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Sample records for lymph nodes evaluated

  1. Intraoperative Sentinel Lymph Node Evaluation

    DEFF Research Database (Denmark)

    Shaw, Richard; Christensen, Anders; Java, Kapil;

    2016-01-01

    BACKGROUND: Intraoperative analysis of sentinel lymph nodes would enhance the care of early-stage oral squamous cell carcinoma (OSCC). We determined the frequency and extent of cytokeratin 19 (CK19) expression in OSCC primary tumours and surrounding tissues to explore the feasibility of a "clinic......-ready" intraoperative diagnostic test (one step nucleic acid amplification-OSNA, sysmex). METHODS: Two cohorts were assembled: cohort 1, OSCC with stage and site that closely match cases suitable for sentinel lymph node biopsy (SLNB); cohort 2, HNSCC with sufficient fresh tumour tissue available for the OSNA assay (>50...

  2. Intraoperative Sentinel Lymph Node Evaluation

    DEFF Research Database (Denmark)

    Shaw, Richard; Christensen, Anders; Java, Kapil

    2016-01-01

    BACKGROUND: Intraoperative analysis of sentinel lymph nodes would enhance the care of early-stage oral squamous cell carcinoma (OSCC). We determined the frequency and extent of cytokeratin 19 (CK19) expression in OSCC primary tumours and surrounding tissues to explore the feasibility of a "clinic...... mg). CK19 assays included qRT-PCR, RNA in situ hybridisation (ISH), and immunohistochemistry (IHC), as well as OSNA. RESULTS: CK19 mRNA expression was detected with variable sensitivity, depending on method, in 60-80% of primary OSCC tumours, while protein expression was observed in only 50......% of tumours. Discordance between different techniques indicated that OSNA was more sensitive than qRT-PCR or RNA-ISH, which in turn were more sensitive than IHC. OSNA results showed CK19 expression in 80% of primary cases, so if used for diagnosis of lymph node metastasis would lead to a false-negative result...

  3. Computed Tomographic Evaluation of Presumptively Normal Canine Sternal Lymph Nodes.

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    Iwasaki, Ryota; Mori, Takashi; Ito, Yusuke; Kawabe, Mifumi; Murakmi, Mami; Maruo, Kohji

    The sternal lymph nodes receive drainage from a wide variety of structures in the thoraco-abdominal region. Evaluation of these lymph nodes is essential, especially in cancer patients. Computed tomography (CT) can detect sternal lymph nodes more accurately than radiography or ultrasonography, and the criteria of the sternal lymphadenopathy are unknown. The purpose of this retrospective study was to describe the CT characteristics of the sternal lymph nodes in dogs considered unlikely to have lymphadenopathy. The ratio of the short axis dimension of the sternal lymph nodes to the thickness of the second sternebra was also investigated. At least one sternal lymph node was identified in each of the 152 dogs included in the study. The mean long axis and short axis dimensions were 0.700 cm and 0.368 cm, respectively. The mean ratio of the sternal lymph nodes to the second sternebrae was 0.457, and the 95% prediction interval ranged from 0.317 to 0.596 (almost a fixed value independent of body weight). These findings will be useful when evaluating sternal lymphadenopathy using CT.

  4. 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.

  5. Sentinel Lymph Node Biopsy

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    ... 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 ...

  6. Lymph node biopsy

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    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 ...

  7. Evaluation of lymph node reactivity in differentiated thyroid carcinoma

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    Ali Amar

    1999-05-01

    Full Text Available CONTEXT: The development of metastases is the most notable characteristic of malignant neoplasias. The filter function of lymph nodes, which led to the idea of including lymphatic treatment in surgical management of metastases. OBJECTIVES: To evaluate morphological alterations in neck nodes in the presence of differentiated thyroid carcinoma (DTC: hyperplasia, histiocytosis, desmoplasia, capsular rupture, necrosis and their relation to the biological behavior of these neoplasias. DESIGN: Retrospective study. SETTING: University referral unit. PARTICIPANTS: 98 DTC patients, from 1977 to 1992, 18 cases were selected for histological analyses, of which 14 were female and 4 males, with an average age of 50.2 years. From these cases, 290 lymph nodes were analyzed (81 with metastasis, with an average of 16 lymph nodes/patient. MAIN MEASUREMENTS: Morphological evaluation of paraffin cuts stained by HE was done using an optical microscope, looking for presence of the abovementioned neoplasias and their UICC-TNM (1997 staging. RESULTS: Sinus histiocytosis was 2.4 times more frequent in the absence of lymph node metastasis (pNo. Disease recurrence occurred in 5 patients, all of whom were more than 40 years old (p= 0.24 and 4 of whom had necrosis (p= 0.02. Six patients with predominance of paracortical hyperplasia (p= 0.02 did not show as much relapse into disease as those with less than 6 metastasis lymph nodes (p= 0.009. CONCLUSIONS: The presence of paracortical hyperplasia is associated with a better prognosis. The existence of necrosis or metastasis in more than 6 lymph nodes in patients over 40 years of age is related to higher risk of relapse of disease in DTC.

  8. Ultrasonographic Evaluation of Cervical Lymph Nodes in Thyroid Cancer.

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    Machado, Maria Regina Marrocos; Tavares, Marcos Roberto; Buchpiguel, Carlos Alberto; Chammas, Maria Cristina

    2017-02-01

    Objective To determine what ultrasonographic features can identify metastatic cervical lymph nodes, both preoperatively and in recurrences after complete thyroidectomy. Study Design Prospective. Setting Outpatient clinic, Department of Head and Neck Surgery, School of Medicine, University of São Paulo, Brazil. Subjects and Methods A total of 1976 lymph nodes were evaluated in 118 patients submitted to total thyroidectomy with or without cervical lymph node dissection. All the patients were examined by cervical ultrasonography, preoperatively and/or postoperatively. The following factors were assessed: number, size, shape, margins, presence of fatty hilum, cortex, echotexture, echogenicity, presence of microcalcification, presence of necrosis, and type of vascularity. The specificity, sensitivity, positive predictive value, and negative predictive value of each variable were calculated. Univariate and multivariate logistic regression analyses were conducted. A receiver operator characteristic (ROC) curve was plotted to determine the best cutoff value for the number of variables to discriminate malignant lymph nodes. Results Significant differences were found between metastatic and benign lymph nodes with regard to all of the variables evaluated ( P < .05). Logistic regression analysis revealed that size and echogenicity were the best combination of altered variables (odds ratio, 40.080 and 7.288, respectively) in discriminating malignancy. The ROC curve analysis showed that 4 was the best cutoff value for the number of altered variables to discriminate malignant lymph nodes, with a combined specificity of 85.7%, sensitivity of 96.4%, and efficiency of 91.0%. Conclusion Greater diagnostic accuracy was achieved by associating the ultrasonographic variables assessed rather than by considering them individually.

  9. 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

    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 upper gastrointestinal cancer who were referred for EUS examination were enrolled if surgical treatment was planned and the patient had a lymph node that was accessible for EUS - FNA and EUS-guided fine-needle marking (FNM). The lymph node was classified using EUS, ESE, and ESE-strain ratio. Finally......, 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...

  10. 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

    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......, 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...... - 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....

  11. 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.

  12. Intramammary lymph nodes.

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    Egan, R L; McSweeney, M B

    1983-05-15

    Radiographic, gross, and histopathologic studies on 158 whole breasts with primary operable carcinoma revealed intramammary lymph nodes in 28%, and of these breasts, 10% contained a metastatic deposit of carcinoma. Cancerous and noncancerous nodes were found in all quadrants of the breast with the positive ones being in the same quadrant as the carcinoma only 50% of the time. There was no demonstrable connection with the usual lymphatic drainage of the breast. With Stage II carcinoma, positive intramammary lymph nodes had no direct effect on prognosis, merely representing advanced disease and indicating a greater likelihood of axillary metastatic disease. There was a trend toward poorer prognosis in Stage I lesions with positive intramammary lymph nodes. This may indicate the Stage I carcinomas that have a similar prognosis as Stage II tumors. Conceivably, a Stage Ia, positive intramammary lymph node(s) but normal axillary lymph nodes, could be defined and used.

  13. Swollen lymph nodes

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    ... gingivitis ) Mononucleosis Mouth sores Sexually transmitted illness (STI) Tonsillitis Tuberculosis Skin infections Immune or autoimmune disorders that ... goes away in a couple of days, without treatment. The lymph node may not return to its ...

  14. Lymph node culture

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    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 ...

  15. Evaluation of the 7th AJCC TNM Staging System in Point of Lymph Node Classification

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    Kim, Sung Hoo; Ha, Tae Kyung

    2011-01-01

    Purpose The 7th AJCC tumor node metastasis (TNM) staging system modified the classification of the lymph node metastasis widely compared to the 6th edition. To evaluate the prognostic predictability of the new TNM staging system, we analyzed the survival rate of the gastric cancer patients assessed by the 7th staging system. Materials and Methods Among 2,083 patients who underwent resection for gastric cancer at the department of surgery, Hanyang Medical Center from July 1992 to December 2009, This study retrospectively reviewed 5-year survival rate (5YSR) of 624 patients (TanyN3M0: 464 patients, TanyNanyM1: 160 patients) focusing on the number of metastatic lymph node and distant metastasis. We evaluated the applicability of the new staging system. Results There were no significant differences in 5YSR between stage IIIC with more than 29 metastatic lymph nodes and stage IV (P=0.053). No significant differences were observed between stage IIIB with more than 28 metastatic lymph nodes and stage IV (P=0.093). Distinct survival differences were present between patients who were categorized as TanyN3M0 with 7 to 32 metastatic lymph nodes and stage IV. But patients with more than 33 metastatic lymph nodes did not show any significant differences compared to stage IV (P=0.055). Among patients with TanyN3M0, statistical significances were seen between patients with 7 to 30 metastatic lymph nodes and those with more than 31 metastatic lymph nodes. Conclusions In the new staging system, modifications of N classification is mandatory to improve prognostic prediction. Further study involving a greater number of cases is required to demonstrate the most appropriate cutoffs for N classification. PMID:22076209

  16. Endoscopic ultrasound elastography for evaluation of lymph nodes and pancreatic masses: a multicenter study

    DEFF Research Database (Denmark)

    Giovannini, Marc; Thomas, Botelberge; Erwan, Bories

    2009-01-01

    AIM: To evaluate the ability of endoscopic ultrasound (EUS) elastography to distinguish benign from malignant pancreatic masses and lymph nodes. METHODS: A multicenter study was conducted and included 222 patients who underwent EUS examination with assessment of a pancreatic mass (n = 121) or lym...

  17. A nodal positivity constant: new perspectives in lymph node evaluation and colorectal cancer.

    LENUS (Irish Health Repository)

    Hogan, Niamh M

    2013-04-01

    To date, associations between the number of lymph nodes evaluated, staging, and survival have been examined in the context of large population-based studies conducted by a small number of investigators. Therefore, although high-quality data are available, perspective is lacking.

  18. Evaluation of sodium chlorate as a pre-harvest intervention for controlling Salmonella in the peripheral lymph nodes of cattle

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    The objective of the current study was to evaluate sodium chlorate as a potential pre-harvest intervention for reducing or eliminating Salmonella from the peripheral lymph nodes of experimentally-infected cattle. The peripheral lymph nodes of Holstein steers (approx. BW = 160 kg; 4 and 6 head in co...

  19. Evaluation of the potential for lymph node metastasis using CRP 1846C>T genetic polymorphism in invasive breast cancer.

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    Terata, Kaori; Motoyama, Satoru; Kamata, Shuichi; Hinai, Yudai; Miura, Masatomo; Sato, Yusuke; Yoshino, Kei; Ito, Aki; Imai, Kazuhiro; Saito, Hajime; Minamiya, Yoshihiro

    2014-06-01

    Lymph node status is a key indicator of the best approach to treatment of invasive breast cancer. However, the accuracy with which lymph node metastasis is diagnosed is not currently satisfactory. New and more reliable methods that enable one to know who has a greater potential for lymph node metastasis would be highly desirable. We previously reported that lymph node involvement in esophageal and lung cancer may have a genetic component: C-reactive protein (CRP) 1846C>T genetic polymorphism. Here we examined the diagnostic value of CRP 1846C>T polymorphism for assessing the risk of lymph node metastasis in cases of invasive breast cancer. The study participants were 185 women with invasive breast cancer who underwent curative surgery with lymph node dissection. Using DNA from blood samples and polymerase chain reaction-restriction fragment length polymorphism, the utility of CRP genetic 1846C>T polymorphism (rs1205) for assessing the risk of lymph node metastasis was evaluated. Fifty-two (28 %) patients had lymph node metastasis. After the patients were divided into two groups based on their CRP 1846 genotypes (C/C+C/T and T/T), the clinical characteristics did not differ between the groups, but there was a significantly greater incidence of lymph node metastasis among patients in the T/T group. Moreover, the odds ratio for lymph node involvement in patients carrying the 1846 T/T genotype was more than 2.2 in multivariate logistic regression models. CRP genetic polymorphism may be a novel predictor of the risk of lymph node metastasis in invasive breast cancer.

  20. Endoscopic evaluation of the tracheobronchial tree and mediastinal lymph nodes.

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    Raymond, Daniel P; Watson, Thomas J

    2010-10-01

    Assessment of the airways and surrounding structures, including the mediastinum and pulmonary parenchyma, has been greatly facilitated by advancements in bronchoscopic techniques, both rigid and flexible. Recent years have seen an explosion in technologies that have revolutionized the ability to visualize, biopsy, or otherwise assess regions of potential pathology within the upper aerodigestive tract and adjacent structures. This article concisely and comprehensively reviews the endoscopic evaluation of the tracheobronchial tree and mediastinum with a focus on emerging technologies and their role in treatment of thoracic disease.

  1. Contrast enhanced ultrasound of sentinel lymph nodes

    Directory of Open Access Journals (Sweden)

    XinWu Cui

    2013-03-01

    Full Text Available Sentinel lymph nodes are the first lymph nodes in the region that receive lymphatic drainage from a primary tumor. The detection or exclusion of sentinel lymph node micrometastases is critical in the staging of cancer, especially breast cancer and melanoma because it directly affects patient’s prognosis and surgical management. Currently, intraoperative sentinel lymph node biopsies using blue dye and radioisotopes are the method of choice for the detection of sentinel lymph node with high identification rate. In contrast, conventional ultrasound is not capable of detecting sentinel lymph nodes in most cases. Contrast enhanced ultrasound with contrast specific imaging modes has been used for the evaluation and diagnostic work-up of peripherally located suspected lymphadenopathy. The method allows for real-time analysis of all vascular phases and the visualization of intranodal focal “avascular” areas that represent necrosis or deposits of neoplastic cells. In recent years, a number of animal and human studies showed that contrast enhanced ultrasound can be also used for the detection of sentinel lymph node, and may become a potential application in clinical routine. Several contrast agents have been used in those studies, including albumin solution, hydroxyethylated starch, SonoVue®, Sonazoid® and Definity®. This review summarizes the current knowledge about the use of ultrasound techniques in detection and evaluation of sentinel lymph node.

  2. CT evaluation of cardiophrenic angle lymph nodes in patients with malignant lymphoma

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    Cho, C.S.; Blank, N.; Castellino, R.A.

    1984-10-01

    Two hundred seventy-four computed tomographic (CT) scans of the thorax were obtained in 209 patients with malignant lymphoma (153 Hodgkin disease and 56 non-Hodgkin lymphoma). Fourteen patients (6.6%) were shown to have adenopathy involving the cardiophrenic angle lymph nodes on CT. Of these, only three were considered positive on the basis of chest radiography alone. The anatomy of these diaphragmatic lymph nodes and CT appearance of these nodes when pathologically enlarged are discussed.

  3. Risk factors for lymph node metastasis and evaluation of reasonable surgery for early gastric cancer

    Institute of Scientific and Technical Information of China (English)

    2007-01-01

    AIM: To give the evidence for rationalizing surgical therapy for early gastric cancer with different lymph node status.METHODS: A series of 322 early gastric cancer patients who underwent gastrectomy with more than 15 lymph nodes retrieved were reviewed in this study. The rate of lymph node metastasis was calculated. Univariate and multivariate analyses were performed to evaluate the independent factors for predicting lymph node metastasis.RESULTS: No metastasis was detected in No.5, 6 lymph nodes (LN) during proximal gastric cancer total gastrectomy, and in No.10, 11p, 11d during for combined resection of spleen and splenic artery and in No.15 LN during combined resection of transverse colon mesentery. No.11p, 12a, 14v LN were proved negative for metastasis. The global metastastic rate was 14.6% for LN, 5.9% for mucosa, and 22.4% for submucosa carcinoma, respectively. The metastasis in group Ⅱ was almost limited in No.7, 8a LN. Multivariate analysis identified that the depth of invasion, histological type and lymphatic invasion were independent risk factors for LN metastasis. No metastasis from distal cancer (≤ 1.0 cm in diameter) was detected in group Ⅱ LN. The metastasis rate increased significantly when the diameter exceeded 3.0 cm. All tumors (≤ 1.0 cm in diameter) with LN metastasis and mucosa invasion showed a depressed macroscopic type, and all protruded carcinomas were >3.0 cm in diameter.CONCLUSION: Segmental/subtotal gastrectomy plus D1/D1 + No.7 should be performed for carcinoma (≤ 1.0 cm in diameter, protruded type and mucosa invasion).Subtotal gastrectomy plus D2 or D1 + No.7, 8a, 9 is the most rational operation, whereas No.11p, 12a,14v lymphadenectomy should not be recommended routinely for poorly differentiated and depressed type of submucosa carcinoma (> 3.0 cm in diameter). Total gastrectomy should not be performed in proximal, so does combined resection or D2+/D3 lymphadenectomy.

  4. USPIO: New MR Contrast Agent for Evaluation of Metastatic Lymph Nodes

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    Mahrooz Malek

    2010-05-01

    Full Text Available accurate detection and characterization of lymph node metastases is crucial for planning therapy and determining prognosis in patients with various un-derlying primary tumors such as the breast, prostate, head and neck, urogenital, melanoma and other cancers. CT and MR imaging are of limited value because they primarily rely on the tumor size for differentiating benign from malignant lymph nodes. Ultrasmall super paramagnetic iron oxide (USPIO (Combidex or Ferumoxtran-10; Advanced Magnetics, Sinerem; Guerbet is an MR contrast agent that has shown improved accuracy in the staging of lymph nodes in cancer patients. Animal and recent human studies have shown that USPIO particles allow MR differentiation of benign from malignant lymph nodes based on enhancement patterns."nThis lecture is a review about new imaging methods in oncological imaging, especially for the lymphatic system.

  5. Preplanning Vascularized Lymph Node Transfer with Duplex Ultrasonography: An Evaluation of 3 Donor Sites

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    Ketan M. Patel, MD

    2014-08-01

    Conclusions: Preoperative imaging with duplex ultrasonography before VLN transfer may allow for accurate identification of specific VLN donor-site characteristics. When considering lymph node–specific characteristics, higher quantity of lymph nodes were found on the groin and submental flap axis compared with the transverse cervical artery axis.

  6. The Sentinel Lymph Node Concept

    Institute of Scientific and Technical Information of China (English)

    2004-01-01

    The sentinel lymph node concept is meeting with steadily growing interest and is being extended to the different sites of the primaries. In addition, the concept is being applied in an increasingly sophisticated manner. In this book the practical

  7. Magnetic Resonance Evaluation of Transplanted Endometrial Carcinoma and Its Lymph Node Metastasis in Rabbits

    Institute of Scientific and Technical Information of China (English)

    2007-01-01

    Objective: To establish a rabbit model of transplanted endometrial carcinoma with lymph node metastasis and observe its magnetic resonance imaging (MRI) features. Methods: VX2 tumor grafts were orthotopically embedded in the endometrium of rabbits, and 3 weeks after the transplantation, thetumor and its metastasis to the retroperitoneal lymph nodes were examined by MRI, and the signal intensities and size of the lymph nodes were compared with those of normal rabbits. Results: The orthotopic transplantation of the tumor grafts resulted in tumor growth in all the 12 recipient rabbits. The tumors infiltrated the serosa of the uterus and metastasized to the retroperitoneal lymph nodes 3 w after transplantation. MRI demonstrated that the lymph nodes of the tumor-bearing rabbits were larger in size than those of normal control rabbits, but the signal intensity of the lymph nodes was not significantly different between them. Conclusion: This transplanted endometrial carcinoma model is characterized by high success rate and similar tumor metastasis behaviors with human endometrial carcinoma, therefore may serve as a good model for testing the efficacy of contrast agents for MR lymphography.

  8. Evaluation of Dynamic Optical Projection of Acquired Luminescence for Sentinel Lymph Node Biopsy in Large Animals.

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    Ringhausen, Elizabeth; Wang, Tylon; Pitts, Jonathan; Sarder, Pinaki; Akers, Walter J

    2016-12-01

    Open surgery requiring cytoreduction still remains the primary treatment course for many cancers. The extent of resection is vital for the outcome of surgery, greatly affecting patients' follow-up treatment including need for revision surgery in the case of positive margins, choice of chemotherapy, and overall survival. Existing imaging modalities such as computed tomography, magnetic resonance imaging, and positron emission tomography are useful in the diagnostic stage and long-term monitoring but do not provide the level of temporal or spatial resolution needed for intraoperative surgical guidance. Surgeons must instead rely on visual evaluation and palpation in order to distinguish tumors from surrounding tissues. Fluorescence imaging provides high-resolution, real-time mapping with the use of a contrast agent and can greatly enhance intraoperative imaging. Here we demonstrate an intraoperative, real-time fluorescence imaging system for direct highlighting of target tissues for surgical guidance, optical projection of acquired luminescence (OPAL). Image alignment, accuracy, and resolution was determined in vitro prior to demonstration of feasibility for operating room use in large animal models of sentinel lymph node biopsy. Fluorescence identification of regional lymph nodes after intradermal injection of indocyanine green was performed in pigs with surgical guidance from the OPAL system. Acquired fluorescence images were processed and rapidly reprojected to highlight indocyanine green within the true surgical field. OPAL produced enhanced visualization for resection of lymph nodes at each anatomical location. Results show the optical projection of acquired luminescence system can successfully use fluorescence image capture and projection to provide aligned image data that is invisible to the human eye in the operating room setting. © The Author(s) 2015.

  9. Lymph node evaluation for colon cancer in routine clinical practice: a population-based study

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    Del Paggio, J.C.; Nanji, S.; Wei, X.; MacDonald, P.H.; Booth, C.M.

    2017-01-01

    Background Guidelines recommend that 12 or more lymph nodes (lns) be evaluated during surgical resection of colon cancer. Here, we report ln yield and its association with survival in routine practice. Methods Electronic records of treatment were linked to the population-based Ontario Cancer Registry to identify all patients with colon cancer treated during 2002–2008. The study population (n = 5508) included a 25% random sample of patients with stage ii or iii disease. Modified Poisson regression was used to identify factors associated with ln yield; Cox models were used to explore the association between ln yield and overall (os) and cancer-specific survival (css). Results During 2002–2008, median ln yield increased to 17 from 11 nodes (p colon cancer. The association between ln yield and survival is unlikely to be a result of stage migration.

  10. 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...

  11. The utility of EBUS-TBNA in mediastinal or hilar lymph node evaluation in extrapulmonary malignancy.

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    Erer, Onur Fevzi; Anar, Ceyda; Erol, Serhat; Özkan, Serir

    2016-01-05

    The aim of this study was to determine the diagnostic performance of endobronchial ultrasound-guided transbronchial needle aspiration (EBUS-TBNA) in the diagnosis of mediastinal and hilar lymph nodes (LNs) in patients with known extrapulmonary malignancy. Between March 2011 and August 2013, 378 EBUS-TBNA procedures were performed. Sixty-three (16.6%) of these were performed on known extrapulmonary malignancy patients. There were 28 male and 35 female patients, with median ages of 65 years (min-max: 53-87) and 57 years (min-max: 39-76), respectively. From the 63 cases, 138 lymph nodes (LNs) were sampled with EBUS-TBNA (median: 2 LNs/patient; min-max: 1-4). Results of EBUS-TBNA revealed malignancy in 18 (28.5%) and nonmalignancy in 45 (71.5%). In the nonmalignant group, there were false negatives in 5 (7.9%), anthracosis in 13 (20.6%), reactive adenitis in 16 (25.3%), sarcoidosis in 7 (11.1%), and tuberculosis in 2 (3.1%), and 2 were not evaluated (lost to follow-up) (3.1%). The diagnostic sensitivity, accuracy, and negative predictive value of EBUS-TBNA per patient were 78.2%, 91.8%, and 88.3%, respectively. EBUS-TBNA is a safe, minimally invasive, and effective method and can be considered as the initial test for the histopathological diagnosis of mediastinal and hilar lymphadenopathy in patients with extrapulmonary malignancy.

  12. Evaluation of sentinel lymph node size and shape as a predictor of occult metastasis in patients with squamous cell carcinoma of the oral cavity

    DEFF Research Database (Denmark)

    Langhans, Linnea; Bilde, Anders; Charabi, Birgitte

    2013-01-01

    The aim of the study was to evaluate sentinel lymph node size as a predictor of metastasis in N0 patients with oral squamous cell carcinoma treated by individual sentinel node biopsy (SNB) guided neck dissection. In addition, to evaluate lymph node shape as an indicator of malignancy. A retrospec...

  13. Predicting non-sentinel lymph node status in breast cancer patients with sentinel lymph node involvement: evaluation of two scoring systems.

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    Sanjuán, Alex; Escaramís, Georgia; Vidal-Sicart, Sergi; Illa, Miriam; Zanón, Gabriel; Pahisa, Jaume; Rubí, Sebastià; Velasco, Martín; Santamaría, Gorane; Farrús, Blanca; Muñoz, Montse; García, Yolanda; Fernández, Pedro Luís; Pons, Francesca

    2010-01-01

    The aim of this study was to validate a nomogram and a scoring system to predict non-sentinel lymph node status in breast cancer patients with sentinel lymph node (SLN) involvement. A total of 516 breast cancer patients underwent sentinel lymph node biopsy at our institution from January 2001 to August 2006. A prospective database was used to identify breast cancer patients with a positive SLN biopsy examination who underwent a completion axillary lymph node dissection. A total of 114 patients were identified. The Memorial Sloan-Kettering Cancer Center (MSKCC) nomogram and an axilla scoring system from Paris (Hôpital Tenon) were used to predict the probability of having non-SLN involvement. One hundred fourteen patients were included in the study. The areas under the receiver operating characteristics (ROC) curves were 0.671 (95% CI: 0.552-0.790) for the MSKCC nomogram and 0.703 (95% CI: 0.596-0.811) for the Tenon score. The univariate analysis shows that size of SLN metastases, the number of positive and negative SLN and the proportion of positive SLN were statistically significant. On multivariate logistic regression analysis, the size of SLN metastases and the proportion of positive SLN were statistically significant. The two scoring systems are similar according to their area under ROC curves, but should be improved to be valid and determinant to the general population. Meanwhile, the use of scoring systems could be applied in an individual manner in some patients.

  14. [Lymph node staging in gastrointestinal cancer. Combination of methylene blue-assisted lymph node dissection and ex vivo sentinel lymph node mapping].

    Science.gov (United States)

    Märkl, B; Arnholdt, H

    2012-11-01

    The histopathological lymph node staging is of crucial importance for the prognosis estimation and therapy stratification in gastrointestinal cancer. However, the recommended numbers of lymph nodes that should be evaluated are often not reached in routine practice. Methylene blue assisted lymph node dissection was introduced as a new, simple and efficient technique to improve lymph node harvest in gastrointestinal cancer. This method is inexpensive, causes no delay and needs no toxic substances. All studies performed revealed a highly significantly improved lymph node harvest in comparison to the conventional technique. Moreover, this technique can be combined with a new ex vivo sentinel lymph node mapping that for the first time is based on histological sentinel lymph node detection. The success rate of this method is similar to conventional techniques and it enables an efficient application of extended investigation methods, such as immunohistochemistry or the polymerase chain reaction.

  15. Evaluation of the Metasin assay for intraoperative assessment of sentinel lymph node metastases in breast cancer.

    Science.gov (United States)

    Smith, G J; Hodges, E; Markham, H; Zhang, S; Cutress, R I

    2017-02-01

    Sentinel lymph node (SLN) biopsy is the preferred surgical technique for staging the axilla in clinically node-negative breast cancer. Accurate intraoperative staging allows for the immediate performance of an axillary clearance in node-positive patients. We assessed the Metasin assay for the intraoperative analysis of SLNs in a prospective evaluation of 250 consecutive patients undergoing intraoperative SLN analysis at the Breast Unit, University Hospital, Southampton, UK. Metasin uses a quantitative reverse transcription PCR to detect two markers of metastasis: cytokeratin 19 (CK19) an epithelial marker and mammaglobin (MGB) a breast specific marker. Metasin results were compared with the results from routine paraffin block histopathology. Metasin was robust, with a failure rate of <1%, and demonstrated excellent accuracy and reproducibility. The average turnaround time for the Metasin assay was 42 min, the largest variable being the number of nodes assayed. A total of 533 SLNs were evaluated with 75 patients testing positive for MGB and/or CK19. Based on the analysis of individual SLNs, the overall concordance between Metasin and histology was 92.3% (sensitivity 88.7%, specificity 92.9%). When adjusted for tissue allocation bias, the concordance was 93.8% (sensitivity 89.8%, specificity 94.6%). In this evaluation, 57/250 patients (23%) proceeded to axillary clearance based on Metasin results and were considered spared a second operative procedure. Metasin has proven to be an accurate, reproducible and reliable laboratory test. The analysis time is acceptable for intraoperative use, and in comparison to routine histology demonstrates acceptable concordance, sensitivity and specificity. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/.

  16. Ultrasound evaluation of the morphometric patterns of lymph nodes of the head and neck in young and middle-aged individuals*

    Science.gov (United States)

    Ogassavara, Beatriz; Tucunduva Neto, Raul Renato; de Souza, Romeu Rodrigues; Tucunduva, Maria José

    2016-01-01

    Objective To show the morphometric patterns of lymph nodes of the head and neck, evaluating their number, shape, dimensions, hilum, and cortex, through the use of ultrasound examination of the neck. Materials and Methods We analyzed 400 right and left lymph nodes in a group of 20 healthy young and middle-aged individuals of both genders. Results In the ultrasound examination, we observed the following lymph nodes: mastoid; parotid (superficial, extraglandular, and intraglandular); submandibular (preglandular, retroglandular, and intracapsular); submental; and cervical (anterior and posterior). Although some individuals had up to seven lymph nodes in the same region, most had only two to three per region. The smallest lymph node diameter observed was 0.4 cm, and the largest was 2.7 cm. Most lymph nodes showed an elongated or oval shape. Most of the lymph node hila were echogenic, although a few were hyperechoic. However, the cortex was clearly hypoechoic in all of the lymph nodes evaluated. Conclusion Ultrasound examination of healthy individuals allowed the characteristics of the lymph nodes of the head and neck to be observed clearly, which could provide a basis for the analysis of patients with diseases of these lymph nodes. PMID:27777475

  17. Ultrasonography for diagnostic evaluation of the skin and lymph nodes; Ultraschalldiagnostik der Haut und Lymphknoten

    Energy Technology Data Exchange (ETDEWEB)

    Garbe, C. [Universitaetsklinikum Tuebingen (Germany). Dermatologische Onkologie; Blum, A. [eds.] [Universitaetsklinikum Tuebingen (Germany). Hautklinik und Poliklinik

    1999-07-01

    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) [German] Dieses Buch bietet - eine ausfuehrliche Darstellung des gesamten Gebietes der Ultraschalldiagnostik in der Dermatologie - eine Anleitung fuer das praktische Vorgehen der Ultraschalluntersuchung der Haut und subkutaner Lymphknoten - Befundinterpretationen, die anhand einer Vielzahl von Bildern visualisiert werden - das notwendige Wissen fuer die KV-Qualifikation 'Ultraschall in der Dermatologie'. (orig.)

  18. Evaluating efficiency of split VMAT plan for prostate cancer radiotherapy involving pelvic lymph nodes

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    Mun, Jun Ki; Son, Sang Jun; Kim, Dae Ho; Seo, Seok Jin [Dept. of Radiation Oncology, Seoul National University Hospital, Seoul (Korea, Republic of)

    2015-12-15

    The purpose of this study is to evaluate the efficiency of Split VMAT planning(Contouring rectum divided into an upper and a lower for reduce rectum dose) compare to Conventional VMAT planning(Contouring whole rectum) for prostate cancer radiotherapy involving pelvic lymph nodes. A total of 9 cases were enrolled. Each case received radiotherapy with Split VMAT planning to the prostate involving pelvic lymph nodes. Treatment was delivered using TrueBeam STX(Varian Medical Systems, USA) and planned on Eclipse(Ver. 10.0.42, Varian, USA), PRO3(Progressive Resolution Optimizer 10.0.28), AAA(Anisotropic Analytic Algorithm Ver. 10.0.28). Lower rectum contour was defined as starting 1 cm superior and ending 1 cm inferior to the prostate PTV, upper rectum is a part, except lower rectum from the whole rectum. Split VMAT plan parameters consisted of 10 MV coplanar 360° arcs. Each arc had 30° and 30° collimator angle, respectively. An SIB(Simultaneous Integrated Boost) treatment prescription was employed delivering 50.4 Gy to pelvic lymph nodes and 63- 70 Gy to the prostate in 28 fractions. D{sub mean} of whole rectum on Split VMAT plan was applied for DVC(Dose Volume Constraint) of the whole rectum for Conventional VMAT plan. In addition, all parameters were set to be the same of existing treatment plans. To minimize the dose difference that shows up randomly on optimizing, all plans were optimized and calculated twice respectively using a 0.2 cm grid. All plans were normalized to the prostate PTV{sub 100%} = 90% or 95%. A comparison of D{sub mean} of whole rectum, upperr ectum, lower rectum, and bladder, V{sub 50%} of upper rectum, total MU and H.I.(Homogeneity Index) and C.I.(Conformity Index) of the PTV was used for technique evaluation. All Split VMAT plans were verified by gamma test with portal dosimetry using EPID. Using DVH analysis, a difference between the Conventional and the Split VMAT plans was demonstrated. The Split VMAT plan demonstrated better in the D

  19. 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.

  20. Evaluation of mediastinal lymph nodes using 18 F-FDG PET-CT scan and its histopathologic correlation

    Directory of Open Access Journals (Sweden)

    Kumar Arvind

    2011-01-01

    Full Text Available Aims and Objectives: To determine the efficacy of integrated 18 F-fluorodeoxy glucose positron emission tomography-computed tomography ( 18 F-FDG PET-CT in the evaluation and characterization of mediastinal lymph nodes into benign and malignant pathology. Methods: Thirty-five patients with mediastinal lymphadenopathies without primary neoplastic or infective lung pathologies were included in the study. The lymph nodes were detected on contrast-enhanced CT scan of the chest. All patients underwent 18 F-FDG PET-CT scan for evaluation of mediastinal lymph nodes. Results of PET-CT were compared with histopathology of the lymph nodes and sensitivity, specificity, positive predictive value, negative predictive value, and accuracy were calculated. Statistical Analysis: The data were collected prospectively and analyzed using (SPSS Inc., Chicago, IL 11.5 software. Results: Histopathology results in 35 patients revealed tuberculosis in 12, sarcoidosis in 8, and lymphoma in 15. Maximum standardized uptake value (SUVmax of the benign lymph nodes ranged from 2.3 to 11.8 with a mean±standard deviation (SD of 5.02±3.26. SUVmax of the malignant lymph nodes ranged from 2.4 to 34 with a mean±SD of 10.8±8.12. There was a statistically significant difference between benign and malignant pathology (P<0.0059. 18 F-FDG PET-CT has sensitivity of 93% and specificity of 40% with SUVmax 2.5 as the cutoff. We found the optimal SUVmax cutoff to be 6.2 as determined by the receiver-operator characteristic curve. With 6.2 as cutoff, the sensitivity, specificity, and accuracy were 87%, 70%, and 77%, respectively. Conclusion : In countries where tuberculosis and other granulomatous diseases are endemic, SUVmax cutoff value of 2.5 has low specificity. Increasing the cutoff value can improve the specificity, while maintaining an acceptable sensitivity.

  1. Evaluation of lymph node metastasis in lung cancer: who is the chief justice?

    Science.gov (United States)

    Xia, Yang; Zhang, Bin; Zhang, Hao; Li, Wen; Wang, Ko-Pen; Shen, Huahao

    2015-12-01

    Accurate determination of the diagnosis and the stage of lung cancer play a critical role to ensure that patients are provided the optimal treatment. However, the process is usually beyond complex. Early studies have suggested lymph nodes (LNs) >1.0 cm in size on computed tomography (CT) are considered as metastatic nodes, while the sensitivity of this criterion is not satisfied. Subsequently, positron emission tomography-computed tomography (PET-CT) was shown to be superior to CT alone on assessment of nodal involvement and was widely used to estimate suitability for resection with curative intent, but the dependability also remains controversial. Furthermore, transbronchial needle aspiration (TBNA) with and without endobronchial ultrasound (EBUS), as a well-accepted minimally invasive approach for LN biopsy, has been documented as an efficient tool in evaluation of CT and PET-CT negative LNs. Additionally, radiographic features including ground-glass/solid nodules ratio, referring as imaging biomarker, were indicated to be correlated with metastasis. Hence, we highlight the importance of comprehensive estimation of mediastinal and hilar LNs, and we suggested the judgment of LNs by radiographic tools alone might not be reliable and TBNA is indispensable in certain circumstances.

  2. Decellularized Lymph Nodes as Scaffolds for Tissue Engineered Lymph Nodes

    Science.gov (United States)

    Cuzzone, Daniel A.; Albano, Nicholas J.; Aschen, Seth Z.; Ghanta, Swapna

    2015-01-01

    Abstract Background: The lymphatic system is commonly injured during cancer treatment. However, despite the morbidity of these injuries, there are currently no options for replacing damaged lymphatics. The purpose of this study was to optimize methods for decellularization of murine lymph nodes (LN) and to determine if these scaffolds can be used to tissue engineer lymph node-like structures. Methods and Results: LNs were harvested from adult mice and subjected to various decellularization protocols. The degree of decellularization and removal of nuclear material was analyzed histologically and quantitatively using DNA isolation. In addition, we analyzed histological architecture by staining for matrix proteins. After the optimal method of decellularization was identified, decellularized constructs were implanted in the renal capsule of syngeneic or allogeneic recipient mice and analyzed for antigenicity. Finally, to determine if decellularized constructs could deliver lymphocytes to recipient animals, the matrices were repopulated with splenocytes, implanted in submuscular pockets, and harvested 14 days later. Decellularization was best accomplished with the detergent sodium dodecyl sulfate (SDS), resulting in negligible residual cellular material but maintenance of LN architecture. Implantation of decellularized LNs into syngeneic or allogeneic mice did not elicit a significant antigenic response. In addition, repopulation of decellularized LNs with splenocytes resulted in successful in vivo cellular delivery. Conclusions: We show, for the first time, that LNs can be successfully decellularized and that these matrices have preserved extracellular matrix architecture and the potential to deliver leukocytes in vivo. Future studies are needed to determine if tissue engineered lymph nodes maintain immunologic function. PMID:25144673

  3. Lymph node staging in prostate cancer.

    Science.gov (United States)

    Sankineni, Sandeep; Brown, Anna M; Fascelli, Michele; Law, Yan Mee; Pinto, Peter A; Choyke, Peter L; Turkbey, Baris

    2015-05-01

    Nodal staging is important in prostate cancer treatment. While surgical lymph node dissection is the classic method of determining whether lymph nodes harbor malignancy, this is a very invasive technique. Current noninvasive approaches to identifying malignant lymph nodes are limited. Conventional imaging methods rely on size and morphology of lymph nodes and have notoriously low sensitivity for detecting malignant nodes. New imaging techniques such as targeted positron emission tomography (PET) imaging and magnetic resonance lymphography (MRL) with iron oxide particles are promising for nodal staging of prostate cancer. In this review, the strengths and limitations of imaging techniques for lymph node staging of prostate cancer are discussed.

  4. Evaluation of a genomic classifier in radical prostatectomy patients with lymph node metastasis

    Directory of Open Access Journals (Sweden)

    Lee HJ

    2016-06-01

    Full Text Available Hak J Lee,1 Kasra Yousefi,2 Zaid Haddad,2 Firas Abdollah,3 Lucia LC Lam,2 Heesun Shin,2 Mohammed Alshalalfa,2 Elana Godebu,1 Song Wang,4 Ahmed Shabaik,5 Elai Davicioni,2 Christopher J Kane1 1Department of Urology, University of California, San Diego, San Diego, CA, USA; 2GenomeDx Biosciences Inc., Vancouver, BC, Canada; 3Vattikuti Urology Institute, Henry Ford Hospital, Detroit, MI, 4UC San Diego Health System, San Diego, CA, 5Department of Pathology, University of California, San Diego, San Diego, CA, USA Objective: To evaluate the performance of the Decipher test in predicting lymph node invasion (LNI on radical prostatectomy (RP specimens. Methods: We identified 1,987 consecutive patients with RP who received the Decipher test between February and August 2015 (contemporary cohort. In the contemporary cohort, only the Decipher score from RP specimens was available for analysis. In addition, we identified a consecutive cohort of patients treated with RP between 2006 and 2012 at the University of California, San Diego, with LNI upon pathologic examination (retrospective cohort. The retrospective cohort yielded seven, 22, and 18 tissue specimens from prostate biopsy, RP, and lymph nodes (LNs for individual patients, respectively. Univariable and multivariable logistic regression analyses were used to evaluate the performance of Decipher in the contemporary cohort with LNI as the endpoint. In the retrospective cohort, concordance of risk groups was assessed using validated cut-points for low (<0.45, intermediate (0.45–0.60, and high (>0.60 Decipher scores. Results: In the contemporary cohort, 51 (2.6% patients had LNI. Decipher had an odds ratio of 1.73 (95% confidence interval, 1.46–2.05 and 1.42 (95% confidence interval, 1.19–1.7 per 10% increase in score on univariable and multivariable (adjusting for pathologic Gleason score, extraprostatic extension, and seminal vesicle invasion, respectively. No significant difference in the clinical

  5. Evaluation of lymph node numbers for adequate staging of Stage II and III colon cancer

    Directory of Open Access Journals (Sweden)

    Bumpers Harvey L

    2011-05-01

    Full Text Available Abstract Background Although evaluation of at least 12 lymph nodes (LNs is recommended as the minimum number of nodes required for accurate staging of colon cancer patients, there is disagreement on what constitutes an adequate identification of such LNs. Methods To evaluate the minimum number of LNs for adequate staging of Stage II and III colon cancer, 490 patients were categorized into groups based on 1-6, 7-11, 12-19, and ≥ 20 LNs collected. Results For patients with Stage II or III disease, examination of 12 LNs was not significantly associated with recurrence or mortality. For Stage II (HR = 0.33; 95% CI, 0.12-0.91, but not for Stage III patients (HR = 1.59; 95% CI, 0.54-4.64, examination of ≥20 LNs was associated with a reduced risk of recurrence within 2 years. However, examination of ≥20 LNs had a 55% (Stage II, HR = 0.45; 95% CI, 0.23-0.87 and a 31% (Stage III, HR = 0.69; 95% CI, 0.38-1.26 decreased risk of mortality, respectively. For each six additional LNs examined from Stage III patients, there was a 19% increased probability of finding a positive LN (parameter estimate = 0.18510, p Conclusions Thus, the 12 LN cut-off point cannot be supported as requisite in determining adequate staging of colon cancer based on current data. However, a minimum of 6 LNs should be examined for adequate staging of Stage II and III colon cancer patients.

  6. 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 METHODS: Forty patients (17 F and 23 M, aged 32-90) with 24 T1 and 16 T2 squamous cell carcinoma of the oral cavity. Planar lymphoscintigraphy, emission and transmission tomography were performed. Detection and excision of the sentinel nodes were guided by a gamma probe. The sentinel nodes were step......-sectioning and stained with hematoxylin and eosin and cytokeratin (CK 1). Histology and follow-up were used as "gold standard". Tumor location, number of sentinel lymph nodes, metastasis, and recurrences were registered. Two observers evaluated the lymphoscintigraphic images to assess the inter-rater agreement. RESULTS...

  7. Dosimetric evaluation of three adaptive strategies for prostate cancer treatment including pelvic lymph nodes irradiation

    Energy Technology Data Exchange (ETDEWEB)

    Cantin, Audrey; Gingras, Luc; Archambault, Louis, E-mail: louis.archambault@phy.ulaval.ca [Département de Physique, de génie Physique et d’optique et Centre de Recherche sur le Cancer, Université Laval, Québec, Québec G1V 0A6, Canada and Département de Radio-Oncologie et Centre de Recherche du CHU de Québec, CHU de Québec—Université Laval, 11 côte du Palais, Québec, Québec G1R 2J6 (Canada); Lachance, Bernard; Foster, William [Département de Radio-Oncologie et Centre de Recherche du CHU de Québec, CHU de Québec—Université Laval, 11 côte du Palais, Québec, Québec G1R 2J6 (Canada); Goudreault, Julie [Département de Radio-Oncologie et Centre de Recherche du CHU de Québec, CHU de Québec—Université Laval, 11 côte du Palais, Québec, Québec G1R 2J6, Canada and Département de Radio-Oncologie, CSSS de Gatineau–Hôpital de Gatineau, 909 Boulevard La Vérendrye, Gatineau, Québec J8P 7H2 (Canada)

    2015-12-15

    Purpose: The movements of the prostate relative to the pelvic lymph nodes during intensity-modulated radiation therapy treatment can limit margin reduction and affect the protection of the organs at risk (OAR). In this study, the authors performed an analysis of three adaptive treatment strategies that combine information from both bony and gold marker registrations. The robustness of those treatments against the interfraction prostate movements was evaluated. Methods: A retrospective study was conducted on five prostate cancer patients with 7–13 daily cone-beam CTs (CBCTs). The clinical target volumes (CTVs) consisting of pelvic lymph nodes, prostate, and seminal vesicles as well as the OARs were delineated on each CBCT and the initial CT. Three adaptive strategies were analyzed. Two of these methods relied on a two-step patient positioning at each fraction. First step: a bony registration was used to deliver the nodal CTV prescription. Second step: a gold marker registration was then used either to (1) complete the dose delivered to the prostate (complement); (2) or give almost the entire prescription to the prostate with a weak dose gradient between the targets to compensate for possible motions (gradient). The third method (COR) used a pool of precalculated plans based on images acquired at previous treatment fractions. At each new fraction, a plan is selected from that pool based on the daily position of prostate center-of-mass. The dosimetric comparison was conducted and results are presented with and without the systematic shift in the prostate position on the CT planning. The adaptive strategies were compared to the current clinical standard where all fractions are treated with the initial nonadaptive plan. Results: The minimum daily prostate D{sub 95%} is improved by 2%, 9%, and 6% for the complement, the gradient, and the COR approaches, respectively, compared to the nonadaptive method. The average nodal CTV D{sub 95%} remains constant across the

  8. Evaluation of the proliferative activity of immunocompetent cells in the jejunal and iliac lymph nodes of prepubertal female wild boars diagnosed with mixed mycotoxicosis

    Directory of Open Access Journals (Sweden)

    Zielonka Łukasz

    2015-06-01

    Full Text Available The study evaluated the proliferative activity of immunocompetent cells in the jejunal and iliac lymph nodes of prepubertal female wild boars exposed to deoxynivalenol and zearalenone in naturally contaminated feed. The evaluation was performed with the use of the MTT assay and 2 mitogens: lipopolysaccharide (LPS and concanavalin A. Intensified proliferative processes in T and B lymphocytes were revealed. The mitogenic activity of LPS was more expressed in the lymphocytes of both iliac and jejunal lymph nodes in comparison with the control group. Proliferative activity was higher in iliac lymph nodes than in jejunal lymph nodes. A reverse trend was observed in the percentage of live cells, which was higher in jejunal lymph nodes during the evaluation of lymphocyte proliferation.

  9. Mediastinal lymph node enlargement in patients with valvular heart disease: CT evaluation and clinical correlation

    Energy Technology Data Exchange (ETDEWEB)

    Park, Hye Ju; Jung, Jung Im; Ahn, Myeong Im; Han, Dae Hee; Park, Seog Hee [Dept. of Radiology, Seoul St. Mary' s Hospital, College of Medicine, The Catholic University of Korea, Seoul (Korea, Republic of)

    2016-04-15

    To evaluate the presence, size and location of enlarged mediastinal lymph nodes (LNs) in patients with valvular heart disease (VHD) using computed tomography scans in correlation with ejection fraction (EF). We retrospectively evaluated 30 patients with VHD, without pre-existing diseases that could cause lymphadenopathy (LAP). The presence, size, and location of LNs greater than 1 cm in short axis diameter were evaluated. The location of mediastinal LNs was recorded according to the International Association for the Study of Lung Cancer. Furthermore, we evaluated the presence of pulmonary edema, pleural effusion, and other thoracic abnormalities and evaluated EF of the heart on transthoracic echocardiography. Sixteen patients (53%) had at least 1 enlarged mediastinal LN. The most frequent locations were lower paratracheal (4R, n = 8/4L, n = 6), subcarinal (7, n = 5) and right upper paratracheal (2R, n = 4) regions. The frequency of mediastinal LAP was higher in patients with aortic regurgitation (2 of 2, 100%) followed by mitral regurgitation (8 of 11, 73%); it was also high in patients with pulmonary edema (80%), pleural effusion (81%), or both (77%), as compared to patients without pulmonary edema or pleural effusion (17%) (p = 0.001). Ten of 30 patients showed an abnormal EF of < 55%; among them, 8 had mediastinal LAP. However, the relationship between EF and LAP was not statistically significant (p = 0.058). Mediastinal LN enlargement is common in patients with VHD, especially in cases of pulmonary edema and pleural effusion. Enlarged mediastinal LNs were frequently observed with abnormal EF, however, the relationship between EF and mediastinal LAP was not statistically significant.

  10. Prediction of treatment response in head and neck carcinomas using IVIM-DWI: Evaluation of lymph node metastasis

    Energy Technology Data Exchange (ETDEWEB)

    Hauser, Thomas, E-mail: Thomas.Hauser@klinikum-augsburg.de [Department of Radiology (E010), German Cancer Research Center (DKFZ), Heidelberg (Germany); Department of Nuclear Medicine, Klinikum Augsburg, Augsburg (Germany); Essig, Marco [Department of Radiology, University of Manitoba, Winnipeg (Canada); Jensen, Alexandra [Department of Radiation Therapy, Ruprecht-Karls University, Heidelberg (Germany); Laun, Frederik B. [Quantitative imaging based disease characterization (E011), German Cancer Research Center (DKFZ), Heidelberg (Germany); Department of Medical Physics in Radiology (E020), German Cancer Research Center (DKFZ), Heidelberg (Germany); Münter, Marc [Department of Radiation Therapy, Ruprecht-Karls University, Heidelberg (Germany); Department of Radiation Therapy, Katharinenhospital, Stuttgart (Germany); Maier-Hein, Klaus H. [Quantitative imaging based disease characterization (E011), German Cancer Research Center (DKFZ), Heidelberg (Germany); Division of Medical and Biological Informatics, German Cancer Research Center (DKFZ), Heidelberg (Germany); Stieltjes, Bram [Quantitative imaging based disease characterization (E011), German Cancer Research Center (DKFZ), Heidelberg (Germany)

    2014-05-15

    Purpose: To obtain diffusion and microperfusion measures in lymph node metastases of head and neck squamous cell carcinomas (HNSCC) using intravoxel incoherent motion (IVIM) imaging. The obtained IVIM parameters were used to characterize lymph nodes in the staging phase and longitudinal follow-up was performed to evaluate the potential predictive value of these parameters considering therapy response. Methods: Fifteen patients with lymph node metastases of histologically confirmed locally advanced HNSCC were examined using diffusion weighted imaging (DWI) before a nonsurgical organ preserving therapy. DWI imaging was performed at 3 T using eight different b-values ranging from 0 to 800 s/mm{sup 2}. Using the IVIM-approach, the perfusion fraction f and the diffusion coefficient D were extracted using a biexponential fit. A follow-up period of 13.5 months was available for all patients. One patient with a macroscopically necrotic lymph node was excluded from analyses. A region of interest (ROI)-analysis was performed in all patients. Results: Locoregional failure (LRF) was present in 3 of 15 patients within 13.5 months follow-up. The initial f-value was significantly higher (p = 0.01) in patients with LRF (14.5 ± 0.6% vs. 7.7 ± 2.6%) compared to patients with locoregional control (LRC). The initial diffusion coefficient D did not differ significantly (p = 0.30) between the two groups (0.97 ± 0.15 × 10{sup −3} mm{sup 2}/s vs. 0.88 ± 0.13 × 10{sup −3} mm{sup 2}/s). Conclusions: Our results indicate that a high initial perfusion fraction f in lymph nodes may predict poor treatment response in patients with HNSCC due to locoregional failure.

