymph node metastasis in OSCC patients. Study Design: Cross sectional. Place and Duration of Study: Department of Histopathology, Shaukat Khanam Memorial Cancer and Research Hospital, Lahore in collaboration with Department of Histopathology, Armed Forces Institute of Pathology, Rawalpindi. Study completed in 2 years. Material and Methods: A Risk Scoring system was applied to 50 cases of OSCC with 2 years follow-up data, based on histopathologic parameters WPOI, LHR and PNI. The cases were divided into High risk and Non-High risk categories according to the specified parameters and then correlated with disease recurrence, overall survival and cervical lymph node metastasis. Results: There were 7 low risk, 17 intermediate risk and 26 high risk cases. No correlation was seen between the risk groups and disease recurrence, overall survival or cervical lymph node metastasis. However, when assessing the individual parameters, significant correlation was observed between PNI with disease recurrence (p = 0.03), and between WPOI and overall survival (p = 0.02) and cervical lymph node metastasis (p = 0.005). Conclusion: The individual parameters, peri-neural invasion and worst pattern of invasion are observed to be significant prognostic indicators in OSCC patients. A study with a larger number of cases is required to truly assess the value of the scoring system in Pakistani patients. (author)

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

    DEFF Research Database (Denmark)

    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...

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

    International Nuclear Information System (INIS)

    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.)

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

    International Nuclear Information System (INIS)

    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.)

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

    Energy Technology Data Exchange (ETDEWEB)

    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.)

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

    Science.gov (United States)

    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

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

    Institute of Scientific and Technical Information of China (English)

    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.

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

    OpenAIRE

    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...

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

    Institute of Scientific and Technical Information of China (English)

    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

  14. Nanoparticles in Sentinel Lymph Node Assessment in Breast Cancer

    Directory of Open Access Journals (Sweden)

    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.

  15. Inflammation and Tumor Microenvironment in Lymph Node Metastasis

    International Nuclear Information System (INIS)

    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

  16. CT lymphography-guided sentinel lymph node biopsy

    International Nuclear Information System (INIS)

    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.)

  17. Detection of Sentinel Lymph Nodes in Gynecologic Tumours by Planar Scintigraphy and SPECT/CT

    Directory of Open Access Journals (Sweden)

    Otakar Kraft

    2012-08-01

    Full Text Available Objective: Assess the role of planar lymphoscintigraphy and fusion imaging of SPECT/CT in sentinel lymph node (SLN detection in patients with gynecologic tumours. Material and Methods: Planar scintigraphy and hybrid modality SPECT/CT were performed in 64 consecutive women with gynecologic tumours (mean age 53.6 with range 30-77 years: 36 pts with cervical cancer (Group A, 21 pts with endometrial cancer (Group B, 7 pts with vulvar carcinoma (Group C. Planar and SPECT/CT images were interpreted separately by two nuclear medicine physicians. Efficacy of these two techniques to image SLN were compared. Results: Planar scintigraphy did not image SLN in 7 patients (10.9%, SPECT/CT was negative in 4 patients (6.3%. In 35 (54.7% patients the number of SLNs captured on SPECT/CT was higher than on planar imaging. Differences in detection of SLN between planar and SPECT/CT imaging in the group of all 64 patients are statistically significant (p<0.05. Three foci of uptake (1.7% from totally visible 177 foci on planar images in 2 patients interpreted on planar images as hot LNs were found to be false positive non-nodal sites of uptake when further assessed on SPECT/CT. SPECT/CT showed the exact anatomical location of all visualised sentinel nodes. Conclusion: In some patients with gynecologic cancers SPECT/CT improves detection of sentinel lymph nodes. It can image nodes not visible on planar scintigrams, exclude false positive uptake and exactly localise pelvic and paraaortal SLNs. It improves anatomic localization of SLNs. (MIRT 2012;21:47-55

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

    International Nuclear Information System (INIS)

    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)

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

    OpenAIRE

    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.

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

    OpenAIRE

    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...

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

    International Nuclear Information System (INIS)

    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

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

    OpenAIRE

    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...

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

    OpenAIRE

    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...

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

    International Nuclear Information System (INIS)

    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.

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

    DEFF Research Database (Denmark)

    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....

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

    International Nuclear Information System (INIS)

    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.)

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

    Energy Technology Data Exchange (ETDEWEB)

    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.).

  8. Cervical Cancer Stage IVB

    Science.gov (United States)

    ... of the body, such as the lymph nodes, lung, liver, intestine, or bone. Stage IVB cervical cancer. Topics/Categories: Anatomy -- Gynecologic Cancer Types -- Cervical Cancer Staging Type: Color, Medical Illustration Source: National Cancer Institute ...

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

    DEFF Research Database (Denmark)

    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...

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

    NARCIS (Netherlands)

    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

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

    Institute of Scientific and Technical Information of China (English)

    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

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

    Science.gov (United States)

    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

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

    International Nuclear Information System (INIS)

    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.)

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

    International Nuclear Information System (INIS)

    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)

  15. Multispectral real-time fluorescence imaging for intraoperative detection of the sentinel lymph node in gynecologic oncology.