  11. The diagnostic utility of ultrasonography, CT and PET/CT for the preoperative evaluation of cervical lymph node metastasis inpapillary thyroid cancer patients

    Energy Technology Data Exchange (ETDEWEB)

    Kim Young Sang; Lee, Tae Hyun; Park, Dong Hee [Dept. of Radiology, Korea Cancer Center Hospital, Seoul (Korea, Republic of)

    2016-08-15

    To compare the diagnostic utility of ultrasonography (US), CT and positron emission tomography/CT (PET/CT) in the preoperative evaluation of cervical lymph node metastasis in patients with papillary thyroid carcinoma. The study population consisted of 300 patients with pathologically diagnosed papillary thyroid carcinoma after thyroidectomy and neck dissection. Preoperative US, CT, and PET/CT findings were compared with pathologic outcomes after thyroidectomy and neck dissection. Sensitivity in detecting central lymph node metastasis (US 29.9%, CT 27.9%, PET/CT 18.8%) was lower than that for lateral lymph node metastasis (US 56.3%, CT 66.2%, PET/CT 43.7%). Specificity in detecting central lymph node metastasis (US 80.6%, CT 77.7%, PET/CT 83.0%) was lower than that for lateral lymph node metastasis (US 96.8%, CT 80.6%, PET/CT 95.2%). The combination of US and CT had higher specificity (77.3%) and higher sensitivity (33.1%) than US alone. PET/CT has no significant additional benefit over the combination of US and CT. In preoperative evaluations of neck lymph node metastasis, US and CT and PET/CT are more useful in lateral lymph node areas than in central lymph node areas. The combination of US and CT has higher sensitivity than US alone.

  12. A prospective comparison of molecular assay and touch imprint cytology for intraoperative evaluation of sentinel lymph nodes

    Institute of Scientific and Technical Information of China (English)

    CHEN Jia-jian; SHEN Zhen-zhou; WANG Yong-sheng; WU Jiong; YANG Ben-long; CHEN Jia-ying; ZHANG Jia-xin; LI Da-li; XU Wei-ping; XU Xiao-li; YANG Wen-tao; SHAO Zhi-min

    2011-01-01

    Background Accurate intraoperative diagnosis of sentinel lymph node (SLN) metastases enables the selection of patients for axillary lymph node dissections during the same operation, reducing the need for a second operation. The present study aimed to prospectively compare the GeneSearchTM Breast Lymph Node (BLN) Assay with touch imprint cytology (TIC) for intraoperative evaluation of SLNs.Methods SLNs were sectioned in 1.5-3.0 mm pieces. TIC was performed on all pieces and the BLN Assay and postoperative histology evaluations were performed on different alternating node pieces. Overall performance of the BLN Assay was compared with that of TIC relative to the postoperative histology results.Results A total of 90 patients enrolled in the study. Complete intraoperative data for both the BLN Assay and TIC were collected in 86 patients. The sensitivity, specificity, and overall accuracy of the BLN Assay were 82%, 97%, and 92%,respectively on a per patient basis compared with those of TIC which were 67%, 100%, and 90%.Conclusions Performance of the BLN Assay was superior to that of TIC and the additional application of TIC did not help improve the total sensitivity and accuracy of the intraoperative assessment. The existence of ectopic breast tissue might be a possible cause of false positive for the BLN assay. In addition, the BLN Assay complements histopathology assessment and can minimize sampling error without increasing pathologists' workload.

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

    Energy Technology Data Exchange (ETDEWEB)

    Eguchi, Reiki; Yamada, Akiyoshi; Ueno, Keiko; Murata, Yoko [Tokyo Women`s Medical Coll. (Japan)

    1996-10-01

    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)

  14. Evaluation of internal mammary lymph nodes dissection combined with selective postoperative radiotherapy in patients with medial breast cancers

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    Yokota, Toru; Roppongi, Takashi; Kanno, Keiichi; Sakamoto, Ichiro; Fujii, Takanao; Mitomo, Osamu [Numata National Hospital, Gunma (Japan)

    1998-08-01

    In the reason that internal mammary lymph nodes (IMN) dissection of extended radical mastectomy (EXT) did not influence overall survival rates in patients with medial or central breast cancers, this procedure is seldom practiced in the European countries and the United States. But in the thought that IMN dissection combined with selective postoperative radiotherapy might increase disease-free or overall survival in these patients, this combined therapy in patients with medial breast cancers was evaluated. Thirty-five patients submitted to IMN dissection with extrapleural method and 114 patients submitted to non-dissection were evaluated in this study. Postoperative prophylactic radiotherapy (to IMN and supraclavicular lymph nodes) was administered to patients with histologically positive IMN or more than 4 of axillary lymph nodes. The dose of irradiation was 5000 to 5100 cGy given in 5 to 6 weeks. Patient characteristics in the two groups did not reveal any significant difference statistically. Statistical analysis was carried out both on disease-free survival and overall survival, computed from the date of radical surgery, by use of the Kaplan-Meier method. Both groups of survival were compared, using the Logrank test. The frequency of IMN metastasis is significantly associated with the one of axillary lymph nodes metastasis (p=0.03). The analysis of the percent disease-free survival related to the presence or absence of IMN dissection failed to reveal any significant difference (10 years of disease-free survival rate 56.1% and 74.5%, respectively). In the same way, the analysis of the percent overall survival failed to reveal any significant difference (10 years overall survival rate 58.8% and 80.4%, respectively). (author)

  15. Preparation and evaluation of poly(2-hydroxyethyl aspartamide)-hexadecylamine-iron oxide for MR imaging of lymph nodes

    Science.gov (United States)

    Ha, Dae Chul; Lee, Ha Young; Son, Yeo Won; Yuk, Soon Hong; Choi, Youn Woong; Kwak, Byung Kook; Shin, Byung Cheol; Cho, Cheong-Weon; Cho, Sun Hang

    2014-01-01

    The purpose of this study was to synthesize biocompatible poly(2-hydroxyethyl aspartamide)-C16-iron oxide (PHEA-C16-iron oxide) nanoparticles and to evaluate their efficacy as a contrast agent for magnetic resonance imaging of lymph nodes. The PHEA-C16-iron oxide nanoparticles were synthesized by coprecipitation method. The core size of the PHEA-C16-iron oxide nanoparticles was about 5 to 7 nm, and the overall size of the nanoparticles was around 20, 60, and 150 nm in aqueous solution. The size of the nanoparticles was controlled by the amount of C16. The 3.0-T MRI signal intensity of a rabbit lymph node was effectively reduced after intravenous administration of PHEA-C16-iron oxide with the size of 20 nm. The in vitro and in vivo toxicity tests revealed the high biocompatibility of PHEA-C16-iron oxide nanoparticles. Therefore, PHEA-C16-iron oxide nanoparticles with 20-nm size can be potentially useful as T2-weighted MR imaging contrast agents for the detection of lymph nodes.

  16. Most frequent location of the sentinel lymph nodes

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    Chiao Lo

    2014-07-01

    Conclusion: The area between these four landmarks is the most frequent location of the sentinel lymph node identified using the radioisotope method. We suggest that this area should be carefully evaluated preoperatively by ultrasound for appropriate surgical planning. A skin incision in this area is also recommended when sentinel lymph node dissection is guided by blue dye.

  17. Evaluation of biologic markers in squamous cell carcinoma biopsy samples of the tongue and correlation with neck lymph node metastasis

    Directory of Open Access Journals (Sweden)

    Madani Kermani Z

    2009-10-01

    Full Text Available "n Normal 0 false false false EN-US X-NONE AR-SA MicrosoftInternetExplorer4 /* Style Definitions */ table.MsoNormalTable {mso-style-name:"Table Normal"; mso-tstyle-rowband-size:0; mso-tstyle-colband-size:0; mso-style-noshow:yes; mso-style-priority:99; mso-style-qformat:yes; mso-style-parent:""; mso-padding-alt:0in 5.4pt 0in 5.4pt; mso-para-margin:0in; mso-para-margin-bottom:.0001pt; mso-pagination:widow-orphan; font-size:11.0pt; font-family:"Calibri","sans-serif"; mso-ascii-font-family:Calibri; mso-ascii-theme-font:minor-latin; mso-fareast-font-family:"Times New Roman"; mso-fareast-theme-font:minor-fareast; mso-hansi-font-family:Calibri; mso-hansi-theme-font:minor-latin; mso-bidi-font-family:Arial; mso-bidi-theme-font:minor-bidi;} Background: Neck lymph node metastasis has the prognostic role in SCC of the tongue and the importance of the biologic markers in tumor invasion and metastasis has been stated in the medical literature. The aim of this study was to evaluate the relationship between two biomarkers, p53 and EGFR (which had the main role in cell proliferation and two other biomarkers, CD44 and E-cadherin, in lymph node metastasis."n"nMethods: In an analytic descriptive study fifty three patients with SCC (Squamous Cell Carcinoma of the tongue who underwent the resection of tumor and dissection of neck lymph nodes were assessed during the year of 2002-2009. Histological samples from 53 patients were immunohistochemically stained and the analysis of these markers were performed due to clinicopathological variable and metastasis of the neck lymph nodes."n"nResults: The result showed that among the clinicopathological factors, the relationship between Age (p=0.01, history of having risk factors (p=0.002, clinical lymphadenopathy (p=0.002, the size of the tumor (p=0.001, decreasing of CD44 (p=0.02 and lymph node metastasis of the neck were statistically significant. No significant relationship were found between sex and other biomarkers

  18. Localized Lymph Node Light Chain Amyloidosis

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    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.

  19. Lymph node mapping with carbon nanoparticles and the risk factors of lymph node metastasis in gastric cancer.

    Science.gov (United States)

    Wang, Hui; Chen, Man-Man; Zhu, Guang-Sheng; Ma, Mao-Guang; Du, Han-Song; Long, Yue-Ping

    2016-12-01

    The study aimed to examine the applicability of carbon nanoparticles as a tracer for lymph node mapping and the related factors of lymph node and No.8p subgroup metastasis in patients with gastric cancer. Clinical data of 50 patients with gastric cancer, who had not received treatment preoperatively and underwent gastrectomy in Department of Gastrointestinal Surgery, Wuhan Union Hospital, between October 2014 and August 2015, were retrospectively analyzed. These patients were found to have no distant metastasis preoperatively. Thirty-five out of 50 patients were subjected to lymphatic mapping technique using carbon nanoparticles as the tracer, and the rest 15 cases did not experience the lymphatic mapping and served as controls. The sensitivity, specificity, false positive rate and false negative rate were calculated according to the number of lymph nodes, and the staining and metastasis condition of lymph nodes. The diagnostic value of carbon nanoparticles on metastatic lymph nodes was evaluated. The relationship between the metastasis of lymph nodes or subgroup No.8p lymph nodes and clinicopathologic features was analyzed by χ(2)-test or Fisher's exact test. All patients underwent D2 surgery (lymph node dissection including all the group 1 and group 2 nodes) plus the dissection of the subgroup No.8p lymph nodes. It was found that the average number of harvested lymph nodes in lymphatic mapping technique group (45.7±14.5) was greater than that in control group (39.2±11.7), but the difference was not significantly different (P=0.138>0.05). The success rate, the accuracy, sensitivity, specificity and false negative rate was 97%, 57%, 28%, 62% and 72% respectively. The metastasis of lymph nodes was correlated to the depth of cancer invasion (T stage) (P=0.004nanoparticles failed to show good selectivity for metastatic lymph nodes; the result of lymphatic mapping does not achieve a satisfactory performance; the incidence of lymph node metastasis may increase

  20. Extended lymph node dissection for prostate cancer.

    Science.gov (United States)

    Jeschke, Stephan; Burkhard, Fiona C; Thurairaja, Ramesh; Dhar, Nivedita; Studer, Urs E

    2008-05-01

    Lymph node status is an important determinant for the management of patients with newly diagnosed prostate cancer. Given the significant limitations of cross-sectional and functional preoperative imaging in the detection of small metastases, pelvic lymph node dissection remains the only reliable staging method in clinically localized prostate cancer. Although lymph node dissection is a well-established form of staging in prostate cancer, controversy remains about indications and the surgical extent of the procedure. Reported practices vary from omitting pelvic lymph node dissection in low-risk disease to routine pelvic lymph node dissection in all radical prostatectomy patients. This review highlights the recent literature concerning pelvic lymphadenectomy in prostate cancer with respect to anatomical extent and oncologic outcome.

  1. Penile Cancer: Contemporary Lymph Node Management.

    Science.gov (United States)

    O'Brien, Jonathan S; Perera, Marlon; Manning, Todd; Bozin, Mike; Cabarkapa, Sonja; Chen, Emily; Lawrentschuk, Nathan

    2017-06-01

    In penile cancer, the optimal diagnostics and management of metastatic lymph nodes are not clear. Advances in minimally invasive staging, including dynamic sentinel lymph node biopsy, have widened the diagnostic repertoire of the urologist. We aimed to provide an objective update of the recent trends in the management of penile squamous cell carcinoma, and inguinal and pelvic lymph node metastases. We systematically reviewed several medical databases, including the Web of Science® (with MEDLINE®), Embase® and Cochrane databases, according to PRISMA (Preferred Reporting Items for Systematic Review and Meta-Analyses) guidelines. The search terms used were penile cancer, lymph node, sentinel node, minimally invasive, surgery and outcomes, alone and in combination. Articles pertaining to the management of lymph nodes in penile cancer were reviewed, including original research, reviews and clinical guidelines published between 1980 and 2016. Accurate and minimally invasive lymph node staging is of the utmost importance in the surgical management of penile squamous cell carcinoma. In patients with clinically node negative disease, a growing body of evidence supports the use of sentinel lymph node biopsies. Dynamic sentinel lymph node biopsy exposes the patient to minimal risk, and results in superior sensitivity and specificity profiles compared to alternate nodal staging techniques. In the presence of locoregional disease, improvements in inguinal or pelvic lymphadenectomy have reduced morbidity and improved oncologic outcomes. A multimodal approach of chemotherapy and surgery has demonstrated a survival benefit for patients with advanced disease. Recent developments in lymph node management have occurred in penile cancer, such as minimally invasive lymph node diagnosis and intervention strategies. These advances have been met with a degree of controversy in the contemporary literature. Current data suggest that dynamic sentinel lymph node biopsy provides excellent

  2. Sarcoidal Granuloma in Cervical Lymph Nodes

    Directory of Open Access Journals (Sweden)

    Hsin-Chien Chen

    2005-07-01

    Full Text Available Sarcoidosis is a multiorgan granulomatous disease, the most common head and neck manifestation of which is cervical lymphadenopathy. Only the presentation of sarcoidal granuloma in cervical lymph nodes without typical manifestations of systemic sarcoidosis poses a diagnostic difficulty. We describe the case of a 39-year-old male who had a 2-month history of a progressively increasing mass with soreness in his right neck. The biopsy from the neck mass demonstrated non-caseating epithelioid cell granuloma of the lymph nodes. The differential diagnoses of mycobacterial or fungal infections were excluded. Thoracic evaluations, including chest X-ray and high-resolution computed tomography, revealed no abnormal findings. Treatment with systemic corticosteroids resulted in improved clinical symptoms. No recurrence of the neck mass or other signs of systemic sarcoidosis were noted during 1.5 years of follow-up. Although our patient's definitive diagnosis could not be determined, the case highlights 2 important issues: sarcoidal granuloma in lymph nodes may be a precursor of sarcoidosis, even in the absence of pulmonary or other systemic involvement; and regular follow-up is recommended in such cases.

  3. Internal mammary sentinel lymph node biopsy: abandon or persist?

    Directory of Open Access Journals (Sweden)

    Qiu PF

    2016-06-01

    Full Text Available Peng-Fei Qiu, Yan-Bing Liu, Yong-Sheng Wang Breast Cancer Center, Shandong Cancer Hospital and Institute, Jinan, Shandong, People’s Republic of China Abstract: Although the 2009 American Joint Committee on Cancer incorporated the internal mammary sentinel lymph node biopsy (IM-SLNB concept, there has been little change in surgical practice patterns due to the low visualization rate of internal mammary sentinel lymph nodes with the traditional injection technique. Meanwhile, as internal mammary lymph nodes (IMLN metastases are mostly found concomitantly with axillary lymph nodes (ALN metastases, previous IM-SLNB clinical trials fail to evaluate the status of IMLN in patients who are really in need (only in clinically ALN negative patients. Our modified injection technique (periareolar intraparenchymal, high volume, and ultrasonographic guidance significantly improved the visualization rate of internal mammary sentinel lymph nodes, making the routine IM-SLNB possible in daily practice. IM-SLNB could provide individual minimally invasive staging, prognosis, and decision-making for breast cancer patients, especially for patients with clinically positive ALN. Moreover, IMLN radiotherapy should be tailored and balanced between the potential benefit and toxicity, and IM-SLNB-guided IMLN radiotherapy could achieve this goal. In the era of effective adjuvant therapy, within the changing treatment approach – more systemic therapy, less loco-regional therapy – clinicians should deliberate the application of regional IMLN therapy. Keywords: breast cancer, internal mammary lymph node, axillary lymph node, sentinel lymph node biopsy 

  4. Transcutaneous Ultrasound: Elastographic Lymph Node Evaluation. Current Clinical Applications and Literature Review.

    Science.gov (United States)

    Chiorean, Liliana; Barr, Richard G; Braden, Barbara; Jenssen, Christian; Cui, Xin-Wu; Hocke, Michael; Schuler, Andreas; Dietrich, Christoph F

    2016-01-01

    Distinguishing malignant versus benign lymphadenopathies is a major diagnostic dilemma in clinical medicine. Metastatic deposits in normal-sized lymph nodes (LNs) can be smaller than a millimeter, thus presenting a diagnostic challenge. In most clinical settings, however, enlarged LNs detected on imaging need to be classified as malignant or benign. Ultrasound seems to be a very reliable method for LN characterization because of the high resolution, especially in the subcutaneous areas. However, B-mode and Doppler-ultrasound criteria for characterization of a lymphadenopathy as benign or malignant are lacking specificity. Newer methods such as elastography seem to be valuable for identifying metastatic deposits within LNs and may help discriminate malignant and benign LNs. This review summarizes the different elastographic methods available and provides an overview of the relevant publications. According to the literature, elastography can be used for identifying metastatic deposits, to guide fine needle aspiration and to non-invasively choose the most suspicious LN of a group of enlarged LNs for targeted biopsy.

  5. Evaluation of two commercially available Salmonella vaccines on Salmonella concentration and prevalance in the peripheral lymph nodes of experimentally infected cattle

    Science.gov (United States)

    Bovine peripheral lymph nodes (PLN) may contain Salmonella, and unless contaminated nodes are removed during slaughter, they serve as a source of contamination for ground beef. Utilizing an experimental model of Salmonella inoculation of the PLN, two experiments were conducted to evaluate commercia...

  6. [Evaluation of neck lymph node dissection and extended lymphadenectomy through a collar incision and median sternotomy for lung cancer].

    Science.gov (United States)

    Miyamoto, H; Hata, E; Sakao, Y; Harada, R; Hamada, T

    1995-11-01

    Since 1983, 421 patients have been treated for lung cancer at this institute. Since 1988, neck lymph node dissection (11 cases) and new extended lymphadenectomy through a collar incision and median sternotomy (22 cases) have been conducted. Indications for this new radical operation are scalene, supraclavicular or highest mediastinal node involvement, or superior pulmonary sulcus carcinoma, in patients aged 70 or less without distant metastasis and NSCLC. No major complications and operative mortality were encountered in this study. Patients with scalene or supraclavicular node involvement showed poor prognosis. Postsurgical local recurrence was frequent. Whether resection in N3 disease should be conducted or not, remains a point of controversy. The authors consider that lymphadenectomy should be conducted more extensively. A significant better survival of N2 disease and satisfactory prognosis of patients without metastasis of cervical lymph nodes demonstrates the effectiveness of neck lymph node dissection in the present superradical operation for lung cancer.

  7. Sentinel lymph node biopsy and melanoma: 2010 update Part I.

    Science.gov (United States)

    Stebbins, William G; Garibyan, Lilit; Sober, Arthur J

    2010-05-01

    Sentinel lymph node biopsy for melanoma was introduced in the early 1990s as a minimally invasive method of identifying and pathologically staging regional lymph node basins in patients with clinical stage I/II melanoma. Numerous large trials have demonstrated that sentinel lymph node evaluation has utility in improving accuracy of prognostication and for risk stratifying patients into appropriate groups for clinical trials. However, there remains a great deal of controversy regarding the therapeutic role of removal of the remainder of locoregional lymph nodes should metastatic cells be identified in the sentinel node. This CME article will outline a brief history of the sentinel node concept before reviewing updates in surgical technique, histopathologic evaluation of nodal tissue, and cost effectiveness of sentinel node biopsy. After completing this learning activity, participants should be able to describe the concept of sentinel lymph node biopsy, to discuss the risks and benefits associated with this procedure, and to summarize the role of sentinel lymph node biopsy in management of patients with melanoma. Copyright 2010 American Academy of Dermatology, Inc. Published by Mosby, Inc. All rights reserved.

  8. Lymph node involvement in multicystic peritoneal mesothelioma.

    Science.gov (United States)

    Engohan-Aloghe, Corinne; Anaf, Vincent; Noël, Jean Christophe

    2009-11-01

    Multicystic peritoneal mesothelioma is an uncommon lesion most frequently encountered in women of reproductive age. Although the pathologic characteristics have been documented, the lymph node status associated with this pathology, the etiopathogenesis and prognosis of which remain unclear, is unknown. We report here the case of a 35-year-old woman with a 5.5 cm multicystic mesothelioma affecting the pelvic peritoneum of the rectum. Involvement by multicystic mesothelioma was observed within two lymph nodes simultaneously resected with the tumor. To the best of our knowledge, lymph node involvement has not been described in previous studies.

  9. [A patient with thyroid cancer evaluated according to Response Evaluation Criteria in Solid Tumors during treatment for breast cancer recurrence in hepatic and cervical lymph nodes].

    Science.gov (United States)

    Hayashi, Keiko; Enomoto, Takumo; Oshida, Sayuri; Habiro, Takeyoshi; Hatate, Kazuhiko; Sengoku, Norihiko; Watanabe, Masahiko

    2013-11-01

    We describe a case of a 69-year-old woman who underwent left breast-preserving surgery and axillary dissection for left-sided breast cancer at 60 years of age. The histopathological diagnosis was papillotubular carcinoma, luminal A (pathological T1N0M0).In the eighth year after surgery, computed tomography (CT) revealed recurrence in the liver and cervical lymph node metastasis. The patient did not respond to 3 months of treatment with letrozole (progressive disease [PD]). Six courses of chemotherapy with epirubicin and cyclophosphamide (EC) were administered. Subsequently, the attending physician was replaced while the patient was receiving paclitaxel( PTX).After 4 courses of treatment with PTX, the liver metastasis disappeared (complete response [CR]).However, the cervical lymph nodes did not shrink (PD).The cytological diagnosis was papillary thyroid cancer with associated cervical lymph node metastasis. Total thyroidectomy and D3b cervical lymph node dissection were performed. The pathological diagnosis was pEx0T1bN1Mx, pStage IVA disease. Replacement of the attending physician is a critical turning point for patients. During chemotherapy or hormone therapy for breast cancer, each organ should be evaluated according to Response Evaluation Criteria in Solid Tumors (RECIST).In the case of our patient, thyroid cancer was diagnosed according to RECIST. Cancer specialists should bear in mind that the treatment policy may change dramatically depending on the results of RECIST assessment.

  10. Evaluation of the enhanced permeability and retention effect in the early stages of lymph node metastasis.

    Science.gov (United States)

    Mikada, Mamoru; Sukhbaatar, Ariunbuyan; Miura, Yoshinobu; Horie, Sachiko; Sakamoto, Maya; Mori, Shiro; Kodama, Tetsuya

    2017-02-17

    Most solid cancers spread to new sites via the lymphatics before hematogenous dissemination. However, only a small fraction of an intravenously administered anti-cancer drug enters the lymphatic system to reach metastatic lymph nodes (LNs). Here, we show that the enhanced permeability and retention (EPR) effect is not induced during the early stages of LN metastasis. Luciferase-expressing tumor cells were injected into the subiliac LN of the MXH10/Mo-lpr/lpr mouse to induce metastasis to the proper axillary LN (PALN). In vivo biofluorescence imaging was used to confirm metastasis induction and to quantify the EPR effect, measured as PALN accumulation of intravenously injected indocyanine green (ICG) liposomes. PALN blood vessel volume changes were measured by contrast-enhanced high-frequency ultrasound imaging. The volume and density of blood vessels in the PALN increased until day 29 after inoculation whereas the LN volume remained constant. ICG retention was first detected on day 29 post-inoculation. While CD31-positive cells increased up to day 29 post-inoculation, α-smooth muscle actin-positive cells were detected on day 29 post-inoculation for the first time. These results suggest that the EPR effect was not induced in the early stages of LN metastasis; therefore, systemic chemotherapy would likely not be beneficial during the early stages of LN metastasis. The development of an alternative drug delivery system, independent of the EPR effect, is required for the treatment of LN metastasis. This article is protected by copyright. All rights reserved.

  11. The value of 18-FDG-PET for diagnosing and evaluating lymph node metastasis in primary breast cancer

    Institute of Scientific and Technical Information of China (English)

    LI Xiao-jun; WANG Ling; LING Rui; WANG Jing; LI Guo-quan

    2007-01-01

    Objective: To analyze the result of 18F-2-deoxy-2-fluoro-D-glucose-positron emission tomography (FDG-PET) in suspicious primary breast cancer patients and to evaluate its value for the surgery therapy. Methods: Total 36 patients suspected of breast neoplasm were enrolled into the research. The result was compared with the pathology result. The rate of missed diagnosis, the rate of misdiagnosis, the sensitivity and specificity were calculated and analyzed. Results: Compared with the pathology results, the misdiagnosis rate, the rate of missed diagnosis, the sensitivity and specificity of FDG-PET for breast cancer were 0%, 36.36%, 63.63% and 100%, respectively. To those who had a neoplasm no more than 2 cm in diameter, the rate of missed diagnosis was as high as 41.67 %. To 33 breast cancer patients, the misdiagnosis rate, the rare of missed diagnosis, the sensitivity and specificity for lymph node metastasis were 18.75%, 41.18%, 58.82% and 81.25%, respectively. Conclusion: FDG-PET has a perfect specificity and a considerable sensitivity to the primary breast neoplasm and similar to the lymph node metastasis diagnosis. It is an ideal choice for those patients with suspected breast cancer but reluctantly to receive a vulnerarious examination.

  12. Touch imprint cytology with cytokeratin immunostaining versus Papanicolau staining for intraoperative evaluation of sentinel lymph node metastasis in clinically node-negative breast cancer.

    Science.gov (United States)

    Fujishima, M; Watatani, M; Inui, H; Hashimoto, Y; Yamamoto, N; Hojo, T; Hirai, K; Yamato, M; Shiozaki, H

    2009-04-01

    This study investigated whether intraoperative assessment of SLN status in patients with clinically node-negative breast cancer was improved using touch imprint immunohistochemistry. Each SLN was cut into slices 2mm thick and evaluated intraoperatively by touch imprint cytology with Papanicolaou staining until the end of 2005, or by a combination of Papanicolaou staining and immunostaining with an anti-cytokeratin antibody from early 2006. When intraoperative cytology of SLN in 85 patients who were clinically node-negative was evaluated with Papanicolaou staining, 81 patients were diagnosed as negative and four were positive. Intraoperative cytology with Papanicolaou staining had a sensitivity of 30%, specificity of 99%, false-negative rate of 70%, false-positive rate of 1.3%, and accuracy of 90.6%. When intraoperative cytology was done with immunohistochemistry plus Papanicolaou staining for SLN evaluation, 92 patients were diagnosed as negative and 17 patients were positive. Intraoperative cytology with immunohistochemistry had a sensitivity of 79%, specificity of 98%, false-negative rate of 21%, false-positive rate of 2.2%, and accuracy of 94.5%. Compared with intraoperative cytology using Papanicolaou staining alone, the combination of immunohistochemistry and Papanicolaou staining achieved a significant increase in sensitivity and a significant decrease in the false-negative rate. Intraoperative SLN evaluation by imprint cytology with immunohistochemistry achieves a more accurate diagnosis of metastasis than imprint cytology alone. This combined method is considered useful for deciding whether to perform axillary lymph node dissection.

  13. The Evaluation of More Lymph Nodes in Colon Cancer Is Associated with Improved Survival in Patients of All Ages.

    Directory of Open Access Journals (Sweden)

    Wouter B Aan de Stegge

    Full Text Available Improvement in survival of patients with colon cancer is reduced in elderly patients compared to younger patients. The aim of this study was to investigate whether the removal of ≥ 12 lymph nodes can explain differences in survival rates between elderly and younger patients diagnosed with colon cancer.In a population-based cohort study, all patients (N = 41,074 diagnosed with colon cancer stage I to III from 2003 through 2010 from the Netherlands Cancer Registry were included. Age groups were defined as 75 years of age. Main outcome measures were overall and relative survival, the latter as a proxy for disease specific survival.Over an eight years time period there was a 41.2% increase in patients with ≥ 12 lymph nodes removed, whereas the percentage of patients with the presence of lymph node metastases remained stable (35.7% to 37.5%. After adjustment for patient and tumour characteristics and adjuvant chemotherapy, it was found that for patients in which ≥ 12 lymph nodes were removed compared to patients with 75: HR: 0.734 (95% CI, 0.700-0.771 and relative survival ( 75: RER: 0.621 (95% CI, 0.567-0.681 in all three age groups.The removal of ≥ 12 lymph nodes is associated with an improvement in both overall and relative survival in all patients. This association was stronger in the elderly patient. The biology of this association needs further clarification.

  14. 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...

  15. Sentinel lymph node biopsy indications and controversies in breast cancer.

    Science.gov (United States)

    Wiatrek, Rebecca; Kruper, Laura

    2011-05-01

    Sentinel lymph node biopsy (SLNB) has become the standard of care for early breast cancer. Its use in breast cancer has been evaluated in several randomized controlled trials and validated in multiple prospective studies. Additionally, it has been verified that SLNB has decreased morbidity when compared to axillary lymph node dissection (ALND). The technique used to perform sentinel lymph node mapping was also evaluated in multiple studies and the accuracy rate increases when radiocolloid and blue dye are used in combination. As SLNB became more accepted, contraindications were delineated and are still debated. Patients who have clinically positive lymph nodes or core biopsy-proven positive lymph nodes should not have SLNB, but should have an ALND as their staging procedure. The safety of SLNB in pregnant patients is not fully established. However, patients with multifocal or multicentric breast cancer and patients having neoadjuvant chemotherapy are considered candidates for SLNB. However, the details of which specific neoadjuvant patients should have SLNB are currently being evaluated in a randomized controlled trial. Patients with ductal carcinoma in situ (DCIS) benefit from SLNB when mastectomy is planned and when there is a high clinical suspicion of invasion. With the advent of SLNB, pathologic review of breast cancer lymph nodes has evolved. The significance of occult metastasis in SLNB patients is currently being debated. Additionally, the most controversial subject with regards to SLNB is determining which patients with positive SLNs benefit from further axillary dissection.

  16. Fluorescence imaging to study cancer burden on lymph nodes

    Science.gov (United States)

    D'Souza, Alisha V.; Elliott, Jonathan T.; Gunn, Jason R.; Samkoe, Kimberley S.; Tichauer, Kenneth M.; Pogue, Brian W.

    2015-03-01

    Morbidity and complexity involved in lymph node staging via surgical resection and biopsy calls for staging techniques that are less invasive. While visible blue dyes are commonly used in locating sentinel lymph nodes, since they follow tumor-draining lymphatic vessels, they do not provide a metric to evaluate presence of cancer. An area of active research is to use fluorescent dyes to assess tumor burden of sentinel and secondary lymph nodes. The goal of this work was to successfully deploy and test an intra-nodal cancer-cell injection model to enable planar fluorescence imaging of a clinically relevant blue dye, specifically methylene blue along with a cancer targeting tracer, Affibody labeled with IRDYE800CW and subsequently segregate tumor-bearing from normal lymph nodes. This direct-injection based tumor model was employed in athymic rats (6 normal, 4 controls, 6 cancer-bearing), where luciferase-expressing breast cancer cells were injected into axillary lymph nodes. Tumor presence in nodes was confirmed by bioluminescence imaging before and after fluorescence imaging. Lymphatic uptake from the injection site (intradermal on forepaw) to lymph node was imaged at approximately 2 frames/minute. Large variability was observed within each cohort.

  17. Inguinal Lymph Node Anthracosis: A Case Report

    Science.gov (United States)

    Soto, Carlos Alberto

    2016-01-01

    Summary: Anthracosis is defined as black, dense pigments in tissues, usually carbon deposits. We, as surgeons, have to make decisions during surgery to the best of our knowledge and based on what the literature provides us. We present the case of a 30-year-old female patient who underwent abdominoplasty. During surgery, bilateral inguinal pigmented and enlarged lymph nodes were seen. Biopsy of the nodes was done to rule out any malignancy. The results showed tattoo pigments on all lymph nodes. We present this case as tattoo pigment migration, which has been rarely described. PMID:27536493

  18. Sentinel Lymph Node Identification in Endometrial Cancer

    Institute of Scientific and Technical Information of China (English)

    Bin Li; Lingying Wu; Xiaoguang Li; Haizhen Lu; Ping Bai; Shumin Li; Wenhua Zhang; Juzhen Gao

    2009-01-01

    OBJECTIVE To evaluate the feasibility of intra-operative detection of sentinel lymph nodes (SLN) in the patient with endometrial cancer (EC).METHODS Thirty-one patients with Stage Ⅰ and Ⅱ endometrial cancer, who underwent a hysterectomy and a lymphadenectomy,were enrolled in the study. At laparotomy, methylene blue dye tracer was injected into the subserosal myometrium of corpus uteri at multiple sites, and dye uptake into the lymphatic channels was observed. The blue nodes which were identified as SLNs were traced and excised. The other nodes were then removed. All of the excised nodes were submitted for pathological hematoxylin and eosin (H&E) staining examination.RESULTS Failure of dye uptake occurred in 4 of the 31 cases (12.9%) because of spillage, and no lymphatic coloration was observed there. Lymphatic staining was clearly observable as blue dye diffused to the lymphatic channels of the uterine surface and the infundibulopelvic ligaments in 27 (87.1%) cases. Concurrent coloration in the pelvic lymphatic vessels was also observed in 22of the 27 patients. The SLNs were identified in 23 of the 27 (85.2%)cases with a lymphatic staining, with a total number of 90 SLNs,and a mean of 3.9 in each case (range, 1-10). Besides one SLN (1.1%)in the para-aortic area, the other 89 (98.9%) were in the nodes of the pelvis. The most dense locations of SLNs included obturator in 38 (42.2%) and interiliac in 19 (21.1%) cases. In our group, pelvic lymphadenectomy was conducted in 27 (87.1%) patients and pelvic nodal sampling in 4 (12.9%). Of the 31 cases, a concurrent abdominal para-aortic lymph node sampling was conducted in 7. A total of 926 nodes were harvested, with an average of 39.8 in each case (range, 14-55). Nodal metastases occurred in 3 patients (9.7%), 2 of them with SLN involvement and the other without SLN involvement. Adverse reactions or injury related to the study was not found.CONCLUSION Application of methylene blue dye is feasible in an intra

  19. Fine needle aspiration cytology of palpable supraclavicular lymph nodes

    Directory of Open Access Journals (Sweden)

    RC Adhikari

    2011-03-01

    Full Text Available Background: Fine needle aspiration cytology as a first line of investigation has assumed importance in diagnosing a variety of disease process. The aim of this study was to assess the diagnostic value of fine needle aspiration cytology in the evaluation of palpable supraclavicular lymph nodes. Materials and methods: This was a retrospective study of fine needle aspiration cytology of palpable supraclavicular lymph node done between January 1, 2007 and December 31, 2009. Fine needle aspiration cytology was performed on 149 patients (49 cases at Om Hospital & Research Centre and 100 cases at Tribhuvan University Teaching Hospital. Results: The right supraclavicular lymph node was enlarged in 55% cases, while the left supraclavicular lymph node alone was palpable in 40.3% cases and in 7 of 149 (4.7% cases, bilateral supraclavicular lymph nodes were palpable. Cytological diagnoses were categorized as reactive (8.7%, tuberculosis (41.6%, lymphoma (4.8% and metastasis (44.9%. Of a total of 74 cases of malignancy, 90.5% were non-lymphoid and 9.5% were lymphoid (5 Non-Hodgkin lymphoma and 2 Hodgkin lymphoma. Of the 67 cases of metastatic disease, three major types of malignancy found in supraclavicular lymph nodes were Squamous cell carcinoma (28 cases, adenocarcinoma (21 cases and others (small cell carcinoma, papillary thyroid carcinoma etc. Adenocarcinoma tended to metastasize to the left supraclavicular lymph node. Lung was the most common primary site (43.3%, followed by stomach, ovary, breast and larynx. However, in 28.4% cases, no primary site was found. Conclusion: The fine needle aspiration cytology can be used as a first line investigation in the evaluation of supraclavicular lymphadenopathy due to its low cost, simplicity and minimal invasiveness. Keywords: Supraclavicular lymph node; Fine needle aspiration cytology; Metastasis DOI: 10.3126/jpn.v1i1.4441 Journal of Pathology of Nepal (2011 Vol.1, 8-12  

  20. Prognostic Implications of Lymph Node Yield and Lymph Node Ratio in Papillary Thyroid Carcinoma

    NARCIS (Netherlands)

    Nunes, Jonathan H. Vas; Clark, Jonathan R.; Gao, Kan; Chua, Elizabeth; Campbell, Peter; Niles, Navin; Gargya, Ash; Elliott, Michael S.

    2013-01-01

    Background: The lymph node yield (LNY) and the lymph node ratio (LNR) have been shown to be important prognostic factors in oral, colon, and gastric cancers. The role of the LNY and LNR in papillary thyroid cancer (PTC) is unclear. The aims of this study were to determine if a high LNR and a low LNY

  1. Evaluation of two commercial, rapid, ELISA kits testing or scrapie in retro-pharyngeal lymph nodes in sheep

    NARCIS (Netherlands)

    Kittelberger, R.; McIntuyre, L.; Watts, S.; MacDiarmid, S.; Hannah, M.J.; Jenner, J.; Bueno, R.; Swainsbury, R.; Langeveld, J.P.M.; Keulen, van L.J.M.; Zijderveld, van F.G.; Wemheuer, W.M.; Richt, J.A.; Sorenson, S.J.; Pigott, C.J.; O'Keefe, J.S.

    2014-01-01

    AIMS: To estimate the number of cases of scrapie that would occur in sheep of different prion protein (PrP) genotypes if scrapie was to become established in New Zealand, and to compare the performance of two commercially available, rapid ELISA kits using ovine retro-pharyngeal lymph nodes (RLN) fro

  2. CyberKnife Stereotactic Ablative Radiotherapy as an Option of Treatment for Patients With Prostate Cancer Having Oligometastatic Lymph Nodes: Single-Center Study Outcome Evaluation.

    Science.gov (United States)

    Napieralska, Aleksandra; Miszczyk, Leszek; Stąpór-Fudzińska, Małgorzata

    2016-10-01

    The aim of this study was to evaluate the effectiveness of CyberKnife-based stereotactic ablative radiotherapy on prostate cancer lymph node metastases. Our material consisted of 18 patients with 31 metastatic lymph nodes irradiated between 2011 and 2014 using CyberKnife-based stereotactic ablative radiotherapy. Patients were irradiated using fraction dose varied from 6 to 15 Gy (median 10), to the total dose of 24 to 45 Gy (median 30). Irradiated lymph node size varied from 0.4 to 4.0 cm. In all, 9 patients had single lymph node metastasis and 9 patients had metastases of 2 to 4 lymph nodes. Prostate-specific antigen concentration before radiotherapy varied from 0.01 to 15.58 (mean 6.97; median 4.66). All patients at the time of radiotherapy and follow-up received androgen deprivation therapy. Mann-Whitney U, Kaplan-Meier method, and log-rank tests were used in statistical analysis. We obtained the following results: after CyberKnife stereotactic ablative radiotherapy, prostate-specific antigen concentration dropped in majority of cases and during the last control varied from 0.00 to 258.00 (median 2.5), and was lower in patients without dissemination to other organs (P = .01). Complete regression was found in 12 lesions, stable disease in 13, and progression in 4. In 7 patients, the dissemination to other organs occurred. Our results allow us to conclude that CyberKnife stereotactic ablative radiotherapy of prostate cancer lymph node oligometastases gives good local control and relatively good prostate-specific antigen response.

  3. Supraclavicular Lymph Node Excision Biopsy in Patients with Suspected Supraclavicular Lymph Node Metastasis of Lung Cancer: Experience in a Tertiary Hospital

    Science.gov (United States)

    Lee, Dong Hoon; Yoon, Tae Mi; Lim, Sang Chul

    2017-01-01

    The aim of this study was to evaluate the usefulness and accuracy of supraclavicular lymph node excision biopsy in the diagnosis of suspected supraclavicular lymph node metastasis of lung cancer. A retrospective review was performed to evaluate patients with suspected supraclavicular lymph node metastasis of lung cancer who underwent supraclavicular lymph node excision biopsy from January 2011 to July 2014. Forty-six patients with suspected supraclavicular lymph node metastasis of lung cancer underwent supraclavicular lymph node excision biopsy, which diagnosed benign diseases in 6 patients and malignant diseases in 40 patients. Supraclavicular lymph node excision biopsy was usually performed on patients during their first clinical visit under local anesthesia. For diagnosing suspected lung cancer, supraclavicular lymph node excision biopsy had a diagnostic sensitivity of 100%, specificity of 97.6%, positive-predictive value of 83.3%, negative-predictive value of 100%, and accuracy of 97.8%. No major complication resulted from surgical intervention. Supraclavicular lymph node excision biopsy is a useful and accurate adjunct for the evaluation of suspected supraclavicular lymph node metastasis of lung cancer in a tertiary hospital. PMID:28184341

  4. Metastases in small lymph nodes from colon cancer.

    Science.gov (United States)

    Herrera-Ornelas, L; Justiniano, J; Castillo, N; Petrelli, N J; Stulc, J P; Mittelman, A

    1987-11-01

    Lymph node metastases are important determinants in the prognosis of primary colorectal cancer. Although it has been established that enlarged, palpable lymph nodes contain metastases in less than half of the cases, no definitive data concerning the incidence of metastases in lymph nodes measuring 5 mm or less are available. We treated the surgical specimens of 52 consecutive patients who had colon cancer with a lymph node clearance technique at the Roswell Park Memorial Institute, Buffalo. We found 2699 lymph nodes in the 52 specimens, with a mean of 52 lymph nodes per specimen (range, five to 151). Sixty-four lymph nodes were found with metastases in 21 (40%) of the 52 patients. Fifty-nine of 64 of the lymph nodes were reexamined and remeasured. Thirty-nine lymph node metastases measured less than 5 mm, 13 were between 5 and 10 mm, and eight were larger than 10 mm. We concluded that lymph node metastases in colon cancer occur most frequently in lymph nodes measuring less than 5 mm (small lymph nodes). The use of lymph node clearing techniques in surgical specimens improves detection of small lymph node metastases and thereby diminishes understaging.

  5. Evaluation of dual energy spectral CT in differentiating metastatic from non-metastatic lymph nodes in rectal cancer: Initial experience

    Energy Technology Data Exchange (ETDEWEB)

    Liu, Huanhuan [Department of Radiology, Ruijin Hospital Affiliated to Shanghai Jiaotong University, School of Medicine, Shanghai 200025 (China); Department of Radiology, Xinhua Hospital affiliated to Shanghai Jiaotong University School of Medicine (China); Yan, Fuhua; Pan, Zilai; Lin, Xiaozhu; Luo, Xianfu; Shi, Cen [Department of Radiology, Ruijin Hospital Affiliated to Shanghai Jiaotong University, School of Medicine, Shanghai 200025 (China); Chen, Xiaoyan [Department of Pathology, Ruijin Hospital Affiliated to Shanghai Jiaotong University, School of Medicine, Shanghai 200025 (China); Wang, Baisong [Department of Biomedical Statistics, Shanghai Jiaotong University, School of Medicine, Shanghai 200025 (China); Zhang, Huan, E-mail: huanzhangy@126.com [Department of Radiology, Ruijin Hospital Affiliated to Shanghai Jiaotong University, School of Medicine, Shanghai 200025 (China)

    2015-02-15

    Highlights: • Colorectal cancer is the third most prevalent cancer and the status of the regional lymph nodes in rectal cancer is considered to be one of the most powerful prognostic factor in the absence of distant metastatic disease. Detecting LNs metastasis is still a challenging problem due to the presence of microscopic metastasis or inflammatory swelling of LNs. • We investigated the value of dual energy spectral CT in differentiating metastatic from non-metastatic lymph nodes in rectal cancer. Our study demonstrated that the quantitative normalized iodine concentration (nIC) could be useful for differentiating metastatic and non-metastatic lymph nodes. The combination of nIC in portal venous phase and conventional size criterion could improve the diagnostic accuracy, sensitivity, specificity, positive predictive value and negative predictive value of rectal cancer. - Abstract: Objectives: To investigate the value of dual energy spectral CT (DEsCT) imaging in differentiating metastatic from non-metastatic lymph nodes in rectal cancer. Methods: Fifty-five patients with rectal cancer underwent the arterial phase (AP) and portal venous phase (PP) contrast-enhanced DEsCT imaging. The virtual monochromatic images and iodine-based material decomposition images derived from DEsCT imaging were interpreted for lymph nodes (LNs) measurement. The short axis diameter and the normalized iodine concentration (nIC) of metastatic and non-metastatic LNs were measured. The two-sample t test was used to compare the short axis diameters and nIC values of metastatic and non-metastatic LNs. ROC analysis was performed to assess the diagnostic performance. Results: One hundred and fifty two LNs including 92 non-metastatic LNs and 60 metastatic LNs were matched using the radiological-pathological correlation. The mean short axis diameter of metastatic LNs was significantly larger than that of the non-metastatic LNs (7.28 ± 2.28 mm vs. 4.90 ± 1.64 mm, P < 0.001). The mean n

  6. B-Flow Twinkling Sign in Preoperative Evaluation of Cervical Lymph Nodes in Patients with Papillary Thyroid Carcinoma

    Directory of Open Access Journals (Sweden)

    Giuseppina Napolitano

    2013-01-01

    Full Text Available Papillary thyroid cancer (PTC is the most common histologic type of differentiated thyroid cancer. The first site of metastasis is the cervical lymph nodes (LNs. The ultrasonography (US is the best diagnostic method for the detection of cervical metastatic LNs. We use a new technique, B-flow imaging (BFI, recently used for evaluation of thyroid nodules, to estimate the presence of BFI twinkling signs (BFI-TS, within metastatic LNs in patients with PTC. Two hundred and fifty-two patients with known PTC were examined for preoperative evaluation with conventional US and BFI. Only 83 with at least one metastatic LN were included. All patients included underwent surgery; the final diagnosis was based on the results of histology. The following LN characteristics were evaluated: shape, abnormal echogenicity, absent hilum, calcifications, cystic appearance, peripheral vascularization, and BFI-TS. A total of 604 LNs were analyzed. Of these, 298 were metastatic, according to histopathology. The BFI-TS showed high values ​​of specificity (99.7% and sensitivity (80.9%. The combination of each conventional US sign with the BF-TS increases the specificity. Our findings suggest that BFI can be helpful in the selection of suspicious neck LNs that should be examined at cytologic examination for accurate preoperative staging and individual therapy selection.

  7. The potential of liquid-based cytology in lymph node cytological evaluation: the role of morphology and the aid of ancillary techniques.

    Science.gov (United States)

    Rossi, E D; Martini, M; Straccia, P; Bizzarro, T; Fadda, G; Larocca, L M

    2016-02-01

    Our aim was to evaluate the feasibility and diagnostic accuracy of liquid-based cytology (LBC) on lymph node fine needle aspiration (FNA). FNA may fulfil a challenging role in the evaluation of the majority of primary (benign and malignant) diagnoses as well as metastatic lymph node lesions. Although the morphological features may be quite easily recognized, cytological samples with a scant cellular component may raise some issues. We appraised 263 cytological lymph nodes from different body regions analysed between January and December 2013, including 137 male and 126 female patients, and processed with LBC. The cytological diagnoses included 160 benign and 103 malignant lesions. We reported 35 benign and 73 malignant lesions from 108 with surgical follow-up. The latter malignant series included 68 metastatic lesions, four suspicious for malignancy and one inadequate sample. The cytological diagnoses were supported by 62 conclusive immunocytochemical and 28 molecular analyses. Of the 108 cases, we documented 35 true negatives, 72 true positives, one false negative and no false positives, resulting in 98.6% sensitivity, 100% specificity, 99% diagnostic accuracy, 97.2% negative predictive value and 100% positive predictive value. FNA represents the first diagnostic tool in lymph node management and a reliable approach in order to avoid an excision biopsy. Furthermore, LBC is a feasible method for ancillary tests for which methanol-fixed samples are suitable, such as immunocytochemistry and molecular analysis. © 2014 John Wiley & Sons Ltd.

  8. 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.

  9. Groin surgery and the sentinel lymph node

    NARCIS (Netherlands)

    de Hullu, JA; van der Zee, AGJ

    2003-01-01

    Vulvar cancer is a rare disease. Squamous-cell carcinomas account for 90% of vulvar cancers. The main mode of spread is lymphogenic to the inguinofemoral lymph nodes. Therefore, elective unior bilateral inguinofemoral lymphadenectomy is part of the standard treatment in combination with radical (wid

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

    Directory of Open Access Journals (Sweden)

    Ge Zhang

    2015-03-01

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

  11. Automatic detection and segmentation of lymph nodes from CT data.

    Science.gov (United States)

    Barbu, Adrian; Suehling, Michael; Xu, Xun; Liu, David; Zhou, S Kevin; Comaniciu, Dorin

    2012-02-01

    Lymph nodes are assessed routinely in clinical practice and their size is followed throughout radiation or chemotherapy to monitor the effectiveness of cancer treatment. This paper presents a robust learning-based method for automatic detection and segmentation of solid lymph nodes from CT data, with the following contributions. First, it presents a learning based approach to solid lymph node detection that relies on marginal space learning to achieve great speedup with virtually no loss in accuracy. Second, it presents a computationally efficient segmentation method for solid lymph nodes (LN). Third, it introduces two new sets of features that are effective for LN detection, one that self-aligns to high gradients and another set obtained from the segmentation result. The method is evaluated for axillary LN detection on 131 volumes containing 371 LN, yielding a 83.0% detection rate with 1.0 false positive per volume. It is further evaluated for pelvic and abdominal LN detection on 54 volumes containing 569 LN, yielding a 80.0% detection rate with 3.2 false positives per volume. The running time is 5-20 s per volume for axillary areas and 15-40 s for pelvic. An added benefit of the method is the capability to detect and segment conglomerated lymph nodes.

  12. FDG PET evaluation of early axillary lymph node response to neoadjuvant chemotherapy in stage II and III breast cancer patients

    Energy Technology Data Exchange (ETDEWEB)

    Rousseau, Caroline [Comprehensive Cancer Center Rene Gauducheau, IRCNA, Nuclear Medicine Department, Saint Herblain (France); Nantes University, INSERM UMR 892, Cancer Research Center CRCNA, Nantes (France); Centre Rene Gauducheau, Service de Medecine Nucleaire, Saint Herblain Cedex (France); Devillers, Anne [Eugene Marquis Cancer Center, Nuclear Medicine Department, Rennes (France); Campone, Mario [Comprehensive Cancer Center Rene Gauducheau, Medical Oncology Department, Saint Herblain (France); Campion, Loic [Comprehensive Cancer Center Rene Gauducheau, Statistic Department, Saint Herblain (France); Ferrer, Ludovic [Comprehensive Cancer Center Rene Gauducheau, Medical Physics Department, Saint Herblain (France); Sagan, Christine [University Hospital, Pathology Department, Nantes (France); Ricaud, Myriam [Comprehensive Cancer Center Rene Gauducheau, Radiology Department, Saint Herblain (France); Bridji, Boumediene [Comprehensive Cancer Center Rene Gauducheau, IRCNA, Nuclear Medicine Department, Saint Herblain (France); Kraeber-Bodere, Francoise [Comprehensive Cancer Center Rene Gauducheau, IRCNA, Nuclear Medicine Department, Saint Herblain (France); Nantes University, INSERM UMR 892, Cancer Research Center CRCNA, Nantes (France)

    2011-06-15

    Regional axillary lymph node status has remained the single most independent variable to predict prognosis both in terms of disease recurrence and survival. This study aimed to prospectively assess sequential [{sup 18}F]fluorodeoxyglucose (FDG) positron emission tomography (PET) findings as early predictors of axillary lymph node response to neoadjuvant chemotherapy in stage II and III breast cancer patients. Images were acquired with a PET/CT scanner in 52 patients after administration of FDG (5 MBq/kg) at baseline and after the first, second, third and sixth course of chemotherapy before surgery. Clinical examination and ultrasound (US) were used to assess the size of axillary nodes. Decrease in the standardized uptake value (SUV) with PET corrected or not for partial volume effects was compared to the pathological response. The sensitivity, specificity and accuracy of axillary node staging was higher with PET (75, 87 and 80%) than with US (50, 83 and 65%), and even more so when PET images were corrected for partial volume effects (86, 83 and 84%). While FDG uptake did not vary much in non-responders, as confirmed by histopathological analysis, it markedly decreased to baseline levels in responders (p < 10{sup -5}). Fifty per cent of baseline SUV was considered the best cutoff value to distinguish responders from non-responders. The sensitivity, specificity, negative predictive value and accuracy of FDG PET after one course of chemotherapy were, respectively, 96, 75, 95 and 84%. The pathological status of regional axillary lymph nodes in stage II and III breast cancer patients could be accurately predicted after one course of neoadjuvant chemotherapy based on FDG PET images. (orig.)

  13. Imaging Classification of Cervical Lymph Nodes

    Directory of Open Access Journals (Sweden)

    Gh. Bakhshandepour

    2008-01-01

    Full Text Available Nearly four decades, Rouviere classification, which is a clinically based system, was the only system for cervical adenopathy classification. The best possible classification of cervical nodal disease may be accomplished by using both clinical palpation and also informations provided by imaging, because imaging can reveal clinically silent lymph nodes. most head and neck tumors spread to the neck nodes as a part of their natural history ,depending on the primary site. Up to 80% of patients with upper aerodigestive mucosal malignancies will have cervical nodal metastasis"nat presentation.The occurrence of nodal metastasis has a profound effect on the management and prognosis of the patients .nodal metastasis is the most important prognostic factor in squamous cell carcinoma of the head and neck. In general it decreases the overall survival by half, and extracapsular spread worsens the prognosis by another half. Our purpose in this presentation is to review imaging classification of cervical lymph nodes.

  14. A Prospective Evaluation of Lymphedema-Specific Quality-of-Life Outcomes Following Vascularized Lymph Node Transfer.

    Science.gov (United States)

    Patel, Ketan M; Lin, Chia-Yu; Cheng, Ming-Huei

    2015-07-01

    Microsurgical techniques for the treatment of lymphedema rapidly increased in popularity. Although surgical success with vascularized lymph node (VLN) transfer has been demonstrated, limited studies have investigated the influence of microsurgical treatments on health-related quality-of-life (HRQoL) parameters. The aim of this study was to prospectively evaluate changes in HRQoL following VLN transfer for upper- and lower-extremity lymphedema using a validated instrument. An Institutional Review Board-approved prospective study was performed of patients who underwent VLN transfer for symptomatic upper- or lower-limb lymphedema. A validated lymphedema-specific questionnaire-lymphoedema quality-of-life study-was utilized to assess specific quality-of-life parameters at multiple time points during the 12-month perioperative period. For a comparison with HRQoL metrics, limb circumference measurements were obtained to assess circumference differentiation. Twenty-five patients met the study criteria. Limb circumference analysis revealed significant early improvements following VLN transfer, with continued improvement during the study period (upper-limb lymphedema: 24.4 %; lower-limb lymphedema: 35.2 %). These improvements were mirrored by improvements in all HRQoL domains and overall quality of life (p lymphedema with VLN transfer procedures effectively decrease limb circumference. This improvement is mirrored by improvements in patient-reported outcomes and quality of life. These changes can be observed as soon as 1 month postoperatively, and continued steady improvement can be expected.

  15. Radiological imaging of lymph nodes for diagnostic evaluation and follow-up; Radiologische Bildgebung von Lymphknoten in Diagnostik und Verlaufskontrolle

    Energy Technology Data Exchange (ETDEWEB)

    Mende, U. [Abt. Klinische Radiologie und Poliklinik, Radiologische Universitaetsklinik Heidelberg (Germany)

    2002-06-01

    CT, MR imaging and sonography are the radiological modalities of choice complementing the conventional methods of anamnesis, clinical examination, laboratory findings, and cellular analysis in primary diagnostics, therapy monitoring, and follow-up of pathological lymph nodes. Final selection of methods will depend on the patients' individual conditions, physical constraints, local availability, and economic boundary conditions. Diagnostic criteria such as spreading patterns, morphology, structure, vascularisation and restriction should be evaluated in the light of case history and clinical findings, so as to permit selection of the most suitable methods for a 'functional imaging' that will answer the clinical queries. In no case, however, will even the most sophisticated imaging method make redundant the pathohistological diagnosis. (orig./CB) [German] Neben Anamnese, klinischer Untersuchung, Laborparametern und feingeweblicher Sicherung bilden die radiologischen Schnittbildverfahren Computertomographie, Magnetresonanztomographie und Sonographie einen Eckpfeiler in Primaerdiagnostik, Therapie-Monitoring und Verlaufskontrolle pathologischer Lymphknoten. Erkrankung des Patienten, physikalische Grenzen, logistische Verfuegbarkeit und oekonomische Erfordernisse bestimmen die Methodenauswahl. Die Kriterienn Ausbreitungsmuster, Morphologie, Struktur, Vaskularisation und Begrenzung sind nur unter Beruecksichtigung von Vorgeschichte und Klinik zu werten. Ziel ist ein 'functional imaging', welches die therapierelevanten Fragen des Klinikers beantwortet. Dennoch ist die Bildgebung, selbst durch Kombination komplementaerer Verfahren und subtile Auswertung, nicht in der Lage, die pathohistologische Diagnose zu ersetzen. (orig.)

  16. Use of indocyanine green for detecting the sentinel lymph node in breast cancer patients: from preclinical evaluation to clinical validation.

    Directory of Open Access Journals (Sweden)

    Chongwei Chi

    Full Text Available Assessment of the sentinel lymph node (SLN in patients with early stage breast cancer is vital in selecting the appropriate surgical approach. However, the existing methods, including methylene blue and nuclides, possess low efficiency and effectiveness in mapping SLNs, and to a certain extent exert side effects during application. Indocyanine green (ICG, as a fluorescent dye, has been proved reliable usage in SLN detection by several other groups. In this paper, we introduce a novel surgical navigation system to detect SLN with ICG. This system contains two charge-coupled devices (CCD to simultaneously capture real-time color and fluorescent video images through two different bands. During surgery, surgeons only need to follow the fluorescence display. In addition, the system saves data automatically during surgery enabling surgeons to find the registration point easily according to image recognition algorithms. To test our system, 5 mice and 10 rabbits were used for the preclinical setting and 22 breast cancer patients were utilized for the clinical evaluation in our experiments. The detection rate was 100% and an average of 2.7 SLNs was found in 22 patients. Our results show that the usage of our surgical navigation system with ICG to detect SLNs in breast cancer patients is technically feasible.

  17. Ultrasound-Guided Needle Biopsy of Neck Lymph Nodes in Patients With Suspected Lung Cancer: Are the Specimens Sufficient for Complete Pathologic Evaluation to Guide Patient Management?

    Science.gov (United States)

    Duguay, Sean; Wagner, Jason M; Zheng, Wei; Ling, Johnny; Zhao, Lichao C; Allen, Karen S; North, Justin C; Deb, Subrato J

    2017-06-01

    The purpose of this study is to determine the ability of ultrasound guided needle biopsy of a neck lymph node to provide adequate tissue for complete pathologic evaluation of suspected metastatic lung cancer, including molecular testing for epidermal growth factor receptor gene mutations by pyrosequencing and anaplastic lymphoma kinase gene rearrangement by fluorescence in situ hybridization. Institutional review board approval was obtained and the requirement for informed consent was waived. All ultrasound guided neck biopsies performed July 1, 2011, to June 30, 2015, were retrospectively reviewed, and all biopsies performed for suspected lung cancer metastatic to supraclavicular and cervical lymph nodes were included. Forty patients with suspected lung cancer underwent ultrasound-guided needle biopsy of an abnormal appearing neck lymph node identified on preprocedure computed tomography or positron emission tomography/computed tomography. Thirty-seven patients were subsequently diagnosed with lung cancer and 3 were diagnosed with lymphoma. A definitive pathologic diagnosis was rendered in 95% of neck node biopsies (38/40; 95% confidence interval, 84%-99%). Of the 36 specimens diagnostic for lung cancer, 16 were considered for further molecular testing and the specimen was adequate for molecular testing in 15 (94%; 73%-100%) cases. Therefore, the neck node biopsy specimens were adequate for complete pathologic workup in 93% (37/40; 81%-98%). No complications related to the biopsies were observed. In patients presenting with suspected lung cancer and suspicious neck lymph nodes, ultrasound-guided needle biopsy frequently provides adequate tissue for complete pathologic evaluation and eliminates the need for more invasive procedures.

  18. Popliteal lymph node metastasis of tibial osteoblastic osteosarcoma

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    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.

  19. Is Full Lymph Node Removal Always Needed for Melanoma?

    Science.gov (United States)

    ... Is Full Lymph Node Removal Always Needed for Melanoma? Survival was just as long for those who ... all lymph nodes in the vicinity of a melanoma skin cancer may not increase a patient's overall ...

  20. A case of lymphangioleiomyomatosis affecting the supraclavicular lymph nodes.

    Science.gov (United States)

    Kamitani, Takeshi; Yabuuchi, Hidetake; Soeda, Hiroyasu; Matsuo, Yoshio; Okafuji, Takashi; Sakai, Shuji; Hatakenaka, Masamitsu; Minami, Takahiro; Inoue, Hiromasa; Tanaka, Atsuo; Kohno, Hiroyuki; Tanaka, Michiko; Nakashima, Yutaka; Honda, Hiroshi

    2006-01-01

    The case of a 46-year-old woman with lymphangioleiomyomatosis (LAM) involving the supraclavicular, mediastinal, and pelvic lymph nodes in addition to the lungs is reported. Computed tomography incidentally revealed multiple thin-walled pulmonary cysts and low-attenuating masses in the supraclavicular, mediastinal, and retroperitoneal lymph nodes. A biopsy of the supraclavicular mass was performed and diagnosed as LAM histopathologically. The common sites of extrapulmonary LAM include retroperitoneal and mediastinal lymph nodes; however, supraclavicular lymph node involvement is extremely rare.

  1. The movement of lymph in the system of lymph node-lymph vessel and its regulation

    Directory of Open Access Journals (Sweden)

    Myrzakhanov Nurken

    2016-10-01

    Full Text Available Background This article presents the results of studying the specific features (rat, pig, sheep, cow of spontaneous rhythmic contractile activity of the lymph nodes of internal organs and body, the role of intranode pressure in the genesis of a node reduction of the lymph nodes activity regulation under the influence of biologically active substances, and the drug immunal and feed additives – polfamix on spontaneous contractile activity of a lymphatic node. Aims So far, well researched are the thin structural-topographic formation and innervation of the lymph circulation machine, the main functions (drainage, immunological, protein transport, etc. of the lymphatic system are set, which ensure the preservation of endoecological homeostasis of the organism environments. Methods We used the technique of recording contractions of isolated solitary lymph nodes of the body and internal organs, placed in an oxygenized chamber with Krebs medium. Results We found a direct link between the spontaneous rhythmic contractile activity of a lymph node and its internal pressure. A direct relationship is established: the higher within certain limits micronodular pressure is, the more intense is the reduction node (r+0,879. Conclusion As well as giving data from the manuscript there will be presentation of the main points of lymph node’s values in the organism.

  2. A longitudinal comparison of arm morbidity in stage I-II breast cancer patients treated with sentinel lymph node biopsy, sentinel lymph node biopsy followed by completion lymph node dissection, or axillary lymph node dissection

    NARCIS (Netherlands)

    Kootstra, Jan J.; Hoekstra-Weebers, Josette E.; Rietman, Johan S.; Vries, de Jakob; Baas, Peter C.; Geertzen, Jan H.B.; Hoekstra, Harald J.

    2010-01-01

    Background: Long-term shoulder and arm function following sentinel lymph node biopsy (SLNB) may surpass that following complete axillary lymph node dissection (CLND) or axillary lymph node dissection (ALND). We objectively examined the morbidity and compared outcomes after SLNB, SLNB + CLND, and ALN

  3. Molecular markers of lymph node metastases in oral cancer

    NARCIS (Netherlands)

    Leusink, FKJ

    2017-01-01

    Cervical lymph node metastasis occurs frequently in patients with oral squamous-cell carcinoma (OSCC) and is a major determinant of prognosis and treatment planning. Accurate lymph node staging is therefore crucial. Current preoperative clinical assessment of the lymph nodes by physical examination

  4. Lymph node content of supraclavicular and thoracodorsal-based axillary flaps for vascularized lymph node transfer.

    Science.gov (United States)

    Gerety, Patrick A; Pannucci, Christopher J; Basta, Marten N; Wang, Amber R; Zhang, Paul; Mies, Carolyn; Kanchwala, Suhail K

    2016-01-01

    Microvascular transfer of lymph node flaps has recently gained popularity as a treatment for secondary lymphedema often occurring after axillary, groin, or pelvic lymph node dissections. This study aimed to delineate the lymph node contents and pedicle characteristics of the supraclavicular (SC) and thoracodorsal (TD)-based axillary flaps as well as to compare lymph node quantification of surgeon vs pathologist. SC and TD flaps were dissected from fresh female cadavers. The surgeon assessed pedicle characteristics, lymph node content, and anatomy. A pathologist assessed all flaps for gross and microscopic lymph node contents. The κ statistic was used to compare surgeon and pathologist. Ten SC flaps and 10 TD flaps were harvested and quantified. In comparing the SC and TD flaps, there were no statistical differences between artery diameter (3.1 vs 3.2 mm; P = .75) and vein diameter (2.8 vs 3.5 mm; P = .24). The TD flap did have a significantly longer pedicle than the SC flap (4.2 vs 3.2 cm; P = .03). The TD flap was found to be significantly heavier than the SC flap (17.0 ± 4.8 vs 12.9 ± 3.3 g; P = .04). Gross lymph node quantity was similar in the SC and TD flaps (2.5 ± 1.7 vs 1.8 ± 1.2; P = .33). There was good agreement between the surgeon and pathologist in detecting gross lymph nodes in the flaps (SC κ = 0.87, TD κ = 0.61). The SC and TD flaps have similar lymph node quantity, but the SC flap has higher lymphatic density. A surgeon's estimation of lymph node quantity is reliable and has been verified in this study by comparison to a pathologist's examination. Copyright © 2016 Society for Vascular Surgery. Published by Elsevier Inc. All rights reserved.

  5. Improved specificity of {sup 18}F-FDG PET/CT for lymph node staging of non-small cell lung cancer considering calcified lymph node as benign

    Energy Technology Data Exchange (ETDEWEB)

    Kwon, Seong Young; Seo, Young Soon; Min, Jung Joon; Song, Ho Chun; Na, Kook Joo; Choi, Chan; Kim, Young Chul; Kim, Yun Hyun; Bom, Hee Seung [Chonnam National University Hospital, Gwangju (Korea, Republic of)

    2007-02-15

    We evaluated the diagnostic value of {sup 18}F-FDG PET/CT (PET/CT) in lymph node staging of non-small cell lung cancer (NSCLC) considering calcification and histologic types as well as FDG uptake. Fifty-three patients (38 men, 15 women; mean age, 62 years) with NSCLC underwent surgical resection (tumor resection and lymph node dissection) after PET/CT. After surgery, we compared PET/CT results with the biopsy results, and analyzed lymph node metastases, based on histologic types. PET diagnosis of lymph node metastasis was determined by maximum SUV (maxSUV) > 3.0, and PET/CT diagnosis was determined by maxSUV > 3.0 without lymph node calcification. By PET diagnosis, the sensitivity, specificity, and accuracy of overall lymph node staging were 45% (13 of 29), 91% (228 of 252), and 86% (241 of 281). Specificity was 91% in both squamous cell carcinoma and adenocarcinoma, while sensitivity was 71% in squamous cell carcinoma and 36% in adenocarcinoma. When we excluded calcified lymph node with maxSUV > 3.0 from metastasis by PET/CT diagnosis, specificity improved to 98% in squamous cell carcinoma and 97% in adenocarcinoma. The degree of improvement was not dependent on histologic types. PET/CT improved specificity of lymph node staging by reducing false positive lymph node regardless of histologic types of NSCLC.

  6. The usefulness of combined axial and coronal computed tomography for the evaluation of metastatic supraclavicular lymph nodes.

    Science.gov (United States)

    Choi, Hyun Jin; Lee, Kyung Hee; Kim, Na Hee; Kim, Jun Ho; Hyun, In Young; Ryu, Jeong-Seon

    2015-01-01

    The purpose is to assess the value of adding coronal images for the identification of metastatic supraclavicular lymph nodes (LNs). Two radiologists reviewed axial images and combined axial and coronal images using thoracic computed tomography (CT) of 386 patients whose maximum standardized uptake value measured in a supraclavicular LN was ≥2.0 on a positron emission tomography. We compared sensitivity and agreement between readers before and after the addition of coronal images. For combined images, agreement was almost perfect (κ=0.982), and sensitivity was significantly higher (90.4%, Psupraclavicular metastasis. Copyright © 2015 Elsevier Inc. All rights reserved.

  7. 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.

  8. 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.

  9. Pattern of Colon Cancer Lymph Node Metastases in Patients Undergoing Central Mesocolic Lymph Node Excision

    DEFF Research Database (Denmark)

    Bertelsen, Claus A; Kirkegaard-Klitbo, Anders; Nielsen, Mingyuan

    2016-01-01

    not considered appropriate. The risk of central mesocolic lymph node metastases for right-sided cancers varies between 1% and 22%. In sigmoid cancer, the risk is reported in ≤12% of the patients and is associated with advanced T stage. LIMITATIONS: The retrospective design and heterogeneity, in terms...... of definitions of lymph node location, tumor sites, stage, morphology, pathology assessment, and inclusion criteria (selection bias), of the included studies were limitations. Also, anatomic definitions were not uniform. CONCLUSIONS: The present literature cannot give a theoretical explanation of a better...... oncological outcome after extended lymph node dissection. Consensus for a standardization of anatomical definitions and surgical and pathological assessments is warranted for future mapping studies....

  10. [Lymph node preparation in colorectal cancer. Ex vivo methylene blue injection as a novel technique to improve lymph node visualization].

    Science.gov (United States)

    Märkl, B; Kerwel, T; Jähnig, H; Anthuber, M; Arnholdt, H

    2008-07-01

    The UICC requires investigation of a minimum of 12 lymph nodes for adequate lymph node staging in colorectal cancer. Despite that, many authors recommend investigation of a larger number, and different techniques, such as fat clearance, have therefore been developed. In this study we introduce a novel technique involving ex vivo lymph node staining with intraarterial methylene blue injection in colon cancer. We compared 14 cases in which methylene injection was used with 14 cases from our records in which conventional investigation techniques were applied. The lymph node harvest differed highly significantly (pmethylene blue group and the unstained group, respectively. The largest difference occurred in the size group 2-4 mm (191 vs 70 lymph nodes). In 6 cases in the unstained group additional embedding of fatty tissue was necessary to reach an adequate number of investigated lymph nodes. Methylene blue injection is a novel and highly effective method that will improve lymph node preparation in colorectal cancer.

  11. 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. Copyright © 2014 Wiley Periodicals, Inc.

  12. Upstaging of early colorectal cancers following improved lymph node yield after methylene blue injection

    DEFF Research Database (Denmark)

    Jepsen, Rikke Karlin; Ingeholm, Peter; Lund, Eva Charlotte Løbner

    2012-01-01

    Jepsen R K, Ingeholm P & Lund E L (2012) Histopathology 61, 788-794 Upstaging of early colorectal cancers following improved lymph node yield after methylene blue injection Aims:  To evaluate whether the use of intra-arterial methylene blue injection improves lymph node yield, and to determine...... concerning tumour characteristics, lymph node count, number of positive lymph nodes and success of methylene injection had been prospectively collected in accordance with the department's ongoing registration. The method was easy to implement and perform with a high rate of success (86%). The number...

  13. Sentinel lymph node biopsy and melanoma: 2010 update Part II.

    Science.gov (United States)

    Stebbins, William G; Garibyan, Lilit; Sober, Arthur J

    2010-05-01

    This article will discuss the evidence for and against the therapeutic efficacy of early removal of potentially affected lymph nodes, morbidity associated with sentinel lymph node biopsy and completion lymphadenectomy, current guidelines regarding patient selection for sentinel lymph node biopsy, and the remaining questions that ongoing clinical trials are attempting to answer. The Sunbelt Melanoma Trial and the Multicenter Selective Lymphadenectomy Trials I and II will be discussed in detail. At the completion of this learning activity, participants should be able to discuss the data regarding early surgical removal of lymph nodes and its effect on the overall survival of melanoma patients, be able to discuss the potential benefits and morbidity associated with complete lymph node dissection, and to summarize the ongoing trials aimed at addressing the question of therapeutic value of early surgical treatment of regional lymph nodes that may contain micrometastases. Copyright 2010 American Academy of Dermatology, Inc. Published by Mosby, Inc. All rights reserved.

  14. 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

    BACKGROUND: Extended histopathologic work-up has increased the detection of micrometastasis in sentinel lymph nodes in malignant melanoma and breast cancer. The aim of this study was to examine if (A) step-sectioning of the central 1000 microM at 250 microM levels with immunostaining were accurate...... 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...... sentinel lymph nodes due to lymphoscintigraphic and surgical sampling error. The central 1000 microM of 147 sentinel lymph nodes were step-sectioned in 250-microm intervals and stained with hematoxylin and eosin and CK-KL1. All lymph nodes were recorded as negative or positive for macrometastases...

  15. Sentinel lymph nodes in cancer of the oral cavity

    DEFF Research Database (Denmark)

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

    2005-01-01

    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...... 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...

  16. The prognostic value of lymph node ratio in a national cohort of rectal cancer patients

    DEFF Research Database (Denmark)

    Lykke, J; Jess, P; Roikjaer, O

    2016-01-01

    OBJECTIVE: To analyze the prognostic implications of the lymph node ratio (LNR) in curative resected rectal cancer. SUMMARY BACKGROUND DATA: It has been proposed that the LNR has a high prognostic impact in colorectal cancer, but the lymph node ratio has not been evaluated exclusively for rectal ...... that the introduction of LNR should be considered for rectal cancer in a revised TNM classification....

  17. Fine-needle aspiration biopsy of lymph nodes

    African Journals Online (AJOL)

    2012-02-02

    Feb 2, 2012 ... Lymph nodes in the posterior cervical triangle and supraclavicular nodes are more suspicious for malignancy. ... exclusively primary or recurrent breast carcinoma in aspirates ... Lung carcinoma – small cell and non- small cell.

  18. Sentinel lymph node concept in gastric cancer with solitary lymph node metastasis

    Institute of Scientific and Technical Information of China (English)

    Li-Yang Cheng; Shi-Zhen Zhong; Zong-Hai Huang

    2004-01-01

    AIM: To study the localization of the solitary metastases in relation to the primary gastric cancers and the feasibility of sentinel lymph node (SLN) concept in gastric cancer.METHODS: Eighty-six patients with gastric cancer, who had only one lymph node involved, were regarded retrospectively as patients with a possible sentinel node metastasis, and the distribution of these nodes were assessed. Thirteen cases with jumping metastases were further studied and followed up.RESULTS: The single nodal metastasis was found in the nearest perigastric nodal area in 65.1% (56/86) of the cases and in 19.8% (17/86) of the cases in a fairly remote perigastric area. Out of 19 middle-third gastric cancers,3 tumors at the lesser or greater curvatures had transverse metastases. There were also 15.1% (13/86) of patients with a jumping metastasis to N2-N3 nodes without N1 involved. Among them, the depth of invasion was mucosal (M) in 1 patient, submucosal (SM) in 2, proper-muscular (MP) in 4, subserosal (SS) in 5, and serosa-exposed (SE)in 1. Five of these patients died of gastric cancer recurrence at the time of this report within 3 years after surgery.CONCLUSION: These results suggest that nodal metastases occur in a random and multidirectional process in gastric cancer and that not every first metastatic node is located in the perigastric region near the primary tumor.The rate of "jumping metastasis" in gastric cancer is much higher than expected, which suggests that the blind examination of the nodal area close to the primary tumor can not be a reliable method to detect the SLN and that a extended lymph node dissection (ELND) should be performed if the preoperative examination indicates submucosal invasion.

  19. [The Role of Supraclavicular lymph node dissection in Breast Cancer Patients with Synchronous Ipsilateral Supraclavicular Lymph Node Metastasis].

    Science.gov (United States)

    Zhang, W; Qi, X M; Chen, A X; Zhang, P; Cao, X C; Xiao, C H

    2017-05-23

    Objective: In this study, we evaluated the effect of supraclavicular lymph node dissection in breast cancer patients who presented with ipsilateral supraclavicular lymph node metastasis (ISLM) without distant metastasis. Methods: A total of 90 patients with synchronous ISLM without distant metastasis between 2000 and 2009 were retrospectively analyzed. Patients were retrospectively divided into two groups, namely supraclavicular lymph node dissection group(34 patients) and non-dissection group(56 patients), according to whether they underwentsupraclavicular lymph node dissection or not.The Kaplan-Meier method was applied to analyze the locoregional relapse free survival (LRFS) and overall survival(OS). Results: Median follow-upwas 85 months(range, 6 to 11 months). Local recurrence in 32 cases, 47 cases of distant metastasis, of which 25 patients were accompanied by both locoregional relapse and distant metastasis. Of the 32 patients with locoregional relapse, 11 patients were in the lymph node dissection group and 21 patients in the control group. Of the 47 patients with distant metastases, 17 were treated with lymph node dissection, 30 in the control group. Thirty-two patients died in the whole group and 16 patients underwentlymph node dissection and 16 patients didn't. There was no significant difference between the rate of 5-year LRFS and 5-year OS (P=0.359, P=0.246). For patients of ER negative, the 5-year loco-regional relapse free survival rates were 63.7% and 43.3% in supraclavicular lymph node dissection group and control group, respectively. The 5-year overall survival rates were 52.1% and 52.3%, respectively, and there were no statistically significant differences (P=0.118, P=0.951). For patients of PR negative, the 5-yearloco-regional relapse free rates were 59.8% and 46.2%, respectively, and the 5-year overall survival rates were 50.6% and 43.2%, respectively, and there was no significant difference between the two groups (P=0.317, P=0.973). The 5-year

  20. Regenerating a kidney in a lymph node.

    Science.gov (United States)

    Francipane, Maria Giovanna; Lagasse, Eric

    2016-10-01

    The ultimate treatment for end-stage renal disease (ESRD) is orthotopic transplantation. However, the demand for kidney transplantation far exceeds the number of available donor organs. While more than 100,000 Americans need a kidney, only 17,000 people receive a kidney transplant each year (National Kidney Foundation's estimations). In recent years, several regenerative medicine/tissue engineering approaches have been exploited to alleviate the kidney shortage crisis. Although these approaches have yielded promising results in experimental animal models, the kidney is a complex organ and translation into the clinical realm has been challenging to date. In this review, we will discuss cell therapy-based approaches for kidney regeneration and whole-kidney tissue engineering strategies, including our innovative approach to regenerate a functional kidney using the lymph node as an in vivo bioreactor.

  1. Sentinel lymph node imaging by a fluorescently labeled DNA tetrahedron.

    Science.gov (United States)

    Kim, Kyoung-Ran; Lee, Yong-Deok; Lee, Taemin; Kim, Byeong-Su; Kim, Sehoon; Ahn, Dae-Ro

    2013-07-01

    Sentinel lymph nodes (SLNs) are the first lymph nodes which cancer cells reach after traveling through lymphatic vessels from the primary tumor. Evaluating the nodal status is crucial in accurate staging of human cancers and accordingly determines prognosis and the most appropriate treatment. The commonly used methods for SLN identification in clinics are based on employment of a colloid of radionuclide or injection of a small dye. Although these methods have certainly contributed to improve surgical practice, new imaging materials are still required to overcome drawbacks of the techniques such as inconvenience of handling radioactive materials and short retention time of small dyes in SLNs. Here, we prepare a fluorescence-labeled DNA tetrahedron and perform SLN imaging by using the DNA nanoconstruct. With a successful identification of SLNs by the DNA nanoconstruct, we suggest that DNA tetrahedron hold great promises for clinical applications.

  2. [Sentinel lymph node biopsy in endometrial cancer - methods].

    Science.gov (United States)

    Yordanov, G; Gorchev, S; Tomov, N; Hinkova

    2014-01-01

    Endometrial canceris the most common gynaecological malignancy after brest cancer. The lymph node status is with great prognostic value and it is important for postoperative treatment and survival. That is why it is looking for methods giving information for the lymph node status and not increasing postoperative complications.

  3. The prognostic value of lymph node ratio and updated TNM classification in rectal cancer patients with adequate versus inadequate lymph node dissection.

    Science.gov (United States)

    Junginger, T; Goenner, U; Lollert, A; Hollemann, D; Berres, M; Blettner, M

    2014-09-01

    The aim of this study was to clarify whether the lymph node ratio (LNR) is superior to the updated TNM classification regarding the prognosis of stage III rectal cancer patients who have not undergone neoadjuvant therapy. The TNM system is based on the absolute number of lymph nodes involved, and the LNR takes into account involved and examined nodes. In 237 patients with stage III rectal cancer, we evaluated prognostic factors for 5-year overall survival (OS), disease-free survival (DFS), and risk of distant metastases (DM) using the Kaplan-Meier method, with patients divided based on adequate versus inadequate lymph node dissection (≥12 vs. TNM divides patients into four groups (1, 2-3, 4-6, and ≥7 involved nodes), while LNR divides patients into quartiles. Multivariate Cox regression analyses were performed. Among patients with adequate lymph node dissection, the distributions within the two systems were in agreement in 141/178 (79.2 %, kappa 0.721), and the predictive values for OS, DFS, and DM were similar. In patients with inadequate lymph node dissection, the classifications of both systems were concordant in only 13/59 (22 %, kappa 0.021). The pN system significantly under-staged patients, while the LNR classification was a better predictor of OS, DFS, and DM. In patients with adequate lymph node dissection, LNR staging does not add substantial information to the predictions of updated TNM lymph node staging. However, in patients with inadequate lymph node harvesting, the LNR compensates for the under-staging of the TNM classification and provides a better estimation of prognosis than the updated TNM system.

  4. Lymph Node Failure Pattern and Treatment Results of Esophageal Cancer Patients Treated with Definitive Radiotherapy

    Energy Technology Data Exchange (ETDEWEB)

    Lee, Sun Young; Kwon, Hyoung Cheol; Kim, Jung Soo [Chonbuk National University Hospital, Jeonju (Korea, Republic of); Lee, Heui Kwan [The Catholic University of Korea, Seoul (Korea, Republic of); Kim, Soo Geon [Jesushospital, Jeonju (Korea, Republic of)

    2008-06-15

    We evaluated the failure pattern of the celiac axis, gastric lymph node, and treatment outcome in the upper and mid-esophageal region of cancer patients treated by definitive radiotherapy, except when treating the celiac axis and gastric lymph node for treatment volume, retrospectively. Materials and Methods: The study constituted the evaluation 108 patients with locally advanced esophageal cancer receiving radiotherapy or a combination of radiotherapy and chemotherapy at Chonbuk National University Hospital from January 1986 to December 2006. In total, 82 patients treated by planned radiotherapy, except when treating the celiac axis and gastric lymph node for treatment volume, were analysed retrospectively. The study population consisted of 78 men and 2 women (mean age of 63.2 years). In addition, 51 patients received radiotherapy alone, whereas 31 patients received a combination of radiation therapy and chemotherapy. The primary cancer sites were located in the upper portion (17 patients), and mid portion (65 patients), respectively. Further, the patients were in various clinical stages including T1N0-1M0 (7 patients), T2N0-1M0 (18 patients), T3N0-1M0 (44 patients) and T4N0-1M0 (13 patients). The mean follow up period was 15 months. Results: The various treatment outcomes included complete response (48 patients), partial response (31 patients) and no response (3 patients). The failure patterns of the lymph node were comprised of the regional lymph node (23 patients) and the distance lymph node which included celiac axis and gastric lymph node (13 patients). However, metastasis was not observed in the regional and distant lymph node in 10 patients, whereas 36 patients were not evaluated. Furthermore, of the 13 patients who developed celiac axis and gastric lymph node metastases, 3 were in stage T1N0-1M0 and 10 were in stage T2-4N0-1M0. A complete response appeared in 12 patients, whereas a partial response appeared in 1 patient. The mean survival time of the

  5. [Accumulation of tattoo pigment in sentinel lymph nodes].

    Science.gov (United States)

    Kürle, S; Schulte, K W; Homey, B

    2009-10-01

    A 22-year-old woman presented with a superficial spreading melanoma on her right thigh (tumor thickness 1.0 mm, Clark-Level III). She also had decorative tattoos on her right ankle, right groin and coccyx. The staging results gave no indication for metastases. Intra-operatively, we observed a black pigmented lymph node highly suspicious for metastatic disease, but histological examination excluded metastatic spread and detected the accumulation of black pigment within the lymph node. Clinical differentiation between tattoo pigments and metastatic disease within lymph nodes is not possible. Histological confirmation of an enlarged pigmented lymph node is therefore essential before radical surgery is performed. Hence, accumulation of tattoo pigment within enlarged and pigmented lymph nodes needs to be included into the differential diagnosis and the documentation of decorative tattoos is important during skin cancer screening as well as during the follow-up of melanoma patients.

  6. Limited effect of lymph node status on the metastatic pattern in colorectal cancer.

    Science.gov (United States)

    Knijn, Nikki; van Erning, Felice N; Overbeek, Lucy I H; Punt, Cornelis J A; Lemmens, Valery E P P; Hugen, Niek; Nagtegaal, Iris D

    2016-05-31

    Regional lymph node metastases in colorectal cancer (CRC) decrease outcome. Whether nodal metastases function as a biomarker, i.e. as a sign of advanced disease, or are in fact involved in the metastatic process is unclear. We evaluated metastatic patterns of CRC according to the lymph node status of the primary tumor.A retrospective review of 1393 patients with metastatic CRC who underwent autopsy in the Netherlands was performed. Metastatic patterns of regional lymph node positive and negative CRC were compared and validated by population-based data from the Eindhoven Cancer Registry (ECR).Patients with regional lymph node positive CRC more often developed peritoneal metastases (28% vs. 21%, p=0.003) and distant lymph node metastases (25% vs. 15%, p <0.001). Incidences of liver and lung metastases were comparable. Data from the ECR confirmed our findings regarding peritoneal (22.4% vs. 17.0%, p=0.003) and distant lymph node metastases (15.8% vs. 9.7%, p <0.001).Regional lymph node positive CRC show a slightly different dissemination pattern, with higher rates of peritoneal and distant lymph nodes metastases. Comparable incidences of liver and lung metastases support the hypothesis that dissemination to distant organs occurs independently of lymphatic spread.

  7. Relationship between Preoperative Clinicopathologic Characteristics and Lymph Node Metastasis in Early Gastric Cancer

    Institute of Scientific and Technical Information of China (English)

    LIU Cai-Gang; LU Ping; LU Yang; ZHANG Rui-shan; JIN Feng; XU Hui-mian; WANG Shu-bao; CHEN Jun-qing

    2007-01-01

    Objective: To investigate the features of the preoperative clinicopathologic characteristics in correlation with lymph node metastasis. Methods: The preoperative clinicopathologic characteristics and lymph node metastasis of 265 patients with early gastric carcinoma were analyzed retrospectively. Results: The three clinicopathologic characteristics, maximum cancer diameter >2cm under endoscope, poor differentiation and excavated type were significant high risk independent preoperative clinicopathologic characteristics(P<0.05). The patients who had none of the three preoperative clinicopathologic characteristics had no lymph node metastasis, while 27.27% of the patients who had all the three preoperative clinicopathologic characteristics had N2 lymph node metastasis. Conclusion: The three preoperative clinicopathologic characteristics, maximum cancer diameter under endoscope, cell differentiation and gross type were very useful to evaluate the extent of lymph node metastasis.

  8. Reliability of sentinel node procedure for lymph node staging in prostate cancer patients at high risk for lymph node involvement

    NARCIS (Netherlands)

    Van den Bergh, Laura; Joniau, Steven; Haustermans, Karin; Deroose, Christophe M.; Isebaert, Sofie; Oyen, Raymond; Mottaghy, Felix M.; Ameye, Filip; Berkers, Joost; Van Poppel, Hendrik; Lerut, Evelyne

    2015-01-01

    PURPOSE Accurate staging modalities to diagnose lymph node involvement in patients with prostate cancer (PCa) are lacking. We wanted to prospectively assess sensitivity, specificity, and positive predictive value (PPV) and negative predictive value of (11)C-choline positron emission tomography (PET)

  9. 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.

  10. The immunohistochemical detection of lymph node metastases from infiltrating lobular carcinoma of the breast.

    OpenAIRE

    Bussolati, G; Gugliotta, P; Morra, I; Pietribiasi, F.; Berardengo, E.

    1986-01-01

    Immunological markers improve specificity and accuracy of cell detection, therefore it is important to evaluate their usefulness in improving standard histological procedures. This study investigates whether immunocytochemical techniques increase the accuracy of detection, in axillary lymph nodes, of metastatic cells from infiltrating breast lobular carcinoma (ILC). Fifty cases of ILC reported to be node-negative were selected. New serial sections were cut from a total of 767 lymph nodes, sta...

  11. Cost analysis of sentinel lymph node biopsy in melanoma.

    Science.gov (United States)

    Martínez-Menchón, T; Sánchez-Pedreño, P; Martínez-Escribano, J; Corbalán-Vélez, R; Martínez-Barba, E

    2015-04-01

    Sentinel lymph node biopsy (SLNB) is the most useful tool for node staging in melanoma. SLNB facilitates selective dissection of lymph nodes, that is, the performance of lymphadenectomy only in patients with sentinel nodes positive for metastasis. Our aim was to assess the cost of SLNB, given that this procedure has become the standard of care for patients with melanoma and must be performed whenever patients are to be enrolled in clinical trials. Furthermore, the literature on the economic impact of SLNB in Spain is scarce. From 2007 to 2010, we prospectively collected data for 100 patients undergoing SLNB followed by transhilar bivalving and multiple-level sectioning of the node for histology. Our estimation of the cost of the technique was based on official pricing and fee schedules for the Spanish region of Murcia. The rate of node-positive cases in our series was 20%, and the mean number of nodes biopsied was 1.96; 44% of the patients in the series had thin melanomas. The total cost was estimated at between €9486.57 and €10471.29. Histopathology accounted for a considerable portion of the cost (€5769.36). The cost of SLNB is high, consistent with amounts described for a US setting. Optimal use of SLNB will come with the increasingly appropriate selection of patients who should undergo the procedure and the standardization of a protocol for histopathologic evaluation that is both sensitive and easy to perform. Copyright © 2014 Elsevier España, S.L.U. and AEDV. All rights reserved.

  12. Patterns of Lymph Node Pathology; Fine Needle Aspiration Biopsy as an Evaluation Tool for Lymphadenopathy: A Retrospective Descriptive Study Conducted at the Largest Hospital in Africa.

    Directory of Open Access Journals (Sweden)

    Denasha Lavanya Reddy

    Full Text Available Lymphadenopathy is a common clinical presentation of disease in South Africa (SA, particularly in the era of Human Immunodeficiency Virus (HIV and tuberculosis (TB co-infection.Data from 560 lymph node biopsy reports of specimens from patients older than 12 years at Chris Hani Baragwanath Academic Hospital (CHBAH between 1 January 2010 and 31 December 2012 was extracted from the National Health Laboratory Service (NHLS, division of Anatomical Pathology. Cytology reports of lymph node fine needle aspirates (FNAs performed prior to lymph node biopsy in 203 patients were also extracted from the NHLS. Consent was not obtained from participants for their records to be used as patient information was anonymized and de-identified prior to analysis.The majority of patients were female (55% and of the African/black racial group (90%. The median age of patients was 40 years (range 12-94. The most common indication for biopsy was an uncertain diagnosis (more than two differential diagnoses entertained, followed by a suspicion for lymphoma, carcinoma and TB. Overall, malignancy constituted the largest biopsy pathology group (39%, with 36% of this group being carcinoma and 27% non-Hodgkin lymphoma. 22% of the total sampled nodes displayed necrotizing granulomatous inflammation (including histopathology and cytology demonstrating definite, and suspicious for mycobacterial infection, 8% comprised HIV reactive nodes; in the remainder no specific pathology was identified (nonspecific reactive lymphoid hyperplasia. Kaposi sarcoma (KS accounted for 2.5% of lymph node pathology in this sample. Concomitant lymph node pathology was diagnosed in four cases of nodal KS (29% of the subset. The co-existing pathologies were TB and Castleman disease. HIV positive patients constituted 49% of this study sample and the majority (64% of this subset had CD4 counts less than 350 cells/ul. 27% were HIV negative and in the remaining nodes, the HIV status of patients was unknown

  13. Lymph node density predicts recurrence and death after inguinal lymph node dissection for penile cancer

    Science.gov (United States)

    Schwen, Zeyad R.; Ko, Joan S.; Meyer, Alexa; Netto, George J.; Burnett, Arthur L.; Bivalacqua, Trinity J.

    2017-01-01

    Purpose To determine the impact of lymph node density (LND) on survival after inguinal lymph node dissection (ILND) for penile cancer. Materials and Methods Our institutional penile cancer database was queried for patients who underwent ILND. Clinicopathologic characteristics including LND and total number of positive lymph nodes (LNs) were analyzed to determine impact on recurrence-free survival (RFS) and overall survival (OS). LND, or the percent of positive LN out of total LN, was calculated as a categorical variable at varying thresholds. Results Twenty-eight patients with complete follow-up were identified. Indications for ILND were stage >T2 in 20 patients (71.4%), palpable adenopathy in 7 (25%), high grade T1 in 1 (3.6%). Median node yield was 17.5 (interquartile range, 12−22), and positive LNs were found in 14 patients (50%). RFS and OS were significantly lower for patients with >15% LN density (median RFS: 62 months vs. 6.3 months, p=0.0120; median OS: 73.6 months vs. 6.3 months, p15% was independently associated with worse RFS (hazard ratio [HR], 3.6; p=0.04) and OS (HR, 73.6; p=0.002). The c-index for LND was higher than total positive LNs for RFS (0.64 vs. 0.54) and OS (0.79 vs. 0.61). Conclusions In this small, retrospective penile cancer cohort, the presence of nodal involvement >15% was associated with decreased RFS and OS, and outperformed total number of positive LN as a prognostic indicator.

  14. Lymphocyte migration into syngeneic implanted lymph nodes

    Energy Technology Data Exchange (ETDEWEB)

    Gordeeva, M.S.

    1986-03-01

    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 /sup 51/Cr was obtained from peripheral LN in different situations from syngeneic mice. The resulting lymphocyte suspension was labeled with a solution of sodium chromate-/sup 51/Cr in a concentration of 20-40 microCi/100.10/sup 6/ cells in 1 ml for 40 min at 37/sup 0/C. The proliferative activity of a suspension of lymphocytes was estimated as incorporation of /sup 3/H-thymidine into DNA during incubation of the cell suspension for 3 days. Data on migration of /sup 51/Cr-labeled cells and the results of the morphological observations revealed marked ability of lymphocytes of the peripheral pool to colonize the regenerating stroma.

  15. LIGHT regulates inflamed draining lymph node hypertrophy

    Science.gov (United States)

    Zhu, Mingzhao; Yang, Yajun; Wang, Yugang; Wang, Zhongnan; Fu, Yang-Xin

    2011-01-01

    Lymph node (LN) hypertrophy, the increased cellularity of LNs, is the major indication of the initiation and expansion of the immune response against infection, vaccination, cancer or autoimmunity. The mechanisms underlying LN hypertrophy remain poorly defined. Here, we demonstrate that LIGHT (TNFSF14) is a novel factor essential for LN hypertrophy after CFA immunization. Mechanistically, LIGHT is required for the influx of lymphocytes into but not egress out of LNs. In addition, LIGHT is required for DC migration from the skin to draining LNs. Compared with WT mice, LIGHT−/− mice express lower levels of chemokines in skin and addressins in LN vascular endothelial cells after CFA immunization. We unexpectedly observed that LIGHT from radioresistant rather than radiosensitive cells, likely Langerhans cells, is required for LN hypertrophy. Importantly, antigen-specific T cell responses were impaired in DLN of LIGHT−/− mice, suggesting the importance of LIGHT regulation of LN hypertrophy in the generation of an adaptive immune response. Collectively, our data reveal a novel cellular and molecular mechanism for the regulation of LN hypertrophy and its potential impact on the generation of an optimal adaptive immune response. PMID:21572030

  16. Extended lymph node dissection in robotic radical prostatectomy: Current status

    Directory of Open Access Journals (Sweden)

    Sameer Chopra

    2016-01-01

    Full Text Available Introduction: The role and extent of extended pelvic lymph node dissection (ePLND during radical prostatectomy (RP for prostate cancer patients remains unclear. Materials and Methods: A PubMed literature search was performed for studies reporting on treatment regimens and outcomes in patients with prostate cancer treated by RP and extended lymph node dissection between 1999 and 2013. Results: Studies have shown that RP can improve progression-free and overall survival in patients with lymph node-positive prostate cancer. While this finding requires further validation, it does allow urologists to question the former treatment paradigm of aborting surgery when lymph node invasion from prostate cancer occurred, especially in patients with limited lymph node tumor infiltration. Studies show that intermediate- and high-risk patients should undergo ePLND up to the common iliac arteries in order to improve nodal staging. Conclusions: Evidence from the literature suggests that RP with ePLND improves survival in lymph node-positive prostate cancer. While studies have shown promising results, further improvements and understanding of the surgical technique and post-operative treatment are required to improve treatment for prostate cancer patients with lymph node involvement.

  17. 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

  18. 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.)

  19. 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

  20. Prognostic impact of splenectomy on advanced proximal gastric cancer with No.10 lymph node metastasis

    Institute of Scientific and Technical Information of China (English)

    HUANG Chang-ming; WANG Jia-bin; LU Hui-shan; ZHENG Chao-hui; LI Ping; XIE Jian-wei; ZHANG Xiang-fu

    2009-01-01

    Background This study evaluated the prognostic impact of D2 lymphadenectomy combined with splenectomy in patients with advanced proximal gastric cancer and lymph node metastasis at the splenic hilum (No. 10 lymph nodes).Methods The clinical records of 216 patients with advanced proximal gastric cancer and No.10 lymph node metastasis who underwent D2 curative resection were retrospectively analyzed. Seventy-three patients underwent simultaneous splenectomy (splenectomy group), while 143 patients did not (spleen-preserving group). Five-year survival rates, mean numbers of dissected No.10 lymph nodes and metastatic No.10 lymph nodes, and operative morbidity and mortality were calculated and compared between the two groups. Potential prognostic factors were evaluated by univariate and multivariate analysis.Results The 5-year survival rate was 30.0% for the splenectomy group and 19.7% for the spleen-preserving group (X~2=14.73, P 0.05).Conclusions Splenectomy is beneficial for No.10 lymph node dissection in patients with advanced proximal gastric cancer. To improve patient prognosis, total gastrectomy with splenectomy is recommended for patients with T3 proximal gastric cancer who have No. 10 lymph node metastasis.

  1. 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.

  2. Number of Lymph Nodes Harvested From a Mediastinal Lymphadenectomy

    Science.gov (United States)

    Allen, Mark S.; Decker, Paul A.; Ballman, Karla; Malthaner, Richard A.; Inculet, Richard I.; Jones, David R.; McKenna, Robert J.; Landreneau, Rodney J.; Putnam, Joe B.

    2011-01-01

    Background: Lymph node status is a major determinant of stage and survival in patients with lung cancer; however, little information is available about the expected yield of a mediastinal lymphadenectomy. Methods: The American College of Surgeons Oncology Group Z0030 prospective, randomized trial of mediastinal lymph node sampling vs complete mediastinal lymphadenectomy during pulmonary resection enrolled 1,111 patients from July 1999 to February 2004. Data from 524 patients who underwent complete mediastinal lymph node dissection were analyzed to determine the number of lymph nodes obtained. Results: The median number of additional lymph nodes harvested from a mediastinal lymphadenectomy following systematic sampling was 18 with a range of one to 72 for right-sided tumors, and 18 with a range of four to 69 for left-sided tumors. The median number of N2 nodes harvested was 11 on the right and 12 on the left. A median of at least six nodes was harvested from at least three stations in 99% of patients, and 90% of patients had at least 10 nodes harvested from three stations. Overall, 21 patients (4%) were found to have occult N2 disease. Conclusions: Although high variability exists in the actual number of lymph nodes obtained from various nodal stations, complete mediastinal lymphadenectomy removes one or more lymph nodes from all mediastinal stations. Adequate mediastinal lymphadenectomy should include stations 2R, 4R, 7, 8, and 9 for right-sided cancers and stations 4L, 5, 6, 7, 8, and 9 for left-sided cancers. Six or more nodes were resected in 99% of patients in this study. Trial registry: ClinicalTrials.gov; No.: NCT00003831; URL: clinicaltrials.gov PMID:20829340

  3. Sentinel Lymph Node Mapping In Gastric Cancer Surgery: Current Status

    Directory of Open Access Journals (Sweden)

    Bara Tivadar

    2016-12-01

    Full Text Available Lymphonodular metastases remain an important predictive and prognostic factor in gastric cancer development. The precise determination of the lymphonodular invasion stage can be made only by extended intraoperative lymphadenectomy and histopathological examination. But the main controversy is the usefulness of extended lymph dissection in early gastric cancer. This increases the duration of the surgery and the complications rate, and it is unnecessary without lymphonodular invasion. The identification of the sentinel lymph nodes has been successfully applied for some time in the precise detection of lymph nodes status in breast cancer, malignant melanoma and the use for gastric cancer patients has been a controversial issue. The good prognosis in early gastric cancer had been a surgery challenge, which led to the establishment of minimally invasive individualized treatment and acceptance of sentinel lymph node mapping. The dual-tracer method, submucosally administered endoscopically is also recommended in sentinel lymph node biopsy by laparoscopic approach. There are new sophisticated technologies for detecting sentinel lymph node such as: infrared ray endoscopy, florescence imaging and near-infrared technology, carbon nanoparticles, which will open new perspectives in sentinel lymph nodes mapping.

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

    Directory of Open Access Journals (Sweden)

    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.

  5. 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.

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

    Institute of Scientific and Technical Information of China (English)

    Takashi Akiyoshi; Toshiaki Watanabe; Masashi Ueno; Tetsuichiro Muto

    2011-01-01

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

  7. The importance of tattoo pigment in sentinel lymph nodes.

    Science.gov (United States)

    Soran, Atilla; Menekse, Ebru; Kanbour-Shakir, Amal; Tane, Kaori; Diego, Emilia; Bonaventura, Marguerite; Johnson, Ronald

    2017-07-06

    The presence of pigment in axillary lymph nodes (LN) secondary to migration of tattoo ink can imitate the appearance of a blue sentinel lymph node (SLN) on visual inspection, causing the operator to either miss the true SLN or excise more than is needed. We present patients with tattoos ipsilateral to an early stage breast cancer who underwent a SLN biopsy. Patients were retrospectively reviewed from medical records and clinicopathologic data was collected. A total of 52 LNs were retrieved from 15 patients for sentinel mapping and 29 of them had tattoo pigmentation on pathologic evaluation. Of those 29 SLNs, 2 of them (6.9%) were pigmented, but did not contain either blue dye or Tc-99m (pseudopigmented SLN). Two (3.8%) SLNs were positive for metastasis; both of these had either blue dye or Tc99m uptake, and 1 demonstrated tattoo pigment in the node. In this cohort of patients with ipsilateral tattoos, removed more LNs lead to unnecessary excision which may important for increasing the risk of arm morbidity from SLN biopsy. However, the presence of tattoo pigment did not interfere with understaging for axillary mapping and it did not effect of pathological identification of SLNs positivity.

  8. Ascending colon cancer with synchronous external iliac and inguinal lymph node metastases but without regional lymph node metastasis: a case report and brief literature review.

    Science.gov (United States)

    Kitano, Yuki; Kuramoto, Masafumi; Masuda, Toshiro; Kuroda, Daisuke; Yamamoto, Kenichiro; Ikeshima, Satoshi; Iyama, Ken-Ichi; Shimada, Shinya; Baba, Hideo

    2017-12-01

    Lymph node metastasis to the iliac or inguinal region of colon cancer is extremely rare. We experienced a case of ascending colon cancer with synchronous isolated right external iliac and inguinal lymph node metastases but without any regional lymph node metastasis. An 83-year-old woman was admitted to our hospital due to anemia. Colonoscopy and computed tomography revealed an ascending colon cancer and also right external iliac and inguinal lymph node swelling. Further examination by F-deoxyglucose positron emission tomography strongly suggested that these lymph nodes were metastatic. Right hemicolectomy with lymph node dissection along the superior mesenteric artery, and right external iliac and inguinal lymph node dissection were performed. Histological examination revealed that both lymph nodes were metastasized from colon cancer, and there was no evidence of regional lymph node metastasis. The patient has shown no sign of recurrence at 27 months after surgery.

  9. Unplanned irradiation of internal mammary lymph nodes in breast cancer.

    Science.gov (United States)

    Kanyilmaz, Gul; Aktan, Meryem; Koc, Mehmet; Demir, Hikmettin; Demir, Lütfi Saltuk

    2017-06-01

    To evaluate the incidental dose to the internal mammary chain (IMC) in patients treated with three-dimensional conformal radiotherapy, to estimate the predictors affecting the magnitude of IMC receiving dose and to determine the predictive role of clinical parameters on survival. Between 2009 and 2015, 348 patients undergoing RT for breast cancer were retrospectively analyzed. All patients underwent our department's routine procedure for breast cancer. The internal mammary lymph nodes were contoured according to Radiation Therapy Oncology Group (RTOG) concensus. Based on each patient's dose-volume histograms, the mean doses (D mean) to internal mammary gland were analyzed. Overall survival and disease-free survival were also evaluated. The median follow-up time was 38 (range 3-80) months. The D mean to IMC was 32.8 Gy and the dose delivered to IMC showed a greater coverage in modified radical mastectomy (MRM) group compared with breast conserving surgery (34.6 vs 26.7 Gy). The T-stage of tumor and the N-stage of tumor affected the incidental dose to IMC. The tumor size, the number of involved lymph nodes, the percentage of involved lymph nodes, hormonal status, advanced T-stage and advanced N-stage were the prognostic factors that affect survival. The IMC received meaningful incidental irradiation dose when treated with two opposite tangential fields and ipsilateral supraclavicular fossa with a single anterior field. The real effect of incidental dose on survival and the hypothesis about the benefit of incidental irradiation of IMC should be examined in clinical studies.