    Science.gov (United States)

    Crane, Lucia M A; Themelis, George; Buddingh, K Tim; Buddingh, 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. 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. As an alternative, the sentinel lymph node procedure (SLN) was developed several decades ago to detect the first draining lymph node from the tumor. In case of lymphogenic dissemination, the SLN is the first lymph node that is affected (Figure 1). Hence, if the SLN does not contain metastases, downstream lymph nodes will also be free from tumor metastases and need not to be removed. The SLN procedure is part of the treatment for many tumor types, like breast cancer and melanoma, but also for cancer of the vulva and cervix. The current standard methodology for SLN-detection is by peritumoral injection of radiocolloid one day prior to surgery, and a colored dye intraoperatively. Disadvantages of the procedure in cervical and vulvar cancer are multiple injections in the genital area, leading to increased psychological distress for the patient, and the use of radioactive colloid. Multispectral fluorescence imaging is an emerging imaging modality that can be applied intraoperatively without the need for injection of radiocolloid. For intraoperative fluorescence imaging, two components are needed: a fluorescent agent and a quantitative optical system for intraoperative imaging. As a fluorophore we have used indocyanine green (ICG). ICG has been used for many decades to assess cardiac function, cerebral perfusion and liver perfusion. It is an inert drug with a safe pharmaco-biological profile. When excited at around 750 nm, it emits light in the near-infrared spectrum around 800 nm. A custom-made multispectral fluorescence imaging camera system was used. The aim of this video article is to demonstrate the detection of

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

    International Nuclear Information System (INIS)

    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

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

    OpenAIRE

    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 ...

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

    DEFF Research Database (Denmark)

    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...

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

    International Nuclear Information System (INIS)

    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

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

    Directory of Open Access Journals (Sweden)

    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.

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

    International Nuclear Information System (INIS)

    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

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

    LENUS (Irish Health Repository)

    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.

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

    Institute of Scientific and Technical Information of China (English)

    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.

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

    International Nuclear Information System (INIS)

    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)

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

    International Nuclear Information System (INIS)

    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

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

    Energy Technology Data Exchange (ETDEWEB)

    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

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

    Energy Technology Data Exchange (ETDEWEB)

    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

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

    International Nuclear Information System (INIS)

    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

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

    Energy Technology Data Exchange (ETDEWEB)

    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.

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

    International Nuclear Information System (INIS)

    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

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

    Science.gov (United States)

    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.

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

    Energy Technology Data Exchange (ETDEWEB)

    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.)

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

    International Nuclear Information System (INIS)

    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.)

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

    OpenAIRE

    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...

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

    OpenAIRE

    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...

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

    International Nuclear Information System (INIS)

    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

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

    OpenAIRE

    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...

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

    Directory of Open Access Journals (Sweden)

    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.

  19. Control of cervical node metastases from carcinoma of the oral tongue by preoperative irradiation

    International Nuclear Information System (INIS)

    A total of 48 patients with carcinoma of the oral tongue, who were treated with surgery after irradiation of the primary lesion and neck node were analyzed. Twenty-six of 33 patients with clinically negative nodes (N0 Group) and all 15 patients with clinically positive nodes (N1-2 Group) underwent neck dissection. Four patients (15%: 4/26) had occult node metastases. Three patients in the N0 Group (9%: 3/33) subsequently developed metastases to the neck after treatment. Incidence of cervical node metastases in the N0 Group was 21% (7/33). Of the six metastatic nodes in the N0 Group and the 36 metastatic nodes in the N1-2 Group, 14 with IIa, 15 with IIb, three with III and ten with IV ab and c histopathological change (Ohboshi-Shimozato's Classification) were found. The combination of preoperative irradiation and neck dissection for regional lymph nodes of the oral tongue was effective against occult and subsequent metastases. (author)

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

    Institute of Scientific and Technical Information of China (English)

    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.

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

    Science.gov (United States)

    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

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

    Energy Technology Data Exchange (ETDEWEB)

    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.

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

    International Nuclear Information System (INIS)

    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

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

    International Nuclear Information System (INIS)

    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. Adjuvant radiation therapy in metastatic lymph nodes from melanoma

    International Nuclear Information System (INIS)

    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)

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

    Directory of Open Access Journals (Sweden)

    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.

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

    Directory of Open Access Journals (Sweden)

    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.

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

    OpenAIRE

    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 ...

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

    OpenAIRE

    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 ...

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

    OpenAIRE

    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...

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

    Energy Technology Data Exchange (ETDEWEB)

    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)

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

    International Nuclear Information System (INIS)

    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)

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

    Energy Technology Data Exchange (ETDEWEB)

    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)

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

    International Nuclear Information System (INIS)

    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)

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

    Directory of Open Access Journals (Sweden)

    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.

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

    International Nuclear Information System (INIS)

    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

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

    Institute of Scientific and Technical Information of China (English)

    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.

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

    International Nuclear Information System (INIS)

    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

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

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    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.

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

    International Nuclear Information System (INIS)

    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.

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

    OpenAIRE

    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.

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

    International Nuclear Information System (INIS)

    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

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

    Directory of Open Access Journals (Sweden)

    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.

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

    International Nuclear Information System (INIS)

    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)

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

    International Nuclear Information System (INIS)

    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

  6. Lymph Node Thyroglobulin Measurement in Diagnosis of Neck Metastases of Differentiated Thyroid Carcinoma