  10. Sentinel lymph node biopsy: technique validation at the Setúbal Medical Centre, Portugal

    Science.gov (United States)

    Ferreira, P; Baía, R; António, A; Almeida, J; Simões, J; Amaro, JC; Quintana, C; Branco, L; Rigueira, MV; Gonçalves, M; Pereira, EV; Ferreira, LM

    2009-01-01

    Aims: To evaluate the accuracy of sentinel lymph node biopsy in breast cancer patients at this institution, using combined technetium-99m (99mTc) sulphur colloid and patent blue vital dye. Methods: From March 2007 to July 2008, 50 patients with a tumour of less than 3 cm and with clinically negative axillary lymph nodes underwent sentinel lymph node biopsy (SLNB), followed by axillary lymph node dissection (ALND). Sub-areolar 99mTc sulphur colloid injection was performed the day before surgery, and patent blue vital dye was also injected sub-areolarly at least 5 minutes before surgery. Sentinel lymph node was identified during the surgical procedure, using a gamma probe and direct vision. All sentinel nodes underwent frozen section analysis. Later haematoxylin and eosin staining and immunohistochemical analysis were performed. Finally, SLNB was compared with standard ALND for its ability to accurately reflect the final pathological status of the axillary nodes. Results: The sentinel lymph node (SLN) was identified in 48 of 50 patients (96%). The number of sentinel lymph nodes ranged from one to four (mean 1.48) and non-sentinel nodes ranged from seven to 27 (mean 14.33). Of the 48 patients with successfully identified SLNs, 29.17% (14/48) were histologically positive. Sensivity of the SLN to predict axilla was 93.75%; accuracy was 97.96%. The SLN was falsely negative in one patient—6.25% (1/16). Conclusions: The SLNB represents a major advance in the surgical treatment of breast cancer as a minimally invasive procedure predicting the axillary lymph node status. This validation study demonstrates the accuracy of the SLNB and its reasonable false negative rate when performed in our institute. It can now be used as the standard method of staging in patients with early breast cancer at this institution. PMID:22275996

  11. Isolated Axillary Lymph Node Metastasis from Serous Ovarian Cancer

    Directory of Open Access Journals (Sweden)

    Hemant Goyal

    2012-01-01

    Full Text Available A 68-year-old female with past medical history of stage IIIc serous ovarian cancer after cytoreductive surgery and adjuvant chemotherapy came to clinic for regular follow-up visit. Physical examination was completely normal except for an isolated left axillary lymph node enlargement. Patient's abdominal sonogram and CT scan of abdomen and pelvis did not show any other new metastasis. Surgical excisional biopsy of the lymph node was performed and pathology revealed features of metastatic serous ovarian carcinoma.

  12. Lymph node hemangioma in one-humped camel

    OpenAIRE

    Aljameel, M.A.; M.O. Halima

    2015-01-01

    Hemangioma is a benign tumor of blood and lymphatic vessels. It is common in skin, mucosa and soft tissues, and its occurrence in lymph nodes is extremely rare. A 10 year-old she-camel was slaughtered at Nyala slaughterhouse, South Darfur State, Sudan. Grossly, the carcass was emaciated. The left ventral superficial cervical lymph node was enlarged, hard on palpation and protruded outside the body. Its cut surface was dark red in color and measured (18 cm) in diameter. Histopathologically, th...

  13. FDG uptake in cervical lymph nodes in children without head and neck cancer.

    Science.gov (United States)

    Vali, Reza; Bakari, Alaa A; Marie, Eman; Kousha, Mahnaz; Charron, Martin; Shammas, Amer

    2017-06-01

    Reactive cervical lymphadenopathy is common in children and may demonstrate increased (18)F-fluoro-deoxyglucose ((18)F-FDG) uptake on positron emission tomography/computed tomography (PET/CT). We sought to evaluate the frequency and significance of (18)F-FDG uptake by neck lymph nodes in children with no history of head and neck cancer. The charts of 244 patients (114 female, mean age: 10.4 years) with a variety of tumors such as lymphoma and post-transplant lymphoproliferative diseases (PTLD), but no head and neck cancers, who had undergone (18)F-FDG PET/CT were reviewed retrospectively. Using the maximum standardized uptake value (SUVmax), increased (18)F-FDG uptake by neck lymph nodes was recorded and compared with the final diagnosis based on follow-up studies or biopsy results. Neck lymph node uptake was identified in 70/244 (28.6%) of the patients. In 38 patients, the lymph nodes were benign. In eight patients, the lymph nodes were malignant (seven PTLD and one lymphoma). In 24 patients, we were not able to confirm the final diagnosis. Seven out of the eight malignant lymph nodes were positive for PTLD. The mean SUVmax was significantly higher in malignant lesions (4.2) compared with benign lesions (2.1) (P = 0.00049). (18)F-FDG uptake in neck lymph nodes is common in children and is frequently due to reactive lymph nodes, especially when the SUVmax is cervical lymph nodes is higher in PTLD patients compared with other groups.

  14. Lymph node micrometastasis and its correlation with MMP-2 expression in gastric carcinoma

    Institute of Scientific and Technical Information of China (English)

    Ze-Yu Wu; Jing-Hua Li; Wen-Hua Zhan; Yu-Long He

    2006-01-01

    AIM: To examine matrix metalloproteinase-2 (MMP-2)expression in gastric cancer tissues and to evaluate its relationship with lymph node micrometastasis.MATERIALS: The authors studied 850 lymph nodes resected from 30 patients with gastric carcinoma who underwent gastrectomy with lymphadenetomy using reverse transcription polymerase chain reaction (RT-PCR)assay in addition to H-E staining. MMP-2 expression of the tumor tissues was detected by immunohistochemical technique (EliVisionTM plus).RESULTS: MMP-2 expression was positive in 21 (70%)cases and negative in 9 (30%) cases. No significant correlations were found between MMP-2 expression and other variables such as age, gender, tumor location,tumor diameter, Lauren classification and lymphatic invasion. In contrast, MMP-2 expression correlated significantly with depth of tumor infiltration (P =0.022), lymph node metastasis (P = 0.030) and tumor differentiation (P = 0.043). Lymph node micrometastases were detected in 77 (12.5%) lymph nodes of 14 (46.7%)gastric carcinoma patients. MMP-2 expression was positive in 12 (85.7%) of the 14 patients with lymph node micrometastasis, and in 9 (56.3%) of the 16patients without lymph node micrometastasis (P = 0.118).CONCLUSIONS: Our results demonstrate that MMP-2 expression has significant correlation with tumor invasion, tumor differentiation and lymph node metastases. MMP-2 expression may be an important biological characteristics and significant prognostic parameter of gastric carcinoma. We also conclude that MMP-2 may participate in the development of lymph node micrometastasis of gastric carcinoma. Further investigations are needed to draw a conclusion.

  15. Prospective evaluation of 68Gallium‐prostate‐specific membrane antigen positron emission tomography/computed tomography for preoperative lymph node staging in prostate cancer

    National Research Council Canada - National Science Library

    Leeuwen, Pim J; Emmett, Louise; Ho, Bao; Delprado, Warick; Ting, Francis; Nguyen, Quoc; Stricker, Phillip D

    2017-01-01

    ... are inadequate for LN staging in PCa. MRI, CT, positron emission tomography (PET)/CT and fluorescence sentinel lymph node detection are neither sensitive nor specific enough to reliably detect LN metastases before RP . Recent data on the novel PET tracer agent Glu‐NH‐CO‐NH‐Lys‐(Ahx)‐[68Ga(HBED‐CC)](PSMA) has shown promising sensitivity (33–85%) and ...

  16. Recurrent ovarian cancer presenting in the right supraclavicular lymph node with isolated metastasis: a case report.

    Science.gov (United States)

    Tanaka, Tomohito; Ohmichi, Masahide

    2012-07-02

    The majority of ovarian cancer recurrences are in the abdomen. However, some cases relapse as isolated lymph node metastases, mostly in pelvic or para-aortic nodes. Peripheral isolated lymph node metastasis is rare. A 69-year-old Japanese woman had recurrent ovarian cancer presenting with isolated right supraclavicular lymph node metastasis. After surgical resection and combination chemotherapy with carboplatin and paclitaxel, her right supraclavicular lymph node completely regressed. Peripheral isolated lymph nodes, including right supraclavicular lymph node, can recur without a macroscopic abdominal lesion. Clinicians should carefully examine peripheral lymph nodes for recurrence.

  17. Recurrent ovarian cancer presenting in the right supraclavicular lymph node with isolated metastasis: a case report

    Directory of Open Access Journals (Sweden)

    Tanaka Tomohito

    2012-07-01

    Full Text Available Abstract Introduction The majority of ovarian cancer recurrences are in the abdomen. However, some cases relapse as isolated lymph node metastases, mostly in pelvic or para-aortic nodes. Peripheral isolated lymph node metastasis is rare. Case presentation A 69-year-old Japanese woman had recurrent ovarian cancer presenting with isolated right supraclavicular lymph node metastasis. After surgical resection and combination chemotherapy with carboplatin and paclitaxel, her right supraclavicular lymph node completely regressed. Conclusions Peripheral isolated lymph nodes, including right supraclavicular lymph node, can recur without a macroscopic abdominal lesion. Clinicians should carefully examine peripheral lymph nodes for recurrence.

  18. Axillary Lymph Nodes and Breast Cancer

    Science.gov (United States)

    ... more likely to affect arm function and cause lymphedema. For this reason, sentinel node biopsy is the ... OR supraclavicular (above the clavicle) nodes have cancer Lymphedema Lymphedema [lim-fa-DEE-ma] is a build- ...

  19. The role of ultrasonography and FDG-PET in axillary lymph node staging of breast cancer

    Energy Technology Data Exchange (ETDEWEB)

    Ahn, Jhii-Hyun; Son, Eun Ju; Kim, Jeong-Ah; Youk, Ji Hyun; Kim, Eun-Kyung; Kwak, Jin Young (Dept. of Radiology, Yonsei Univ. College of Medicine, Research Inst. of Radiological Science, Seoul (Korea)), e-mail: ejsonrd@yuhs.ac; Ryu, Young Hoon (Dept. of Nuclear Medicine, Yonsei Univ. College of Medicine, Research Inst. of Radiological Science, Seoul (Korea)); Jeong, Joon (Dept. of General Surgery, Yonsei Univ. College of Medicine, Research Inst. of Radiological Science, Seoul (Korea))

    2010-10-15

    Background: The presence of axillary lymph node metastasis is the most important prognostic factor and an essential part of staging and prognosis of breast cancer. Purpose: To elucidate the usefulness and accuracy of ultrasonography (United States), fluorodeoxyglucose positron emission tomography (FDG-PET) scan, and combined analysis for axillary lymph node staging in breast cancer. Material and Methods: A total of 250 consecutive breast cancer patients who had undergone US, FDG-PET, and sentinel lymph node biopsy (SLNB) before surgery from January 2005 to December 2006 were included in the study. If an axillary lymph node had a length to width ratio =1.5 or cortical thickening =3 mm or compression of the hilum on US, focal hot uptake (maximal standardized uptake value, SU V{sub max} =2.0) in the ipsilateral axilla on FDG-PET, it was considered to be a metastatic lymph node. In combined analysis of US and FDG-PET, the interpretation was considered positive if at least two of any of the criteria were met. Each imaging finding was compared with a pathologic report regarding the presence of axillary lymph node metastasis, the number of metastatic lymph nodes, and the T stage of the breast mass. Results: Pathologically confirmed axillary lymph node metastasis was noted in 73 cases (29.2%). The mean number of metastatic lymph nodes in pathology was 3.1 +- 3.2, and the size of breast cancer was 2.0 +- 1.04 cm. In the detection of lymph node metastasis, the diagnostic accuracy of US was 78.8% and that of FDG-PET was 76.4%. On combined US and FDG-PET, accuracy was improved (91.6%). The number of metastatic lymph nodes on pathology was correlated with the positivity of US and FDG-PET (P < 0.01). Conclusion: Combined evaluation of US and FDG-PET was a sensitive and accurate method for axillary lymph node staging in breast cancer

  20. Ultrasonography-guided percutaneous radiofrequency ablation for cervical lymph node metastasis from thyroid carcinoma

    Directory of Open Access Journals (Sweden)

    Liping Wang

    2014-01-01

    Full Text Available Purpose: The aim was to explore the efficacy and safety of ultrasonography-guided percutaneous radiofrequency ablation (RFA for cervical lymph node metastases from thyroid carcinoma. Materials and Methods: Eight patients with previous total thyroidectomy and radioiodine therapy were enrolled in this study. A total of 20 cervical lymph node metastases were confirmed by percutaneous biopsy. Participants underwent ultrasonography-guided RFA treatment for all confirmed metastatic lymph nodes. Contrast-enhanced ultrasound (CEUS and sonoelastography were performed to rapidly evaluate treatment responses before and shortly after RFA. Routine follow-up consisted of conventional US, CEUS, sonoelastography, thyroglobulin level, and necessary fine needle aspiration cytology. Results: All eight patients were successfully treated without obvious complications. Post-RFA CEUS showed that total metastatic lymph nodes were ablated. The sonoelastographic score of ablated area elevated significantly shortly after RFA (P < 0.001. With a mean follow-up of 9.4 ± 5.1 months, there were no evidences of recurrence at ablated sites; however, two new cervical recurrent lymph nodes occurred in one case, which was successfully ablated as well. The mass volume shrinkages of the ablated nodes were observed in all cases. We found that 5 treated lymph nodes disappeared, 4 were reduced more than 80%, 9 were reduced between 50% and 80%, and 2 were reduced less than 50%. At the last follow-up evaluation, the serum thyroglobulin levels had decreased in 6 of 8 patients. Conclusion: Ultrasonography-guided percutaneous RFA for cervical lymph node metastasis of thyroid malignancy is a feasible, effective, and safe therapy. This procedure shows a nonsurgical therapeutic option for metastatic lymph nodes in patients with difficult reoperations or inoperations, it may reduce or delay a large number of highly invasive repeated neck dissections.

  1. [INDOCYANINE GREEN (ICG) IN THE DETECTION OF SENTINEL LYMPH NODES IN ENDOMETRIAL AND CERVIX CANCER].

    Science.gov (United States)

    Berlev, I V; Ulrikh, E A; Ibragimov, Z N; Guseinov, K D; Gorodnova, T V; Korolkova, E N; Trifanov, Yu N; Nekrasova, E A; Saparov, A B; Khadzhimba, A V; Mikaya, N A; Urmancheeva, A F

    2015-01-01

    We analyzed the international and our own experience of using different dyes in the identification of sentinel lymph nodes in oncogynecological practice. We evaluated the possibility of using indocyanine green (ICG) in the detection of sentinel lymph nodes in patients with endometrial and cervical cancer. The first results of the use of ICG at the Oncogynecology Department of the N.N.Petrov Research Institute of Oncology are presented.

  2. Lymph node and lymphoid organs fine needle aspiration cytology: historical background.

    Science.gov (United States)

    Cozzolino, Immacolata; Vigliar, Elena; Vetrani, Antonio; Zeppa, Pio

    2012-01-01

    Lymph node has probably been the first target of Fine Needle Cytology (FNC) and among the latest to be accepted as an affordable diagnostic procedure. In 1912, dr. Hirschfeld performed FNC to diagnose cutaneous lymphomas and other tumours. Subsequently FNC was used to diagnose lymphoblastoma and splenic FNC to diagnose leishmaniasis on Romanowsky-stained smears. One of the first systematic study on lymph node FNC was then performed at John Hopkins Hospital, in Baltimore (USA) using FNC and Romanowsky stain on air-dried smears. In the twenties, two independent groups from Memorial Hospital (New York, USA), worked on FNC of a large scale of different human pathologies. One of this study reported 1,405 diagnoses of cancer and other diseases by means of FNC, mainly performed on lymph nodes (662 cases). In the sixties, at the Karolinska Hospital (Stockholm, Sweden) a group of cytopathologists started a Cytopathology Service available to the whole Institution, which exploited all fields of FNC. Since then, the procedure spread all over the word and nowadays it is routinely used for the diagnosis of different organs and pathologies including lymph node. Distinguished cytopathologists have worked on lymph nodal FNC producing significant advances and highlighting advantages and inevitable limitations of the technique. Despite some persistent criticism, FNC is a generally accepted procedure in the first diagnosis of lymph nodes enlargement. Moreover, numerous studies have demonstrated that vital cells obtained by FNC are excellent samples suitable for molecular evaluation, offering new challenging application to lymph node FNC.

  3. Incidental Suspicious Regional Lymph Nodes on Breast Sonography: Is Sampling Necessary?

    Science.gov (United States)

    Raj, Sean D; Amer, Ahmed M; Garg, Naveen; Krishnamurthy, Savitri; Hess, Kenneth R; Park, Young Mi; Moseley, Tanya; Whitman, Gary J

    Suspicious regional lymph nodes may be incidentally identified on breast ultrasound examinations in patients who present for sonographic evaluation without a known or a suspected breast malignancy, and there is a paucity of data on whether biopsy should be performed. This study aims to characterize incidental sonographically detected suspicious regional lymph nodes and determine whether tissue sampling or follow-up imaging is required. A total of 40,773 consecutive breast ultrasounds were reviewed. Overall, 7 women with nonpalpable, incidental, suspicious axillary or supraclavicular lymph nodes in an otherwise unremarkable breast and without history of malignancy or systemic disease were identified. In all, 5 women with 6 nodes underwent ultrasound-guided fine needle aspiration and 2 women with 3 nodes were recommended follow-up ultrasound. Follow-up imaging, cytology, and all-cause clinical data were reviewed to evaluate outcomes. All 6 biopsied lymph nodes (mean = 1.5cm) were benign on cytology. Follow-up imaging was available for 3 nodes (mean = 2.6 years), with all-cause follow-up for all nodes of 2.2 years. In the follow-up group, 3 lymph nodes (mean = 1.6cm) were monitored (mean = 4.3 years) with all-cause follow-up of 4.7 years. No new cancers, growth, or suspicious features were found in these nodes during follow-up for either group of women. In conclusion, women without history of prior malignancy or systemic disease with incidentally detected, nonpalpable, suspicious regional lymph nodes with an otherwise normal breast ultrasound examination underwent fine needle aspiration or were recommended short-term follow-up ultrasound. No indeterminate features or malignancies were observed at the time of tissue sampling or developed over several years of follow-up. Avoiding sampling of these nodes would reduce patient morbidity and health care costs. Copyright © 2017 Elsevier Inc. All rights reserved.

  4. Detection of Sentinel Lymph Nodes in Patients with Papillary Thyroid Cancer

    Directory of Open Access Journals (Sweden)

    Hiroshi Takami

    2003-07-01

    Conclusions: Sentinel lymph node biopsy may allow discrimination between patients with true lymph-node-negative papillary thyroid carcinoma and those with non-palpable metastatic lymph nodes. It may also be helpful in diagnosing metastases and avoiding unnecessary lymph node dissection in thyroid cancer.

  5. Molecular and functional imaging for detection of lymph node metastases in prostate cancer

    NARCIS (Netherlands)

    Fortuin, A.S.; Rooij, M. de; Zamecnik, P.; Haberkorn, U.; Barentsz, J.

    2013-01-01

    Knowledge on lymph node metastases is crucial for the prognosis and treatment of prostate cancer patients. Conventional anatomic imaging often fails to differentiate benign from metastatic lymph nodes. Pelvic lymph node dissection is an invasive technique and underestimates the extent of lymph node

  6. Dual-energy CT can detect malignant lymph nodes in rectal cancer

    DEFF Research Database (Denmark)

    Al-Najami, I.; Lahaye, M. J.; Beets-Tan, Regina G H

    2017-01-01

    node assessment, and compared it to Magnetic Resonance Imaging (MRI). The objective of this prospective observational feasibility study was to determine the clinical value of the DECT for the detection of metastases in the pelvic lymph nodes of rectal cancer patients and compare the findings to MRI......Background There is a need for an accurate and operator independent method to assess the lymph node status to provide the most optimal personalized treatment for rectal cancer patients. This study evaluates whether Dual Energy Computed Tomography (DECT) could contribute to the preoperative lymph...... a pelvic DECT scan and a standard MRI. The Dual Energy CT quantitative parameters were analyzed: Water and Iodine concentration, Dual-Energy Ratio, Dual Energy Index, and Effective Z value, for the benign and malignant lymph node differentiation. Results DECT scanning showed statistical difference between...

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

    DEFF Research Database (Denmark)

    Lykke, J.; Roikjær, Ole; Jess, P.

    2013-01-01

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

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

    Institute of Scientific and Technical Information of China (English)

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

    2012-01-01

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

  9. Dual-energy CT can detect malignant lymph nodes in rectal cancer

    DEFF Research Database (Denmark)

    Al-Najami, I.; Lahaye, M. J.; Beets-Tan, Regina G H

    2017-01-01

    node assessment, and compared it to Magnetic Resonance Imaging (MRI). The objective of this prospective observational feasibility study was to determine the clinical value of the DECT for the detection of metastases in the pelvic lymph nodes of rectal cancer patients and compare the findings to MRI......Background There is a need for an accurate and operator independent method to assess the lymph node status to provide the most optimal personalized treatment for rectal cancer patients. This study evaluates whether Dual Energy Computed Tomography (DECT) could contribute to the preoperative lymph...... and histopathology. Materials and methods The patients were referred to total mesorectal excision (TME) without any neoadjuvant oncological treatment. After surgery the rectum specimen was scanned, and lymph nodes were matched to the pathology report. Fifty-four histology proven rectal cancer patients received...

  10. 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......-risk prostate cancer. Two hundred ten patients who awaited curative indented therapy were included. We first performed a standard pathological examination of the LN, followed by an extended pathological examination of the patients who were LN negative in the standard examination. The extended pathological...... indicate that an extended pathological examination of LN will improve the staging of intermediate- and high-risk prostate cancer patients; however, we acknowledge that it is both costly and time consuming. We do not recommend the use of cytokeratin staining in routine staining because...

  11. Predictive Factors for Nonsentinel Lymph Node Metastasis in Patients With Positive Sentinel Lymph Nodes After Neoadjuvant Chemotherapy: Nomogram for Predicting Nonsentinel Lymph Node Metastasis.

    Science.gov (United States)

    Ryu, Jai Min; Lee, Se Kyung; Kim, Ji Young; Yu, Jonghan; Kim, Seok Won; Lee, Jeong Eon; Han, Se Hwan; Jung, Yong Sik; Nam, Seok Jin

    2017-04-06

    Axillary lymph node (ALN) status is an important prognostic factor for breast cancer patients. With increasing numbers of patients undergoing neoadjuvant chemotherapy (NAC), issues concerning sentinel lymph node biopsy (SLNB) after NAC have emerged. We analyzed the clinicopathologic features and developed a nomogram to predict the possibility of nonsentinel lymph node (NSLN) metastases in patients with positive SLNs after NAC. A retrospective medical record review was performed of 140 patients who had had clinically positive ALNs at presentation, had a positive SLN after NAC on subsequent SLNB, and undergone axillary lymph node dissection (ALND) from 2008 to 2014. On multivariate stepwise logistic regression analysis, pathologic T stage, lymphovascular invasion, SLN metastasis size, and number of positive SLN metastases were independent predictors for NSLN metastases (P Samsung Medical Center NAC nomogram was developed to predict the likelihood of additional positive NSLNs. The Samsung Medical Center NAC nomogram could provide information to surgeons regarding whether to perform additional ALND when the permanent biopsy revealed positive findings, although the intraoperative SLNB findings were negative. Copyright © 2017 Elsevier Inc. All rights reserved.

  12. Sparing level Ib lymph nodes by intensity-modulated radiotherapy in the treatment of nasopharyngeal carcinoma.

    Science.gov (United States)

    Chen, Jing; Ou, Dan; He, Xiayun; Hu, Chaosu

    2014-12-01

    We retrospectively investigated the patterns of locoregional relapse and survival of patients to evaluate whether sparing level Ib lymph nodes by intensity-modulated radiotherapy (IMRT) in the treatment of nasopharyngeal carcinoma was feasible. One hundred and twenty nasopharyngeal carcinoma patients received treatment with level Ib lymph nodes spared by IMRT between January 2005 and August 2008 in our center. Before treatment, each patient underwent enhanced magnetic resonance imaging of the nasopharynx and neck. Patients with negative cervical lymph nodes received radiotherapy to the nasopharynx, skull base and upper neck drainage areas, while patients with cervical lymph node involvement received treatment to the whole neck. The prescription doses were 66-70.4 Gy/30-32 fractions to the gross tumor volume of nasopharynx, 66 Gy to the positive neck nodes, 60 Gy to the high-risk clinical target volume and 54 Gy to the low-risk clinical target volume. Patients staged III, IV A/B or II also received chemotherapy. The median follow-up of these 120 patients was 54 months. The 5-year local control, regional control, distant metastasis-free and overall survival rates were 90.7, 96.5, 84.8 and 81.4 %, respectively. Four patients suffered regional recurrence: 2, 1 and 1 experienced regional recurrence in level II, retropharyngeal and parotid lymph nodes, respectively. In nasopharyngeal carcinoma patients with negative level Ib lymph nodes who are treated with level Ib-sparing IMRT, regional lymph node recurrence alone is rare. Therefore, sparing level Ib lymph nodes by IMRT is feasible in selected patients.

  13. Popliteal lymph node metastasis of tibial osteoblastic osteosarcoma.

    Science.gov (United States)

    Dirik, Yalın; Çınar, Arda; Yumrukçal, Feridun; Eralp, Levent

    2014-01-01

    We report a case with lymph node metastasis of osteosarcoma, which is a rare entity in comparison to hematogeneous lung or bone metastasis. Twenty-seven years old male patient referred to our clinic complaining of ongoing left knee pain and swelling since one month without a history of prior trauma. Magnetic resonance imaging (MRI) revealed a mass of malignant nature which causes more prominent expansion and destruction of the bone distally with periosteal reaction. A lymphadenomegaly 16mm×13mm in diameter was also present in the popliteal fossa having the same signal pattern with the primary lesion. Thirteen weeks following the first referral of the patient, wide resection and reconstruction with modular tumor prosthesis was performed. Popliteal lymph node was excised through the same incision. Pathologic examination of the resected speciman reported osteoblastic osteosarcoma. The lymph node extirpated from the popliteal fossa was reported to be a metastasis of the primary tumor. Osteosarcoma of the long bones is the most common primary malignant bone neoplasm of both childhood and adulthood. Osteosarcomas commonly metastasize hematogeneously to the lungs and bones. Lymph node metastasis is a rare entity. Similar studies report rates between 2.3% and 4%. It is not clearly explained, how lymph node metastasis in osteosarcoma occurs despite lack of lymphatic drainage in normal cortical and spongious bone. 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. Copyright © 2014 The Authors. Published by Elsevier Ltd.. All rights reserved.

  14. Procedure guidelines for sentinel lymph node diagnosis; Verfahrensanweisung fuer die nuklearmedizinische Waechter-Lymphknoten-Diagnostik

    Energy Technology Data Exchange (ETDEWEB)

    Vogt, H. [Klinikum Augsburg (Germany). Klinik fuer Nuklearmedizin; Schmidt, Matthias [Universitaeten zu Koeln (Germany). Klinik fuer Nuklearmedizin; Bares, R. [Klinik fuer Nuklearmedizin, Tuebingen (DE)] (and others)

    2010-07-01

    The authors present a procedure guideline for scintigraphic detection of sentinel lymph nodes in malignant melanoma and other skin tumours, in breast cancer, in head and neck cancer, and in prostate and penile carcinoma. Important goals of sentinel lymph node scintigraphy comprise reduction of the extent of surgery, lower postoperative morbidity and optimization of histopathological examination focussing on relevant lymph nodes. Sentinel lymph node scintigraphy itself does not diagnose tumorous lymph node involvement and is not indicated when lymph node metastases have been definitely diagnosed before sentinel lymph node scintigraphy. Procedures are compiled with the aim to reliably localise sentinel lymph nodes with a high detection rate typically in early tumour stages. Radiation exposure is low so that pregnancy is not a contraindication for sentinel lymph node scintigraphy. Even with high volumes of scintigraphic sentinel lymph node procedures surgeons, theatre staff and pathologists receive a radiation exposure <1 mSv/year so that they do not require occupational radiation surveillance. (orig.)

  15. Contouring Guidelines for the Axillary Lymph Nodes for the Delivery of Radiation Therapy in Breast Cancer: Evaluation of the RTOG Breast Cancer Atlas

    Energy Technology Data Exchange (ETDEWEB)

    Gentile, Michelle S. [Department of Radiation Oncology, Robert H. Lurie Comprehensive Cancer Center of Northwestern University, Chicago, Illinois (United States); Usman, Asad A.; Neuschler, Erin I. [Department of Radiology, Robert H. Lurie Comprehensive Cancer Center of Northwestern University, Chicago, Illinois (United States); Sathiaseelan, Vythialinga; Hayes, John P. [Department of Radiation Oncology, Robert H. Lurie Comprehensive Cancer Center of Northwestern University, Chicago, Illinois (United States); Small, William, E-mail: WMSMALL@lumc.edu [Department of Radiation Oncology, Loyola University, Chicago, Illinois (United States)

    2015-10-01

    Purpose: The purpose of this study was to identify the axillary lymph nodes on pretreatment diagnostic computed tomography (CT) of the chest to determine their position relative to the anatomic axillary borders as defined by the Radiation Therapy Oncology Group (RTOG) breast cancer atlas for radiation therapy planning. Methods and Materials: Pretreatment diagnostic CT chest scans available for 30 breast cancer patients with clinically involved lymph nodes were fused with simulation CT. Contouring of axillary levels I, II, and III according to the RTOG guidelines was performed. Measurements were made from the area of distal tumor to the anatomic borders in 6 dimensions for each level. Results: Of the 30 patients, 100%, 93%, and 37% had clinical involvement of levels I, II, and III, respectively. The mean number of lymph nodes dissected was 13.6. The mean size of the largest lymph node was 2.4 cm. Extracapsular extension was seen in 23% of patients. In 97% of patients, an aspect of the involved lymph node lay outside of the anatomic border of a level. In 80% and 83% of patients, tumor extension was seen outside the cranial (1.78 ± 1.0 cm; range, 0.28-3.58 cm) and anterior (1.27 ± 0.92 cm; range, 0.24-3.58 cm) borders of level I, respectively. In 80% of patients, tumor extension was seen outside the caudal border of level II (1.36 ± 1.0 cm, range, 0.27-3.86 cm), and 0% to 33% of patients had tumor extension outside the remaining borders of all levels. Conclusions: To cover 95% of lymph nodes at the cranial and anterior borders of level I, an additional clinical target volume margin of 3.78 cm and 3.11 cm, respectively, is necessary. The RTOG guidelines may be insufficient for coverage of axillary disease in patients with clinical nodal involvement who are undergoing neoadjuvant chemotherapy, incomplete axillary dissection, or treatment with intensity modulated radiation therapy. In patients with pretreatment diagnostic CT chest scans, fusion with

  16. Salvage Lymph Node Dissection for Node-only Recurrence of Prostate Cancer: Ready for Prime Time?

    Science.gov (United States)

    Suardi, Nazareno; Briganti, Alberto; Gandaglia, Giorgio; Fossati, Nicola; Montorsi, Francesco

    2016-12-30

    Several studies show that salvage lymph-node dissection for node-only recurrence of prostate cancer after radical treatment might represent a viable treatment modality for node-only recurrent PCa. However, as long as high quality data is not available, this approach should still be considered experimental.

  17. Modeling lymphocyte homing and encounters in lymph nodes

    Directory of Open Access Journals (Sweden)

    Bernaschi Massimo

    2009-11-01

    Full Text Available 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 of the lymph node and the regulation of cells migration, encounter, and antigen presentation during the inflammation process. Conclusion Our model reproduces the correct timing of an immune response, including the observed time delay between duplication of T helper cells and duplication of B cells in response to antigen exposure. Furthermore, we investigate the consequences of the absence of dendritic cells at different times during infection, and the dependence of system dynamics on the regulation of lymphocyte exit from lymph nodes. In both cases, the model predicts the emergence of an impaired immune response, i.e., the response is significantly reduced in magnitude. Dendritic cell removal is also shown to delay the response time with respect to normal conditions.

  18. Anatomic distribution of supraclavicular lymph node in patients with esophageal cancer

    National Research Council Canada - National Science Library

    Xing, Jun; Luo, Yijun; Wang, Xiaoli; Gao, Min; Sun, Mingping; Ding, Xiuping; Fan, Tingyong; Yu, Jinming

    2016-01-01

    ...), especially for lower cervical lymph nodes. This study aimed to map the location of metastatic supraclavicular lymph nodes in thoracic esophageal carcinoma patients with supraclavicular node involvement and generate an atlas to delineate...

  19. Analysis of molecular markers as predictive factors of lymph node involvement in breast carcinoma.

    Science.gov (United States)

    Paula, Luciana Marques; De Moraes, Luis Henrique Ferreira; Do Canto, Abaeté Leite; Dos Santos, Laurita; Martin, Airton Abrahão; Rogatto, Silvia Regina; De Azevedo Canevari, Renata

    2017-01-01

    Nodal status is the most significant independent prognostic factor in breast cancer. Identification of molecular markers would allow stratification of patients who require surgical assessment of lymph nodes from the large numbers of patients for whom this surgical procedure is unnecessary, thus leading to a more accurate prognosis. However, up to now, the reported studies are preliminary and controversial, and although hundreds of markers have been assessed, few of them have been used in clinical practice for treatment or prognosis in breast cancer. The purpose of the present study was to determine whether protein phosphatase Mg2+/Mn2+ dependent 1D, β-1,3-N-acetylglucosaminyltransferase, neural precursor cell expressed, developmentally down-regulated 9, prohibitin, phosphoinositide-3-kinase regulatory subunit 5 (PIK3R5), phosphatidylinositol-5-phosphate 4-kinase type IIα, TRF1-interacting ankyrin-related ADP-ribose polymerase 2, BCL2 associated agonist of cell death, G2 and S-phase expressed 1 and PAX interacting protein 1 genes, described as prognostic markers in breast cancer in a previous microarray study, are also predictors of lymph node involvement in breast carcinoma Reverse transcription-quantitative polymerase chain reaction analysis was performed on primary breast tumor tissues from women with negative lymph node involvement (n=27) compared with primary tumor tissues from women with positive lymph node involvement (n=23), and was also performed on primary tumors and paired lymph node metastases (n=11). For all genes analyzed, only the PIK3R5 gene exhibited differential expression in samples of primary tumors with positive lymph node involvement compared with primary tumors with negative lymph node involvement (P=0.0347). These results demonstrate that the PIK3R5 gene may be considered predictive of lymph node involvement in breast carcinoma. Although the other genes evaluated in the present study have been previously characterized to be involved with

  20. Analysis of molecular markers as predictive factors of lymph node involvement in breast carcinoma

    Science.gov (United States)

    Paula, Luciana Marques; De Moraes, Luis Henrique Ferreira; Do Canto, Abaeté Leite; Dos Santos, Laurita; Martin, Airton Abrahão; Rogatto, Silvia Regina; De Azevedo Canevari, Renata

    2017-01-01

    Nodal status is the most significant independent prognostic factor in breast cancer. Identification of molecular markers would allow stratification of patients who require surgical assessment of lymph nodes from the large numbers of patients for whom this surgical procedure is unnecessary, thus leading to a more accurate prognosis. However, up to now, the reported studies are preliminary and controversial, and although hundreds of markers have been assessed, few of them have been used in clinical practice for treatment or prognosis in breast cancer. The purpose of the present study was to determine whether protein phosphatase Mg2+/Mn2+ dependent 1D, β-1,3-N-acetylglucosaminyltransferase, neural precursor cell expressed, developmentally down-regulated 9, prohibitin, phosphoinositide-3-kinase regulatory subunit 5 (PIK3R5), phosphatidylinositol-5-phosphate 4-kinase type IIα, TRF1-interacting ankyrin-related ADP-ribose polymerase 2, BCL2 associated agonist of cell death, G2 and S-phase expressed 1 and PAX interacting protein 1 genes, described as prognostic markers in breast cancer in a previous microarray study, are also predictors of lymph node involvement in breast carcinoma Reverse transcription-quantitative polymerase chain reaction analysis was performed on primary breast tumor tissues from women with negative lymph node involvement (n=27) compared with primary tumor tissues from women with positive lymph node involvement (n=23), and was also performed on primary tumors and paired lymph node metastases (n=11). For all genes analyzed, only the PIK3R5 gene exhibited differential expression in samples of primary tumors with positive lymph node involvement compared with primary tumors with negative lymph node involvement (P=0.0347). These results demonstrate that the PIK3R5 gene may be considered predictive of lymph node involvement in breast carcinoma. Although the other genes evaluated in the present study have been previously characterized to be involved with

  1. 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.

  2. Frozen section analysis of sentinel lymph nodes in patients with breast cancer does not impair the probability to detect lymph node metastases

    NARCIS (Netherlands)

    E.V.E. Madsen (Eva V. E.); J. van Dalen (Jan); P.J. van Gorp (Patrick); P.M.P. Van Oort (Poultje M. P.)

    2012-01-01

    textabstractIntra-operative frozen section analysis (FS analysis) of sentinel lymph nodes (SLNs) in patients with breast cancer can prevent a second operation for axillary lymph node dissection. In contrast, loss of tissue during FS analysis may impair the probability to detect lymph node metastases

  3. Region-based snake with edge constraint for segmentation of lymph nodes on CT images.

    Science.gov (United States)

    Yu, Peicong; Poh, Chueh Loo

    2015-05-01

    Lymph nodes segmentation is a tedious process with large inter-user variability when performed manually. To facilitate lymph nodes assessment for lung cancer patient, we present an automatic and improved snake segmentation method for thoracic lymph nodes on CT images in this paper. We first investigated the performance of both edge-based and region-based snake algorithms for the segmentation task, using a B-spline contour parameterization. The effect of the number of B-spline control points on the snake performance was also examined. Both edge-based and region-based snakes were found to have their own advantages and disadvantages for lymph nodes segmentation. We further developed a method of region-based snake with edge constraint, which utilizes a self-adjusting mechanism to integrate both edge and region information in a constructive manner. The average Dice Similarity Coefficient obtained was 0.853 ± 0.059 and 0.841 ± 0.108 for the baseline and follow-up lymph nodes respectively using the proposed method. The method was found to be an effective lymph node segmentation method and would potentially be useful to help with treatment response evaluations in the clinical practice. Copyright © 2015 Elsevier Ltd. All rights reserved.

  4. Quantitative analysis and prediction of regional lymph node status in rectal cancer based on computed tomography imaging

    Energy Technology Data Exchange (ETDEWEB)

    Cui, Chunyan; Liu, Lizhi; Li, Li [Sun Yat-sen University, State Key Laboratory of Oncology in Southern China, Imaging Diagnosis and Interventional Center, Cancer Center, Guangzhou, Guangdong (China); Cai, Hongmin; Tian, Haiying [Sun Yat-Sen University, Department of Automation, School of Science Information and Technology, Guangzhou (China); Li, Liren [Sun Yat-sen University, State Key Laboratory of Oncology in Southern China, Department of Abdominal (colon and rectal) Surgery, Cancer Center, Guangzhou (China)

    2011-11-15

    To quantitatively evaluate regional lymph nodes in rectal cancer patients by using an automated, computer-aided approach, and to assess the accuracy of this approach in differentiating benign and malignant lymph nodes. Patients (228) with newly diagnosed rectal cancer, confirmed by biopsy, underwent enhanced computed tomography (CT). Patients were assigned to the benign node or malignant node group according to histopathological analysis of node samples. All CT-detected lymph nodes were segmented using the edge detection method, and seven quantitative parameters of each node were measured. To increase the prediction accuracy, a hierarchical model combining the merits of the support and relevance vector machines was proposed to achieve higher performance. Of the 220 lymph nodes evaluated, 125 were positive and 95 were negative for metastases. Fractal dimension obtained by the Minkowski box-counting approach was higher in malignant nodes than in benign nodes, and there was a significant difference in heterogeneity between metastatic and non-metastatic lymph nodes. The overall performance of the proposed model is shown to have accuracy as high as 88% using morphological characterisation of lymph nodes. Computer-aided quantitative analysis can improve the prediction of node status in rectal cancer. (orig.)

  5. 2D ultrasonography and contrast enhanced ultrasound for the evaluation of cavitating mesenteric lymph node syndrome in a patient with refractory celiac disease and enteropathy T cell lymphoma

    Directory of Open Access Journals (Sweden)

    Pojoga Cristina

    2013-02-01

    Full Text Available Abstract Background The cavitating mesenteric lymph node syndrome (CMLNS is a rare manifestation of celiac disease, with an estimated mortality rate of 50%. Specific infections and malignant lymphoma may complicate its clinical course and contribute to its poor prognosis. Diagnosing the underlying cause of CMLNS can be challenging. This is the first report on contrast enhanced ultrasound (CEUS findings in enteropathy associated T-cell lymphoma (EATL complicating CMLNS in a gluten-free compliant patient with persistent symptoms and poor outcome. Case presentation We present the case of a 51-year old Caucasian male patient, diagnosed with celiac disease and CMLNS. Despite his compliance to the gluten-free diet the symptoms persisted and we eventually considered the possible development of malignancy. No mucosal changes suggestive of lymphoma were identified with capsule endoscopy. Low attenuation mesenteric lymphadenopathy, without enlarged small bowel segments were seen on computed tomography. CEUS revealed arterial rim enhancement around the necrotic mesenteric lymph nodes, without venous wash-out. No malignant cells were identified on laparoscopic mesenteric lymph nodes biopsies. The patient died due to fulminant liver failure 14 months later; the histopathological examination revealed CD3/CD30-positive atypical T-cell lymphocytes in the liver, mesenteric tissue, spleen, gastric wall, kidney, lung and bone marrow samples; no malignant cells were present in the small bowel samples. Conclusions CEUS findings in EATL complicating CMLNS include arterial rim enhancement of the mesenteric tissue around the cavitating lymph nodes, without venous wash-out. This vascular pattern is not suggestive for neoangiogenesis, as arteriovenous shunts from malignant tissues are responsible for rapid venous wash-out of the contrast agent. CEUS failed to provide a diagnosis in this case.

  6. Superficial and deep lymph node dissection for stage III cutaneous melanoma: clinical outcome and prognostic factors

    Directory of Open Access Journals (Sweden)

    Mozzillo Nicola

    2013-02-01

    Full Text Available Abstract Background The aims of this retrospective analysis were to evaluate the effect of combined superficial and deep groin dissection on disease-free and melanoma-specific survival, and to identify the most important factors for predicting the involvement of deep nodes according to clinically or microscopically detected nodal metastases. Methods Between January 1996 and December 2005, 133 consecutive patients with groin lymph node metastases underwent superficial and deep dissection at the National Cancer Institute, Naples. Lymph node involvement was clinically evident in 84 patients and detected by sentinel node biopsy in 49 cases. Results The 5-year disease-free survival was significantly better for patients with superficial lymph node metastases than for patients with involvement of both superficial and deep lymph nodes (34.9% vs. 19.0%; P = 0.001. The 5-year melanoma-specific survival was also significantly better for patients with superficial node metastases only (55.6% vs. 33.3%; P = 0.001. Conclusions Metastasis in the deep nodes is the strongest predictor of both disease-free and melanoma-specific survival. Deep groin dissection should be considered for all patients with groin clinical nodal involvement, but might be spared in patients with a positive sentinel node. Prospective studies will clarify the issue further.

  7. 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.

  8. Lymph node hemangioma in one-humped camel

    Directory of Open Access Journals (Sweden)

    M.A. Aljameel

    2015-12-01

    Full Text Available Hemangioma is a benign tumor of blood and lymphatic vessels. It is common in skin, mucosa and soft tissues, and its occurrence in lymph nodes is extremely rare. A 10 year-old she-camel was slaughtered at Nyala slaughterhouse, South Darfur State, Sudan. Grossly, the carcass was emaciated. The left ventral superficial cervical lymph node was enlarged, hard on palpation and protruded outside the body. Its cut surface was dark red in color and measured (18 cm in diameter. Histopathologically, the sections revealed vascular masses were composed of non-encapsulated clusters of small and medium sized with thick and thin-walled, filled with blood, separated by courageous stroma and surrounded by closely packed proliferating capillaries. To the best of our knowledge, this is the first record of the left ventral superficial cervical lymph node hemangioma in a camel in the Sudan.

  9. Methylene blue-assisted lymph node dissection technique is not associated with an increased detection of lymph node metastases in colorectal cancer.

    Science.gov (United States)

    Märkl, Bruno; Schaller, Tina; Krammer, Ines; Cacchi, Claudio; Arnholdt, Hans M; Schenkirsch, Gerhard; Kretsinger, Hallie; Anthuber, Matthias; Spatz, Hanno

    2013-09-01

    Lymph node staging is of paramount importance for prognosis estimation and therapy stratification in colorectal cancer. A high number of harvested lymph nodes is associated with an improved outcome. Methylene blue-assisted lymph node dissection effectively improves the lymph node harvest and ensures sufficient staging. Now, the effect on node positivity rate and stage-related outcome was investigated. The study cohort with advanced lymph node dissection consisted of 669 colorectal cancer cases of all stages, which were collected between 2007 and 2012. A historical collection of 663 cases investigated with conventional techniques between 2002 and 2004 served as control. Lymph node harvest was dramatically improved in the study group with mean lymph node numbers of 34 ± 17 vs 13 ± 5 (Pcancer and is therefore extremely helpful. The hypothesis that it also provides a higher sensitivity in detecting metastases, however, could be not proved.

  10. Robotic Salvage Lymph Node Dissection After Radical Prostatectomy.

    Science.gov (United States)

    Torricelli, Fabio C M; Cividanes, Arnaldo; Guglielmetti, Giuliano B; Coelho, Rafael F

    2015-01-01

    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. A 70 year-old asymptomatic man presented with a prostate-specific antigen (PSA) of 7.45 ng/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 1.45 ng/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. 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. 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.

  11. 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.

  12. Ultrasound guided fine-needle aspiration biopsy of metastases in nonpalpable supraclavicular lymph nodes in lung cancer patients.

    Science.gov (United States)

    Kendirlinan, Resat; Ozkan, Gülcihan; Bayram, Mehmet; Bakan, Nur Dilek; Tutar, Mehmet; Gür, Aygün; Camsari, Güngör

    2011-08-31

    To assess frequency and significance of enlarged nonpalpable supraclavicular lymph nodes with routine ultrasound (US) evaluation and US-guided fineneedle aspiration biopsy (FNAB) for the diagnosis and staging of patients with lung cancer. 106 consecutive patients with lung cancer and nonpalpable supraclavicular lymph nodes were evaluated with cervical US for the presence of pathological lymph nodes. FNAB was performed in patients with nodes with short-axis > 5 mm, rounded shape and missing echogenic hilum. 27 (25.5%) patients had enlarged supraclavicular lymph nodes on US. Fourteen patients (13.2%) had cytologically proven lymph node involvement. Supraclavicular lymph node metastasis was more frequent in patients with mediastinal invasion (p = 0.0001) and patients with enlarged lymph nodes on upper paratracheal stations on thorax CT (p = 0.0001). No relation was found between supraclavicular lymph node involvement and T stage (p = 0.27), distant metastasis (p = 0.50) or histological type (p = 0.80). Three patients were upstaged from IIIA to IIIB status. US-guided FNAB was the only diagnostic method in 2 patients. US-guided FNAB is a simple and safe procedure which can document N3 stage of disease in lung cancer patients. Thereby more invasive and expensive diagnostic procedures can be avoided in selected lung cancer patients.

  13. Ultrasound guided fine-needle aspiration biopsy of metastases in nonpalpable supraclavicular lymph nodes in lung cancer patients

    Directory of Open Access Journals (Sweden)

    Kendirlinan Resat

    2011-08-01

    Full Text Available Abstract Background and objectives To assess frequency and significance of enlarged nonpalpable supraclavicular lymph nodes with routine ultrasound (US evaluation and US-guided fineneedle aspiration biopsy (FNAB for the diagnosis and staging of patients with lung cancer. Materials and methods 106 consecutive patients with lung cancer and nonpalpable supraclavicular lymph nodes were evaluated with cervical US for the presence of pathological lymph nodes. FNAB was performed in patients with nodes with short-axis > 5 mm, rounded shape and missing echogenic hilum. Results 27 (25.5% patients had enlarged supraclavicular lymph nodes on US. Fourteen patients (13.2% had cytologically proven lymph node involvement. Supraclavicular lymph node metastasis was more frequent in patients with mediastinal invasion (p = 0.0001 and patients with enlarged lymph nodes on upper paratracheal stations on thorax CT (p = 0.0001. No relation was found between supraclavicular lymph node involvement and T stage (p = 0.27, distant metastasis (p = 0.50 or histological type (p = 0.80. Three patients were upstaged from IIIA to IIIB status. US-guided FNAB was the only diagnostic method in 2 patients. Conclusion US-guided FNAB is a simple and safe procedure which can document N3 stage of disease in lung cancer patients. Thereby more invasive and expensive diagnostic procedures can be avoided in selected lung cancer patients.

  14. Use of Lymph Node Ultrasound Prior to Sentinel Lymph Node Biopsy in 384 Patients with Melanoma: A Cost-Effectiveness Analysis.

    Science.gov (United States)

    Olmedo, D; Brotons-Seguí, M; Del Toro, C; González, M; Requena, C; Traves, V; Pla, A; Bolumar, I; Moreno-Ramírez, D; Nagore, E

    2017-08-08

    Locoregional lymph node ultrasound is not typically included in guidelines as part of the staging process prior to sentinel lymph node biopsy (SLNB). The objective of the present study was to make a clinical and economic analysis of lymph node ultrasound prior to SLNB. We performed a retrospective study of 384 patients with clinical stage I-II primary melanoma who underwent locorregional lymph node ultrasound (with or without ultrasound-guided biopsy) prior to SLNB between 2004 and 2015. We evaluated the reliability and cost-effectiveness of the strategy. Use of locorregional lymph node ultrasound avoided SLNB in 23 patients (6%). Ultrasound had a sensitivity of 46% and specificity of 76% for the detection of metastatic lymph nodes that were not clinically palpable. False negatives were significantly more common in patients aged over 60 years and in tumors with a thickness of less than 2mm. The staging process using SLNB and ultrasound with ultrasound-guided biopsy produced an increase of €16.30 in the unit price. Our cost-effectiveness analysis identified the staging protocol with ultrasound and SLNB as the dominant strategy, with a lower cost-effectiveness ratio than the alternative, consisting of SLNB alone (8,095.24 vs. €28,605.00). Ultrasound with ultrasound-guided biopsy for the diagnostic staging of melanoma prior to SLNB is a useful and cost-effective tool. This procedure does not substitute SLNB, though it does allow to avoid SLNB in a not insignificant proportion of patients. Copyright © 2017 AEDV. Publicado por Elsevier España, S.L.U. All rights reserved.

  15. Lymph node metastases of adenocarcinoma of the esophagus and esophagogastric junction

    Institute of Scientific and Technical Information of China (English)

    ZHANG Xun; David I Watson; Glyn G Jamieson

    2007-01-01

    Background Esophageal adenocarcinoma is becoming an increasingly important problem.It has been the most rapidly increasing malignancy in western countries in the last decades,and its prognosis is poor.The aim of this study was to evaluate the relationship between tumor invasion depth and lymph node metastasis for adenocarcinoma of the esophagus and esophagogastric junction,and to analyze the impact of lymph node metastases on survival of the patients.Methods The study group comprised 121 patients with adenocarcinoma of the esophagus or esophagogastric junction,who underwent esophagectomy between January 1985 and December 2003 at either the Royal Adelaide Hospital or the Flinders Medical Center,Australia.Overall,there were 101 males and 20 females,with a mean age at surgery of 62 years(range 36-80).All of them were followed up for 6 months to 13 years(mean,6.5 years).The relationship between tumor invasion depth and lymph node metastasis,as well as between survival and lymph node metastasis in these patients were analyzed by Chi-square or Fisher's exact test.A P<0.05 was considered statistically significant.Results The tumors were located entirely within the esophagus in 83 patients,and involved the gastro-esophageal junction in 38.The overall resection rate was 96.7%(117/121).When tumor invasion was within mucosa or submucosa of the esophagus(T1),the lymph node metastasis rate was 22.2%(10/45),the mean number of metastatic lymph nodes was 0.3,and the proportion of more than 4 lymph nodess metastases was 0% (0/45).When tumor invaded the adjacent structures of the esophagus(T4),the lymph node metastasis rate was 85.7%(6/7);the mean number of metastatic lymph nodes was 5.1,and the proportion of more than 4 lymph nodes metastases was 71.4%(5/7).There was a significant difference between T1 and T4(P<0.01).The 5-year survival rate for patients without lymph node metastasis was 52.9%,for those with 1-4 nodes involved was 11.5%,and for patients with more than 4 positive

  16. Prospective study found thatperipheral lymph node sampling reduced the false-negative rate ofsentinel lymph node biopsy forbreast cancer

    Institute of Scientific and Technical Information of China (English)

    ChaoHan; BenYang; WenShuZuo; YanSongLiu; GangZheng; LiYang; MeiZhuZheng

    2016-01-01

    Background:Although sentinel lymph node biopsy (SLNB) can accurately predict the status of axillary lymph node (ALN) metastasis, the high false‑negative rate (FNR) of SLNB is still the main obstacle for the treatment of patients who receive SLNB instead of ALN dissection (ALND). The purpose of this study was to evaluate the clinical signiifcance of SLNB combined with peripheral lymph node (PLN) sampling for reducing the FNR for breast cancer and to discuss the effect of “skip metastasis” on the FNR of SLNB. Methods:At Shandong Cancer Hospital Affliated to Shandong University between March 1, 2012 and June 30, 2015, the sentinel lymph nodes (SLNs) of 596 patients with breast cancer were examined using radiocolloids with blue dye tracer. First, the SLNs were removed; then, the area surrounding the original SLNs was selected, and the visible lymph nodes in a ifeld of 3–5cm in diameter around the center (i.e., PLNs) were removed, avoiding damage to the structure of the breast. Finally, ALND was performed. The SLNs, PLNs, and remaining ALNs underwent pathologic examination, and the relationship between them was analyzed. Results:The identiifcation rate of SLNs in the 596 patients was 95.1% (567/596); the metastasis rate of ALNs was 33.7% (191/567); the FNR of pure SLNB was 9.9% (19/191); and after the SLNs and PLNs were eliminated, the FNR was 4.2% (8/191), which was signiifcantly decreased compared with the FNR before removal of PLNs (P=0.028). According to the detected number (N) of SLNs, the patients were divided into four groups of N=1, 2, 3, and≥4; the FNR in these groups was 19.6, 9.8, 7.3, and 2.3%, respectively. For the patients with≤2 or≤3 detected SLNs, the FNR after removal of PLNs was signiifcantly decreased compared with that before removal of PLNs (N≤2: 14.0% vs. 4.7%, P=0.019; N≤3: 12.2% vs. 4.7%,P=0.021), whereas for patients with≥4 detected SLNs, the decrease in FNR was not statistically signiifcant (P=1.000). In the entire cohorts

  17. Defining the role of modern imaging techniques in assessing lymph nodes for metastasis in cancer: evolving contribution of PET in this setting

    Energy Technology Data Exchange (ETDEWEB)

    Kwee, Thomas C. [University Medical Center Utrecht, Department of Radiology, Utrecht (Netherlands); Basu, Sandip [Tata Memorial Center Annexe, Radiation Medicine Center (Bhabha Atomic Research Center), Bombay (India); Hospital of the University of Pennsylvania, Division of Nuclear Medicine, Philadelphia, PA (United States); Torigian, Drew A.; Saboury, Babak; Alavi, Abass [Hospital of the University of Pennsylvania, Division of Nuclear Medicine, Philadelphia, PA (United States)

    2011-07-15

    Accurate characterization of lymph nodes in patients with cancer and in patients who present with unexplained lymphadenopathy is of major importance for appropriate treatment planning and determination of prognosis. Size measurements are still the most frequently used method for discriminating malignant from non-malignant lymph nodes, but are insufficiently accurate. In order to improve evaluation of lymph nodes, there is a need for imaging modalities that go beyond anatomical lymph node assessment and that allow visualization and quantification of physiological and biochemical processes at the cellular level. We review and discuss functional imaging techniques in the evaluation of lymph nodes. (orig.)

  18. Temporary shielding of hot spots in the drainage areas of cutaneous melanoma improves accuracy of lymphoscintigraphic sentinel lymph node diagnostics

    Energy Technology Data Exchange (ETDEWEB)

    Maza, S.; Valencia, R.; Geworski, L.; Zander, A.; Munz, D.L. [Clinic for Nuclear Medicine, University Hospital Charite, Humboldt University of Berlin, Schumannstrasse 20-21, 10117 Berlin (Germany); Draeger, E.; Winter, H.; Sterry, W. [Clinic for Dermatology, Venereology and Allergology, University Hospital Charite, Humboldt University of Berlin, Berlin (Germany)

    2002-10-01

    Detection of the ''true'' sentinel lymph nodes, permitting correct staging of regional lymph nodes, is essential for management and prognostic assessment in malignant melanoma. In this study, it was prospectively evaluated whether simple temporary shielding of hot spots in lymphatic drainage areas could improve the accuracy of sentinel lymph node diagnostics. In 100 consecutive malignant melanoma patients (45 women, 55 men; age 11-91 years), dynamic and static lymphoscintigraphy in various views was performed after strict intracutaneous application of technetium-99m nanocolloid (40-150 MBq; 0.05 ml/deposit) around the tumour (31 patients) or the biopsy scar (69 patients, safety distance 1 cm). The images were acquired with and without temporary lead shielding of the most prominent hot spots in the drainage area. In 33/100 patients, one or two additional sentinel lymph nodes that showed less tracer accumulation or were smaller (<1.5 cm) were detected after shielding. Four of these patients had metastases in the sentinel lymph nodes; the non-sentinel lymph nodes were tumour negative. In 3/100 patients, hot spots in the drainage area proved to be lymph vessels, lymph vessel intersections or lymph vessel ectasias after temporary shielding; hence, a node interpreted as a non-sentinel lymph node at first glance proved to be the real sentinel lymph node. In two of these patients, lymph node metastasis was histologically confirmed; the non-sentinel lymph nodes were tumour free. In 7/100 patients the exact course of lymph vessels could be mapped after shielding. In one of these patients, two additional sentinel lymph nodes (with metastasis) were detected. Overall, in 43/100 patients the temporary shielding yielded additional information, with sentinel lymph node metastases in 7%. In conclusion, when used in combination with dynamic acquisition in various views, temporary shielding of prominent hot spots in the drainage area of a malignant melanoma of the

  19. Single benign metastasising leiomyoma of an inguinal lymph node.

    Science.gov (United States)

    Laban, Kamil G; Tobon-Morales, Roberto E; Hodge, Janice A L; Schreuder, Henk W R

    2016-08-10

    Benign metastasising leiomyoma (BML) is a rare benign disease associated with uterine leiomyoma and history of uterine surgery. It most frequently occurs in premenopausal woman, with a pulmonary localisation, and consisting of multiple nodules. We present an uncommon case of a 69-year-old woman with a single BML of an inguinal lymph node. CT scans of thorax and abdomen excluded other metastasis localisation. The patient was cured with surgical excision of the mass. Lymph node involvement has been reported incidentally in BML literature. Lymphangitic spread can be considered a possible mechanism of BML metastasis.

  20. Cavitatory mesenteric lymph node syndrome: A rare entity

    Directory of Open Access Journals (Sweden)

    Vibhuti

    2010-01-01

    Full Text Available Celiac disease is a gluten sensitive enteropathy that involves an abnormal immunological response to glutens in wheat, rye etc. It predominantly involves the small intestinal mucosa, though, extra luminal manifestations can also occur. One rare extraluminal manifestation is cavitatory mesenteric lymph node syndrome. It occurs in refractory celiac disease and is associated with poor prognosis due to various complications. The diagnosis is often made on imaging when cystic mesenteric lymph nodes with fat-fluid levels are seen and this can then be confirmed by histopathological examination. We recently had a typical case where we were able to make this diagnosis.

  1. Malakoplakia of the pancreas with diffuse lymph-node involvement.

    Science.gov (United States)

    Nuciforo, Paolo Giovanni; Moneghini, Laura; Braidotti, Paola; Castoldi, Laura; De Rai, Paolo; Bosari, Silvano

    2003-01-01

    We report a case of malakoplakia involving the pancreas in a 74-year-old man with associated regional lymphoadenopathy. Histological examination of both pancreas and lymph nodes revealed a diffuse histiocytic infiltrate containing numerous Michaelis-Gutmann bodies. Electron microscopy supported the diagnosis of malakoplakia and showed bacterial-like structures. Differential diagnosis includes myofibroblastic inflammatory tumor and histiocytic neoplasms. Lymph-node involvement during malakoplakia is extremely rare and it has never been documented microscopically. Lymphohematogenous spread of bacteria may be the cause of the nodal involvement, which, however, does not appear to influence the clinical course of the disease.

  2. Metastasis in the subcarinal lymph node with unknown primary tumor

    DEFF Research Database (Denmark)

    Eckardt, J.; Olsen, K. E.; Petersen, H.

    2011-01-01

    -differentiated squamous cell carcinoma but no primary tumor was visible on PET-computed tomography. Because of his previous lymphoma the patient was scheduled for mediastinoscopy where the diagnosis was confirmed. Subsequent gastroscopy was normal and a right-sided thoracotomy showed no evidence of cancer elsewhere, only...... an inoperable metastasis in a subcarinal lymph node which infiltrated the trachea, esophagus and aorta. Such isolated squamous cell carcinoma in a subcarinal lymph node without a primary tumor despite invasive work-up has not been reported before....

  3. Preoperative axillary lymph node evaluation in breast cancer patients by breast magnetic resonance imaging (MRI): Can breast MRI exclude advanced nodal disease?

    Energy Technology Data Exchange (ETDEWEB)

    Hyun, Su Jeong [Yonsei University College of Medicine, Department of Radiology, Breast Cancer Clinic, Severance Hospital, Research Institute of Radiological Science, Seoul (Korea, Republic of); Hallym University Medical Center, Department of Radiology, Kangnam Sacred Heart Hospital, Seoul (Korea, Republic of); Kim, Eun-Kyung; Moon, Hee Jung; Yoon, Jung Hyun; Kim, Min Jung [Yonsei University College of Medicine, Department of Radiology, Breast Cancer Clinic, Severance Hospital, Research Institute of Radiological Science, Seoul (Korea, Republic of)

    2016-11-15

    To evaluate the diagnostic performance of breast magnetic resonance imaging (MRI) in preoperative evaluation of axillary lymph node metastasis (ALNM) in breast cancer patients and to assess whether breast MRI can be used to exclude advanced nodal disease. A total of 425 patients were included in this study and breast MRI findings were retrospectively reviewed. The diagnostic performance of breast MRI for diagnosis of ALNM was evaluated in all patients, patients with neoadjuvant chemotherapy (NAC), and those without NAC (no-NAC). We evaluated whether negative MRI findings (cN0) can exclude advanced nodal disease (pN2-pN3) using the negative predictive value (NPV) in each group. The sensitivity and NPV of breast MRI in evaluation of ALNM was 51.3 % (60/117) and 83.3 % (284/341), respectively. For cN0 cases on MRI, pN2-pN3 manifested in 1.8 % (6/341) of the overall patients, 0.4 % (1/257) of the no-NAC group, and 6 % (5/84) of the NAC group. The NPV of negative MRI findings for exclusion of pN2-pN3 was higher for the no-NAC group than for the NAC group (99.6 % vs. 94.0 %, p = 0.039). Negative MRI findings (cN0) can exclude the presence of advanced nodal disease with an NPV of 99.6 % in the no-NAC group. (orig.)

  4. Cervical lymph node metastases from remote primary tumor sites

    Science.gov (United States)

    López, Fernando; Rodrigo, Juan P.; Silver, Carl E.; Haigentz, Missak; Bishop, Justin A.; Strojan, Primož; Hartl, Dana M.; Bradley, Patrick J.; Mendenhall, William M.; Suárez, Carlos; Takes, Robert P.; Hamoir, Marc; Robbins, K. Thomas; Shaha, Ashok R.; Werner, Jochen A.; Rinaldo, Alessandra; Ferlito, Alfio

    2016-01-01

    Although most malignant lymphadenopathy in the neck represent lymphomas or metastases from head and neck primary tumors, occasionally, metastatic disease from remote, usually infraclavicular, sites presents as cervical lymphadenopathy with or without an obvious primary tumor. In general, these tumors metastasize to supraclavicular lymph nodes, but occasionally may present at an isolated higher neck level. A search for the primary tumor includes information gained by histology, immunohistochemistry, and evaluation of molecular markers that may be unique to the primary tumor site. In addition, 18F-fluoro-2-deoxyglocose positron emission tomography combined with CT (FDG-PET/CT) has greatly improved the ability to detect the location of an unknown primary tumor, particularly when in a remote location. Although cervical metastatic disease from a remote primary site is often incurable, there are situations in which meaningful survival can be achieved with appropriate local treatment. Management is quite complex and requires a truly multidisciplinary approach. PMID:26713674

  5. 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.

  6. MR imaging of pelvic lymph nodes in primary pelvic carcinoma with ultrasmall superparamagnetic iron oxide (Combidex): preliminary observations.

    Science.gov (United States)

    Harisinghani, M G; Saini, S; Slater, G J; Schnall, M D; Rifkin, M D

    1997-01-01

    The potential of ultrasmall superparamagnetic iron oxide (Combidex)-enhanced MRI of pelvic lymph nodes in patients with primary pelvic carcinoma is evaluated. Fifteen histologically classified lymph nodes in six patients with known primary pelvic cancer (four prostate; one rectum; one uterus) were evaluated with T2-weighted fast spin-echo (FSE) and T2*-weighted gradient-echo (GRE) MRI at 1.5T 12 to 48 hours after intravenous administration of Combidex at a dose of 1.7 mg Fe/kg. Quantitative image evaluation was performed by comparing signal intensity of individual nodes on pre- and postcontrast images. All patients proceeded to pelvic lymph-node biopsy or surgical dissection, where six were found to be benign and nine were malignant. Of the 15 lymph nodes, four nodes showed a decrease in signal intensity. Of these, three, in which signal loss was homogenous were benign, and one, in which the signal-intensity decrease was heterogeneous, was malignant (micrometastases). No signal change was noted in 11 of 15 lymph nodes of which three were benign (inflammatory) and eight were malignant. Combidex is a promising MR contrast agent for evaluating pelvic lymph nodes. Our preliminary observations suggest that the agent is most useful for classifying normal lymph nodes.

  7. Axillary Irradiation as an Imperative Alternative to Axillary Dissection in Clinically Lymph Node-Negative but Sentinel Node-Positive Breast Cancer Patients?

    Science.gov (United States)

    Nitsche, Mirko; Hermann, Robert

    2011-10-01

    At the moment, positive sentinel lymph node dissection (SLND) of the axilla is followed by axillary lymph node dissection (ALND) as standard of care. Recent data proves that omitting ALND after positive SLND in clinically lymph node-negative early stage breast cancer patients is feasible with low recurrence rates. The well known effect of radiotherapy to destroy occult tumor cells highly contributes to these results as a large extent of level I and II lymph nodes are unavoidably included in standard tangential radiation treatment fields. Reviewing the up to date published data on axillary lymph node treatment with radiotherapy, we hypothesize that full dosage coverage of level I and II of the axilla in early stage breast cancer will improve outcome and should be further evaluated.

  8. 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.

  9. The surgical anatomy of the supraclavicular lymph node flap: A basis for the free vascularized lymph node transfer.

    Science.gov (United States)

    Steinbacher, Johannes; Tinhofer, Ines E; Meng, Stefan; Reissig, Lukas F; Placheta, Eva; Roka-Palkovits, Julia; Rath, Thomas; Cheng, Ming-Huei; Weninger, Wolfgang J; Tzou, Chieh Han

    2017-01-01

    Vascularized lymph node transfer is an effective surgical method in reducing lymphedema. This study provides the first detailed description of the surgical anatomy of the supraclavicular lymph node flap in regard to pedicle length, pedicle diameter, and the number of lymph nodes and their exact location inside the flap. Bilateral supraclavicular dissections of nine fresh cadavers (five female) were performed. Before the dissection, the exact number of lymph nodes was determined sonographically by an experienced radiologist, and their distance from the jugular notch was measured. After anatomic dissection, the vascular pedicle's diameter and length were measured. The mean number of lymph nodes was 1.5 ± 1.85 on the right side and 3 ± 2.26 on the left. Their mean distance from the jugular notch was 8.29 ± 2.15 cm on the right and 6.10 ± 1.21 cm on the left. The pedicle's length was 4.72 ± 1.03 cm on the right and 4.86 ± 0.99 cm on the left, and its diameter 2.03 ± 0.83 on the right and 1.80 ± 0.77 on the left. The pedicle length and diameter of the supraclavicular lymph node flap are suitable for a microvascular tissue transfer. J. Surg. Oncol. 2017;115:60-62. © 2016 Wiley Periodicals, Inc. © 2016 Wiley Periodicals, Inc.

  10. Computed tomography image of the mediastinal and axillary lymph nodes in clinically sound Rottweilers

    Directory of Open Access Journals (Sweden)

    Ana Carolina B. Fonseca Pinto

    2013-03-01

    Full Text Available Trough computed tomography (CT, it is possible to evaluate lymph nodes in detail and to detect changes in these structures earlier than with radiographs and ultrasound. Lack of information in the veterinary literature directed the focus of this report to normal aspects of the axillary and mediastinal lymph nodes of adult dogs on CT imaging. A CT scan of 15 normal adult male and female Rottweilers was done. To define them as clinically sound, anamnesis, physical examination, complete blood count, renal and hepatic biochemistry, ECG, and thoracic radiographs were performed. After the intravenous injection of hydrosoluble ionic iodine contrast medium contiguous 10mm in thickness thoracic transverse images were obtained with an axial scanner. In the obtained images mediastinal and axillary lymph nodes were sought and when found measured in their smallest diameter and their attenuation was compared to musculature. Mean and standard deviation of: age, weight, body length and the smallest diameter of the axillary and mediastinal lymph nodes were determined. Mean and standard deviation of parameters: age 3.87±2.03 years, weight 41.13±5.12, and body length 89.61±2.63cm. Axillary lymph nodes were seen in 60% of the animals, mean of the smallest diameter was 3.58mm with a standard deviation of 2.02 and a minimum value of 1mm and a maximum value of 7mm. From 13 observed lymph nodes 61.53% were hypopodense when compared with musculature, and 30.77% were isodense. Mediastinal lymph nodes were identified in 73.33% of the dogs; mean measure of the smallest diameter was 4.71mm with a standard deviation of 2.61mm and a minimum value of 1mm, and a maximum value of 8mm. From 14 observed lymph nodes 85.71% were isodense when compared with musculature and 14.28% were hypodense. The results show that it is possible to visualize axillary and mediastinal lymph nodes in adult clinically sound Rottweilers with CT using a slice thickness and interval of 10mm. The

  11. Detection of Melanoma Metastases in Resected Human Lymph Nodes by Noninvasive Multispectral Photoacoustic Imaging

    Directory of Open Access Journals (Sweden)

    Gerrit Cornelis Langhout

    2014-01-01

    Full Text Available Objective. Sentinel node biopsy in patients with cutaneous melanoma improves staging, provides prognostic information, and leads to an increased survival in node-positive patients. However, frozen section analysis of the sentinel node is not reliable and definitive histopathology evaluation requires days, preventing intraoperative decision-making and immediate therapy. Photoacoustic imaging can evaluate intact lymph nodes, but specificity can be hampered by other absorbers such as hemoglobin. Near infrared multispectral photoacoustic imaging is a new approach that has the potential to selectively detect melanin. The purpose of the present study is to examine the potential of multispectral photoacoustic imaging to identify melanoma metastasis in human lymph nodes. Methods. Three metastatic and nine benign lymph nodes from eight melanoma patients were scanned ex vivo using a Vevo LAZR© multispectral photoacoustic imager and were spectrally analyzed per pixel. The results were compared to histopathology as gold standard. Results. The nodal volume could be scanned within 20 minutes. An unmixing procedure was proposed to identify melanoma metastases with multispectral photoacoustic imaging. Ultrasound overlay enabled anatomical correlation. The penetration depth of the photoacoustic signal was up to 2 cm. Conclusion. Multispectral three-dimensional photoacoustic imaging allowed for selective identification of melanoma metastases in human lymph nodes.

  12. Detection of melanoma metastases in resected human lymph nodes by noninvasive multispectral photoacoustic imaging.

    Science.gov (United States)

    Langhout, Gerrit Cornelis; Grootendorst, Diederik Johannes; Nieweg, Omgo Edo; Wouters, Michel Wilhelmus Jacobus Maria; van der Hage, Jos Alexander; Jose, Jithin; van Boven, Hester; Steenbergen, Wiendelt; Manohar, Srirang; Ruers, Theodoor Jacques Marie

    2014-01-01

    Objective. Sentinel node biopsy in patients with cutaneous melanoma improves staging, provides prognostic information, and leads to an increased survival in node-positive patients. However, frozen section analysis of the sentinel node is not reliable and definitive histopathology evaluation requires days, preventing intraoperative decision-making and immediate therapy. Photoacoustic imaging can evaluate intact lymph nodes, but specificity can be hampered by other absorbers such as hemoglobin. Near infrared multispectral photoacoustic imaging is a new approach that has the potential to selectively detect melanin. The purpose of the present study is to examine the potential of multispectral photoacoustic imaging to identify melanoma metastasis in human lymph nodes. Methods. Three metastatic and nine benign lymph nodes from eight melanoma patients were scanned ex vivo using a Vevo LAZR(©) multispectral photoacoustic imager and were spectrally analyzed per pixel. The results were compared to histopathology as gold standard. Results. The nodal volume could be scanned within 20 minutes. An unmixing procedure was proposed to identify melanoma metastases with multispectral photoacoustic imaging. Ultrasound overlay enabled anatomical correlation. The penetration depth of the photoacoustic signal was up to 2 cm. Conclusion. Multispectral three-dimensional photoacoustic imaging allowed for selective identification of melanoma metastases in human lymph nodes.

  13. Evaluation of Early Breast Cancer Sentinel Lymph Node Biopsy%早期乳腺癌前哨淋巴结活检术的应用评价

    Institute of Scientific and Technical Information of China (English)

    黄两喜; 林艇; 蔡道广

    2014-01-01

    Objective To explore the significance and value of sentinel lymph node biopsy applied in patients with early breast cancer. Methods 60 cases of patients with early breast cancer treated in our hospital from March, 2009 to January, 2013 were se-lected. All the patients were node-negative, and given axillary sentinel lymph node biopsy without axillary dissection, 1% concen-tration of methylene blue solution could be used for specific operation. Results 60 patients were followed up for 3 years after surgery, it was found that the patients had no upper extremity numbness, swelling and upper limb movement disorders and other complications, all patients showed no evidence of enlarged axillary lymph nodes and local recurrence. Conclusion For patients with early breast cancer, axillary sentinel lymph node biopsy can reduce the incidence of complications and replace axillary dis-section, which is recommended to be applied and promoted clinically.%目的:探讨对早期乳腺癌患者应用前哨淋巴结活检术的意义及价值。方法该研究选取在该院接受治疗的60例早期乳腺癌患者,所选患者均为淋巴结阴性,不予以腋窝清扫,对所有患者使用腋窝前哨淋巴结活检术,具体可应用浓度为1%的亚甲蓝溶液进行操作。结果对60例患者进行随访3年,术后发现患者无上肢麻木感、上肢肿胀以及运动障碍等并发症,全部患者检查未见腋窝肿大淋巴结,更无局部复发情况。结论对早期乳腺癌患者使用腋窝前哨淋巴结活检术,可以减少并发症,能够替代腋窝清扫术,在临床可建议应用与推广。

  14. Advances in Lymph Node Metastasis and the Modes of Lymph Node 
Dissection in Early Stage Non-small Cell Lung Caner

    Directory of Open Access Journals (Sweden)

    Ningning DING

    2016-06-01

    Full Text Available Lung cancer ranks the first position in morbidity and mortality among all malignances in China. Non-small cell lung cancer (NSCLC accounts for nearly 80% of all lung malignancies. Surgical resection is still the current major treatment method for early stage NSCLC. Lymph node stages together with the extent of lymph node dissection directly affect the prognosis. Anatomical lobectomy with systematic mediastinal lymph node dissection have been the standard surgical treatment for NSCLC. However, it is controversial in the extent of lymph node dissection for early stage NSCLC. Accurate nodes stage and the extent of mediatinal nodes dissection affect the peri-operative complications and the prognosis of NSCLC greatly. In the past decade, more and more surgeons demostrated that lobe-specific or selective mediastinal lymph node dissection is suitable for clinical stage I NSCLC, especially the stage Ia lesions, and may become the standard lymph node dissection mode in the future.

  15. [Advances in Lymph Node Metastasis and the Modes of Lymph Node 
Dissection in Early Stage Non-small Cell Lung Caner].

    Science.gov (United States)

    Ding, Ningning; Mao, Yousheng

    2016-06-20

    Lung cancer ranks the first position in morbidity and mortality among all malignances in China. Non-small cell lung cancer (NSCLC) accounts for nearly 80% of all lung malignancies. Surgical resection is still the current major treatment method for early stage NSCLC. Lymph node stages together with the extent of lymph node dissection directly affect the prognosis. Anatomical lobectomy with systematic mediastinal lymph node dissection have been the standard surgical treatment for NSCLC. However, it is controversial in the extent of lymph node dissection for early stage NSCLC. Accurate nodes stage and the extent of mediatinal nodes dissection affect the peri-operative complications and the prognosis of NSCLC greatly. In the past decade, more and more surgeons demostrated that lobe-specific or selective mediastinal lymph node dissection is suitable for clinical stage I NSCLC, especially the stage Ia lesions, and may become the standard lymph node dissection mode in the future.

  16. Retroperitoneal unicentric Castleman's disease (giant lymph node hyperplasia: case report

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    Jaques Waisberg

    Full Text Available CONTEXT AND OBJECTIVE: Castleman's disease, or giant lymph node hyperplasia, is a rare disorder of the lymphoid tissue that causes lymph node enlargement. It is considered benign in its localized form, but aggressive in the multicentric type. The definitive diagnosis is based on postoperative pathological findings. The aim here was to describe a case of retroperitoneal unicentric Castleman's disease in the retroperitoneum. CASE REPORT: A 61-year old white male with weight loss and listlessness presented with moderate arterial hypertension and leukopenia. Abdominal tomography revealed a 5 x 4 x 5 cm oval mass of low attenuation, with inner calcification and intense enhancement on intravenous contrast, located in the retroperitoneal region, between the left kidney and the aorta, at the renal hilus. Exploratory laparotomy revealed a non-pulsatile solid oval mass situated in the retroperitoneum, adjacent to the left renal hilus. The retroperitoneal lesion was removed in its entirety. Examination of frozen samples revealed benign lymph node tissue and histopathological examination of the surgical sample revealed hyaline-vascular giant lymph node hyperplasia (Castleman's disease. The patient was discharged on the 12th day without significant events. Two months after the operation, the patient was readmitted with severe cardiac insufficiency, acute renal failure and bronchopneumonia, which progressed to acute respiratory insufficiency, sepsis and death.

  17. Supraclavicular lymph node: incidence of unsuspected metastatic prostate cancer.

    Science.gov (United States)

    Hematpour, Khashayar; Bennett, Carol J; Rogers, David; Head, Christian S

    2006-09-01

    An uncommon presentation of prostate carcinoma to the supraclavicular lymph nodes is herein reviewed. With prompt diagnosis and treatment, patient survival can be extended. A high index of suspicion is necessary to make the diagnosis. The clinical features of four cases involving metastatic prostate carcinoma will be discussed.

  18. Sentinel Lymph Node Dissection in Locally Recurrent Breast Cancer

    DEFF Research Database (Denmark)

    Uth, Charlotte Caspara; Christensen, Mette Haulund; Oldenbourg, Mette Holmqvist

    2015-01-01

    BACKGROUND: The aim of this study was to investigate the use of sentinel lymph node dissection (SLND) in the treatment of patients with locally recurrent breast cancer. METHODS: A total of 147 patients with locally recurrent breast cancer were included from five different breast surgery departments...

  19. Relapse of leprosy presenting as nodular lymph node swelling

    Directory of Open Access Journals (Sweden)

    Kiran K

    2009-01-01

    Full Text Available Lymphadenopathy is known to be associated with lepromatous leprosy and has also been observed as a feature of type-2 lepra reaction. However, nodular lymph node enlargement is not commonly reported in leprosy patients or as a feature of relapse. We herewith are presenting a case of bacteriological relapse in a patient of lepromatous leprosy treated 22 years before till smear negativity with WHO multidrug therapy (MDT multibacillary type (MB. She presented with prominent nodular swelling of the cervical group of lymph nodes along with generalized lymphadenopathy, which was mistakenly treated as tubercular lymphadenopathy. A diagnosis of late bacteriological relapse of lepromatous leprosy presenting with prominent lymphadenopathy and ENL was made after relevant investigations. The patient was started on treatment with WHO MDT MB (daily dapsone and clofazimine and monthly rifampicin and thalidomide (200 mg/day. Nerve pain regressed within 2 weeks of therapy. The lymph nodal swelling regressed within 3 months of starting treatment.

  20. Vascularized axillary lymph node transfer: A novel model in the rat.

    Science.gov (United States)

    Kwiecien, Grzegorz J; Uygur, Safak; Korn, Jason; Gharb, Bahar Bassiri; Madajka, Maria; Djohan, Risal; Zins, James E; Schwarz, Graham S

    2015-11-01

    Vascularized lymph node transfer (VLNT) is a promising microvascular free flap technique for the surgical treatment of lymphedema. To date, few experimental animal models for VLNT have been described and the viability of lymph nodes after the transfer tested. We aimed to evaluate the feasibility of axillary VLNT in the rat. Lymph node containing flaps were harvested from the axillary region in 10 Lewis rats based on the axillary vessels. Flaps were transferred to the ipsilateral groin and end-to-side microanastomosis was performed to the femoral vessels using 10-0 sutures. Indocyanine green (ICG) angiography was used to confirm flap perfusion. On postoperative day 7, flaps were elevated to assess their structure and vessel patency. Hematoxylin and eosin staining was used to confirm the presence and survival of lymph nodes. All animals tolerated the procedure well. Immediate post-procedure ICG angiography confirmed flap perfusion. No signs of ischemia or necrosis were observed in donor extremities. At postoperative day 7, all flaps remained viable with patent vascular pedicles. Gross examination and histology confirmed the presence of 3.6 ± 0.5 lymph nodes in each flap without any signs of necrosis. This study showed that the transfer of axillary lymph nodes based on the axillary vessels is feasible. The flap can be used without the need for donor animals and it contains a consistent number of lymph nodes. This reliable VLNT can be further utilized in studies involving lymphedema, transplantation, and induction of immunologic tolerance. © 2015 Wiley Periodicals, Inc.

  1. Factors influencing lymph node recovery from the operative specimen after gastrectomy for gastric adenocarcinoma.

    Science.gov (United States)

    Schoenleber, Scott J; Schnelldorfer, Thomas; Wood, Christina M; Qin, Rui; Sarr, Michael G; Donohue, John H

    2009-07-01

    Regional lymph node metastases are an important predictor of survival for patients with resectable adenocarcinoma of the stomach. Currently, the number of lymph nodes examined is frequently less than requirements for accurate staging. Clinical factors associated with lymph node recovery are understood poorly. We performed a retrospective chart review of 99 consecutive patients who underwent gastrectomy for gastric adenocarcinoma distal to the gastroesophageal junction to determine clinical variables associated lymph node recovery. Ninety-nine patients underwent gastrectomy for gastric adenocarcinoma at our two hospitals. More than 15 lymph nodes were examined in 64% of specimens. Univariate analysis showed an association between the number of lymph nodes recovered and the number of positive nodes, lymphadenectomy extent, hospital, surgeon, and pathology technician (p analysis identified the pathology technician as the most important healthcare-related variable contributing to the variation of lymph node recovery, using fixed- (p technical aspects of specimen processing may be of benefit in maximizing the number of lymph nodes recovered.

  2. Comparison of vascularized supraclavicular lymph node transfer and lymphaticovenular anastomosis for advanced stage lower extremity lymphedema.

    Science.gov (United States)

    Akita, Shinsuke; Mitsukawa, Nobuyuki; Kuriyama, Motone; Kubota, Yoshitaka; Hasegawa, Masakazu; Tokumoto, Hideki; Ishigaki, Tatsuya; Togawa, Takashi; Kuyama, Junpei; Satoh, Kaneshige

    2015-05-01

    Vascularized lymph node transfer has become a popular surgical option to improve lower extremity lymphedema (LEL), although potential donor sites are limited. The free supraclavicular flap with deep cervical lymph nodes has been recently associated with a minimal risk of secondary lymphedema caused by donor site dissection. However, the effectiveness of this procedure has not yet been evaluated. Vascularized supraclavicular lymph node transfer (VSLNT) was performed for patients with International Society of Lymphology late stage II or more severe LEL. The results were compared with lymphaticovenular anastomosis (LVA) performed for patients with the same stages of severity. To evaluate improvement in lymphatic function, indocyanine green lymphography and lymphoscintigraphy were performed. Vascularized supraclavicular lymph node transfer was performed in 13 limbs of 13 patients. The results were compared with 43 limbs of 33 patients who underwent multiple LVA. No severe complications were observed in either group. Improvement in lymphatic function, as measured by the LEL index, was 26.5 ± 4.4 and 21.2 ± 2.0 in the VSLNT and LVA groups, respectively. Lymphatic function was improved in 7 cases in the VSLNT group and 10 cases in the LVA group. Vascularized supraclavicular lymph node transfer is an effective technique for the treatment of advanced stage LEL. Lymphaticovenular anastomosis is also effective, but to a lesser degree than VSLNT. However, LVA is less invasive and requires a shorter hospital stay.

  3. Treatment results of chemoradiation for T1 esophageal cancer with lymph node metastases

    Energy Technology Data Exchange (ETDEWEB)

    Itoh, Yoshiyuki [Nishio Municipal Hospital, Aichi (Japan); Fuwa, Nobukazu; Matsumoto, Akira; Asano, Akiko; Sasaoka, Masahiro

    2000-04-01

    We clinically evaluated 12 patients with advanced superficial esophageal cancer who had undergone chemoradiotherapy. A retrospective analysis was performed between October 1992 and December 1998 on 12 patients with M1 metastasis in lymph nodes or direct invasion of enlarged lymph nodes (A3) to adjacent structures. Combined treatment with radiotherapy and chemotherapy was applied to all patients. High-dose cisplatin (CDDP) and 5-fluorouracil (5FU) were administered to five patients, low-dose CDDP and 5-FU to five patients, and others to two patients. Ten patients were treated by external irradiation alone, and two patients were treated by external and intracavitary irradiation. Of the 12 patients, the response of the primary tumor to this therapy resulted in 11 CRs (91.6%) and one PR, while the response of the largest metastatic lesion in lymph nodes in each patient resulted in three CRs (25%), four PRs (33.3%), and five NCs (41.6%). The 2-year survival rate of all patients was 51.9%, and MST was 28.9 months. The 2-year survival rates of the M1 and A3 patients were 60.0% and 41.7%, respectively. This study revealed that the present chemotherapy regimen is ineffective in treating metastatic lymph node lesions. Therefore, it will be necessary to evaluate the effectiveness of chemoradiotherapeutic agents from the perspective of their effects on metastatic lymph nodes. (author)

  4. Evaluating local lymph node metastasis with magnetic resonance imaging, endoluminal ultrasound and computed tomography in rectal cancer: a meta-analysis.

    Science.gov (United States)

    Li, X-T; Sun, Y-S; Tang, L; Cao, K; Zhang, X-Y

    2015-06-01

    Magnetic resonance imaging (MRI), endorectal ultrasound (EUS) and computed tomography (CT) are commonly used to evaluate lymph node (LN) metastasis for rectal cancer, but there is no agreement on which form of imaging is most accurate. The study aimed to review systematically the diagnostic performance of the three imaging modalities. The PubMed, Cochrane Library and EMBASE databases were systematically searched for English and Chinese language studies evaluating the diagnostic accuracy of MRI, EUS and/or CT for evaluating LN metastasis. Papers published before 31 December 2013 were included in the search. Subject-level data were included. Diagnostic odds ratios were calculated for each modality and summary receiver operating characteristic curves were constructed using hierarchical regression models. The performance of the three modalities was compared. The analysis included data from 123 studies evaluating LN metastasis. The sensitivity and specificity in patients having no chemoradiotherapy were 0.77 and 0.76 for MRI, 0.57 and 0.80 for EUS and 0.79 and 0.76 for CT. The three modalities showed similar accuracy (P = 0.39). MRI showed higher accuracy than EUS for patients who received neoadjuvant therapy (P = 0.04). MRI at a field strength > 1.5 T yielded better performance than EUS (P = 0.03) and similar performance to CT (P = 0.17). High resolution MRI showed similar diagnostic accuracy to EUS (P = 0.18) and CT (P = 0.16). MRI, EUS and CT show similar accuracy but none could provide reliable evaluation for LN metastasis. MRI rather than EUS is recommended for LN evaluation after neoadjuvant therapy. MRI at a field strength of 3.0 T is the recommended method for MRI examination. But high resolution MRI does not improve the diagnostic performance in evaluating LN metastasis. Colorectal Disease © 2015 The Association of Coloproctology of Great Britain and Ireland.

  5. Factors affecting results of lymph node dissection in patients with skin Melanoma, 1987-92

    Directory of Open Access Journals (Sweden)

    Mir M

    1998-08-01

    Full Text Available In this paper, factors affecting the result of prophylactic lymph node dissection in 125 patients with skin melanoma during the period between 1987-1992 in the cancer institute were evaluated and prognostic parameters ascertained. The result showed prevalence of head and neck melanoma in men were two times more than in women with a preponderance of regional and lymphatic recurrence. Majority of patients presented with advanced clark levels (76.8 Pct. Clinical and histologic evaluation of the regional lymph nodes failed to show any meaningful relation.

  6. Evaluation of local immune response to Fasciola hepatica experimental infection in the liver and hepatic lymph nodes of goats immunized with Sm14 vaccine antigen

    Directory of Open Access Journals (Sweden)

    Ricardo E Mendes

    2010-08-01

    Full Text Available Protection against Fasciola hepatica in goats immunized with a synthetic recombinant antigen from Schistosoma mansoni fatty acid-binding protein 14 (rSm14 was investigated by assessing worm burdens, serum levels of hepatic enzymes, faecal egg count and hepatic damage, which was evaluated using gross and microscopic morphometric observation. The nature of the local immune response was assessed by examining the distribution of CD2+, CD4+, CD8+ and γ´+ T lymphocytes along with IgG+, IL-4+ and IFN-γ+ cells in the liver and hepatic lymph nodes (HLN. The goats used consisted of group 1 (unimmunized and uninfected, group 2 [infected control - immunized with Quillaia A (Quil A] and group 3 (immunized with rSm14 in Quil A and infected, each containing seven animals. Immunization with rSm14 in Quil A adjuvant induced a reduction in gross hepatic lesions of 56.6% (p < 0.001 and reduced hepatic and HLN infiltration of CD2+, CD4+, CD8+ and γ´+ T lymphocytes as well as IL-4+ and IFN-γ+ cells (p < 0.05. This is the first report of caprine immunization against F. hepatica using a complete rSm14 molecule derived from S. mansoni. Immunization reduced hepatic damage and local inflammatory infiltration into the liver and HLN. However, considering that Quil A is not the preferential/first choice adjuvant for Sm14 immunization, further studies will be undertaken using the monophosphoryl lipid A-based family of adjuvants during clinical trials to facilitate anti-Fasciolavaccine development.

  7. The Prognostic Value of Lymph Nodes Dissection Number on Survival of Patients with Lymph Node-Negative Gastric Cancer

    Directory of Open Access Journals (Sweden)

    Wu Song

    2014-01-01

    Full Text Available Objective. The study was designed to explore the prognostic value of examined lymph node (LN number on survival of gastric cancer patients without LN metastasis. Methods. Between August 1995 and January 2011, 300 patients who underwent gastrectomy with D2 lymphadenectomy for LN-negative gastric cancer were reviewed. Patients were assigned to various groups according to LN dissection number or tumor invasion depth. Some clinical outcomes, such as overall survival, operation time, length of stay, and postoperative complications, were compared among all groups. Results. The overall survival time of LN-negative GC patients was 50.2±30.5 months. Multivariate analysis indicated that LN dissection number (P30. Besides, it was not correlated with operation time, transfusion volume, length of postoperative stay, or postoperative complication incidence (P>0.05. Conclusions. The number of examined lymph nodes is an independent prognostic factor of survival for patients with lymph node-negative gastric cancer. Sufficient dissection of lymph nodes is recommended during surgery for such population.

  8. Does Metastatic Lymph Node SUVmax Predict Survival in Patients with Esophageal Cancer?

    Directory of Open Access Journals (Sweden)

    Betül Vatankulu

    2015-10-01

    Full Text Available Objective: We aimed to investigate the SUVmax of primary tumor and metastatic lymph node in predicting survival in patients with esophageal cancer. Methods: We retrospectively analyzed patients with esophageal cancer between 2009 and 2011 who had FDG positronemission tomography (PET/computed tomography (CT. All patients were followed-up to 2013. Clinical staging, SUVmax of primary tumor and metastatic lymph node were evaluated. Results: One hundred seven patients were included in the study. All patients were followed-up between 2 and 49 months. The mean SUVmax of primary tumor and metastatic lymph node were 19.3±8.8 and 10.4±9.1, respectively. Metastatic lymph node SUVmax had an effect in predicting survival whereas primary tumor SUVmax did not have an effect (p=0.014 and p=0.262, respectively. Multivariate Cox regression analysis showed that clinical stage of the disease was the only independent factor predicting survival (p=0.001. Conclusion: Among patients with esophageal cancer, the value of primary tumor SUVmax did not have an effect on survival. Clinical stage assessed with FDG PET/CT imaging was found to predict survival in esophageal carcinoma. Additionally, lymph node SUVmax was identified as a new parameter in predicting survival in the present study

  9. Lymph node melanocytic nevi: pathogenesis and differential diagnoses, with special reference to p16 reactivity.

    Science.gov (United States)

    Piana, Simonetta; Tagliavini, Elena; Ragazzi, Moira; Zanelli, Magda; Zalaudek, Iris; Ciarrocchi, Alessia; Valli, Riccardo

    2015-05-01

    Lymph node nevi (NN) have been occasionally described, yet little is currently known on their origin. According to a theoretical model of nevogenesis, the dissemination of nevus progenitor cells through lymphatic routes is responsible for the development of both nodal and skin nevi. The true incidence of NN is largely unknown but it has been reported to vary from 0.017% to as high as 22%. The frequency of NN nevi has increased since the introduction of sentinel lymph node mapping as a routine prognostic procedure in breast cancer and melanoma. The aim of this study was to analyze the frequency and morphological findings of NN, to discuss possible pathogenetic pathways in their evolution, and to verify the consistency of p16 immunostaining in the critical differential approach between NN and melanoma metastases. We therefore morphologically and immunohistochemically evaluated a series of 60 NN from 58 patients. In 21 patients, the lymph nodes had been removed during the staging for a skin melanoma; in all these patients NN immunostaining with p16 was strongly positive and p16 proved to be a reliable marker for the crucial differential diagnosis between NN and melanoma metastasis, strongly reacting in NN and lacking in melanoma deposits. A deeper knowledge on NN could help to clarify some important topics such as lymph node metastatic melanoma with unknown primary and the current debate on the lymph node involvement from atypical spitzoid tumors.

  10. Regional hyperthermia combined with radiotherapy for esophageal squamous cell carcinoma with supraclavicular lymph node metastasis

    Science.gov (United States)

    Liming, Sheng; Yongling, Ji; Qiner, Wu; Xianghui, Du

    2017-01-01

    To assess the efficacy and toxicity of Intensity-modulated radiotherapy (IMRT) and hyperthermia for upper and middle thoracic esophageal squamous cell carcinoma (UMT-ESCC) with supraclavicular lymph node metastasis. A total of 50 patients with UMT-ESCC with supraclavicular lymph node metastasis were evaluated in this retrospective study. All patients received IMRT. Hyperthermia was delivered simultaneously with irradiation, in 45 minutes twice a week for 5-6 weeks. Hyperthermia included supraclavicular lymph node metastasis. Forty-four patients (88.0%) received concurrent chemoradiotherapy based on cisplatin regimens. The most common types of hematological toxicities were anemia (62.0%) and leukopenia (60.0%). Most of these events were grade 1-2 and transient. The 3-year progression-free survival (PFS) rate and overall survival (OS) rate were 34.9% and 42.5%, respectively. Cox regression revealed that tumor length and number of supraclavicular lymph node metastasis were two independent predictors of OS (tumor length: HR=3.65, p=0.008; nodal stage: HR=8.07, p=0.019). The IMRT combined with supraclavicular regional hyperthermia has low toxicity and well tolerated with excellent local control in UMT-ESCC with supraclavicular lymph node metastasis. PMID:28029663

  11. Biodistribution of ~(99)Tc~m Labelled Dextran Conjugates for Sentinel Lymph Node Detection

    Institute of Scientific and Technical Information of China (English)

    2011-01-01

    Mannosylated dextran conjugates showed high receptor affinity to the receptors on the surface of macrophages in the lymph node. 99Tcm labelled mannosylated dextran conjugates could be used for sentinel lymph node (SLN) detection. In this paper,

  12. 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

  13. Optimising magnetic sentinel lymph node biopsy in an in vivo porcine model

    NARCIS (Netherlands)

    Ahmed, M.; Anninga, Bauke; Pouw, Joost Jacob; Vreemann, S.; Peek, M.; van Hemelrijck, Mieke; Pinder, Sara E.; ten Haken, Bernard; Pankhurst, Quentin A.; Douek, Michael

    2015-01-01

    The magnetic technique for sentinel lymph node biopsy (SLNB) has been evaluated in several clinical trials. An in vivo porcine model was developed to optimise the magnetic technique by evaluating the effect of differing volume, concentration and time of injection of magnetic tracer. A total of 60

  14. Pretreatment Retroperitoneal Para-aortic Lymph Node Staging in Advanced Cervical Cancer: A Review

    NARCIS (Netherlands)

    Smits, R.M.; Zusterzeel, P.L.M.; Bekkers, R.L.M.

    2014-01-01

    OBJECTIVE: The aims of this study were to evaluate the safety and impact of pretreatment surgical para-aortic lymph node staging (PALNS) in advanced cervical cancer (International Federation of Gynecology and Obstetrics stage IB2-IVA) and to evaluate the preoperative imaging of PALNs. METHODS: We

  15. Pretreatment Retroperitoneal Para-aortic Lymph Node Staging in Advanced Cervical Cancer: A Review

    NARCIS (Netherlands)

    Smits, R.M.; Zusterzeel, P.L.M.; Bekkers, R.L.M.

    2014-01-01

    OBJECTIVE: The aims of this study were to evaluate the safety and impact of pretreatment surgical para-aortic lymph node staging (PALNS) in advanced cervical cancer (International Federation of Gynecology and Obstetrics stage IB2-IVA) and to evaluate the preoperative imaging of PALNs. METHODS: We se

  16. Differential Motion Between Mediastinal Lymph Nodes and Primary Tumor in Radically Irradiated Lung Cancer Patients

    Energy Technology Data Exchange (ETDEWEB)

    Schaake, Eva E. [Department of Thoracic Oncology, The Netherlands Cancer Institute, Amsterdam (Netherlands); Department of Radiation Oncology, The Netherlands Cancer Institute, Amsterdam (Netherlands); Rossi, Maddalena M.G. [Department of Radiation Oncology, The Netherlands Cancer Institute, Amsterdam (Netherlands); Buikhuisen, Wieneke A.; Burgers, Jacobus A. [Department of Thoracic Oncology, The Netherlands Cancer Institute, Amsterdam (Netherlands); Smit, Adrianus A.J. [Department of Pulmonary Disease, Onze Lieve Vrouwe Gasthuis, Amsterdam (Netherlands); Belderbos, José S.A. [Department of Radiation Oncology, The Netherlands Cancer Institute, Amsterdam (Netherlands); Sonke, Jan-Jakob, E-mail: j.sonke@nki.nl [Department of Radiation Oncology, The Netherlands Cancer Institute, Amsterdam (Netherlands)

    2014-11-15

    Purpose/Objective: In patients with locally advanced lung cancer, planning target volume margins for mediastinal lymph nodes and tumor after a correction protocol based on bony anatomy registration typically range from 1 to 1.5 cm. Detailed information about lymph node motion variability and differential motion with the primary tumor, however, is lacking from large series. In this study, lymph node and tumor position variability were analyzed in detail and correlated to the main carina to evaluate possible margin reduction. Methods and Materials: Small gold fiducial markers (0.35 × 5 mm) were placed in the mediastinal lymph nodes of 51 patients with non-small cell lung cancer during routine diagnostic esophageal or bronchial endoscopic ultrasonography. Four-dimensional (4D) planning computed tomographic (CT) and daily 4D cone beam (CB) CT scans were acquired before and during radical radiation therapy (66 Gy in 24 fractions). Each CBCT was registered in 3-dimensions (bony anatomy) and 4D (tumor, marker, and carina) to the planning CT scan. Subsequently, systematic and random residual misalignments of the time-averaged lymph node and tumor position relative to the bony anatomy and carina were determined. Additionally, tumor and lymph node respiratory amplitude variability was quantified. Finally, required margins were quantified by use of a recipe for dual targets. Results: Relative to the bony anatomy, systematic and random errors ranged from 0.16 to 0.32 cm for the markers and from 0.15 to 0.33 cm for the tumor, but despite similar ranges there was limited correlation (0.17-0.71) owing to differential motion. A large variability in lymph node amplitude between patients was observed, with an average motion of 0.56 cm in the cranial-caudal direction. Margins could be reduced by 10% (left-right), 27% (cranial-caudal), and 10% (anteroposterior) for the lymph nodes and −2%, 15%, and 7% for the tumor if an online carina registration protocol replaced a

  17. A single cervical lymph node metastasis of malignant ameloblastoma.

    Science.gov (United States)

    Kim, Yoori; Choi, Sung-Weon; Lee, Jong-Ho; Ahn, Kang-Min

    2014-12-01

    Cervical node metastasis of malignant ameloblastoma is extremely rare. Because of its rarity, there is no standard treatment modality in a single lymph node metastasis in malignant ameloblastoma. Eleven patients of malignant ameloblastoma involving a single cervical lymph node metastasis and one new case were reviewed. Neck treatment was classified into neck dissection and simple excision. Local nodal recurrence, distant metastasis and follow-up periods were investigated. Eight patients were treated with neck dissection (group A) and four patients underwent a simple node excision (group B). Two patients in group A experienced multiple organ metastases such as liver and lung seven months and 13 years after neck dissection respectively. The other patients showed no recurrence and metastasis. In group B, there was no report of a regional neck recurrence and distant metastasis during follow-up of 1-7 years. Multiple nodes metastasis requires a radical neck dissection; however, simple excision with close follow-up may be used in a single node metastasis in malignant ameloblastoma. Copyright © 2014 European Association for Cranio-Maxillo-Facial Surgery. Published by Elsevier Ltd. All rights reserved.

  18. 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...

  19. The method and efficacy of support vector machine classifiers based on texture features and multi-resolution histogram from {sup 18}F-FDG PET-CT images for the evaluation of mediastinal lymph nodes in patients with lung cancer

    Energy Technology Data Exchange (ETDEWEB)

    Gao, Xuan [Center of PET/CT, The Third Affiliated Hospital of Harbin Medical University, The Affiliated Tumor Hospital of Harbin Medical University, Harbin (China); Chu, Chunyu [HIT–INSA Sino French Research Centre for Biomedical Imaging, Harbin Institute of Technology, Harbin (China); Li, Yingci; Lu, Peiou; Wang, Wenzhi [Center of PET/CT, The Third Affiliated Hospital of Harbin Medical University, The Affiliated Tumor Hospital of Harbin Medical University, Harbin (China); Liu, Wanyu [HIT–INSA Sino French Research Centre for Biomedical Imaging, Harbin Institute of Technology, Harbin (China); Yu, Lijuan, E-mail: yulijuan2003@126.com [Center of PET/CT, The Third Affiliated Hospital of Harbin Medical University, The Affiliated Tumor Hospital of Harbin Medical University, Harbin (China)

    2015-02-15

    Highlights: • Three support vector machine classifiers were constructed from PET-CT images. • The areas under the ROC curve for SVM1, SVM2, and SVM3 were 0.689, 0.579, and 0.685, respectively. • The areas under curves for maximum short diameter and SUV{sub max} were 0.684 and 0.652, respectively. • The algorithm based on SVM was potential in the diagnosis of mediastinal lymph nodes. - Abstract: Objectives: In clinical practice, image analysis is dependent on simply visual perception and the diagnostic efficacy of this analysis pattern is limited for mediastinal lymph nodes in patients with lung cancer. In order to improve diagnostic efficacy, we developed a new computer-based algorithm and tested its diagnostic efficacy. Methods: 132 consecutive patients with lung cancer underwent {sup 18}F-FDG PET/CT examination before treatment. After all data were imported into the database of an on-line medical image analysis platform, the diagnostic efficacy of visual analysis was first evaluated without knowing pathological results, and the maximum short diameter and maximum standardized uptake value (SUV{sub max}) were measured. Then lymph nodes were segmented manually. Three classifiers based on support vector machine (SVM) were constructed from CT, PET, and combined PET-CT images, respectively. The diagnostic efficacy of SVM classifiers was obtained and evaluated. Results: According to ROC curves, the areas under curves for maximum short diameter and SUV{sub max} were 0.684 and 0.652, respectively. The areas under the ROC curve for SVM1, SVM2, and SVM3 were 0.689, 0.579, and 0.685, respectively. Conclusion: The algorithm based on SVM was potential in the diagnosis of mediastinal lymph nodes.

  20. Molecular and Functional Imaging for Detection of Lymph Node Metastases in Prostate Cancer

    Directory of Open Access Journals (Sweden)

    Ansje Fortuin

    2013-07-01

    Full Text Available Knowledge on lymph node metastases is crucial for the prognosis and treatment of prostate cancer patients. Conventional anatomic imaging often fails to differentiate benign from metastatic lymph nodes. Pelvic lymph node dissection is an invasive technique and underestimates the extent of lymph node metastases. Therefore, there is a need for more accurate non-invasive diagnostic techniques. Molecular and functional imaging has been subject of research for the last decades, in this respect. Therefore, in this article the value of imaging techniques to detect lymph node metastases is reviewed. These techniques include scintigraphy, sentinel node imaging, positron emission tomography/computed tomography (PET/CT, diffusion weighted magnetic resonance imaging (DWI MRI and magnetic resonance lymphography (MRL. Knowledge on pathway and size of lymph node metastases has increased with molecular and functional imaging. Furthermore, improved detection and localization of lymph node metastases will enable (focal treatment of the positive nodes only.

  1. Molecular and functional imaging for detection of lymph node metastases in prostate cancer.

    Science.gov (United States)

    Fortuin, Ansje; Rooij, Maarten de; Zamecnik, Patrik; Haberkorn, Uwe; Barentsz, Jelle

    2013-07-03

    Knowledge on lymph node metastases is crucial for the prognosis and treatment of prostate cancer patients. Conventional anatomic imaging often fails to differentiate benign from metastatic lymph nodes. Pelvic lymph node dissection is an invasive technique and underestimates the extent of lymph node metastases. Therefore, there is a need for more accurate non-invasive diagnostic techniques. Molecular and functional imaging has been subject of research for the last decades, in this respect. Therefore, in this article the value of imaging techniques to detect lymph node metastases is reviewed. These techniques include scintigraphy, sentinel node imaging, positron emission tomography/computed tomography (PET/CT), diffusion weighted magnetic resonance imaging (DWI MRI) and magnetic resonance lymphography (MRL). Knowledge on pathway and size of lymph node metastases has increased with molecular and functional imaging. Furthermore, improved detection and localization of lymph node metastases will enable (focal) treatment of the positive nodes only.

  2. Prognostic value of lateral lymph node metastasis for advanced low rectal cancer

    Institute of Scientific and Technical Information of China (English)

    2007-01-01

    AIM: To evaluate the risk factors for lateral lymph node metastasis in patients with advanced low rectal cancer,in order to make the effective selection of patients who could benefit from lateral lymph node dissection, as well as the relationship of lateral lymph node metastasis with local recurrence and survival of patients with advanced low rectal cancer.METHODS: A total of 96 consecutive patients who underwent curative surgery with lateral pelvic lymphadenectomy for advanced lower rectal cancer were retrospectively analyzed. The relation of lateral lymph node metastasis with clinicopathologic characteristics,local recurrence and survival of patients was identified.RESULTS: Lateral lymph node metastasis was observed in 14.6% (14/96) of patients with advanced low rectal cancer. Lateral lymph node metastasis was detected in 10(25.0%) of 40 patients with tumor diameter ≥ 5 cm and in 4 (7.1%) of 56 patients with tumor diameter < 5 cm.The difference between the two groups was statistically significant (x2=5.973, P = 0.015). Lateral lymph node metastasis was more frequent in patients with 4/4diameter of tumor infiltration (7 of 10 cases, 70.0%),compared with patients with 3/4, 2/4 and 1/4 diameter of tumor infiltration (3 of 25 cases, 12.0%; 3 of 45 cases,6.7%; 1 of 16 cases, 6.3%) (x2 = 27.944, ,P = 0.0001).The lateral lymph node metastasis rate was 30.0% (9of 30 cases), 9.1% (4 of 44 cases) and 4.5% (1 of 22cases) for poorly, moderately and well-differentiated carcinoma, respectively. The difference between the three groups was statistically significant (x2 =8.569,P = 0.014). Local recurrence was 18.8% (18 of 96cases), 64.3% (9 of 14 cases), and 11.0% (9 of 82cases) in patients with advanced low rectal cancer, in those with and without lateral lymph node metastasis,respectively. The difference between the two groups was statistically significant (x2= 22.308, ,P = 0.0001).Kaplan-Meier survival analysis showed significant improvements in median survival (80.9±2

  3. Lymph-migrating, tissue-derived dendritic cells are minor constituents within steady-state lymph nodes

    OpenAIRE

    Jakubzick, Claudia; Bogunovic, Milena; Bonito, Anthony J.; Kuan, Emma L.; Merad, Miriam; Randolph, Gwendalyn J.

    2008-01-01

    Observations that dendritic cells (DCs) constitutively enter afferent lymphatic vessels in many organs and that DCs in some tissues, such as the lung, turnover rapidly in the steady state have led to the concept that a major fraction of lymph node DCs are derived from migratory DCs that enter the lymph node through upstream afferent lymphatic vessels. We used the lysozyme M–Cre reporter mouse strain to assess the relationship of lymph node and nonlymphoid organ DCs. Our findings challenge the...

  4. Internal mammary lymph node management – further direction

    Directory of Open Access Journals (Sweden)

    Vrana D

    2017-02-01

    Full Text Available D Vrana,1,2 J Gatek3,4 1Department of Oncology, 2Institute of Molecular and Translational Medicine, Faculty of Medicine and Dentistry, Palacky University, Olomouc, 3Department of Surgery, Atlas Hospital, 4Faculty of Humanities, Tomas Bata University in Zlín, Zlín, Czech Republic We read the article titled “Internal mammary sentinel lymph node biopsy: abandon or persist?” by Qiu et al with high interest. This was an excellent paper regarding the contemporary management of internal mammary lymph nodes (IMLN in early-stage breast cancer1 and we would like to take this opportunity to comment on this paper.There are several unresolved questions regarding early-stage breast management including axillary staging, clear resection margin, or IMLN.2–4 We have been focusing on the issues of IMLN for almost a decade and just recently published our data regarding IMLN management. We absolutely agree that one has to carefully balance the benefit and potential risks of biopsy or radiotherapy of IMLN.  Authors' reply Peng-Fei Qiu, Yong-Sheng WangBreast Cancer Center, Shandong Cancer Hospital Affiliated to Shandong University, Jinan, People’s Republic of China  We appreciate the letter from Professors Vrana and Gatek regarding our article titled “Internal mammary sentinel lymph node biopsy: abandon or persist?”.1 We have been following their publications regarding internal mammary lymph nodes (IMLN management since the publication of their article titled “Prognostic influence of internal mammary node drainage in patients with early-stage breast cancer” in December 20162 and we share their interest on this topic.  View the original paper by Qiu and colleagues.

  5. A Computerized System to Assess Axillary Lymph Node Malignancy from Sonographic Images.

    Science.gov (United States)

    Chmielewski, Aneta; Dufort, Paul; Scaranelo, Anabel M

    2015-10-01

    A computational approach to classifying axillary lymph node metastasis in sonographic images is described. One hundred five ultrasound images of axillary lymph nodes from patients with breast cancer were evaluated (81 benign and 24 malignant), and each lymph node was manually segmented, delineating both the whole lymph node and internal hilum surfaces. Normalized signed distance transforms were computed from the segmented boundaries of both structures, and each pixel was then assigned coordinates in a 3-D feature space according to the pixel's intensity, its signed distance to the node boundary and its signed distance to the hilum boundary. Three-dimensional histograms over the feature space were accumulated for each node by summing over all pixels, and the bin counts served as predictor inputs to a support vector machine learning algorithm. Repeated random sampling of 80/25 train/test splits was used to estimate generalization performance and generate receiver operating characteristic curves. The optimal classifier had an area under the receiver operating characteristic curve of 0.95 and sensitivity and specificity of 0.90 and 0.90. Our results indicate the feasibility of axillary nodal staging with computerized analysis. Copyright © 2015 World Federation for Ultrasound in Medicine & Biology. Published by Elsevier Inc. All rights reserved.

  6. 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.

  7. File list: His.Bld.10.AllAg.Lymph_node_metastasis [Chip-atlas[Archive

    Lifescience Database Archive (English)

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  10. 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.

  11. Peritoneal malignant mesothelioma metastatic to supraclavicular lymph nodes.

    Science.gov (United States)

    Zannella, Stefano; Testi, Maria Adele; Cattoretti, Giorgio; Pelosi, Giuseppe; Zucchini, Nicola

    2014-09-01

    Distinguishing between malignant mesothelioma and reactive mesothelial hyperplasia is often inestimable, but may be a challenging gauntlet for pathologists. A 62-year-old man underwent appendectomy after the identification of a peritoneal mass and the histological examination showed mesothelial proliferation along the appendix surface with no clear images of infiltration. After a few months the patient developed mediastinal and supraclavicular lymphadenopathies, and a nodal biopsy showed mesothelial cell proliferation invading lymphatic sinuses, consistent with the cells seen in the abdominal cavity. Since overt morphologic criteria for malignancy were lacking and reactive mesothelial cell deposits have been documented in lymph nodes, a molecular investigation of the CDKN2A (henceforth simply p16) gene status via fluorescence in situ hybridization was performed, which showed homozygous deletion in 100% tumor cells. These data ruled out the hypothesis of reactive mesothelial cells inclusion in lymph nodes, thus confirming the diagnosis of epithelioid malignant mesothelioma. © The Author(s) 2014.

  12. A Clinico-Pathological Study of Cervical Lymph Nodes.

    Science.gov (United States)

    Batni, Gaurav; Gaur, Sushil; Sinha, O N; Agrawal, Siddhant Priya; Srivasatva, Abhinav

    2016-12-01

    Cervical lymphadenopathy is one of the commonest presenting complaint of patient in ENT OPD Fine Needle Aspiration Cytology (FNAC) is one of the most reliable, less expensive, and basic diagnostic procedure for the definitive and conclusive diagnosis for the immune system which reciprocates in the form of enlarged lymph nodes. A study was conducted in ENT Department of Santosh Medical College, Ghazibad from August 2015 to May 2016 on 64 patients with enlarged cervical lymph nodes. FNAC was done to make the diagnosis. Out of 64 patients (51.5 %) was reactive non-specific, 28 % tubercular, 3.1 % lymphoma and 17 % were malignant. FNAC is one of the most dependable diagnostic tools in case of cervical lymphadenopathy for early diagnosis and detection for the better management.

  13. 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.

  14. Sentinel lymph node biopsy in paediatric melanoma. A case series.

    Science.gov (United States)

    Sánchez Aguilar, M; Álvarez Pérez, R M; García Gómez, F J; Fernández Ortega, P; Borrego Dorado, I

    2015-01-01

    The incidence of melanoma in children is uncommon, being particularly rare in children under 10 years-old. However, this disease is increasing by a mean of 2% per year. As in adults, the lymph node status is the most important prognostic factor, crucial to performing the selective sentinel lymph node biopsy (SLNB). We report 3 cases of paediatric patients of 3, 4 and 8 years-old, in which SLNB was performed for malignant melanoma. Paediatric age implies greater technical difficulty to the scintigraphy scan due to poor patient cooperation, with mild sedation required in some cases, and only being able to acquire planar images in other cases. SPECT/CT was only performed in the oldest patient. In our cases, SLNB was useful for selecting the least invasive surgery in order to reduce morbidity. Copyright © 2014 Elsevier España, S.L.U. y SEMNIM. All rights reserved.

  15. 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...... 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...

  16. A Logistic Regression Model for Predicting Axillary Lymph Node Metastases in Early Breast Carcinoma Patients

    Directory of Open Access Journals (Sweden)

    Jiaqing Zhang

    2012-07-01

    Full Text Available Nodal staging in breast cancer is a key predictor of prognosis. This paper presents the results of potential clinicopathological predictors of axillary lymph node involvement and develops an efficient prediction model to assist in predicting axillary lymph node metastases. Seventy patients with primary early breast cancer who underwent axillary dissection were evaluated. Univariate and multivariate logistic regression were performed to evaluate the association between clinicopathological factors and lymph node metastatic status. A logistic regression predictive model was built from 50 randomly selected patients; the model was also applied to the remaining 20 patients to assess its validity. Univariate analysis showed a significant relationship between lymph node involvement and absence of nm-23 (p = 0.010 and Kiss-1 (p = 0.001 expression. Absence of Kiss-1 remained significantly associated with positive axillary node status in the multivariate analysis (p = 0.018. Seven clinicopathological factors were involved in the multivariate logistic regression model: menopausal status, tumor size, ER, PR, HER2, nm-23 and Kiss-1. The model was accurate and discriminating, with an area under the receiver operating characteristic curve of 0.702 when applied to the validation group. Moreover, there is a need discover more specific candidate proteins and molecular biology tools to select more variables which should improve predictive accuracy.

  17. Maximum standardized uptake value on PET/CT in preoperative assessment of lymph node metastasis from thoracic esophageal squamous cell carcinoma

    Institute of Scientific and Technical Information of China (English)

    Amos JM Ela Bella; Ya-Rui Zhang; Wei Fan; Kong-Jia Luo; Tie-Hua Rong; Peng Lin; Hong Yang; Jian-Hua Fu

    2014-01-01

    The presence of lymph node metastasis is an important prognostic factor for patients with esophageal cancer. Accurate assessment of lymph nodes in thoracic esophageal carcinoma is essential for selecting appropriate treatment and forecasting disease progression. Positron emission tomography combined with computed tomography (PET/CT) is becoming an important tool in the workup of esophageal carcinoma. Here, we evaluated the effectiveness of the maximum standardized uptake value (SUVmax) in assessing lymph node metastasis in esophageal squamous cell carcinoma (ESCC) prior to surgery. Fifty-nine surgical patients with pathologically confirmed thoracic ESCC were retrospectively studied. These patients underwent radical esophagectomy with pathologic evaluation of lymph nodes. They al had 18F-FDG PET/CT scans in their preoperative staging procedures. None had a prior history of cancer. The pathologic status and PET/CT SUVmax of lymph nodes were col ected to calculate the receiver operating characteristic (ROC) curve and to determine the best cutoff value of the PET/CT SUVmax to distinguish benign from malignant lymph nodes. Lymph node data from 27 others were used for the validation. A total of 323 lymph nodes including 39 metastatic lymph nodes were evaluated in the training cohort, and 117 lymph nodes including 32 metastatic lymph nodes were evaluated in the validation cohort. The cutoff point of the SUVmax for lymph nodes was 4.1, as calculated by ROC curve (sensitivity, 80%; specificity, 92%;accuracy, 90%). When this cutoff value was applied to the validation cohort, a sensitivity, a specificity, and an accuracy of 81%, 88%, and 86%, respectively, were obtained. These results suggest that the SUVmax of lymph nodes predicts malignancy. Indeed, when an SUVmax of 4.1 was used instead of 2.5, FDG-PET/CT was more accurate in assessing nodal metastasis.

  18. 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.

  19. Popliteal lymph node metastasis of tibial osteoblastic osteosarcoma

    OpenAIRE

    Dirik, Yalın; Çınar, Arda; Yumrukçal, Feridun; Eralp, Levent

    2014-01-01

    INTRODUCTION: We report a case with lymph node metastasis of osteosarcoma, which is a rare entity in comparison to hematogeneous lung or bone metastasis. PRESENTATION OF CASE: Twenty-seven years old male patient referred to our clinic complaining of ongoing left knee pain and swelling since one month without a history of prior trauma. Magnetic resonance imaging (MRI) revealed a mass of malignant nature which causes more prominent expansion and destruction of the bone distally with perioste...

  20. Robotic Salvage Lymph Node Dissection After Radical Prostatectomy

    OpenAIRE

    Torricelli,Fabio C. M.; Arnaldo Cividanes; Guglielmetti,Giuliano B.; Coelho,Rafael F.

    2015-01-01

    ABSTRACT Introduction 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 ...

  1. 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 I131 therapy 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 concept 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.

  2. Nanoparticles in Sentinel Lymph Node Assessment in Breast Cancer

    OpenAIRE

    Michael Douek; Geoff Charles-Edwards; Laura Johnson

    2010-01-01

    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 potent...

  3. DETECTION OF OCCULT LYMPH NODE TUMOR CELLS IN NODE-NEGATIVE GASTRIC CANCER PATIENTS.

    Science.gov (United States)

    Pereira, Marina Alessandra; Ramos, Marcus Fernando Kodama Pertille; Dias, Andre Roncon; Yagi, Osmar Kenji; Faraj, Sheila Friedrich; Zilberstein, Bruno; Cecconello, Ivan; Mello, Evandro Sobroza de; Ribeiro-Jr, Ulysses

    2017-01-01

    The presence of lymph nodes metastasis is one of the most important prognostic indicators in gastric cancer. The micrometastases have been studied as prognostic factor in gastric cancer, which are related to decrease overall survival and increased risk of recurrence. However, their identification is limited by conventional methodology, since they can be overlooked after routine staining. To investigate the presence of occult tumor cells using cytokeratin (CK) AE1/AE3 immunostaining in gastric cancer patients histologically lymph node negative (pN0) by H&E. Forty patients (T1-T4N0) submitted to a potentially curative gastrectomy with D2 lymphadenectomy were evaluated. The results for metastases, micrometastases and isolated tumor cells were also associated to clinicopathological characteristics and their impact on stage grouping. Tumor deposits within lymph nodes were defined according to the tumor-node-metastases guidelines (7th TNM). A total of 1439 lymph nodes were obtained (~36 per patient). Tumor cells were detected by immunohistochemistry in 24 lymph nodes from 12 patients (30%). Neoplasic cells were detected as a single or cluster tumor cells. Tumor (p=0.002), venous (p=0.016), lymphatic (p=0.006) and perineural invasions (p=0.04), as well as peritumoral lymphocytic response (p=0.012) were correlated to CK-positive immunostaining tumor cells in originally negative lymph nodes by H&E. The histologic stage of two patients was upstaged from stage IB to stage IIA. Four of the 28 CK-negative patients (14.3%) and three among 12 CK-positive patients (25%) had disease recurrence (p=0.65). The CK-immunostaining is an effective method for detecting occult tumor cells in lymph nodes and may be recommended to precisely determine tumor stage. It may be useful as supplement to H&E routine to provide better pathological staging. A presença de metástase em linfonodos é um dos indicadores prognósticos mais importantes no câncer gástrico. As micrometástases têm sido

  4. Evaluation of the effect of neoadjuvant chemotherapy on tumor and axillary lymph nodes in locally advanced breast cancer:a study of 50 patients

    Institute of Scientific and Technical Information of China (English)

    Ali H.Meebed; Ihab S.Fayek; Amany Saber; Reda H.Tabashy; Mona A.Sakr

    2014-01-01

    The purpose of the study was to correlate between ef ect of pre neoadjuvant chemotherapy (NACT) and post NACT clinical, sonographic and pathologic features of the tumor and axil ary lymph nodes (ALNs) and to raise the possibility of applying the concept of sentinel lymph node biopsy (SLNB) in patients with initial y positive ALNs before NACT. Methods:A prospective study of 50 female patients with local y advanced breast cancer (LABC) with clinical y palpable and cytological y (under ultrasonographic guidance) positive ALNs. Al patients received NACT and then referred for ultrasono graphic assessment of the axil a regarding any detectable sonographic criteria of metastatic deposits in ALNs as wel as the tumor size in relation to its pre chemotherapy size. Al patients were then subjected either to modified radical mastectomy or breast conserving surgery. The clinical, sonographic and pathological response of the tumor and the ALNs were documented, classified and correlated with each other. Results:Patients’ mean age was 47.7 ± 9.1 years. The mean clinical tumor size was 6.7 ± 1.4 cm;stage IIIA that was presented in 32 patients (64%) and IIIB was presented in 18 patients (36%). Chemotherapy was given for a median of 4 cycles. there was reduction of the mean clinical tumor size from 6.7 ± 1.4 cm to 4.3 ± 2.7 cm (P<0.001). Clinical response was complete in 5 (10%) tumors, complete pathological tumor response (post neoadjuvant) was detected in 8 (16%) of patients. Complete clinical nodal response (post neoadjuvant) in 23 (46%) axil ae, on sonographic assessment of the axil a, response was complete in 17 (34%) axil ae. Complete pathological nodal response occurred in 16 (32%) axil ae. Out of 17 axil ae that showed complete sonographic response 11 axil ae showed complete pathological nodal response (P<0.001). Conclusion:Formal axil ary lymph node dissection can be avoided and replaced by SLNB post NACT in patients with LABC with metastatic ALNs if there were complete

  5. High definition infrared spectroscopic imaging for lymph node histopathology.

    Directory of Open Access Journals (Sweden)

    L Suzanne Leslie

    Full Text Available Chemical imaging is a rapidly emerging field in which molecular information within samples can be used to predict biological function and recognize disease without the use of stains or manual identification. In Fourier transform infrared (FT-IR spectroscopic imaging, molecular absorption contrast provides a large signal relative to noise. Due to the long mid-IR wavelengths and sub-optimal instrument design, however, pixel sizes have historically been much larger than cells. This limits both the accuracy of the technique in identifying small regions, as well as the ability to visualize single cells. Here we obtain data with micron-sized sampling using a tabletop FT-IR instrument, and demonstrate that the high-definition (HD data lead to accurate identification of multiple cells in lymph nodes that was not previously possible. Highly accurate recognition of eight distinct classes - naïve and memory B cells, T cells, erythrocytes, connective tissue, fibrovascular network, smooth muscle, and light and dark zone activated B cells was achieved in healthy, reactive, and malignant lymph node biopsies using a random forest classifier. The results demonstrate that cells currently identifiable only through immunohistochemical stains and cumbersome manual recognition of optical microscopy images can now be distinguished to a similar level through a single IR spectroscopic image from a lymph node biopsy.

  6. Cardiac Sarcoidosis Diagnosed by Incidental Lymph Node Biopsy.

    Science.gov (United States)

    Matsuda, Jun; Fujiu, Katsuhito; Roh, Solji; Tajima, Miyu; Maki, Hisataka; Kojima, Toshiya; Ushiku, Tetsuo; Nawata, Kan; Takeda, Norihiko; Watanabe, Masafumi; Akazawa, Hiroshi; Komuro, Issei

    2017-02-07

    Cardiac involvement in systemic sarcoidosis sometimes provokes life-threatening ventricular tachyarrhythmia. Steroid administration is one of the fundamental anti-arrhythmia therapies. For an indication of steroid therapy, a definitive diagnosis of sarcoidosis is required.(1)) However, cases that are clearly suspected of cardiac sarcoidosis based on their clinical courses sometimes do not meet the current diagnostic criteria and result in the loss of an appropriate opportunity to perform steroid therapy.Here we report a case that was diagnosed as sarcoidosis by incidental biopsy of an inguinal lymph node during cardiac resuscitation for cardiac tamponade.(2)) While the inguinal lymph node was not swollen on computed tomography, a specimen obtained from an incidental biopsy during the exposure of a femoral vessel for the establishment of extracorporeal cardio-pulmonary resuscitation showed a non-caseating granuloma.This findings suggest a non-swelling lymph node biopsy might be an alternative strategy for the diagnosis for sarcoidosis if other standard strategies do not result in a diagnosis of sarcoidosis.

  7. The important risk factor for lateral pelvic lymph node metastasis of lower rectal cancer is node-positive status on magnetic resonance imaging: study of the Lymph Node Committee of Japanese Society for Cancer of the Colon and Rectum.

    Science.gov (United States)

    Ogawa, Shimpei; Hida, Jin-Ichi; Ike, Hideyuki; Kinugasa, Tetsushi; Ota, Mitsuyoshi; Shinto, Eiji; Itabashi, Michio; Okamoto, Takahiro; Sugihara, Kenichi

    2016-10-01

    This study seeks to evaluate lateral pelvic lymph node (LPLN) and perirectal lymph node (PRLN) status on magnetic resonance imaging (MRI) as potential risk factors for lymph node metastasis. The subjects were 394 patients with lower rectal cancer who underwent MRI prior to mesorectal excision (combined with lateral pelvic lymph node dissection in 272 patients) at 6 institutes. No patients received neoadjuvant therapy. Cases were classified as cN(+) and cN(-) based on the short axis of the largest lymph node ≥5 and right LPLN metastasis included histopathological grade (G3 + G4), pPRLN(+), M1, cLPLN(+) [odds ratio (OR) 10.73, 95 % confidence interval (CI) 4.59-27.1], and those for left LPLN metastasis were age (right and left cLPLN status of 0.7484 (95 % CI 0.6672-0.8153) and 0.7904 (95 % CI 0.7088-0.8538), respectively, were significantly higher than those for other risk factors. In contrast, the ORs for cPRLN(+) and cPRLN status of 2.46 (95 % CI 1.47-4.18) and 0.6396 (95 % CI 0.5917-0.6848) were not much higher than for other factors. An LPLN-positive status with a short axis ≥5 mm on MRI is an important predictor of LPLN metastasis, but PRLN status is not a strong predictor of PRLN metastasis.

  8. Semi-automated volumetric analysis of artificial lymph nodes in a phantom study.

    Science.gov (United States)

    Fabel, M; Biederer, J; Jochens, A; Bornemann, L; Soza, G; Heller, M; Bolte, H

    2011-12-01

    Quantification of tumour burden in oncology requires accurate and reproducible image evaluation. The current standard is one-dimensional measurement (e.g. RECIST) with inherent disadvantages. Volumetric analysis is discussed as an alternative for therapy monitoring of lung and liver metastases. The aim of this study was to investigate the accuracy of semi-automated volumetric analysis of artificial lymph node metastases in a phantom study. Fifty artificial lymph nodes were produced in a size range from 10 to 55mm; some of them enhanced using iodine contrast media. All nodules were placed in an artificial chest phantom (artiCHEST®) within different surrounding tissues. MDCT was performed using different collimations (1-5 mm) at varying reconstruction kernels (B20f, B40f, B60f). Volume and RECIST measurements were performed using Oncology Software (Siemens Healthcare, Forchheim, Germany) and were compared to reference volume and diameter by calculating absolute percentage errors. The software performance allowed a robust volumetric analysis in a phantom setting. Unsatisfying segmentation results were frequently found for native nodules within surrounding muscle. The absolute percentage error (APE) for volumetric analysis varied between 0.01 and 225%. No significant differences were seen between different reconstruction kernels. The most unsatisfactory segmentation results occurred in higher slice thickness (4 and 5 mm). Contrast enhanced lymph nodes showed better segmentation results by trend. The semi-automated 3D-volumetric analysis software tool allows a reliable and convenient segmentation of artificial lymph nodes in a phantom setting. Lymph nodes adjacent to tissue of similar density cause segmentation problems. For volumetric analysis of lymph node metastases in clinical routine a slice thickness of ≤3mm and a medium soft reconstruction kernel (e.g. B40f for Siemens scan systems) may be a suitable compromise for semi-automated volumetric analysis. Copyright

  9. Contraindications of sentinel lymph node biopsy: Áre there any really?

    Directory of Open Access Journals (Sweden)

    Zografos George

    2007-01-01

    Full Text Available Abstract Background One of the most exciting and talked about new surgical techniques in breast cancer surgery is the sentinel lymph node biopsy. It is an alternative procedure to standard axillary lymph node dissection, which makes possible less invasive surgery and side effects for patients with early breast cancer that wouldn't benefit further from axillary lymph node clearance. Sentinel lymph node biopsy helps to accurately evaluate the status of the axilla and the extent of disease, but also determines appropriate adjuvant treatment and long-term follow-up. However, like all surgical procedures, the sentinel lymph node biopsy is not appropriate for each and every patient. Methods In this article we review the absolute and relative contraindications of the procedure in respect to clinically positive axilla, neoadjuvant therapy, tumor size, multicentric and multifocal disease, in situ carcinoma, pregnancy, age, body-mass index, allergies to dye and/or radio colloid and prior breast and/or axillary surgery. Results Certain conditions involving host factors and tumor biologic characteristics may have a negative impact on the success rate and accuracy of the procedure. The overall fraction of patients unsuitable or with multiple risk factors that may compromise the success of the sentinel lymph node biopsy, is very small. Nevertheless, these patients need to be successfully identified, appropriately advised and cautioned, and so do the surgeons that perform the procedure. Conclusion When performed by an experienced multi-disciplinary team, the SLNB is a highly effective and accurate alternative to standard level I and II axillary clearance in the vast majority of patients with early breast cancer.

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

    Energy Technology Data Exchange (ETDEWEB)

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

    2003-05-01

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

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

    Energy Technology Data Exchange (ETDEWEB)

    Holzapfel, Konstantin [Department of Radiology, Klinikum rechts der Isar, Technical University of Munich, Ismaninger Str. 22, D-81675 Munich (Germany)], E-mail: holzapfel@roe.med.tum.de; Duetsch, Sabrina; Fauser, Claudius [Department of Otorhinolaryngology, Klinikum rechts der Isar, Technical University of Munich, Ismaninger Str. 22, D-81675 Munich (Germany); Eiber, Matthias; Rummeny, Ernst J.; Gaa, Jochen [Department of Radiology, Klinikum rechts der Isar, Technical University of Munich, Ismaninger Str. 22, D-81675 Munich (Germany)

    2009-12-15

    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/mm{sup 2}. 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{sup -3} mm{sup 2}/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{sup -3} mm{sup 2}/s. Conclusion: According to our first experience, DWI using a SSEPI sequence allows reliable differentiation between benign and malignant cervical lymph nodes.

  12. Meta‐analysis of sentinel lymph node biopsy in breast cancer using the magnetic technique

    NARCIS (Netherlands)

    Zada, A.; Peek, M.C.L.; Ahmed, M.; Anninga, B.; Baker, R.; Kusakabe, M.; Sekino, M.; Klaase, J.M.; Haken, ten B.; Douek, M.

    2016-01-01

    Background The standard for sentinel lymph node biopsy (SLNB), the dual technique (radiolabelled tracer and blue dye), has several drawbacks. A novel magnetic technique without these drawbacks has been evaluated in a number of clinical trials. It uses a magnetic tracer and a handheld magnetometer to

  13. Vulvar melanoma - Is there a role for sentinel lymph node biopsy?

    NARCIS (Netherlands)

    de Hullu, JA; Hollema, H; Hoekstra, HJ; Piers, DA; Mourits, MJE; Aalders, JG; van der Zee, AGJ

    2002-01-01

    BACKGROUND. The objective of this study was to evaluate the author's recent, preliminary experience with the sentinel lymph node procedure in patient with vulvar melanoma and to compare this experience with treatment and follow-up of patients with vulvar melanomas who were treated previously at thei

  14. Current concepts in the mediastinal lymph node staging of nonsmall cell lung cancer

    NARCIS (Netherlands)

    Kramer, H; Groen, HJM

    2003-01-01

    Objective: To review the current concepts in the mediastinal staging of nonsmall cell lung cancer (NSCLC), evaluating traditional and modem staging modalities. Summary Background Data: Staging of NSCLC includes the assessment of mediastinal lymph nodes. Traditionally, computed tomography (CT) and me

  15. 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 psentinel 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...

  16. The clinicopathologic differences of central lymph node metastasis in predicting lateral lymph node metastasis and prognosis in papillary thyroid cancer associated with or without Hashimoto's thyroiditis.

    Science.gov (United States)

    Zhu, Youzhi; Zheng, Ke; Zhang, Huihao; Chen, Ling; Xue, Jiajie; Ding, Mingji; Wu, Kunlin; Wang, Zongcai; Kong, Lingjun; Chen, Xiangjin

    2016-06-01

    This study aims to evaluate the difference of central lymph node metastases (LNM) in papillary thyroid carcinoma (PTC) associated with or without Hashimoto's thyroiditis (HT) in predicting lateral node metastasis. A retrospective case control study was performed. Patients (1276) with PTC who underwent a total or near-total thyroidectomy with at least one lymph node dissection in our institution were retrospectively reviewed. All patients were divided into two groups (HT-group and non-HT group) according to the pathological diagnosis. In HT-group, the incidence of both central and lateral LNM was lower compared with non-HT group. The average of central metastatic lymph node radio (LNR) was also lower than that in Non-HT group. The multivariate analysis showed that the number of metastatic central LNs (HT ≥ 4, Non-HT ≥ 2) and the central LNR (HT ≥ 0.4, Non-HT ≥ 0.6) were independently associated with lateral LNM. Patients with HT need larger primary tumor size, more positive central LN and higher LNR to predict the presence of lateral LNM. HT may protect against central and lateral LNM in PTC. The number of positive central LNs and central LNR in PTC could be used to determine the presence of lateral LNM and inform postoperative follow-up.

  17. CCR7 as a predictive biomarker associated with computed tomography for the diagnosis of lymph node metastasis in bladder carcinoma.

    Science.gov (United States)

    Chen, Jinbo; Cui, Y U; Liu, Longfei; Li, Chao; Tang, Yunhua; Zhou, X U; Qi, Lin; Zu, Xiongbing

    2016-01-01

    The aim of the present study was to investigate whether the expression levels of CC-chemokine receptor 7 (CCR7) combined with computed tomography (CT) was associated with lymph node metastasis in bladder transitional cell carcinoma (BTCC). For this purpose, 115 cases of BTCC were analyzed at the Department of Urology of Xiangya Hospital, Central South University (Changsha, China). Preoperative CT scans of abdomen and pelvis, immunohistochemistry of CCR7 expression in the tumor specimens and pathological findings for lymph node metastasis were assessed. In addition, the sensitivity, specificity and accuracy of CCR7 and CT for the diagnosis of lymph node metastasis in BTCC were evaluated separately and jointly. The expression levels of CCR7 were observed to be significantly higher in BTCC than in normal controls (PCCR7 was an independent predictor for lymph node metastasis in BTCC (PCCR7 combined with CT scan for the diagnosis of lymph node metastasis in BTCC were 92.3, 83.6 and 70.0%, respectively. By contrast, the sensitivity, specificity and accuracy of CCR7 alone were 88.1, 69.9 and 76.5%, respectively, while the sensitivity, specificity and accuracy of CT alone were 52.4, 79.5 and 69.6%, respectively. The results of the present study indicated that CCR7 is an independent predictor of lymph node metastasis in BTCC. Therefore, the use of CCR7 combined with CT may improve the accuracy of the diagnosis of lymph node metastasis in BTCC.

  18. Comparative study of lymph node metastasis from squamous cell carcinoma and non-squamous cell carcinoma on neck CT

    Energy Technology Data Exchange (ETDEWEB)

    Lee, Hyoung Nam; Han, Jong Kyu; Kim, Hyung Hwan; Shin, Hyeong Cheol; Kim, Il Yong; Jou, Sung Shik [Dept. of Radiology, Soonchunhyang University Cheonan Hospital, Cheonan (Korea, Republic of)

    2015-04-15

    To assess the differential imaging findings of metastatic lymph nodes in squamous cell carcinoma (SCC) and non-squamous cell carcinoma (non-SCC) on neck CT and to facilitate the identification of primary focus before performing a biopsy. We retrospectively analyzed 46 patients with SCC and 50 patients with non-SCC who underwent neck CT from January 2006 to January 2011. Patients were divided into two groups; SCC and non-SCC. The total number of lymph nodes was 204 in the SCC group and 530 in the non-SCC group. Two observers were asked to assess the characteristics of abnormal lymph nodes (number, margin types, enhancement patterns, size, bilaterality, calcification, fat infiltration, conglomeration, invasion of adjacent tissue, and nodal distribution). Nodal distribution was evaluated by imaging-based nodal classification on neck CT. Between the SCC group and the non-Succ group except for cases of thyroid cancer, the number of lymph nodes and the number of lymph nodes smaller than 3 cm in the non-Succ group except for cases of thyroid cancer were significantly greater than those in the Succ group (p < 0.05). The number of lymph nodes, the number of lymph nodes smaller than 3 cm, and nodal distribution are helpful in differential diagnosis between Succ and non-Succ before performing a biopsy.

  19. Nonpalpable supraclavicular lymph nodes in lung cancer patients: preoperative characterization with 18F-FDG PET/CT.

    Science.gov (United States)

    Sung, Yon Mi; Lee, Kyung Soo; Kim, Byung-Tae; Kim, Seonwoo; Kwon, O Jung; Choi, Joon Young; Yang, Seoung-Oh

    2008-01-01

    Our purpose was to evaluate the usefulness of integrated 18F-FDG PET/CT in the detection and characterization of nonpalpable supraclavicular lymph node metastasis in patients with the initial diagnosis of lung cancer. This study was conducted from May 2005 to May 2006 and included 32 consecutively registered lung cancer patients in whom supraclavicular lymph nodes were not palpable but were identified on contrast-enhanced CT or exhibited increased FDG uptake on integrated PET/CT. Three patients had bilateral nodes, for a total of 35 nodes in the 32 patients. Results of cytologic analysis of a specimen obtained with sonographically guided fine-needle aspiration (n = 27), normal initial and follow-up sonographic findings (n = 3), and no change in the size of supraclavicular lymph nodes on follow-up sonography (n = 2) were the reference standards. The presence of supraclavicular lymph node metastasis was determined with integrated PET/CT (uptake greater than that of surrounding tissue) and contrast-enhanced CT (node short-axis diameter of 5 mm or more). The diagnostic efficacies of these methods in the detection of supraclavicular lymph node metastasis were compared. Supraclavicular lymph node metastasis was diagnosed cytologically in 12 (34%) of 35 lesions. The diagnostic accuracies of integrated PET/CT and contrast-enhanced CT in the detection of supraclavicular lymph node metastasis were 71% and 66%, respectively; the difference was not statistically significant. Although the difference was not statistically significant, the sensitivity (92%) and negative predictive value (93%) of integrated PET/CT were higher than those of contrast-enhanced CT. Because of its high sensitivity and negative predictive value, integrated PET/CT is useful in the detection and characterization of nonpalpable supraclavicular lymph nodes in lung cancer patients.

  20. Gray-scale contrast-enhanced utrasonography in detecting sentinel lymph nodes: An animal study

    Energy Technology Data Exchange (ETDEWEB)

    Wang Yuexiang, E-mail: wangyuexiang1999@sina.co [Department of Ultrasound, Chinese People' s Liberation Army General Hospital, 28 Fuxing Road, Beijing 100853 (China); Cheng Zhigang, E-mail: qlczg@sina.co [Department of Ultrasound, Chinese People' s Liberation Army General Hospital, 28 Fuxing Road, Beijing 100853 (China); Li Junlai, E-mail: junlai555@sina.co [Department of Ultrasound, Chinese People' s Liberation Army General Hospital, 28 Fuxing Road, Beijing 100853 (China); Tang Jie, E-mail: txiner@vip.sina.co [Department of Ultrasound, Chinese People' s Liberation Army General Hospital, 28 Fuxing Road, Beijing 100853 (China)

    2010-06-15

    Objective: To investigate the usefulness of gray-scale contrast-enhanced ultrasonography for detecting sentinel lymph nodes. Methods: Contrast-enhanced ultrasonography was performed in five normal dogs (four female and one male) after subcutaneous administration of a sonographic contrast agent (Sonovue, Bracco, Milan, Italy). Four distinct regions in each animal were examined. After contrast-enhanced ultrasonography, 0.8 ml of blue dye was injected into the same location as Sonovue and the sentinel lymph nodes were detected by surgical dissection. The findings of contrast-enhanced ultrasonography were compared with those of the blue dye. Results: Twenty-one sentinel lymph nodes were detected by contrast-enhanced ultrasonography while 23 were identified by blue dye with surgical dissection. Compared with the blue dye, the detection rate of enhanced ultrasonography for the sentinel lymph nodes is 91.3% (21/23). Two patterns of enhancement in the sentinel lymph nodes were observed: complete enhancement (5 sentinel lymph nodes) and partial enhancement (16 sentinel lymph nodes). The lymphatic channels were demonstrated as hyperechoic linear structures leading from the injection site and could be readily followed to their sentinel lymph nodes. Histopathologic examination showed proliferation of lymphatic follicles or lymphatic sinus in partial enhanced sentinel lymph nodes while normal lymphatic tissue was demonstrated in completely enhanced sentinel lymph nodes. Conclusions: Sonovue combined with gray-scale contrast-enhanced ultrasonography may provide a feasible method for detecting sentinel lymph nodes.

  1. Predictors to assess non-sentinel lymph node status in breast cancer patients with only one sentinel lymph node metastasis

    Institute of Scientific and Technical Information of China (English)

    YANG Ben; YANG Li; ZUO Wen-shu; GE Wen-kai; ZHENG Gang; ZHENG Mei-zhu; YU Zhi-yong

    2013-01-01

    Background The purpose of this study was to investigate the feasibility of avoiding axillary lymph node dissection (ALND) for patients with only one sentinel lymph node (SLN) metastasis.The characteristics and predictive factors for non-sentinel lymph node (NSLN) metastasis of patients with single positive SLN were also analyzed.Methods Patients with no and only one SLN metastasis (0/n and 1/n group,n ≥2) were selected from 1228 cases of invasive breast carcinoma,who underwent axillary dissection in Shandong Cancer Hospital between November 1999 and December 2011,to compare the characteristics of NSLN metastasis between them.For the 1/n group,the factors that influenced the NSLN metastasis were analyzed by univariate and multivariate analysis.Results Differences of the NSLN metastasis between the 0/n and the 1/n groups were significant (P <0.001).There was no significant difference between the axillary lymph node metastasis on level Ⅲ in 1/n group and 0/n group (P=0.570).When the total SLN number was ≥4 and with one positive case,the NSLN metastasis was not significantly different from that in the 0/n group (P=0.118).In the 1/n group,clinical tumor size (P =0.012),over-expression of Her-2 (P=0.003),tumor grade (P=-0.018) and the total number of SLN (P=-0.047) significantly correlated with non-SLN metastasis.Clinical tumor size (P=-0.015) and the expression of Her-2 (P=0.01) were independent predictive factors for non-SLN metastasis by the Logistic regression model.Conclusion Under certain conditions,breast cancer patients with single SLN metastasis could avoid ALND.

  2. Lymph node-positive prostate cancer: current issues, emerging technology and impact on clinical outcome.

    Science.gov (United States)

    Adams, Julia; Cheng, Liang

    2011-09-01

    Lymph node metastasis in patients with prostate cancer indicates a poorer prognosis compared with patients without lymph node metastasis; however, some patients with node-positive disease have long-term survival. Many studies have attempted to discern what characteristics of lymph node metastasis are prognostically significant. These characteristics include nodal tumor volume, number of positive lymph nodes, lymph node density, extranodal extension, lymphovascular invasion and tumor dedifferentiation. Favorable characteristics of regional lymph node involvement included a smaller tumor size and smaller tumor volume. However, the current staging system for prostate cancer does not provide different subclassifications for patients with node-positive prostate cancer. In recent years numerous advanced technologies for the detection of lymph node metastasis have been developed, including molecular imaging techniques and the CellSearch Circulating Tumor Cell System. With the increased detection of patients with prostate cancer, emergence of new technology to identify lymph node metastasis and the number of radical prostatectomies being performed on the rise, subclassifying patients with lymph node-positive disease is imperative. Subclassification would provide a better picture of patient prognosis and allow for a better understanding of targeted therapies to treat patients with lymph node metastasis.

  3. Occult supraclavicular lymph node metastasis identified by FDG-PET in patients with carcinoma of the uterine cervix.

    Science.gov (United States)

    Tran, Binh N; Grigsby, Perry W; Dehdashti, Farrokh; Herzog, Thomas J; Siegel, Barry A

    2003-09-01

    The objective was to evaluate the frequency and prognostic significance of occult supraclavicular lymph node metastases identified by 2-[(18)F]fluoro-2-deoxy-D-glucose-positron emission tomography (FDG-PET) in patients with cervical carcinoma. Between March 1998 and January 2002, 186 patients with a new diagnosis of cervical cancer underwent whole-body FDG-PET before therapy. Fourteen patients had abnormal FDG uptake in left supraclavicular lymph nodes without palpable disease. All 14 patients underwent sonographically guided fine-needle aspiration of the left supraclavicular lymph nodes. One patient refused therapy, 6 were treated with palliative intent, and 7 received definitive irradiation and concurrent chemotherapy. Survival was calculated by the Kaplan-Meier method. The overall frequency of FDG-positive left supraclavicular lymph nodes was 8% (14/186). Metastasis was pathologically confirmed in all 14 patients. Therefore, the positive predictive value of abnormal FDG uptake in left supraclavicular lymph nodes was 100%. Nineteen percent of all patients (35/186) had abnormal FDG uptake in para-aortic lymph nodes. The frequency of positive FDG uptake in the left supraclavicular lymph nodes was 40% (14/35) in those with para-aortic lymph node uptake and 15% in those with stage IIIb disease. The median overall survival was 7.5 months. At last follow-up, 11 patients were dead and 3 were alive with disease. All patients developed metastatic disease, most commonly to bone and lung. The positive predictive value of abnormal FDG uptake in left supraclavicular lymph nodes was 100%. Prognosis for these patients was dismal despite aggressive therapy.

  4. Optimized lymph node staging in breast cancer in the era of sentinel node biopsy

    NARCIS (Netherlands)

    Madsen, E.V.E.

    2012-01-01

    SLNB has revolutionized staging and treatment in breast cancer patients, several issues provoked renewed attention. If small lymph node metastases are relevant, the pathologist should detect them. The current Dutch pathology guideline is not sensitive enough to detect them. To obtain a 95% detection

  5. Lymph-migrating, tissue-derived dendritic cells are minor constituents within steady-state lymph nodes

    Science.gov (United States)

    Jakubzick, Claudia; Bogunovic, Milena; Bonito, Anthony J.; Kuan, Emma L.; Merad, Miriam; Randolph, Gwendalyn J.

    2008-01-01

    Observations that dendritic cells (DCs) constitutively enter afferent lymphatic vessels in many organs and that DCs in some tissues, such as the lung, turnover rapidly in the steady state have led to the concept that a major fraction of lymph node DCs are derived from migratory DCs that enter the lymph node through upstream afferent lymphatic vessels. We used the lysozyme M–Cre reporter mouse strain to assess the relationship of lymph node and nonlymphoid organ DCs. Our findings challenge the idea that a substantial proportion of lymph node DCs derive from the upstream tissue during homeostasis. Instead, our analysis suggests that nonlymphoid organ DCs comprise a major population of DCs within lymph nodes only after introduction of an inflammatory stimulus. PMID:18981237

  6. Contrast-enhanced endoscopic ultrasound in discrimination between benign and malignant mediastinal and abdominal lymph nodes.

    Science.gov (United States)

    Hocke, Michael; Menges, Markus; Topalidis, Theodor; Dietrich, Christoph F; Stallmach, Andreas

    2008-04-01

    Enlarged lymph nodes in the mediastinum reflect neoplastic, infectious or other diseases. The classification of these nodes is crucial in the management of the patient. Currently, only invasive measures obtaining tissue samples reach satisfying specificity. Contrast-enhanced endoscopic ultrasound (EUS) may offer a non-invasive alternative. A total of 122 patients (age: 63 +/- 15 years, 92 males, 30 females) with enlarged mediastinal and/or paraaortic lymph nodes diagnosed by CT scan were included in the study. EUS-guided fine needle aspiration was performed and cytologic specimens were diagnosed as representing a malignant or benign process in case of Papanicolau IV and V, or Papanicolau I and II, respectively. Based on cytology results, the investigated lymph nodes were classified as neoplastic (n = 48) or non-neoplastic lymph nodes. Using the B-mode criteria the preliminary diagnosis was confirmed in 64 out of 74 benign lymph nodes (specificity 86%). Regarding malignant lymph nodes 33 of 48 were confirmed (sensitivity 68%). Using the advanced contrast-enhanced EUS criteria the diagnosis was confirmed in 68 of 74 benign lymph nodes (specificity 91%). However, in case of malignant lymph nodes the number of correct diagnoses dropped to 29 of 48 lymph nodes (sensitivity 60%). The contrast-enhanced EUS criteria to identify benign lymph nodes and node enlargement in malignant lymphoma do not differ. If those ten patients with malignant lymphoma are excluded, the sensitivity of the contrast enhanced EUS for malignant lymph nodes rises to 73%. Contrast-enhanced EUS improves the specificity in diagnosing benign lymph nodes as compared to B-mode EUS. It does not improve the correct identification of malignant lymph nodes and cannot replace EUS-guided fine-needle aspiration.

  7. Clinicopathological features for predicting central and lateral lymph node metastasis in papillary thyroid microcarcinoma: Analysis of 66 cases that underwent central and lateral lymph node dissection.

    Science.gov (United States)

    Tao, Yang; Wang, Chongjie; Li, Liye; Xing, Haijun; Bai, Yun; Han, Bing; Liu, Zhiyan; Yang, Xiangshan; Zhu, Shourong

    2017-01-01

    Currently the surgical approach for papillary thyroid microcarcinoma (PTMC), particularly the range of lymph node dissection, remains controversial. The present study aims to evaluate the risk factors for central and lateral lymph node metastasis (CLNM and LLNM) for appropriate clinical decision of neck lymph node dissection in PTMC. A total of 66 cases of PTMC that underwent unilateral or bilateral lobectomy plus prophylactic cervical lymph node dissection were collected for clinicopathological evaluation, including age, gender, tumor size, subtypes, extrathyroidal invasion, multifocality, calcifications, loss of cellular polarity/cohesiveness (LOP/C) in the invasive front, CLNM and LLNM, and retrospectively analysis. Univariate analysis revealed that LOP/C was significantly associated with CLNM (P=0.001) and LLNM (P0.5 cm and multifocality were high-risk factors of LLNM (P=0.022, 0.044 and 0.005, respectively). Multivariable analysis revealed that LOP/C was significantly associated with CLNM [P=0.007, odds ratio (OR)=7.765, 95% confidence interval (CI)=1.773-33.996] and LLNM [P=0.029, OR=5.717, 95% CI=1.190-27.470]. Both multivariable analysis and χ(2) test revealed that CLNM was another important high-risk factor of LLNM (P=0.021, OR=5.444, 95% CI=1.290-22.969, χ(2)=17.867, PLOP/C and CLNM, which can be performed by intraoperative frozen section pathological examination. This must be considered discreetly in the case of patients with age 0.5 cm and multifocal lesions.

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

    Directory of Open Access Journals (Sweden)

    Alberto Julius Alves Wainstein

    2015-12-01

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

  9. Correlation between clinical nodal status and sentinel lymph node biopsy false negative rate after neoadjuvant chemotherapy.

    Science.gov (United States)

    Takahashi, Maiko; Jinno, Hiromitsu; Hayashida, Tetsu; Sakata, Michio; Asakura, Keiko; Kitagawa, Yuko

    2012-12-01

    Neoadjuvant chemotherapy (NAC) is the standard treatment for locally advanced breast cancer. It is now being used to treat operable breast cancer to facilitate breast-conserving surgery, but the accuracy of sentinel lymph node biopsy (SLNB) in breast cancer patients receiving NAC remains open to considerable debate. We enrolled 96 patients with stage II-III breast cancer who received NAC from January 2001 to July 2010. All patients underwent breast surgery and SLNB, followed immediately by complete axillary lymph node dissection (ALND). Sentinel lymph nodes were detected with blue dye and radiocolloid injected intradermally just above the tumor and then evaluated with hematoxylin and eosin and immunohistochemical staining. The overall identification rate for SLNB was 87.5% (84/96); the false negative rate (FNR) was 24.5% (12/49); and the accuracy rate was 85.7% (72/84). The FNR was significantly lower in clinically node-negative patients than in node-positive patients before NAC (5.5% vs. 35.5%; p=0.001). Accuracy was also significantly higher in clinically node-negative patients than in node-positive patients before NAC (97.2% vs. 77.1%; p=0.009). The FNR was 27.3% among 46 clinically node-positive patients before NAC who were clinically node-negative after NAC. Among 12 patients with a complete tumor response (CR), the FNR was 0%, compared with 26.1% for 83 patients with a partial response and stable disease (p=0.404). Although associated with a high FNR after NAC, SLNB would have successfully replaced ALND in clinically node-negative patients before NAC and in patients with a CR after NAC.

  10. 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;

    2015-01-01

    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 pat...

  11. Retroperitoneal Lymph Node Dissection as First-Line Treatment of Node-Positive Seminoma.

    Science.gov (United States)

    Hu, Brian; Shah, Swar; Shojaei, Sepehr; Daneshmand, Siamak

    2015-08-01

    The long-term morbidity associated with treating advanced seminoma can be significant. Retroperitoneal lymph node dissection (RPLND) has established oncologic efficacy in treating germ cell tumors with minimal long-term toxicity. We describe our experience with RPLND as a front-line treatment of lymph node-positive seminoma. We reviewed our institutional review board-approved testicular cancer database to find the patients with pure seminoma and isolated retroperitoneal lymph node disease who had undergone primary RPLND. The clinical and pathologic variables were obtained. The follow-up data were used to determine recurrence and death. Four patients with a mean age of 37 years were identified. All patients had normal tumor markers and retroperitoneal lymphadenopathy measuring 1.1, 1.5, 1.8, and 5.5 cm before RPLND. Of the 4 patients, 3 had had seminoma diagnosed at orchiectomy and 1 (with a 5.5-cm retroperitoneal lymphadenopathy and a burned out primary testicular mass) had had seminoma diagnosed at RPLND after 2 nondiagnostic retroperitoneal biopsies. All patients had undergone nerve-sparing, template, extraperitoneal RPLND and were discharged home after 3 days. An average of 3 positive lymph nodes were found. Of the 4 patients, 3 had pathologic stage IIA and 1 stage IIB disease, with no patient undergoing adjuvant therapy. At a mean follow-up period of 25 months, no patient had experienced disease recurrence, and none had died. All patients maintained antegrade ejaculation, and no long-term complications had developed. Our small series has demonstrated encouraging oncologic efficacy for RPLND as a primary treatment of retroperitoneal lymph node-positive seminoma. A multi-institutional phase II trial of RPLND for stage IIA seminoma is being developed. Copyright © 2015 Elsevier Inc. All rights reserved.

  12. Interval sentinel lymph nodes in melanoma: a digital pathology analysis of Ki67 expression and microvascular density.

    Science.gov (United States)

    Marinaccio, Christian; Giudice, Giuseppe; Nacchiero, Eleonora; Robusto, Fabio; Opinto, Giuseppina; Lastilla, Gaetano; Maiorano, Eugenio; Ribatti, Domenico

    2016-08-01

    The presence of interval sentinel lymph nodes in melanoma is documented in several studies, but controversies still exist about the management of these lymph nodes. In this study, an immunohistochemical evaluation of tumor cell proliferation and neo-angiogenesis has been performed with the aim of establishing a correlation between these two parameters between positive and negative interval sentinel lymph nodes. This retrospective study reviewed data of 23 patients diagnosed with melanoma. Bioptic specimens of interval sentinel lymph node were retrieved, and immunohistochemical reactions on tissue sections were performed using Ki67 as a marker of proliferation and CD31 as a blood vessel marker for the study of angiogenesis. The entire stained tissue sections for each case were digitized using Aperio Scanscope Cs whole-slide scanning platform and stored as high-resolution images. Image analysis was carried out on three selected fields of equal area using IHC Nuclear and Microvessel analysis algorithms to determine positive Ki67 nuclei and vessel number. Patients were divided into positive and negative interval sentinel lymph node groups, and the positive interval sentinel lymph node group was further divided into interval positive with micrometastasis and interval positive with macrometastasis subgroups. The analysis revealed a significant difference between positive and negative interval sentinel lymph nodes in the percentage of Ki67-positive nuclei and mean vessel number suggestive of an increased cellular proliferation and angiogenesis in positive interval sentinel lymph nodes. Further analysis in the interval positive lymph node group showed a significant difference between micro- and macrometastasis subgroups in the percentage of Ki67-positive nuclei and mean vessel number. Percentage of Ki67-positive nuclei was increased in the macrometastasis subgroup, while mean vessel number was increased in the micrometastasis subgroup. The results of this study suggest

  13. Histologic changes associated with false-negative sentinel lymph nodes after preoperative chemotherapy in patients with confirmed lymph node-positive breast cancer before treatment.

    Science.gov (United States)

    Brown, Alexandra S; Hunt, Kelly K; Shen, Jeannie; Huo, Lei; Babiera, Gildy V; Ross, Merrick I; Meric-Bernstam, Funda; Feig, Barry W; Kuerer, Henry M; Boughey, Judy C; Ching, Christine D; Gilcrease, Michael Z

    2010-06-15

    A wide range of false-negative rates has been reported for sentinel lymph node (SLN) biopsy after preoperative chemotherapy. The purpose of this study was to determine whether histologic findings in negative SLNs after preoperative chemotherapy are helpful in assessing the accuracy of SLN biopsy in patients with confirmed lymph node-positive disease before treatment. Eighty-six patients with confirmed lymph node-positive disease at presentation underwent successful SLN biopsy and axillary dissection after preoperative chemotherapy at a single institution between 1994 and 2007. Available hematoxylin and eosin-stained sections from patients with negative SLNs were reviewed, and associations between histologic findings in the negative SLNs and SLN status (true negative vs false negative) were evaluated. Forty-seven (55%) patients had at least 1 positive SLN, and 39 (45%) patients had negative SLNs. The false-negative rate was 22%, and the negative predictive value was 67%. The negative SLNs from 17 of 34 patients with available slides had focal areas of fibrosis, some with associated foamy parenchymal histiocytes, fat necrosis, or calcification. These histologic findings occurred in 15 (65%) of 23 patients with true-negative SLNs and in only 2 (18%) of 11 patients with false-negative SLNs (P = .03, Fisher exact test, 2-tailed). The lack of these histologic changes had a sensitivity and specificity for identifying a false-negative SLN of 82% and 65%, respectively. Absence of treatment effect in SLNs after chemotherapy in patients with lymph node-positive disease at initial presentation has good sensitivity but low specificity for identifying a false-negative SLN.

  14. 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.

  15. Lymphatic uptake and biodistribution of liposomes after subcutaneous injection - IV. Fate of liposomes in regional lymph nodes

    NARCIS (Netherlands)

    Oussoren, C; Scherphof, G; van der Want, JJ; van Rooijen, N; Storm, G

    1998-01-01

    The ability of clodronate-containing liposomes to deplete lymph nodes of macrophages was used as a tool to investigate the fate of liposomes in regional lymph nodes after subcutaneous (s.c.) administration. Reduced lymph node localization of liposomes in macrophage-depleted lymph nodes confirmed

  16. Quantifying the number of lymph nodes identified in one-stage versus two-stage axillary dissection in breast cancer

    DEFF Research Database (Denmark)

    Damgaard, Olaf E; Jensen, Maj-Britt; Kroman, Niels

    2013-01-01

    To establish whether a different number of lymph nodes is identified in a delayed versus an immediate axillary lymph node dissection (ALND) in breast cancer patients.......To establish whether a different number of lymph nodes is identified in a delayed versus an immediate axillary lymph node dissection (ALND) in breast cancer patients....

  17. Comparison of dual-energy CT-derived iodine content and iodine overlay of normal, inflammatory and metastatic squamous cell carcinoma cervical lymph nodes.

    Science.gov (United States)

    Tawfik, Ahmed M; Razek, A A; Kerl, J Matthias; Nour-Eldin, N E; Bauer, Ralf; Vogl, Thomas J

    2014-03-01

    To evaluate whether dual-energy computed tomography (DECT)-derived iodine content and iodine overlay could differentiate between normal, inflammatory and metastatic squamous cell carcinoma (SCC) cervical lymph nodes. This study was approved by the institutional review board. Sixteen patients with normal lymph nodes, 20 patients with enlarged nodes draining deep cervical inflammations and 23 patients with pathologically proved metastatic SCC nodes who underwent contrast enhanced DECT were retrospectively identified. Iodine content and overlay of 36 normal, 43 inflammatory and 52 metastatic lymph nodes were calculated using circular regions of interest and compared among the three groups. A receiver operating characteristic (ROC) curve was used to determine the sensitivity and specificity of iodine content and overlay for diagnosis of metastatic nodes. Iodine content (mg/ml) was significantly lower for metastatic lymph nodes (2.34 ± 0.45) than for normal (2.86 ± 0.37) and inflammatory (3.53 ± 0.56) lymph nodes, P overlay (HU) was also significantly lower for metastatic lymph nodes (47 ± 11.6) than normal (57.4 ± 8.2) and inflammatory nodes (69.3 ± 11.5), P overlay were 0.923 and 0.896. DECT-derived iodine content and overlay differ significantly among normal, inflammatory and metastatic SCC cervical lymph nodes. • Derived iodine content can be calculated from contrast-enhanced dual-energy CT. • Derived iodine content and iodine overlay could help characterise cervical lymph nodes. • Iodine parameters were significantly lower in metastatic lymph nodes than normal/inflammatory lymph nodes. • Iodine content appears more sensitive than iodine overlay for lymph node characterisation.

  18. Hsp70 vaccination-induced primary immune responses in efferent lymph of the draining lymph node.

    Science.gov (United States)

    Vrieling, Manouk; Santema, Wiebren; Vordermeier, Martin; Rutten, Victor; Koets, Ad

    2013-10-01

    Bovine paratuberculosis is a highly prevalent chronic infection of the small intestine in cattle, caused by Mycobacterium avium subspecies paratuberculosis (MAP). In earlier studies we showed the protective effect of Hsp70/DDA subunit vaccination against paratuberculosis. In the current study we set out to measure primary immune responses generated at the site of Hsp70 vaccination. Lymph vessel cannulation was performed to obtain efferent lymph from the prescapular lymph node draining the neck area where the vaccine was applied. Hsp70 vaccination induced a significant increase of CD21(+) B cells in efferent lymph, accounting for up to 40% of efferent cells post-vaccination. Proliferation (Ki67(+)) within the CD21(+) B cell and CD4(+) T cell populations peaked between day 3 and day 5 post-vaccination. From day 7, Hsp70-specific antibody secreting cells (ASCs) could be detected in efferent lymph. Hsp70-specific antibodies, mainly of the IgG1 isotype, were also detected from this time point onwards. However, post-vaccination IFN-γ production in efferent lymph was non-sustained. In conclusion, Hsp70-vaccination induces only limited Th1 type immune responsiveness as reflected in efferent lymph draining the vaccination site. This is in line with our previous observations in peripheral blood. The main primary immunological outcome of the Hsp70/DDA subunit vaccination is B cell activation and abundant Hsp70-specific IgG1 production. This warrants the question whether Hsp70-specific antibodies contribute to the observed protective effect of Hsp70 vaccination in calves.

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

    Directory of Open Access Journals (Sweden)

    Barekati Zeinab

    2012-06-01

    Full Text Available Abstract Background 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. Methods 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. Results 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 (PAPC, BMP6, BRCA1 and P16 displayed higher methylation proportion in the matched lymph node metastasis than that found in the normal tissue (PBMP6, BRCA1 and P16 have a role in prevention of neoplasm metastasis. Conclusions 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.

  20. FEATURES TOPOGRAPHY AND MACROSTRUCTURE OF LYMPH NODES IN CAMELS (Camelus dromedarius

    Directory of Open Access Journals (Sweden)

    P GAVRYLIN

    2013-03-01

    Full Text Available This study was conducted to investigate the special features of topography and macrostructure of some somatic and visceral lymph nodes of the dromedary (Camelus dromedarius. The result of the study demonstrated that the arrangement and the morphometric characteristics of some lymph nodes of camel correspond to the analogical indices of cattle. At the organ level, the lymph nodes of camel congregate; they are partially fused. A pattern of spatial orientation of these nodes is not established. Lymph nodes of dromedary (Camelus dromedarius according to their topography and linear characteristics in general correspond to the similar nodes of cattle. 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 efferent lymphatic’s. In approximately half of nodes examined, there was extra nodal communic-ations between the lymphatic vessels (afferent and efferent, allowing to bypass the lymph node. Lymph nodes are characterized by their dromedary lobule appearance and size.

  1. Management of the Regional Lymph Nodes Following Breast-Conservation Therapy for Early-Stage Breast Cancer: An Evolving Paradigm

    Energy Technology Data Exchange (ETDEWEB)

    Warren, Laura E.G. [Harvard Radiation Oncology Program, Boston, Massachusetts (United States); Punglia, Rinaa S.; Wong, Julia S. [Department of Radiation Oncology, Brigham and Women' s Hospital and Dana-Farber Cancer Institute, Boston, Massachusetts (United States); Bellon, Jennifer R., E-mail: jbellon@lroc.harvard.edu [Department of Radiation Oncology, Brigham and Women' s Hospital and Dana-Farber Cancer Institute, Boston, Massachusetts (United States)

    2014-11-15

    Radiation therapy to the breast following breast conservation surgery has been the standard of care since randomized trials demonstrated equivalent survival compared to mastectomy and improved local control and survival compared to breast conservation surgery alone. Recent controversies regarding adjuvant radiation therapy have included the potential role of additional radiation to the regional lymph nodes. This review summarizes the evolution of regional nodal management focusing on 2 topics: first, the changing paradigm with regard to surgical evaluation of the axilla; second, the role for regional lymph node irradiation and optimal design of treatment fields. Contemporary data reaffirm prior studies showing that complete axillary dissection may not provide additional benefit relative to sentinel lymph node biopsy in select patient populations. Preliminary data also suggest that directed nodal radiation therapy to the supraclavicular and internal mammary lymph nodes may prove beneficial; publication of several studies are awaited to confirm these results and to help define subgroups with the greatest likelihood of benefit.

  2. Simultaneous lymph node involvement by Castleman disease and Kaposi sarcoma

    Directory of Open Access Journals (Sweden)

    Luciana Wernersbach Pinto

    2011-02-01

    Full Text Available Both multicentric Castleman disease and Kaposi sarcoma are more frequently observed in HIV infected patients. The coexistence of these Human herpesvirus 8 related lesions, in the same tissue, has been observed, but literature reports are scant. On the other hand, the expression of HHV-8-LANA-1 is easily demonstrable by immunohistochemistry. This has been shown to be a powerful tool for the diagnosis of these entities. The aim of this report is to communicate our experience with a case of multicentric Castleman disease occurring in the setting of HIV infection, which demonstrated microscopic Kaposi sarcoma in the same lymph node during the pathological work-up

  3. Renal histology of mucocutaneous lymph node syndrome (Kawasaki disease).

    Science.gov (United States)

    Salcedo, J R; Greenberg, L; Kapur, S

    1988-01-01

    Renal involvement is well described in patients with mucocutaneous lymph node syndrome (MCLNS), or Kawasaki disease and is manifested by mild azotemia, hematuria, pyuria or cylinduria, and more often, proteinuria. Renal morphology during the acute stages of the illness has never been reported. In this paper we describe the renal histopathologic changes in a child with MCLNS. The glomerular histopathologic findings suggest immune complex damage to the kidney as a possible mechanism of nephrotoxicity in MCLNS. Presence of kidney lesions, which speak in favor of the injurious role of immune complexes in MLCNS may be relevant to the understanding of the pathogenesis of the vascular lesions that are characteristic of this disease.

  4. 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.

  5. Improved immunohistochemical evaluation of micrometastases in sentinel lymph nodes of cutaneous melanoma with 'MCW Melanoma Cocktail' – A mixture of monoclonal antibodies to MART-1, melan-A, and tyrosinase

    Directory of Open Access Journals (Sweden)

    Kampalath Bal

    2003-05-01

    Full Text Available Abstract Background MART-1, Melan-A, and Tyrosinase have shown encouraging results for evaluation of melanoma micrometastases in sentinel lymph nodes, as compared to conventionally used S-100 protein and HMB-45. To achieve higher sensitivity, some studies recommend evaluation of three sections, each at intervals of 200 μ. This would mean, routine staining of three adjacent sections in each of the three clusters at intervals of 200 μ, requiring nine slides resulting in added expense. If a cocktail of these antibodies could be used, only one section would be required instead of three generating significant cost savings. Methods We prepared a combination of monoclonal antibodies to these three immunomarkers in optimized dilutions (MART-1, clone M2-7C10, dilution 1:500; Melan-A, clone A103, dilution 1:100; and Tyrosinase, clone T311, dilution 1:50 and designated it as 'MCW melanoma cocktail'. Formalin-fixed paraffin-embedded tissue sections of sentinel lymph nodes from patients with cutaneous melanoma, without macro-metastases were evaluated with this cocktail. Results Melanoma micrometastases were easily detectable with the cocktail in 41 out of 188 slices (8/24 cases. The diagnostic accuracy amongst five pathologists did not show statistically significant difference. Out of 188 slices, 78 had adjacent sections immunostained individually with MART-1 and Melan-A during our previous study. Of these 78 slices, 21 were positive for melanoma micrometastases with MART-1 and Melan-A individually. However, the adjacent section of these slices immunostained with the cocktail detected metastases in four additional slices. Thus, MART-1 and Melan-A could not detect melanoma micrometastases individually in 16% (4/25 of slices positive with the cocktail. Benign capsular nevi were immunoreactive for the cocktail in 4.8% (9/188 slices. All 81 slices of negative test controls (sentinel lymph nodes of mammary carcinoma were interpreted correctly as negative for

  6. Comparison of the staging of regional lymph nodes using the sixth and seventh editions of the tumor-node-metastasis (TNM) classification system for the evaluation of overall survival in gastric cancer patients: findings of a case-control analysis involving a single institution in China.

    Science.gov (United States)

    Deng, Jingyu; Zhang, Rupeng; Pan, Yuan; Wang, Baogui; Wu, Liangliang; Jiao, Xuguang; Bao, Tao; Hao, Xishan; Liang, Han

    2014-07-01

    It has recently been reported that the sixth edition of the tumor-node-metastasis (TNM) classification system for gastric cancer involving the staging of regional lymph nodes (N) has inappropriate cut-offs with regard to counts of metastatic lymph nodes. It remains controversial, however, as to whether the seventh edition of this classification system is completely accurate in staging N for the prediction of the prognosis of gastric cancer. Our aim was to determine which of these two editions of the TNM classification system was superior with regard to the prediction of the prognosis of Chinese patients with gastric cancer. We analyzed relevant clinicopathological data statistically from 1,563 patients with gastric cancer who had undergone curative resection to evaluate the sixth and seventh editions of the TNM classification system for N staging with regard to the prediction of overall survival (OS). Our survival analyses demonstrated that N staging via use of both the sixth and seventh editions of the TNM classification system was correlated with OS. Furthermore, case-control analysis indicated that the seventh edition was significantly superior to the sixth edition in predicting the OS of patients, regardless of the extent of lymphadenectomy (D1 or D2) and the number of dissected lymph nodes (TNM classification system was superior to the sixth edition regarding the evaluation of the OS in the various subgroups of gastric cancer patients. The seventh edition proved more reliable and accurate than the sixth edition of the TNM classification system in categorizing the number of metastatic lymph nodes for the purpose of predicting the OS of patients with gastric cancer after curative resection. Copyright © 2014 Mosby, Inc. All rights reserved.

  7. Accuracy of internal mammary lymph node localization using lymphoscintigraphy, sonography and CT.

    NARCIS (Netherlands)

    Saarnak, A.E.; Hurkmans, C.W.; Pieters, B.R.; Valdes Olmos, R.A.; Hart, A.A.M.; Schultze Kool, L.J.; Muller, S.H.

    2002-01-01

    Background and PURPOSE: An accurate internal mammary (IM) lymph node localization technique is required for proper irradiation of the IM lymph nodes in breast cancer patients. In this study the measurement accuracy of three techniques for direct or indirect localization of the IM nodes was

  8. Ki-67 expression in axillary lymph node metastases in breast cancer is prognostically significant.

    Science.gov (United States)

    Tawfik, Kareem; Kimler, Bruce F; Davis, Marilyn K; Fan, Fang; Tawfik, Ossama

    2013-01-01

    Several studies have documented the prognostic significance of cell proliferation in breast cancer and its positive relationship with tumor grade, size, mitotic activity, hormonal and Her-2 status, and tumor progression. The Ki-67 antigen provides an accurate measure of the growth fraction of a tumor. Ki-67 expression in 103 primary breast carcinomas and their corresponding axillary lymph node metastases was correlated with age, tumor grade, size, estrogen receptor (ER), progesterone receptor (PgR), p53, epidermal growth factor receptor (EGFR), Bcl-2, Her-2 status, and patients' overall survival. Median Ki-67 expression in primary and metastatic tumors was 20% and 15%, respectively. Although there was no difference in overall survival (P = .65, log-rank test) between primary tumors with less than or at least 10% Ki-67 expression, there was significantly better overall survival when Ki-67 expression in lymph nodes was less than 10% (P = .040). For patients whose primary tumors exhibited Ki-67 expression less than 10%, most of their metastatic lesions had a similar low Ki-67; these patients had a favorable outcome. A small subgroup was noted to have a nodal Ki-67 of 10% or more and worse survival (P = .047). For patients whose primary tumors had a Ki-67 of 10% or more, most of their metastatic lesions had similar high Ki-67 values; however, a group of 12 patients had lymph node Ki-67 less than 10% and had a better overall survival (P = .092). Our results showed that measurement of Ki-67 in lymph node is superior to its evaluation in primary tumors. Identification of subgroups of patients in whom Ki-67 expression in lymph nodes differs from expression in primary tumor may assist in the selection of therapeutic options.

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

    Institute of Scientific and Technical Information of China (English)

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

    2006-01-01

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

  10. STRUCTURAL AND FUNCTIONAL CHARACTERISTICS OF THE PARENCHYMA OF THE LYMPH NODES DROMEDARY (Camelus dromedarius

    Directory of Open Access Journals (Sweden)

    Pavel GAVRILIN

    2015-09-01

    Full Text Available The study of somatic and visceral lymph nodes of mature dromedary (Camelus dromedarius has shown a structure of conglomerates, which are they made up of same subunits, the detailed histological study shows a wide parenchyma and lymphatic sinuses divided into distinct structural and functional areas (compartments. It was found that somatic lymph node (LN has an unequal development of the main components of the tissue (stroma of connective tissue, lymphatic sinuses, lymphoid parenchyma the relative area of each of them is about 30 to 35%. The richest areas in cells in the lymph nodes of the dromedary are the depth cortex units in the somatic lymph nodes and the medullar cords in visceral lymph nodes. The content in the two groups of follicles of the lymph nodes of the adult dromedary does not exceed 6%.

  11. 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.)

  12. Lymph node dissection for Siewert II esophagogastric junction adenocarcinoma

    Science.gov (United States)

    Duan, Xiao-Feng; Yue, Jie; Tang, Peng; Shang, Xiao-Bin; Jiang, Hong-Jing; Yu, Zhen-Tao

    2017-01-01

    Abstract The present study was aimed to investigate the application of right thansthoracic Ivor–Lewis (IL), left transthoracic (LTT), and left thoracoabdominal (LTA) approach in Siewert type II adenocarcinoma of esophagogastric junction (AEG). The data of 196 patients with Siewert type II AEG received surgical resection in our cancer center between January 2014 and April 2016 was retrospectively analyzed. Finally, 136 patients met the inclusion criteria were enrolled in the study and divided into the IL (47 cases), LTT (51 cases), and LTA group (38 cases). Clinical and short-term treatment effects were compared among the 3 groups. The patients with weight loss, diabetes, and heart disease increased in the LTT group (P = 0.054, P = 0.075, and P = 0.063, respectively). Operation time was significantly longest in the IL group (P  0.05), but the dissection rate of the hepatic artery, splenic artery, and celiac trunk lymph nodes was significantly highest in the IL group (P  0.05). Compared with the traditional left transthoracic approach, the Ivor–Lewis approach did not increase the perioperative mortality and complication rates in Siewert type II AEG, but obtained satisfactory length of the proximal surgical margin, and was better than the left transthoracic approach in thoracic and abdominal lymph node dissection. However, the advantages of Ivor–Lewis procedure requires further follow-up and validation through prospective randomized controlled trials. PMID:28207537

  13. Prognostic impact of metastatic lymph node ratio on gastric cancer after curative distal gastrectomy

    Institute of Scientific and Technical Information of China (English)

    2010-01-01

    AIM:To investigate the prognostic impact of metastatic lymph node ratio(rN) on gastric cancer after curative distal gastrectomy.METHODS:A total of 634 gastric cancer patients who underwent curative resection(R0) of lymph nodes at distal gastrectomy in 1995-2004.Correlations between positive nodes and retrieved nodes,between rN and retrieved nodes,and between rN and negative lymph node(LN) count were analyzed respectively.Prognostic factors were identif ied by univariate and multivariate analyses.Staging acc...

  14. Validation of the Memorial Sloan Kettering Cancer Center nomogram for predicting non-sentinel lymph node metastasis in sentinel lymph node-positive breast-cancer patients

    Directory of Open Access Journals (Sweden)

    Bi X

    2015-02-01

    Full Text Available Xiang Bi,1,* Yongsheng Wang,2 Minmin Li,1,* Peng Chen,2 Zhengbo Zhou,2 Yanbing Liu,2 Tong Zhao,2 Zhaopeng Zhang,2 Chunjian Wang,2 Xiao Sun,2 Pengfei Qiu2 1School of Medicine and Life Sciences, University of Jinan-Shandong Academy of Medical Sciences, Shandong Cancer Hospital, 2Breast Cancer Center, Shandong Cancer Hospital, Jinan, People’s Republic of China *These authors contributed equally to this study Background: The main purpose of the study reported here was to validate the clinical value of the Memorial Sloan Kettering Cancer Center (MSKCC nomogram that predicts non-sentinel lymph node (SLN metastasis in SLN-positive patients with breast cancer. Methods: Data on 1,576 patients who received sentinel lymph node biopsy (SLNB at the Shandong Cancer Hospital from December 2001 to March 2014 were collected in this study, and data on 509 patients with positive SLN were analyzed to evaluate the risk factors for non-SLN metastasis. The MSKCC nomogram was used to estimate the probability of non-SLN metastasis and was compared with actual probability after grouping into deciles. A receiver-operating characteristic (ROC curve was drawn and predictive accuracy was assessed by calculating the area under the ROC curve. Results: Tumor size, histological grade, lymphovascular invasion, multifocality, number of positive SLNs, and number of negative SLNs were correlated with non-SLN metastasis (P<0.05 by univariate analysis. However, multivariate analysis showed that tumor size (P=0.039, histological grade (P=0.043, lymphovascular invasion (P=0.001, number of positive SLNs (P=0.001, and number of negative SLNs (P=0.000 were identified as independent predictors for non-SLN metastasis. The trend of actual probability in various decile groups was comparable to the predicted probability. The area under the ROC curve was 0.722. Patients with predictive values lower than 10% (97/492, 19.7% had a frequency of non-SLN metastasis of 17.5% (17/97. Conclusion: The

  15. Improved detection of Mycobacterium bovis infection in bovine lymph node tissue using immunomagnetic separation (IMS-based methods.

    Directory of Open Access Journals (Sweden)

    Linda D Stewart

    Full Text Available Immunomagnetic separation (IMS can selectively isolate and concentrate Mycobacterium bovis cells from lymph node tissue to facilitate subsequent detection by PCR (IMS-PCR or culture (IMS-MGIT. This study describes application of these novel IMS-based methods to test for M. bovis in a survey of 280 bovine lymph nodes (206 visibly lesioned (VL, 74 non-visibly lesioned (NVL collected at slaughter as part of the Northern Ireland bovine TB eradication programme. Their performance was evaluated relative to culture. Overall, 174 (62.1% lymph node samples tested positive by culture, 162 (57.8% by IMS-PCR (targeting IS6110, and 191 (68.2% by IMS-MGIT culture. Twelve (6.9% of the 174 culture positive lymph node samples were not detected by either of the IMS-based methods. However, an additional 79 M. bovis positive lymph node samples (27 (13.1% VL and 52 (70.3% NVL were detected by the IMS-based methods and not by culture. When low numbers of viable M. bovis are present in lymph nodes (e.g. in NVLs of skin test reactor cattle decontamination prior to culture may adversely affect viability, leading to false negative culture results. In contrast, IMS specifically captures whole M. bovis cells (live, dead or potentially dormant which are not subject to any deleterious treatment before detection by PCR or MGIT culture. During this study only 2.7% of NVL lymph nodes tested culture positive, whereas 70.3% of the same samples tested M. bovis positive by the IMS-based tests. Results clearly demonstrate that not only are the IMS-based methods more rapid but they have greater detection sensitivity than the culture approach currently used for the detection of M. bovis infection in cattle. Adoption of the IMS-based methods for lymph node testing would have the potential to improve M. bovis detection in clinical samples.

  16. Predictors of lymph node count in colorectal cancer resections: data from US nationwide prospective cohort studies.

    Science.gov (United States)

    Morikawa, Teppei; Tanaka, Noriko; Kuchiba, Aya; Nosho, Katsuhiko; Yamauchi, Mai; Hornick, Jason L; Swanson, Richard S; Chan, Andrew T; Meyerhardt, Jeffrey A; Huttenhower, Curtis; Schrag, Deborah; Fuchs, Charles S; Ogino, Shuji

    2012-08-01

    To identify factors that influence the total and negative lymph node counts in colorectal cancer resection specimens independent of pathologists and surgeons. We used multivariate negative binomial regression. Covariates included age, sex, body mass index, family history of colorectal carcinoma, year of diagnosis, hospital setting, tumor location, resected colorectal length (specimen length), tumor size, circumferential growth, TNM stage, lymphocytic reactions and other pathological features, and tumor molecular features (microsatellite instability, CpG island methylator phenotype, long interspersed nucleotide element 1 [LINE-1] methylation, and BRAF, KRAS, and PIK3CA mutations). Two US nationwide prospective cohort studies. Patients with rectal and colon cancer (N=918). The negative and total node counts (continuous). Specimen length, tumor size, ascending colon location, T3N0M0 stage, and year of diagnosis were positively associated with the negative node count (all P.002). Mutation of KRAS might also be positively associated with the negative node count (P=.03; borderline significance considering multiple hypothesis testing). Among node-negative (stages I and II) cases, specimen length, tumor size, and ascending colon location remained significantly associated with the node count (all P.002), and PIK3CA and KRAS mutations might also be positively associated (P=.03 and P=.049, respectively, with borderline significance). This molecular pathological epidemiology study shows that specimen length, tumor size, tumor location, TNM stage, and year of diagnosis are operator-independent predictors of the lymph node count. These crucial variables should be examined in any future evaluation of the adequacy of lymph node harvest and nodal staging when devising individualized treatment plans for patients with colorectal cancer.

  17. A new model for predicting non-sentinel lymph node status in Chinese sentinel lymph node positive breast cancer patients.

    Directory of Open Access Journals (Sweden)

    Miao Liu

    Full Text Available BACKGROUND: Our goal is to validate the Memorial Sloan-Kettering Cancer Center (MSKCC nomogram and Stanford Online Calculator (SOC for predicting non-sentinel lymph node (NSLN metastasis in Chinese patients, and develop a new model for better prediction of NSLN metastasis. METHODS: The MSKCC nomogram and SOC were used to calculate the probability of NSLN metastasis in 120 breast cancer patients. Univariate and multivariate analyses were performed to evaluate the relationship between NSLN metastasis and clinicopathologic factors, using the medical records of the first 80 breast cancer patients. A new model predicting NSLN metastasis was developed from the 80 patients. RESULTS: The MSKCC and SOC predicted NSLN metastasis in a series of 120 patients with an area under the receiver operating characteristic curve (AUC of 0.688 and 0.734, respectively. For predicted probability cut-off points of 10%, the false-negative (FN rates of MSKCC and SOC were both 4.4%, and the negative predictive value (NPV 75.0% and 90.0%, respectively. Tumor size, Kiss-1 expression in positive SLN and size of SLN metastasis were independently associated with NSLN metastasis (p<0.05. A new model (Peking University People's Hospital, PKUPH was developed using these three variables. The MSKCC, SOC and PKUPH predicted NSLN metastasis in the second 40 patients from the 120 patients with an AUC of 0.624, 0.679 and 0.795, respectively. CONCLUSION: MSKCC nomogram and SOC did not perform as well as their original researches in Chinese patients. As a new predictor, Kiss-1 expression in positive SLN correlated independently with NSLN metastasis strongly. PKUPH model achieved higher accuracy than MSKCC and SOC in predicting NSLN metastasis in Chinese patients.

  18. A retrospective study of different local treatments in breast cancer patients with synchronous ipsilateral supraclavicular lymph node metastasis.

    Science.gov (United States)

    Chang, Xin-Zhong; Yin, Jian; Sun, Jinyan; Zhang, Xue-Hui; Cao, Xu-Chen

    2013-11-01

    To evaluate the local treatment outcome and efficacy of supraclavicular lymph node dissection and radical radiotherapy for breast cancer patients with synchronous ipsilateral supraclavicular lymph node metastasis (ISLM). A total of 29 patients with ISLM in the absence of distant metastases were retrospectively analyzed. All patients received radical or modified radical mastectomy and systemic therapy. Thirteen patients received supraclavicular lymph node dissection surgery and the other patients were treated with radical radiotherapy. At the median follow-up of 47 months, 23 patients had developed distant metastases. The 3-year distant metastasis-free survival (DMFS) rates were 46.2% for the supraclavicular lymph node dissection group and 31.3% for the radical radiotherapy group. The 5-year overall survival rates were 46.2% for the supraclavicular lymph node dissection group and 37.5% for the radical radiotherapy group. Breast cancer with ISLM should be considered as a locoregional disease. Besides systemic therapy, local therapy may be helpful in enhancing local control and correspondingly reducing distant metastasis. In some individual patients, supraclavicular lymph node dissection might get a good prognosis.

  19. 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.

  20. 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.

  1. EXPERIMENTAL STUDY OF INFLAMMATORY AND METASTATIC LYMPH NODES WITH DIFFUSION WEIGHTED IMAGING ON ANIMAL MODEL: COMPARISON WITH CONVENTIONAL METHODS

    Institute of Scientific and Technical Information of China (English)

    Hua-dan Xue; Shuo Li; Hong-yi Sun; Zheng-yu Jin; Fei Sun

    2008-01-01

    Objective To investigate the feasibility of magnetic resonance (MR) diffusion weighted imaging (DWI) in discriminating inflammatory from VX2 carcinoma metastatic lymph nodes in rabbit model. Methods Twenty New Zealand white rabbits were randomly divided into 2 groups. Complete Freund's adjuvant was injected into the bilateral dorsal footpads to set up ipsilateral lymphadenitis model (n = 10), and the other 10 rabbits received a subcutaneous implantation of VX2 tumor cell suspension (1.5×107 cells/mL) in both thighs to set up metastatic lymph node model. MR imaging scan covering the popliteal fossa and iliac fossa including short time inversion recovery echo-planar imaging DWI (STIR-EPI-DWI), T1-weighted imaging (T1WI) and T2-weighted imaging (T2WI) was performed 2 weeks after injection. T2WI signal intensity (SI), DWI SI, long/short axial ratio (LSR) and apparent diffusion coefficient (ADC) values of the lymph nodes were evaluated in all cases. Right after MR imaging scan, popliteal and iliac fossa lymph nodes were collected for hematoxylin-eosin staining. Results Totally 33 lymph nodes larger than 5 mm, including 22 inflammatory and 11 metastatic ones, were successfully isolated and taken into pathological analysis. LSR showed no significant difference between the inflammatory and malignant lymph nodes (P > 0.05). Both benign and malignant lymph nodes appeared iso-intense on TIWI and hyperintense on both T2WI and DWI images with an even lower TIWI and higher T2WI SI core at the hilum. Both T2WI and DWI SI showed no significant difference between two pathological groups (P > 0.01) in popli-teal fossa. The mean ADC value of inflammatory nodes [(1.199 ± 0.281)×10-3 mm2/s] was significantly higher than that of metastatic nodes [(0.858 ± 0.090)×10-3 mm2/s, p < 0.01]. On ADC map, a high ADC value central area could be seen in most of the lymph nodes no matter benign or malignant. ADC value gave out the largest area under curve (AUCADC = 0.955) compared with other

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

    Science.gov (United States)

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

    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 (n = 41) and positive (n = 35) lymph node status matched for possible confounding factors were subjected to laser microdissection and gene expression data generated. Although ANOVA analysis (P .001, fold-change >1.5) revealed 13 differentially expressed genes, hierarchical clustering classified 90% of node-negative but only 66% of node-positive tumors correctly. The inability to derive molecular profiles of metastasis in primary tumors may reflect tumor heterogeneity, paucity of cells within the primary tumor with metastatic potential, influence of the microenvironment, or inherited host susceptibility to metastasis. PMID:22295210

  3. Postmastectomy lymphedema: long-term results following microsurgical lymph node transplantation

    National Research Council Canada - National Science Library

    Becker, Corinne; Assouad, Jalal; Riquet, Marc; Hidden, Geneviève

    2006-01-01

    Lymphedema complicating breast cancer treatment remains a challenging problem. The purpose of this study was to analyze the long-term results following microsurgical lymph node (LN) transplantation...

  4. Cervical Lymph Node Metastasis as the Primary Presentation of Prostatic Cancer: A Rare Case Report

    Directory of Open Access Journals (Sweden)

    Bita Geramizadeh

    2014-10-01

    Full Text Available Cervical and supraclavicular lymph nodes metastases generally arise from carcinomas of the head and neck. Metastases to cervical lymph nodes from the prostate are very rare. The common site for lymph node metastasis from the prostate is infradiaphrag- matic. Herein, we report a 69 year-old male who presented with cervical lymph node enlargement in the setting of prostate cancer. This type of presentation although rare, may warrant investigating the prostate as a source of metastasis in cases where the head and neck are free from carcinoma.

  5. 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.)

  6. Robotic-Assisted Dissection of Bulky Lymph Nodes in Cervical Cancer

    Directory of Open Access Journals (Sweden)

    Ahmet Göçmen

    2014-01-01

    Full Text Available The resection of bulky lymph node metastases, which may provide a therapeutic benefit, has been proposed in several studies based on laparotomy and laparoscopy. There is no published study in the literature examining the resection of bulky lymph node metastases using a robotic technique. In this report, we presented a patient with cervical cancer who underwent robotic-assisted dissection of bulky lymph nodes. The robotic-assisted operation time was 255 minutes, and the mean console time was 215 minutes. The estimated blood loss was 70 mL. The number of lymph nodes retrieved was 28, and the number of the dissected paraaortic lymph nodes was 13. The number of the lymph node metastases was eight. The bulky lymph nodes which are difficult to be eradicated with standard radiation therapy can be resected with robotic-assisted surgery and successful resection of the lymph nodes can improve the treatment strategy. This minimal invasive technique is safe and feasible for bulky lymph node dissection.

  7. Left upper lobectomy and systematic lymph nodes dissection in enlarged pulmonary hilar lymph nodes in primary lung cancer patient by uniportal video-assisted thoracic surgery.

    Science.gov (United States)

    Fan, Jun-Qiang; Yao, Jie; Chang, Zhi-Bo; Wang, Qi

    2016-08-01

    Uniportal video-assisted thoracic surgery (VATS) anatomical pulmonary resection, with only one small incision for surgery instruments and camera insertion, requires higher operative skills, especially in the cases of the enlarged pulmonary hilar lymph nodes. With improved technology and increased experiences in VATS lobectomy, uniportal VATS lobectomy has been applied in major medical centers recently. A 67-year-old male patient with left upper peripheral lung cancer and enlarged hilar lymph nodes underwent unipotal VATS lobectomy and systemic mediastinal lymph node dissection. The patient recovered uneventfully.

  8. Accuracy of 18F-FDG PET/CT for lymph node staging in non-small-cell lung cancers

    Institute of Scientific and Technical Information of China (English)

    LIU Bao-jun; DONG Jing-cheng; XU Chang-qing; ZUO Chuan-tao; LE Jing-jing; GUAN Yi-hui; ZHAO Jun; WU Jin-feng; DUAN Xiao-hong; CAO Yu-xue

    2009-01-01

    Background This retrospective study evaluated the diagnostic accuracy of 2-(F18)-fluoro-2-deoxy-D-glucose-positron emission tomography(18F-FDG-PET)/COmputed tomography(PET/CT)in the preoperative diagnosis of metastatic mediastinal and hilar lymph node in patients with non-small-cell lung cancer(NSCLC).Methods A total of 39 patients received preoperative 18F-FDG PET/CT and the postoperative biopsy.We compared preoperative PET/CT scan results with corresponding intraoperative histopathalogic findings in 39 NSCLC patients.The sensitivity,specificity,accuracy,positive and negative predictive value of 18F-FDG PET/CT were assessed.Results Histopathologic examination confirmed metastasis in 57 out of the 208 excised lymph nodes;23 of the 57 nodes were mediastinal and hilar lymph nodes.The sensitivity,specificity,accuracy,positive predictive value and negative predictive value of PET/CT in the preoperative diagnosis of mediastinal lymph node metastasis in NSCLC patients were 65%,96.8%,92%,78.5%and 90%,respectively.Conclusions PET/CT scan showed good accuracy in the preoperative diagnosis of mediastinal and hilar lymph node metastasis in the patients with NSCLC.We recommend that PET/CT scanning be used as a first-line evaluation tool for tumor diagnosis,therapy evaluation and follow-up.

  9. Lymph node revealing solutions in colorectal cancer: should they be used routinely?

    Science.gov (United States)

    Horne, Joanne; Bateman, Adrian C; Carr, Norman J; Ryder, Isobel

    2014-05-01

    The Royal College of Pathologists (RCPath) and College of American Pathologists recommend that at least 12 lymph nodes should be harvested for adequate staging of colorectal carcinoma. Just one nodal tumour deposit upstages the malignancy from pN0 to pN1. This is critically important as node-positive patients (pN1) are considered for adjuvant chemotherapy whereas node-negative patients (pN0) may not be. It is not always easy to harvest the required number, especially in patients with rectal carcinoma who may have received neoadjuvant therapy-an increasingly common treatment. The use of neoadjuvant therapy is known to further decrease the number and size of identifiable lymph nodes within specimens, meaning that the lymph node harvest often fails to reach RCPath guidelines. Lymph node revealing solutions consisting of either single chemicals such as alcohol or acetone or compounds have been investigated to help improve the lymph node harvest in difficult specimens, for example, those received following neoadjuvant therapy. Published research evidence reviewed here suggests that lymph node revealing solutions significantly improve lymph node harvesting, and that glacial acetic acid, ethanol, water and formalin is advantageous in comparison with other revealing solutions in that it is safe, cheap, easy to use and relatively quick. However, the quantity of good evidence is limited and the clinical implications of improving lymph node harvesting require further research.

  10. 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.

  11. Sentinel lymph node detection by combined dye-isotope technique and its predictive value for cervical lymph node metastasis in patients with lingual carcinoma

    Institute of Scientific and Technical Information of China (English)

    王国慧; 樊卫; 张伟光; 彭汉伟

    2003-01-01

    Objectives To investigate the clinical value of combined dye-isotope technique in detecting sentinel lymph node (SLN) and to examine whether the characteristics of SLN accurately predict cervical lymph node metastasis in lingual carcinoma. Methods Thirty patients with lingual carcinoma without lymph metastasis were injected with a dose of about 18.5 MBq of 99mTc-SC (sulfur colloid), around the tumor tissues before surgery, and lymphoscintigraphy was performed 5, 10, 30, 60 minutes, and 6 hours after injection. In the following day, all patients were injected with isosulfan blue dye around the primary tumor during surgery to trace SLN and underwent standard cervical lymph node dissection after SLN dissection. The pathological results of SLN were compared with standard lymph node dissection for their ability to accurately predict the final pathological status of the cervical lymph nodes.Results SLN was successfully identified in 100% of the patients. Both positive and negative predictive values of SLN were 100%. The accuracy rate was 100%, and there were no false negatives. Conclusions The detection of SLN using combined dye-isotope technique could accurately predict cervical lymph node metastasis in lingual carcinoma.

  12. Scope definition and resection significance of No. 12a group lymph nodes in gastric cancer.

    Science.gov (United States)

    Huang, Yongjian; Zhu, Guangwei; Zheng, Wei; Hua, Jin; Yang, Shugang; Zhuang, Jinfu; Wang, Jinzhou; Ye, Jianxin

    2016-08-01

    A discrepancy exists between the 7th edition guidelines of the American Joint Committee on Cancer (AJCC) and the 3rd edition Japanese treatment guidelines in terms of the classification of No. 12a lymph nodes as regional or distant lymph nodes in D2 lymphadenectomy for gastric cancer. The scope definition of No. 12a lymph nodes has yet to be fully elucidated. The present study aimed to assess the appropriateness of reclassifying No. 12a lymph node metastasis as distant metastasis according to the survival rate outcome, and to provide a clear and practical definition of the No. 12a group lymph nodes of gastric cancer. A retrospective analysis was performed on patients with gastric cancer who underwent standard or greater lymphadenectomy between January 2000 and December 2009 to find an association between No. 12a node metastasis and survival outcome. The present study first presented a clear and practical scope definition of the No. 12a group lymph nodes of gastric cancer, according to our clinical experiences and practices (Table I and Fig. 1). The survival outcome of patients with gastric cancer and No. 12a lymph node metastasis was poorer compared with that of patients with no No. 12a lymph node metastasis (P=0.0003). The results were similar in stage III patients with gastric cancer (Pcancer (P=0.1968). Cox regression analysis revealed that the AJCC stage was independently associated with an unfavorable cumulative survival rate. Logistic regression analysis revealed that tumor location, AJCC stage, intravascular cancer emboli and nerve invasion were associated with No. 12a lymph node metastasis. In conclusion, the data in the present study suggested that No. 12a lymph node metastasis is associated with distant metastasis, and therefore they concur with the 7th edition AJCC gastric cancer guidelines, which appear to be correct in terms of considering No. 12a lymph node metastasis as distant metastasis.

  13. Significance of supraclavicular lymph node involvement on determination of clinical staging for thoracic esophageal carcinoma

    Energy Technology Data Exchange (ETDEWEB)

    Wu, Hong Gyun; Park, Charn II; Ha, Sung Whan; Kim, Il Han [College of Medicine, Seoul National Univ., Seoul (Korea, Republic of)

    1999-06-01

    Involvement of supraclavicular lymph nodes (SCL) is considered distant metastasis for thoracic esophageal carcinoma in AJCC staging system revised in 1997. We investigated significance of SCL involvement compared to other regional lymph node involvement. Two- hundred eighty-nine patients with unresectable esophageal carcinoma were treated with radiation therapy from June of 1979 through December 1992. of these patients, 25 were identified having SCL involvement. Survival rate and relapse patterns were compared with that of mediastinal and perigastric lymph node positive patients to evaluate prognostic significance of SCL involvement. Median survival for patients with SCL involvement was 7 months and 2- and 5-year overall survival rates were 12.0% and 4.0% respectably. Corresponding features for regional node positive patients were 9 month, 17.0% and 3.8%. There was no significant difference between two groups. There was also no difference in patterns of recurrence. Results of this analysis showed that SCL involvement should be staged as nodal disease in contrast to present classification of metastatic disease.

  14. Diagnostic Value of CT for the Detection of Cervical Lymph Node Metastases in Papillary Thyroid Carcinoma

    Energy Technology Data Exchange (ETDEWEB)

    Son, Kyu Ri [Boramae Medical Center, Seoul (Korea, Republic of); Na, Dong Gyu; Chang, Kee Hyun [Seoul National University Hospital, Seoul (Korea, Republic of)

    2009-06-15

    To determine the diagnostic accuracy of CT for the detection of cervical lymph node metastases in patients with papillary thyroid carcinoma (PTC). Two hundred twelve consecutive patients with surgically proven PTC were included in this study. CT images were retrospectively evaluated to determine the presence of a node metastasis using morphologic CT criteria (at least one of the following: strong nodal enhancement without hilar vessel enhancement, heterogeneous enhancement, calcification, and cystic change). The diagnostic accuracy of CT for the diagnosis of a metastatic lymph node was assessed using a level-bylevel analysis. The accuracy of the CT finding for strong nodal enhancement was greater than the other morphologic CT criteria (81.6% and 74.5-78.5%, respectively). The sensitivity, specificity, and accuracy were 64.4%, 91.4%, and 84.3% by the morphologic CT criteria, and were 34.6%, 93.9%, and 78.2% by size criteria, respectively. The morphologic CT criteria are more accurate than the size criteria in the detection of cervical lymph node metastases in patients with papillary thyroid carcinoma; and, strong nodal enhancement on a CT scan is the most important factor for its diagnostic accuracy.

  15. Segmental gastrectomy with radical lymph node dissection for early gastric cancer

    Institute of Scientific and Technical Information of China (English)

    Takeru; Matsuda; Kunihiko; Kaneda; Manabu; Takamatsu; Keishi; Aishin; Masahide; Awazu; Akiko; Okamoto; Katsunori; Kawaguchi

    2010-01-01

    AIM: To describe a new surgical technique and evaluate the early results of segmental gastrectomy (SG) with modified D2 lymph node (LN) dissection for early gastric cancer (EGC). METHODS: Fourteen patients with EGC underwent SG with modified D2 dissection from 2006 to 2008. Their operative results and postoperative courses were compared with those of 17 patients who had distal gastrectomy (DG) for EGC during the same period. RESULTS: Operating time, blood loss, and hospital stay were similar between the 2 g...

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

    Directory of Open Access Journals (Sweden)

    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.

  17. Nodal ratio of positive to excised nodes, but not number of positive lymph nodes is better to predict group to avoid chemotherapy among postmenopausal ER-positive, lymph node-positive T1-T2 breast cancer patients

    Directory of Open Access Journals (Sweden)

    X Q Jia

    2015-01-01

    Conclusion: This retrospective analysis demonstrates that NR of positive to excised nodes, but not number of positive lymph nodes is better to predict group to avoid chemotherapy among postmenopausal ER-positive, lymph node-positive T1-T2 breast cancer patients.

  18. Comparative study between ultrasound-guided fine needle aspiration cytology of axillary lymph nodes and sentinel lymph node histopathology in early-stage breast cancer

    Science.gov (United States)

    Cardoso-Coelho, Lívio Portela; Borges, Rafael Soares; Alencar, Airlane Pereira; Cardoso-Campos-Verdes, Larysse Maira; da Silva-Sampaio, João Paulo; Borges, Umbelina Soares; Gebrim, Luiz Henrique; da Silva, Benedito Borges

    2017-01-01

    The replacement of sentinel lymph node biopsy (SNB) by ultrasound-guided fine-needle aspiration (US-guided FNA) cytology of axillary lymph nodes is controversial, despite the simplicity and reduced cost of the latter. In the present study, US-guided FNA was performed in 27 patients with early-stage breast cancer for comparison with SNB. Data were analyzed by calculation of sample proportions. Tumor subtypes included invasive ductal carcinoma (85%), invasive lobular carcinoma (7%), and tubular and metaplastic carcinoma (4%). FNA had a sensitivity of 45%, specificity of 100%, positive predictive value of 100% and a negative predictive value of 73%. Axillary lymph node cytology obtained by US guided-FNA in patients with breast cancer had a specificity similar to that of sentinel lymph node histopathology in the presence of axillary node metastases. However, when lymph node cytology is negative, it does not exclude the existence of metastatic implants, due to its low sensitivity in comparison to sentinel lymph node histopathology. PMID:28521436

  19. Comparison of dual-energy CT-derived iodine content and iodine overlay of normal, inflammatory and metastatic squamous cell carcinoma cervical lymph nodes

    Energy Technology Data Exchange (ETDEWEB)

    Tawfik, Ahmed M. [Johan Wolfgang Goethe University Hospital, Department of Diagnostic and Interventional Radiology, Frankfurt am Main, Hessen (Germany); Mansoura University Hospital, Department of Diagnostic and Interventional Radiology, Mansoura (Egypt); Razek, A.A. [Mansoura University Hospital, Department of Diagnostic and Interventional Radiology, Mansoura (Egypt); Kerl, J.M.; Nour-Eldin, N.E.; Bauer, Ralf; Vogl, Thomas J. [Johan Wolfgang Goethe University Hospital, Department of Diagnostic and Interventional Radiology, Frankfurt am Main, Hessen (Germany)

    2014-03-15

    To evaluate whether dual-energy computed tomography (DECT)-derived iodine content and iodine overlay could differentiate between normal, inflammatory and metastatic squamous cell carcinoma (SCC) cervical lymph nodes. This study was approved by the institutional review board. Sixteen patients with normal lymph nodes, 20 patients with enlarged nodes draining deep cervical inflammations and 23 patients with pathologically proved metastatic SCC nodes who underwent contrast enhanced DECT were retrospectively identified. Iodine content and overlay of 36 normal, 43 inflammatory and 52 metastatic lymph nodes were calculated using circular regions of interest and compared among the three groups. A receiver operating characteristic (ROC) curve was used to determine the sensitivity and specificity of iodine content and overlay for diagnosis of metastatic nodes. Iodine content (mg/ml) was significantly lower for metastatic lymph nodes (2.34 ± 0.45) than for normal (2.86 ± 0.37) and inflammatory (3.53 ± 0.56) lymph nodes, P < 0.0001. Iodine overlay (HU) was also significantly lower for metastatic lymph nodes (47 ± 11.6) than normal (57.4 ± 8.2) and inflammatory nodes (69.3 ± 11.5), P < 0.0001. The areas under the ROC curve for iodine content and iodine overlay were 0.923 and 0.896. DECT-derived iodine content and overlay differ significantly among normal, inflammatory and metastatic SCC cervical lymph nodes. (orig.)

  20. 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

  1. Internal mammary lymph nodes as incidental findings at screening breast MRI.

    Science.gov (United States)

    Ray, Kimberly M; Munir, Reema; Wisner, Dorota J; Azziz, Ania; Holland, Belinda Chang; Kornak, John; Joe, Bonnie N

    2015-01-01

    To evaluate the prevalence of internal mammary lymph nodes (IMLNs) on breast magnetic resonance imaging (MRI) in a screening population. We retrospectively reviewed 92 consecutive screening breast MRI exams. Logistic regression was performed to ascertain the risk of IMLNs in cancer-free subjects and to determine whether the risk varies with age. IMLNs were present in 48.9% of patients. Mean node size was 4 mm (range, 3-10 mm). The prevalence of IMLNs was not related to age. No patients developed breast cancer after a mean follow-up of 3 years. Subcentimeter IMLNs are common incidental findings at screening breast MRI. Published by Elsevier Inc.

  2. Semi-automated volumetric analysis of lymph node metastases during follow-up--initial results.

    Science.gov (United States)

    Fabel, Michael; Bolte, H; von Tengg-Kobligk, H; Bornemann, L; Dicken, V; Delorme, S; Kauczor, H-U; Heller, M; Biederer, J

    2011-04-01

    Quantification of tumour burden in oncology requires accurate and reproducible evaluation. The current standard is RECIST measurement with its inherent disadvantages. Volumetric analysis is an alternative for therapy monitoring. The aim of this study was to evaluate the feasibility of volumetric analysis of lymph node metastases using a software prototype in a follow-up setting. MSCT was performed in 50 patients covering the chest, abdomen and pelvis. A total of 174 suspicious lymph nodes were evaluated by two radiologists regarding short axis diameters and volumetric analysis using semi-automated software. Quality of segmentation, time, maximum diameter and volume were documented. Variability of the derived change rates was computed as the standard deviation of the difference of the obtained respective change rates. The software performance provides robust volumetric analysis. Quality of segmentation was rated acceptable to excellent in 76-79% by each reader. Mean time spent per lesion was 38 s. The variability of change in effective diameters was 10.6%; for change rates of RECIST maximum diameter variability was 27.5%. Semi-automated volumetric analysis allows fast and convenient segmentation of most lymph node metastases. Compared with RECIST the inter-observer-variability in baseline and follow-up is reduced. This should principally allow subtle changes to be subclassified within the RECIST stable range as minor response [-15% to +10%].

  3. Inverse association between visceral obesity and lymph node metastasis in gastric cancer.

    Science.gov (United States)

    Park, Se Woo; Lee, Hang Lak; Ju, Yong Won; Jun, Dae Won; Lee, Oh Young; Han, Dong Soo; Yoon, Byung Chul; Choi, Ho Soon; Hahm, Joon Soo

    2015-02-01

    The relationship between fat distribution and lymph node metastasis has not been well studied. The goal of this study was to determine the impact of visceral obesity on lymph node metastasis in gastric cancer. Metastatic lymph node ratio (MLR) was defined as the number of involved nodes by tumor divided by the total number of resected lymph nodes. Visceral (VFA) and subcutaneous fat areas (SFA) were determined by measuring abdominal fat volume distribution via CT scan, and visceral obesity was defined as a VFA to total fat area ratio (V/T) >0.29. With lymph node metastasis as a dependent variable, the following factors were significant in multivariate analysis among 495 patients: pathologic T stage (P obesity defined by higher visceral to total fat area ratio was significantly associated with decreased MLR.

  4. Malignant Adenomyoepithelioma of the Breast with Lymph Node Metastasis: A Detailed Immunohistochemical Study

    Directory of Open Access Journals (Sweden)

    Ahlam A. Awamleh

    2012-01-01

    Full Text Available Malignant adenomyoepithelioma of the breast is a rare tumour with around 30 cases reported in the literature. Metastases associated with these tumours are usually haematogenous. Axillary lymph node metastases are thought to be unusual, and it has been recently suggested that axillary node dissection is not indicated unless clinically palpable. We here present a case of a 63-year-old woman, who developed a malignant adenomyoepithelioma with axillary lymph node metastasis, that included epithelial and myoepithelial elements, in spite of the absence of clinically enlarged nodes. We suggest that histological examination of axillary sentinel node(s or node sampling may be worthwhile in this condition.

  5. Integrated ratio of metastatic to examined lymph nodes and number of metastatic lymph nodes into the AJCC staging system for colon cancer.

    Directory of Open Access Journals (Sweden)

    Peng Gao

    Full Text Available OBJECTIVE: At present, only the number of metastatic lymph nodes (LNs+ is used for the pN category of AJCC TNM system for colon cancer. Recently, the ratio of metastatic to examined lymph nodes (LNR has been reported to represent powerful independent predictive capacity in colon cancer. We sought to propose a novel category (nLN which intergrades LNR and LNs+ into the AJCC staging system for colon cancer. DESIGN: 34476 patients from the National Cancer Institute's Surveillance, Epidemiology, and End Results (SEER dataset with stage III colon cancer were reviewed. Harrell's C statistic was used to evaluate the predictive capacity. The Cox proportional hazards model was used to construct a novel category. RESULTS: The LNR category had more predictive capacity than the pN category in whole groups of patients (Harrell's C index: 0.6194 vs 0.6113, p = 0.003. Subgroup analysis showed that the LNR category was not better than pN category in predictive capacity if the number of lymph nodes examined was more than 13. We also found that there was significant survival heterogeneity among different pN categories at the same LNR category (P<0.001. The Harrell's C index for our nLN category which intergrades LNR and LNs+ was 0.6228, which was significant higher than that of the pN category (Harrell's C index: 0.6113, P<0.001 or LNR category (Harrell's C index: 0.6194, P = 0.005, respectively. CONCLUSION: To evaluate the prognosis of colon cancer, our nLN category which intergrades LNR with LNs+ is more accurate than the pN category or LNR category, respectively.

  6. Lymphangiogenesis and lymph node metastasis in breast cancer

    Directory of Open Access Journals (Sweden)

    Subramanian Ashok

    2008-03-01

    Full Text Available Abstract Introduction There have been few studies on lymphangiogenesis in the past due to the lack of specific lymphatic endothelial markers, and lymphatic-specific growth factors. Recently, these limitations have been relieved by the discovery of a small number of potential lymphatic-specific markers. The relationship between lymphangiogenesis and regional or distant metastasis has not previously been investigated in humans. Using these lymphatic markers, it is possible to explore the relationship between lymphangiogenesis and tumour metastasis. This study indirectly quantified lymphangiogenesis by measuring mRNA expression of all seven lymphatic markers described above in breast cancers and correlated these markers with lymphatic involvement and survival. The cDNA from 153 frozen archived breast samples were analysed with Q-PCR for all seven lymphangiogenic markers. This was correlated with various prognostic factors as well as patient survival. Results There was significantly greater expression of all 7 markers in malignant compared to benign breast tissue. In addition, there was greater expression in lymph node positive/grade 3 tumours when compared to lymph node negative/grade 1 tumours. In 5 of the markers, there was a greater expression in poor NPI prognostic tumours when compared to favourable prognostic tumours which was not statistically significant. There was no association between recurrence risk and lymphangiogenic marker expression. Conclusion In summary, the findings from this study show that lymphangiogenesis, measured by specific lymphatic marker expression, is higher in breast cancers than in normal breast tissue. Secondly, breast cancers which have metastasised to the regional lymphatics show higher expression compared to those which have not, although the individual differences for all five markers were not statistically significant.

  7. Sentinel lymph node mapping with indocyanine green in vaginal cancer.

    Science.gov (United States)

    Lee, In Ok; Lee, Jung Yun; Kim, Sunghoon; Kim, Sang Wun; Kim, Young Tae; Nam, Eun Ji

    2017-07-01

    Sentinel lymph node (SLN) mapping is being adapted to gynecologic cancer. Higher SLN mapping rates were reported with indocyanine green (ICG) compared to other dyes. The aim of this film is to share our experience of SLN mapping with ICG in vaginal cancer. A 40 year-old woman was diagnosed with squamous cell vaginal cancer. About 1.5 cm-sized tumor was located on the posterior vaginal fornix. Preoperatively she was assumed to be stage I vaginal cancer. Beginning of surgery, we performed SLN mapping by ICG injection into 3- and 9-o'clock positions of the vaginal tumor. Concentrated in 1.25 mg/mL, 1 mL of ICG solution was injected into deep stroma and another 1 mL submucosally in both sides. Bilateral SLN identification and lymphadenectomy were done. Afterward, laparoscopic Type C1 Querleu-Morrow radical hysterectomy with vaginectomy was done. A fluorescence endoscope produced by KARL STORZ (Tuttlingen, Germany) was used for ICG detection. To our knowledge, this is the first film report performing SLN mapping with ICG in vaginal cancer. The mapping was successful and we were able to recognize SLN of vaginal cancer. SLNs were located in the bilateral obturator fossa. According to the pathologic diagnosis, the mass size was 15 mm and invasion depth was 1 mm. Subvaginal tissue involvement and pelvic wall extension were absent. Resection margin of the vagina was free from carcinoma. No lymph node metastasis was reported including the bilateral SLNs. For vaginal cancer, SLN mapping can be applied by injecting ICG into the bilateral sides of the vaginal tumor.

  8. Robot - assisted laparoscopic retroperitoneal lymph node dissection in testicular tumor

    Science.gov (United States)

    Torricelli, Fabio C. M.; Jardim, Denis; Guglielmetti, Giuliano B.; Patel, Vipul; Coelho, Rafael F.

    2017-01-01

    ABSTRACT Introduction and objective Retroperitoneal lymph node dissection (RPLND) is indicated for patients with non-seminomatous germ cell tumor (NSGCT) with residual disease after chemotherapy. Although the gold standard approach is still the open surgery, few cases of robot-assisted laparoscopic RPLND have been described. Herein, we aim to present the surgical technique for robot-assisted laparoscopic RPLND. Patient and method A 30 year-old asymptomatic man presented with left testicular swelling for 2 months. Physical examination revealed an enlarged and hard left testis. Alpha-fetoprotein (>1000ng/mL) and beta-HCG (>24.000U/L) were increased. Beta-HCG increased to >112.000U/L in less than one month. The patient underwent a left orchiectomy. Pathological examination showed a mixed NSGCT (50% embryonal carcinoma; 30% teratoma; 10% yolk sac; 10% choriocarcinoma). Computed tomography scan revealed a large tumor mass close to the left renal hilum (10x4x4cm) and others enlarged paracaval and paraortic lymph nodes (T2N3M1S3-stage III). Patient was submitted to 4 cycles of BEP with satisfactory response. Residual mass was suggestive of teratoma. Based on these findings, he was submitted to a robot-assisted RPLND. Results RPLND was uneventfully performed. Operative time was 3.5 hours. Blood loss was minimal, and there were no intra- or postoperative complications. The patient was discharged from hospital in the 1st postoperative day. Pathological examination showed a pure teratoma. After 6 months of follow-up, patient is asymptomatic with an alpha-fetoprotein of 2.9ng/mL and an undetectable beta-HCG. Conclusion Robot-assisted laparoscopic RPLND is a feasible procedure with acceptable morbidity even for post chemotherapy patients when performed by an experienced surgeon.

  9. LYMPH NODE ASPIRATION CYTOLOGY FINDING IN HIV INFECTED CASES OF A RURAL POPULATION IN SOUTH INDIA

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    Amrutha

    2015-10-01

    Full Text Available OBJECTIVE: To evaluate the findings of aspiration cytology of lymph nodes in HIV infected subjects in a rural population. STUDY DESIGN: The study was conducted in rural population of field practice area of Kamineni institute of medical sciences ( KIMS, Narketpally, Nalgonda. Fine needle aspiration ( FNA was done from different lymph - node site from 50 HIV infected subjects, both air dried and wet smears were prepared. Routine cytology stains and when required special stain were done. Detailed cytomorphological study was conducted. RESULTS: Tuberculus lymphadenitis 28(56% was most common finding followed by reactive lymphadenitis 14(28%, G ranulomatous lymphadenitis 6(12% and suppurative lymphadenitis 2(4%. No other opportunistic infection or malignancy was seen in our study. CONCLUSION: Tuberculus lymphadenitis is the most common cause of lymphadenopathy in HIV infected individuals follow ed by reactive lympadenitis. Fine needle aspiration cytology ( FNAC is a very useful tool in early diagnosis of opportunistic infection and in providing appropriate treatment .

  10. The Significance of CXCR4 Expression for the Prediction of Lymph Node Metastasis in Breast Cancer Patients

    Institute of Scientific and Technical Information of China (English)

    Yongxing Ding; Chenghua Li; Qingling Yang; Changjie Chen; Zenong Cheng

    2008-01-01

    OBJECTIVE The chemokine receptor (CXCR4) CXC chemokine receptor 4) plays an important role in cancer metastasis. We therefore studied differential expression of the CXCR4, as well as that of the biomarker HER2, so as to evaluate whether these biomarkers can be used to predict axillary lymph node metastasis in breast cancer patients.METHODS Immunohistochemistry was used to evaluate the CXCR4 and HER2 expressions and to examine the paraffin sections of the breast cancers at various stages. Positive lymph node expression was found in 80 of the cases, and in 7 there was negative expression.RESULTS Compared to the cases with negative lymph nodes,there was a high expression of CXCR4 (26.3% vs. 14.3%, P = 0.013),and an over-expression of HER2 (28.8% vs. 14.3%, P = 0.011).Moreover, there was a direct correlation between the CXCR4 and HER2 expressions and the tumor staging (P = 0.000) and lymph node metastasis (P = 0.032). When the two biomarkers, I.e. CXCR4 and HER2, were concurrently labeled, a high expression of one of the biomarkers could be seen in the cases with positive lymph nodes (51.3% vs. 28.6%, P < 0.003).CONCLUSION The chemokine receptor, CXCR4, is a new-type biomarker in predicting axillary lymph-node metastasis in breast cancers. Compared with the other markers, such as HER2 etc.,assessment of CXCR4 can improve the prediction of the presence and extent of lymph node involvement.

  11. CT texture analysis can help differentiate between malignant and benign lymph nodes in the mediastinum in patients suspected for lung cancer

    DEFF Research Database (Denmark)

    Andersen, Michael Brun; Harders, Stefan Walbom; Ganeshan, Balaji;

    2016-01-01

    BACKGROUND: In patients with non-small-cell lung carcinoma NSCLC the lymph node staging in the mediastinum is important due to impact on management and prognosis. Computed tomography texture analysis (CTTA) is a postprocessing technique that can evaluate the heterogeneity of marked regions...... in images. PURPOSE: To evaluate if CTTA can differentiate between malignant and benign lymph nodes in a cohort of patients with suspected lung cancer. MATERIAL AND METHODS: With tissue sampling as reference standard, 46 lymph nodes from 29 patients were analyzed using CTTA. For each lymph node, CTTA...... in differentiating between malignant and benign lymph nodes in the mediastinum in patients suspected for lung cancer, with a low intra-observer variance....

  12. Utility of Thyroglobulin measurement in fine-needle aspiration biopsy specimens of lymph nodes in the diagnosis of recurrent thyroid carcinoma

    Directory of Open Access Journals (Sweden)

    Baloch Zubair W

    2008-01-01

    Full Text Available Abstract Introduction The most common site for the metastasis of papillary carcinoma of the thyroid (PTC is regional lymph nodes. Ultrasound (US imaging may identify abnormal appearing lymph nodes, suspicious for PTC recurrence. Although fine needle aspiration biopsy (FNAB of abnormal lymph nodes is often diagnostic of recurrence, small or cystic lymph nodes may be non-diagnostic due to lack of tumor cells. The measurement of thyroglobulin (TG levels in FNAB specimens from lymph nodes suspicious for recurrent PTC can serve as an adjunct to the cytologic diagnosis. Materials and methods 115 abnormal appearing lymph nodes were aspirated under ultrasound guidance in 89 patients with history of thyroid carcinoma. In addition to obtaining material for cytologic interpretation, an additional aspirate was obtained by FNAB and rinsed in 1 ml of normal saline for TG level measurements. Results The cytologic diagnoses included: 35 (30% reactive lymph node, no tumor seen (NTS, 39 (34% PTC, 23 (20% inadequate for evaluation due to lack of lymphoid or epithelial cells (NDX 15 (13% atypical/suspicious for PTC, and 3 (3% other (e.g. paraganglioma, poorly differentiated carcinoma and carcinoma not otherwise specified. TG levels were markedly elevated (median 312 ng/ml; normal Conclusion The measurement of TG in FNAB specimens from lymph node in patients with history of PTC is useful in detecting recurrent disease, especially in cases when the specimen is known to be or likely to be inadequate for cytologic evaluation.

  13. 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.

  14. FDG-PET for axillary lymph node staging in primary breast cancer

    Energy Technology Data Exchange (ETDEWEB)

    Crippa, Flavio; Gerali, Alberto; Alessi, Alessandra; Bombardieri, Emilio [Division of Nuclear Medicine, PET Center, Istituto Nazionale per lo Studio e la Cura dei Tumori, Via Venezian 1, 20133, Milan (Italy); Agresti, Roberto [Division of Surgical Oncology, Breast Unit, Istituto Nazionale per lo Studio e la Cura dei Tumori, Milan (Italy)

    2004-06-01

    Management of the axilla in patients with operable breast cancer is still one of the most controversial areas in clinical oncology. The best procedure to examine the lymph nodes is still standard axillary lymph node dissection; nevertheless, the morbidity associated with this procedure is well known. Based on these considerations, it is important for progress in the treatment of operable breast cancer that strategies are found that permit a less invasive method of axillary sampling which does not impair the patient's quality of life. The technique of sentinel lymph node (SLN) biopsy has recently been proposed for this purpose, with very important results. SLN has now become routine practice in the surgical management of breast cancer, and in many institutions patients with a negative SLN biopsy are spared axillary dissection, while those with a positive SLN biopsy are submitted to axillary node dissection. The good accuracy of SLN biopsy represents a significant advance in the management of primary breast cancer; however, false negative axillary results can occur in a variable percentage of patients, and the contribution of the SLN procedure to the detection of metastases in the internal mammary and supraclavicular lymph nodes is not clear. Among the recently developed imaging modalities, positron emission tomography (PET) with {sup 18}F-fluorodeoxyglucose (FDG) has in particular been applied to the study of lymph node metastases in cancer patients. Several clinical studies have been carried out to evaluate the accuracy of PET in the axillary staging of operable primary breast cancer. These studies have sometimes provided conflicting results, either supporting the possibility of using FDG-PET to select patients who need axillary dissection or questioning whether FDG-PET can accurately assess the axillary status in primary breast cancer. All the limitations and the advantages of FDG-PET are discussed in this paper, by examining the performance of scanner

  15. Computed tomography–based distribution of involved lymph nodes in patients with upper esophageal cancer

    Science.gov (United States)

    Li, M.; Liu, Y.; Xu, L.; Huang, Y.; Li, W.; Yu, J.; Kong, L.

    2015-01-01

    Background Delineating the nodal clinical target volume (ctvn) remains a challenging task in patients with cervical or upper thoracic esophageal carcinoma (ec). In particular, the extent of the lymph area that should be included in the irradiation field remains controversial. In the present study, the extent of the ctvn was determined based on the incidence of lymph node involvement mapped by computed tomography (ct) imaging. Methods Our study included 468 patients who were diagnosed with cervical and upper thoracic ec and who received staging information between June 2005 and April 2011. The anatomic distribution of metastatic regional lymph nodes was mapped using ct images and grouped using the levels established by the Radiation Therapy Oncology Group. The probability of the various groups being involved was examined. If a lymph node group had a probability of 10% or more of being involved, it was considered at high risk for metastasis, and elective treatment as part of the ctvn was recommended. Results Lymph node involvement was mapped by ct in 256 patients (54.7%). Not all lymph node groups should be included in the ctvn. For cervical lesions, the involved lymph nodes were located mainly between the hyoid bone and the arcus aortae; the recommended ctvn should consist of the neck lymph nodes at levels iii and iv (supraclavicular group) and thoracic groups 2 and 3P. In upper thoracic ec patients, most of the involved lymph nodes were distributed between the cricoid cartilage and the subcarinal area; the ctvn should cover the supraclavicular group and thoracic nodal groups 2, 3P, 4, 5, and 7. Conclusions Our ct-based study indicates a specific distribution and incidence of metastatic lymph node groups in patients with cervical and upper thoracic ec. The results suggest that regional lymph node groups should be electively included in the ctvn for precise radiation administration. PMID:26089729

  16. Computed tomography-based distribution of involved lymph nodes in patients with upper esophageal cancer.

    Science.gov (United States)

    Li, M; Liu, Y; Xu, L; Huang, Y; Li, W; Yu, J; Kong, L

    2015-06-01

    Delineating the nodal clinical target volume (ctvn) remains a challenging task in patients with cervical or upper thoracic esophageal carcinoma (ec). In particular, the extent of the lymph area that should be included in the irradiation field remains controversial. In the present study, the extent of the ctvn was determined based on the incidence of lymph node involvement mapped by computed tomography (ct) imaging. Our study included 468 patients who were diagnosed with cervical and upper thoracic ec and who received staging information between June 2005 and April 2011. The anatomic distribution of metastatic regional lymph nodes was mapped using ct images and grouped using the levels established by the Radiation Therapy Oncology Group. The probability of the various groups being involved was examined. If a lymph node group had a probability of 10% or more of being involved, it was considered at high risk for metastasis, and elective treatment as part of the ctvn was recommended. Lymph node involvement was mapped by ct in 256 patients (54.7%). Not all lymph node groups should be included in the ctvn. For cervical lesions, the involved lymph nodes were located mainly between the hyoid bone and the arcus aortae; the recommended ctvn should consist of the neck lymph nodes at levels iii and iv (supraclavicular group) and thoracic groups 2 and 3P. In upper thoracic ec patients, most of the involved lymph nodes were distributed between the cricoid cartilage and the subcarinal area; the ctvn should cover the supraclavicular group and thoracic nodal groups 2, 3P, 4, 5, and 7. Our ct-based study indicates a specific distribution and incidence of metastatic lymph node groups in patients with cervical and upper thoracic ec. The results suggest that regional lymph node groups should be electively included in the ctvn for precise radiation administration.

  17. 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...

  18. Quantitative analysis of superparamagnetic contrast agent in sentinel lymph nodes using ex vivo vibrating sample magnetometry

    NARCIS (Netherlands)

    Visscher, M.; Pouw, Joost Jacob; van Baarlen, J.; Klaase, J.M.; ten Haken, Bernard

    2013-01-01

    As the first step in developing a new clinical technique for the magnetic detection of colorectal sentinel lymph nodes (SLNs), a method is developed to measure the magnetic content in intact, formalin fixated lymph nodes using a vibrating sample magnetometer (VSM). A suspension of superparamagnetic

  19. Lymphatic Vessel Function and Lymphatic Growth Factor Secretion after Microvascular Lymph Node Transfer in Lymphedema Patients

    Directory of Open Access Journals (Sweden)

    Tiina P. Viitanen, MD

    2013-05-01

    Conclusions: Reconstructing the lymphatic anatomy of the axilla with a lymph node flap may offer possibilities that other reconstructive options are lacking. However, we will need further reports and comparative studies about the clinical efficacy of this new promising technique. In addition to the transferred lymph nodes, lymphatic growth factor production may also be induced by other factors related to microvascular breast reconstruction.

  20. 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

  1. Assessment of Risk Reduction for Lymphedema Following Sentinel Lymph Noded Guided Surgery for Primary Breast Cancer

    Science.gov (United States)

    2006-10-01

    Lymphedema Following Sentinel Lymph Noded Guided Surgery for Primary Breast Cancer PRINCIPAL INVESTIGATOR: Andrea L. Cheville, M.D...5a. CONTRACT NUMBER Assessment of Risk Reduction for Lymphedema Following Sentinel Lymph Noded Guided Surgery for Primary Breast Cancer 5b...14. ABSTRACT Lymphedema is a common complication of primary breast cancer therapy. It is a chronic, insidiously progressive, and potentially

  2. Primary Kaposi's sarcoma in lymph nodes concurrent with chronic lymphatic leukemia.

    Science.gov (United States)

    Weshler, Z; Leviatan, A; Krasnokuki, D; Kopolovitch, J

    1979-02-01

    Both Kaposi's sarcoma and chronic lymphatic leukemia affect the lymph nodes, and not infrequently, the same patient. The authors describe the occurrence of both diseases in the same lymph node. The rarity of this finding suggests different histopathogenic origins of the two diseases.

  3. 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.

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

    DEFF Research Database (Denmark)

    Straalman, Kristina; Kristoffersen, Ulrik S; Galatius, Hanne

    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...

  5. [Sentinel lymph node biopsy in endometrial cancer--a part of modern operative treatment].

    Science.gov (United States)

    Jordanov, A; Gorchev, G; Tomov, S; Hinkova, N

    2014-01-01

    After brest cancer the endometrial cancer is the most common gynaecological malignancy. The lymphno destatus is with great prognostic value. There is no agreement for the therapeutic valuae and the contents of the lymph node desectionin early stages. That is why the sentinel lymph node biopsy is a part of modern operative treatment of endometrial cancer.

  6. Persistent postoperative pain and sensory changes following lymph node excision in melanoma patients: a topical review

    DEFF Research Database (Denmark)

    Slagelse, Charlotte; Petersen, Karin L; Dahl, Jørgen Berg

    2014-01-01

    Studies on complications related to chronic nerve injury following sentinel lymph node biopsy (SLNB) and complete lymph node dissection (CLND) for melanoma are sparse. This review summarizes the existing literature on pain and neuropathic complications in melanoma patients undergoing SLNB with or...

  7. Lymph node metastases from an occult sclerosing carcinoma of the thyroid. A case report.

    Science.gov (United States)

    Santini, L; Pezzullo, L; D'Arco, E; De Rosa, N; Guerriero, O; Salza, C

    1989-01-01

    Lymph node metastases from occult thyroid papillary carcinoma are not a rare event. An unusual case of cystic lymph node metastases from this type of carcinoma is reported, suggesting that fine needle aspiration biopsy or frozen section biopsies should always be performed in the presence of a cystic lesion of the neck.

  8. Automated 3-dimensional segmentation of pelvic lymph nodes in magnetic resonance images

    NARCIS (Netherlands)

    Debats, O.A.; Litjens, G.J.S.; Barentsz, J.O.; Karssemeijer, N.; Huisman, H.J.

    2011-01-01

    Purpose: Computer aided diagnosis (CAD) of lymph node metastases may help reduce reading time and improve interpretation of the large amount of image data in a 3-D pelvic MRI exam. The purpose of this study was to develop an algorithm for automated segmentation of pelvic lymph nodes from a single

  9. Omics-based profiling of carcinoma of the breast and matched regional lymph node metastasis

    DEFF Research Database (Denmark)

    Li, J.; Gromov, P.; Gromova, I.;

    2008-01-01

    Axillary lymph node (ALN) status is currently used as an important clinical indicator of breast cancer prognosis. However, the molecular mechanisms underlying lymph node metastasis are poorly understood and the relationship between ALN metastasis and the primary tumor remains unclear. In an effort...

  10. Persistent pain, sensory disturbances and functional impairment after immediate or delayed axillary lymph node dissection

    DEFF Research Database (Denmark)

    Geving Andersen, Kenneth; Jensen, Maj-Britt Raaby; Tvedskov, Tove Filtenborg

    2013-01-01

    BACKGROUND: Patients treated with 2-step axillary lymph node dissection (ALND) may be at increased risk of nerve damage due to more challenging surgery than an ALND immediately after a sentinel lymph node biopsy (SLNB), and thus more at risk for persistent pain after breast cancer treatment (PPBCT...

  11. Response to chemoradiotherapy and lymph node involvement in locally advanced rectal cancer

    Institute of Scientific and Technical Information of China (English)

    Luis; J; García-Flórez; Guillermo; Gómez-álvarez; Ana; M; Frunza; Luis; Barneo-Serra; Manuel; F; Fresno-Forcelledo

    2015-01-01

    AIM: To establish the association between lymph node involvement and the response to neoadjuvant therapy in locally advanced rectal cancer.METHODS: Data of 130 patients with mid and low locally advanced rectal adenocarcinoma treated with neoadjuvant chemoradiation followed by radical surgery over a 5-year period were reviewed. Tumor staging was done by endorectal ultrasound and/or magnetic resonance imaging. Tumor response to neoadjuvant therapy was determined by T-downstaging and tumor regression grading(TRG). Pathologic complete response(p CR) is defined as the absence of tumor cells in the surgical specimen(yp T0N0). The varying degrees TRG were classified according to Mandard’s scoring system. The evaluation of the response is based on the comparison between previous clinico-radiological staging and the results of pathological evaluation. χ2 and Spearman’s correlation tests were used for the comparison of variables. RESULTS: Pathologic complete response(p CR, yp T0N0, TRG1) was observed in 19 cases(14.6%), and other 18(13.8%) had only very few residual malignant cells in the rectal wall(TRG2). T-downstaging was found in 63(48.5%). Mean lymph node retrieval was 9.4(range0-38). In 37 cases(28.5%) more than 12 nodes were identified in the surgical specimen. Preoperative lymph node involvement was seen in 77 patients(59.2%), 71 N1 and 6 N2. Postoperative lymph node involvement was observed in 41 patients(31.5%), 29 N1 and 12 N2, while the remaining 89 were N0(68.5%). In relation to yp T stage, we found nodal involvement of 9.4% in yp T0-1, 22.2% in yp T2 and 43.7% in yp T3-4. Of the 37 patients considered "responders" to neoadjuvant therapy(TRG1 and 2), there were only 4 N+(10.8%) and the remainder N0(89.2%). In the "non responders" group(TRG 3, 4 and 5), 37 cases were N+(39.8%) and 56(60.2%) were N0(P < 0.001).CONCLUSION: Response to neoadjuvant chemoradiation in rectal cancer is associated with lymph node involvement.

  12. Isolated Supraclavicular Lymph Node Metastasis in Pancreatic Adenocarcinoma: A Report of Three Cases and Review of the Literature

    Directory of Open Access Journals (Sweden)

    Arundhati D Soman

    2010-11-01

    Full Text Available Context Supraclavicular lymph nodes represent a rare site of metastasis in pancreatic cancer. We report three cases of pancreatic adenocarcinoma with metastases to supraclavicular lymph nodes. Case report A 51-year-old male was diagnosed with locally advanced pancreatic adenocarcinoma on computed tomography (CT scan. He was recommended neoadjuvant chemotherapy followed by chemoradiation therapy. However, positron emission tomography (PET/CT scans and subsequent fine needle aspiration cytology showed supraclavicular lymph node metastasis. The patient received systemic chemotherapy for metastatic pancreatic adenocarcinoma. The second patient, a 66-year-old female with pancreatic adenocarcinoma, underwent pancreaticoduodenectomy and was found to have peripancreatic lymph node involvement. She received adjuvant chemotherapy and was followed-up with surveillance CT scans, which did not reveal any metastasis. However, the patient complained of neck swelling. PET/CT scan and biopsy revealed supraclavicular lymph node metastasis from a pancreatic adenocarcinoma primary. The third patient, a 79-year-old male with a past history of thyroid carcinoma who was treated with partial thyroidectomy, developed neck swelling 4 years after his surgery. Fine needle aspiration cytology was consistent with known papillary thyroid carcinoma. Staging evaluations revealed a pancreatic mass for which he underwent subtotal pancreatectomy and splenectomy. Histopathology revealed grade 3 pancreatic adenocarcinoma. Excisional biopsy of a supraclavicular lymph node showed metastatic pancreatic adenocarcinoma. PET/CT results were consistent with these findings. Conclusion In patients with pancreatic adenocarcinoma, supraclavicular lymph node metastasis represents an uncommon, but clinically significant finding that can lead to changes in treatment planning. PET imaging represents a valuable tool in the detection and follow up of these patients.

  13. Isolated supraclavicular lymph node metastasis in pancreatic adenocarcinoma: a report of three cases and review of the literature.

    Science.gov (United States)

    Soman, Arundhati D; Collins, Joseph M; DePetris, Giovanni; Decker, G Anton; Silva, Alvin; Moss, Adyr; Greer, Wendy; Ashman, Jonathan; Callister, Matthew; Borad, Mitesh J

    2010-11-09

    Supraclavicular lymph nodes represent a rare site of metastasis in pancreatic cancer. We report three cases of pancreatic adenocarcinoma with metastases to supraclavicular lymph nodes. A 51-year-old male was diagnosed with locally advanced pancreatic adenocarcinoma on computed tomography (CT) scan. He was recommended neoadjuvant chemotherapy followed by chemoradiation therapy. However, positron emission tomography (PET)/CT scans and subsequent fine needle aspiration cytology showed supraclavicular lymph node metastasis. The patient received systemic chemotherapy for metastatic pancreatic adenocarcinoma. The second patient, a 66-year-old female with pancreatic adenocarcinoma, underwent pancreaticoduodenectomy and was found to have peripancreatic lymph node involvement. She received adjuvant chemotherapy and was followed-up with surveillance CT scans, which did not reveal any metastasis. However, the patient complained of neck swelling. PET/CT scan and biopsy revealed supraclavicular lymph node metastasis from a pancreatic adenocarcinoma primary. The third patient, a 79-year-old male with a past history of thyroid carcinoma who was treated with partial thyroidectomy, developed neck swelling 4 years after his surgery. Fine needle aspiration cytology was consistent with known papillary thyroid carcinoma. Staging evaluations revealed a pancreatic mass for which he underwent subtotal pancreatectomy and splenectomy. Histopathology revealed grade 3 pancreatic adenocarcinoma. Excisional biopsy of a supraclavicular lymph node showed metastatic pancreatic adenocarcinoma. PET/CT results were consistent with these findings. In patients with pancreatic adenocarcinoma, supraclavicular lymph node metastasis represents an uncommon, but clinically significant finding that can lead to changes in treatment planning. PET imaging represents a valuable tool in the detection and follow up of these patients.

  14. Axillary Irradiation as an Imperative Alternative to Axillary Dissection in Clinically Lymph Node-Negative but Sentinel Node-Positive Breast Cancer Patients?

    OpenAIRE

    Nitsche, Mirko; Hermann, Robert

    2011-01-01

    At the moment, positive sentinel lymph node dissection (SLND) of the axilla is followed by axillary lymph node dissection (ALND) as standard of care. Recent data proves that omitting ALND after positive SLND in clinically lymph node-negative early stage breast cancer patients is feasible with low recurrence rates. The well known effect of radiotherapy to destroy occult tumor cells highly contributes to these results as a large extent of level I and II lymph nodes are unavoidably included in s...

  15. Modified methylene blue injection improves lymph node harvest in rectal cancer.

    Science.gov (United States)

    Liu, Jianpei; Huang, Pinjie; Zheng, Zongheng; Chen, Tufeng; Wei, Hongbo

    2017-04-01

    The presence of nodal metastases in rectal cancer plays an important role in accurate staging and prognosis, which depends on adequate lymph node harvest. The aim of this prospective study is to investigate the feasibility and survival benefit of improving lymph node harvest by a modified method with methylene blue injection in rectal cancer specimens. One hundred and thirty-one patients with rectal cancer were randomly assigned to the control group in which lymph nodes were harvested by palpation and sight, or to the methylene blue group using a modified method of injection into the superior rectal artery with methylene blue. Analysis of clinicopathologic records, including a long-term follow-up, was performed. In the methylene blue group, 678 lymph nodes were harvested by simple palpation and sight. Methylene blue injection added 853 lymph nodes to the total harvest as well as 32 additional metastatic lymph nodes, causing a shift to node-positive stage in four patients. The average number of lymph nodes harvested was 11.7 ± 3.4 in the control group and 23.2 ± 4.7 in the methylene blue group, respectively. The harvest of small lymph nodes (methylene blue group. The modified method of injection with methylene blue had no impact on overall survival. The modified method with methylene blue injection improved lymph node harvest in rectal cancer, especially small node and metastatic node retrieval, which provided more accurate staging. However, it was not associated with overall survival. © 2014 Royal Australasian College of Surgeons.

  16. In-situ and invasive carcinoma within a phyllodes tumor associated with lymph node metastases

    Directory of Open Access Journals (Sweden)

    Ross Joan

    2004-12-01

    Full Text Available Abstract Background Phyllodes tumors (cystosarcoma phyllodes are uncommon lesions in the female breast. Rarely, the occurrence of carcinoma within a phyllodes tumor has been reported in the literature, but has never been associated with lymph node metastases. Case presentation A 26-year-old woman presented with a firm, mobile, non-tender mass in the left breast and palpable lymph nodes in the left axilla. The excised lesion appeared well circumscribed and lobulated, with variable fleshy and firm areas. Microscopic examination showed a circumscribed fibroepithelial lesion with a well developed leaf-like architecture, in keeping with a benign phyllodes tumor. The epithelial component showed extensive high grade ductal carcinoma in-situ (DCIS and invasive carcinoma of no special type, located entirely within the phyllodes tumor. Subsequent axillary lymph node dissection revealed metastatic carcinoma in four lymph nodes. Conclusions Although rare, phyllodes tumors may harbor DCIS and invasive carcinoma, with potential for lymph node metastasis.

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

    Science.gov (United States)

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

    2012-10-01

    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 the survival of mice with lethal metabolic disease. Furthermore, thymuses transplanted into single lymph nodes of athymic nude mice generated functional immune systems that were capable of rejecting allogeneic and xenogeneic grafts. Additionally, pancreatic islets injected into the lymph nodes of diabetic mice restored normal glucose control. Collectively, these results suggest the practical approach of targeting lymph nodes to restore, maintain or improve tissue and organ functions.

  18. Periaortic lymph node involvement by metastatic angiosarcoma and benign sinus mesothelial cells.

    Science.gov (United States)

    Isotalo, P A; Jabit, M; Wenckebach, G F

    2001-05-01

    Hyperplastic mesothelial cells involving lymph node sinuses have only been recently described. Most nodal mesothelial cells are thought to originate from mesothelial surfaces disrupted by serosal effusions. Dislodged mesothelial cells likely gain access to submesothelial lymphatics via mesothelial stomata and disseminate to draining lymph nodes. Unusual lymph node architectural patterns result when benign sinus mesothelial cells occur concurrently with a neoplastic nodal process. We describe a young man who developed diffuse metastases from a primary cardiac angiosarcoma. His periaortic lymph nodes contained metastatic angiosarcoma and hyperplastic mesothelial cells with a sinus distribution. The patient had a clinical history of progressive haemoperitoneum, exacerbated by thrombocytopaenia and disseminated intravascular coagulation. Massive haemoperitoneum of 5000 ml was confirmed at autopsy. This is the first report to suggest that multiple episodes of intraperitoneal haemorrhage and ascites may both act in the same manner to cause dislodgment and dissemination of mesothelial cells to draining lymph node sinuses.

  19. Sentinel Lymph Node in Breast Cancer: Review Article from a Pathologist's Point of View.

    Science.gov (United States)

    Apple, Sophia K

    2016-03-01

    Breast cancer staging, in particular N-stage changed most significantly due to the advanced technique of sentinel lymph node biopsy two decades ago. Pathologists have more thoroughly examined and scrutinized sentinel lymph node and found increased number of small volume metastases. While pathologists use the strict criteria from the Tumor Lymph Node Metastasis (TNM) Classification, studies have shown poor reproducibility in the application of American Joint Committee on Cancer and International Union Against Cancer/TNM guidelines for sentinel lymph node classification in breast cancer. In this review article, a brief history of TNM with a focus on N-stage is described, followed by innate problems with the guidelines, and why pathologists may have difficulties in assessing lymph node metastases uniformly. Finally, clinical significance of isolated tumor cells, micrometastasis, and macrometastasis is described by reviewing historical retrospective data and significant prospective clinical trials.

  20. Supraclavicular lymph node metastasis as the initial presentation of primary fallopian tube carcinoma.

    Science.gov (United States)

    Sakurai, Nobuyuki; Tateoka, Kazuhiro; Fukaya, Kazumasa; Terada, Tadashi; Kubushiro, Kaneyuki

    2010-06-01

    Supraclavicular lymph node metastasis is a rare presentation of primary fallopian tube carcinoma. A 76-year-old woman presented with an enlarged supraclavicular lymph node. A biopsy was performed, and its findings confirmed metastatic adenocarcinoma. Subsequent exploratory laparotomy revealed right fallopian tube carcinoma as the primary lesion; consequently, right salpingo-oophorectomy was performed. After adjuvant chemotherapy, she underwent a laparotomy with total abdominal hysterectomy, left salpingo-oophorectomy, pelvic and para-aortic lymph node sampling, and omentectomy. Supraclavicular lymph node metastasis was thought to be, although rarely, the first manifestation of primary fallopian tube carcinoma (PFTC). When supraclavicular lymph node metastasis of an unknown origin is encountered, the possibility of PFTC should be considered.

  1. Fixed Size of Enlarged Calcified Lymph Nodes in Esophageal Adenocarcinoma despite Complete Remission

    Directory of Open Access Journals (Sweden)

    B.A. Grotenhuis

    2009-07-01

    Full Text Available Untreated malignant lymph nodes that are calcified are rare. Publications on such calcifications are restricted to case reports. We present a case of calcified lymph nodes in a patient with adenocarcinoma of the gastroesophageal junction that seemed to be nonresponsive to induction chemotherapy, as they did not decrease in size. However, on pathological examination of the resected lymph nodes no vital tumor cells could be detected anymore. Therefore, we hypothesize that a calcified lymph node is unable to shrink, even after adequate remission on induction chemotherapy. This should be taken into account when clinical decision-making depends on the change in size of an enlarged, calcified lymph node as a measure of treatment effect.

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

    Energy Technology Data Exchange (ETDEWEB)

    Ohtake, K.; Shingaki, S.; Nakajima, T. (Nigata Univ. (Japan))

    1990-07-01

    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.

  3. 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 %. 

  4. Clinical significance of lymph node ratio and location of nodal involvement in patients with right colon cancer.

    Science.gov (United States)

    Kobayashi, Hirotoshi; Enomoto, Masayuki; Higuchi, Tetsuro; Uetake, Hiroyuki; Iida, Satoru; Ishikawa, Toshiaki; Ishiguro, Megumi; Kato, Shunsuke; Sugihara, Kenichi

    2011-01-01

    Increasing negative lymph node count has been reported to be associated with better outcomes in patients with colon cancer. The present study aimed to clarify the clinical significance of the lymph node ratio (LNR) and location of lymph node metastasis (LNM) in patients with stage III right colon cancer. We enrolled 820 patients who had undergone curative resection due to colon cancer at a single institution between 1991 and 2005. Among them, 197 underwent curative resection for T2-T4 right colon cancer. We evaluated the oncological outcomes according to LNR (quartiles) and distribution of LNM (n1 = LNM adjacent to the colon or along the vascular arcades of the marginal arteries; n2 = LNM along the major vessels; n3 = LNM near the roots of the major vessels). The rates of LNM in T2, T3 and T4 right colon cancer were 11.1, 38.6 and 58.0%, respectively (p colon cancer. Some patients with extensive LNM benefited from lymph node dissection with high ligation. Those with T3-T4 right colon cancer are suitable candidates for lymph node dissection with high ligation. Adding the concept of LNR and location of LNM to conventional TNM staging could improve the accuracy of evaluating nodal status. Copyright © 2011 S. Karger AG, Basel.

  5. Value and efficiency of sentinel lymph node diagnostics in patients with penile carcinoma with palpable inguinal lymph nodes as a new multimodal, minimally invasive approach

    Energy Technology Data Exchange (ETDEWEB)

    Luetzen, Ulf; Zuhayra, Maaz; Marx, Marlies; Zhao, Yi [University Hospital Schleswig Holstein, Campus Kiel, Department of Nuclear Medicine, Molecular Imaging Diagnostics and Therapy, Kiel (Germany); Colberg, Christian; Knuepfer, Stephanie; Juenemann, Klaus-Peter; Naumann, Carsten Maik [University Hospital Schleswig Holstein, Campus Kiel, Department of Urology and Pediatric Urology, Kiel (Germany); Baumann, Rene [University Hospital Schleswig Holstein, Campus Kiel, Department of Radio Oncology, Kiel (Germany); Kaehler, Katharina Charlotte [University Hospital Schleswig Holstein, Campus Kiel, Department of Dermatology, Venerology and Allergology, Kiel (Germany)

    2016-12-15

    The international guidelines recommend sentinel lymph node biopsy (SLNB) for lymph node staging in penile cancer with non-palpable inguinal lymph nodes (LN) but it is not recommended with palpable inguinal LN. The aim of this study was to evaluate the reliability and morbidity of SLNB in combination with an ultrasound-guided resection of suspect inguinal LNs as a new multimodal, minimally invasive staging approach in these patients. We performed SLNB in 26 penile cancer patients with 42 palpable inguinal LNs. Prior to the combined staging procedures the patients underwent an ultrasound examination of the groins as well as planar lymphatic drainage scintigraphy and SPECT/CT scans. During the surgical procedure, the radioactive-labelled sentinel lymph nodes and, in addition, sonographically suspect LNs, were resected under ultrasound guidance. Follow-up screening was done by ultrasound examination of the groins according to the guidelines of the European Association of Urology. Nineteen groins of 42 preoperatively palpable inguinal findings were histologically tumor-positive. SLNB alone showed lymphogenic metastases in 14 groins. Sonography revealed five further metastatic groins, which would not have been detected during SLNB due to a tumor-related blockage of lymphatic drainage or a so-called re-routing of the tracer. During follow-up, none of the 28 groins with tumor-negative LN status showed any LN recurrence in this combined investigation technique. The median follow-up period was 46 (24 to 92) months. Morbidity of this procedure was low at 4.76 % in relation to the number of groins resp. 7.69 % in relation to the number of patients. The results show that this combined procedure is a reliable multimodal diagnostic approach for treatment of penile cancer patients with palpable inguinal LNs. It is associated with low morbidity rates. SLNB alone would lead to a significantly higher false-negative rate in these patients. The encouraging results of this work can

  6. Usefulness of sentinel lymph node biopsy for prognostic prediction in extramammary Paget's disease.

    Science.gov (United States)

    Ogata, Dai; Kiyohara, Yoshio; Yoshikawa, Syusuke; Tsuchida, Tetsuya

    2016-06-01

    Complete excision of the primary lesion has long been considered the standard treatment for extramammary Paget's disease (EMPD). However, the presence of lymph node metastases has been reported as an important prognostic factor. We evaluated the association between lymph node metastasis and prognosis for EMPD using sentinel lymph node (SLN) biopsy. This retrospective study included 59 patients with histopathologically-confirmed primary EMPD. A total of 45 patients with microinvasion to the papillary dermis and deep invasion into the reticular dermis or subcutaneous tissue were included in the analysis. The survival curves of the SLN-negative group and the SLN-positive group were compared and we examined the risk factors for SLN positivity. A total of 139 SLNs were excised from one (28 patients) or both inguinal regions (31 patients). The average number of detected SLNs was 2.4. The incidence of SLN metastases was 16.9%. SLN positivity rates according to level of invasion were 0% for intraepithelial lesions, 4.1% for microinvasion, and 42.8% for dermal invasion. The five-year survival rates were 100% in the SLN-negative and 24% in the SLN-positive groups (p = 0.0001). Reticular dermis or subcutaneous tissue invasion was a significant independent risk factor for SLN positivity according to multivariate analysis. The result of SLN biopsy affected prognosis. It is extremely important to accurately ascertain the presence, i.e. the number, or absence of regional lymph node metastases in patients with EMPD. We conclude that SLN biopsy may be appropriate for cases where invasion is suspected.

  7. 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.)

  8. Factors associated with successful bilateral sentinel lymph node mapping in endometrial cancer.

    Science.gov (United States)

    Tanner, Edward J; Sinno, Abdulrahman K; Stone, Rebecca L; Levinson, Kimberly L; Long, Kara C; Fader, Amanda N

    2015-09-01

    As our understanding of sentinel lymph node (SLN) mapping for endometrial cancer (EC) evolves, tailoring the technique to individual patients at high risk for failed mapping may result in a higher rate of successful bilateral mapping (SBM). The study objective is to identify patient, tumor, and surgeon factors associated with successful SBM in patients with EC and complex atypical hyperplasia (CAH). From September 2012 to November 2014, women with EC or CAH underwent SLN mapping via cervical injection followed by robot-assisted total laparoscopic hysterectomy (RA-TLH) at a tertiary care academic center. Completion lymphadenectomy and ultrastaging were performed according to an institutional protocol. Patient demographics, tumor and surgeon/intraoperative variables were prospectively collected and analyzed. Univariate and multivariate analyses were performed evaluating factors known or hypothesized to impact the rate of successful lymphatic mapping. RA-TLH and SLN mapping was performed in 111 women; 93 had EC and 18 had CAH. Eighty women had low grade and 31 had high grade disease. Overall, at least one SLN was identified in 85.6% of patients with SBM in 62.2% of patients. Dye choice (indocyanine green versus isosulfan blue), odds ratio (OR: 4.5), body mass index (OR: 0.95), and clinically enlarged lymph nodes (OR: 0.24) were associated with SBM rate on multivariate analyses. The use of indocyanine green dye was particularly beneficial in patients with a body mass index greater than 30. Injection dye, BMI, and clinically enlarged lymph nodes are important considerations when performing sentinel lymph node mapping for EC. Copyright © 2015 Elsevier Inc. All rights reserved.

  9. Lymph node trafficking of regulatory T cells is prerequisite for immune suppression.

    Science.gov (United States)

    Huang, Miao-Tzu; Lin, Been-Ren; Liu, Wei-Liang; Lu, Chun-Wei; Chiang, Bor-Luen

    2016-04-01

    Regulatory T cells have a crucial role in health and disease because of their immune regulation function. However, the anatomic sites where regulatory T cells exert optimal immune regulation are open to debate. In our current study with the use of a shear-stress flow assay, we found that regulatory T cells exhibited significantly decreased adhesion to either activated endothelial monolayer or intercellular adhesion molecule 1 or E-selectin-coated surfaces compared with activated effector T cells. The less transmigration capacity of the regulatory T cells prompted our speculation of preferential lymph node localization for the regulatory T cells that endowed these cells with immune regulation function in the most efficient manner. To test this hypothesis, the role of lymph node localization in regulatory T cell-mediated immune suppression was evaluated with a footpad inflammation model. We found that adoptively transferred regulatory T cells inhibited the development of footpad inflammation. In addition, although blockage of CCR7 or CD62L had no effect on the immune suppressive function of the regulatory T cells per se, pretreatment of the regulatory T cells with either CCR7 or CD62L blocking antibodies prevented their recruitment into draining lymph nodes and concomitantly abrogated the immune suppressive effects of adoptively transferred regulatory T cells during footpad inflammation. Our data demonstrate the crucial role of lymph node localization in regulatory T cell-mediated immune suppression and suggest a probable hierarchy in the anatomic sites for optimal immune regulation. Elucidating the relationships between the transmigration characteristics of the regulatory T cells and their immune regulation function will provide insightful information for regulatory T cell-based cell therapy.

  10. The Prevalence of Linguatula serrata Nymphs in Mesenteric Lymph Nodes in Cattle

    Directory of Open Access Journals (Sweden)

    Saeid R. N. Fard

    2010-01-01

    Full Text Available Problem statement: The Linguatula serrata is one of the parasitic zoonoses. Human beings may also be infected by both the nymph stage, a condition called nasopharyngeal linguatulosis or Halzoun syndrome and the egg, a condition called visceral linguatulosis. Approach: The aim of the present study was to evaluate the prevalence of nymphal stages of L. serrata in mediastenal and mesenteric lymph nodes of cattle slaughtered in Kerman slaughterhouse, south east of Iran. For this purpose, mesenteric and mediastenal lymph nodes of 450 cattle of different sex and age were examined. Results: A prevalence of 16.22% was observed in mesenteric lymph nodes. Higher prevalence of infection was observed in animals aged above four years and during autumn season. The infection rate increased with age (pL. serrata nymphs in different seasons was significantly different (pConclusion: The high prevalence of infection observed in a ruminant is of concern owing to the zoonotic nature of the parasite and the risk of infection to humans and other animals.

  11. Mycobacterium tuberculosis complex detected by modified fluorescent in situ hybridization in lymph nodes of clinical samples.

    Science.gov (United States)

    Rodriguez-Nuñez, Juan; Avelar, Francisco J; Marquez, Francisco; Rivas-Santiago, Bruno; Quiñones, Cesar; Guerrero-Barrera, Alma L

    2012-01-12

    Lymph node tuberculosis (TB) is the leading cause of extrapulmonary tuberculosis and is the most frequently identified type in Aguascalientes, Mexico. Conventional diagnosis has serious limitations for rapid detection of extrapulmonary tuberculosis in clinical samples. Here PCR and modified FISH have been tested as complementary diagnosis methods for extrapulmonary tuberculosis. The specific insertion sequence IS6110 for Mycobacterium tuberculosis complex was used to perform PCR and build DNA and PNA FISH probes (20bp). PCR and modified DNA and PNA FISH assays were performed to evaluate 41 lymph node paraffin-embedded tissue samples, in comparison with the histopathology diagnosis, which was considered the gold standard (22 positive and 19 negative). In comparison with histopathology diagnosis PCR showed 62.5 % sensitivity and 77.8 % specificity (χ(2) = 4.583 p 0.05). Ziehl Neelsen stain was positive in only four cases of 22 lymph node samples positive to histopathology.  In contrast, PCR and modified DNA FISH were positive in 20 cases of the same group. The negative cases were coincident in all tests. PCR and DNA FISH showed a significant increase in the number of cases detected and also showed higher sensitivity and specificity compared with data reported by traditional methodology. In developing countries, these techniques could help to complement the early diagnosis and timely treatment of extrapulmonary tuberculosis.

  12. Ultrastructural findings in lymph nodes from pigs suffering from naturally occurring postweaning multisystemic wasting syndrome.

    Science.gov (United States)

    Rodriguez-Cariño, C; Segalés, J

    2009-07-01

    The aims of this study were to evaluate ultrastructural lesions in lymph nodes from postweaning multisystemic wasting syndrome (PMWS)-affected pigs and to correlate these alterations with detection of viral-like particles (VLPs). Samples of lymph nodes were taken from 4 PMWS-affected pigs and 2 healthy animals and processed by transmission electron microscopy. Significant ultrastructural alterations were only noted in PMWS-affected pigs, mainly in histiocytes and rarely in other cell types. Histiocytes showed severe swelling and proliferation of mitochondria, and proliferation and dilation of rough endoplasmic reticulum and Golgi complex. Infected histiocytes contained large numbers of intracytoplasmic inclusion (ICI) bodies with VLPs; some histiocytes also had intranuclear inclusions (INIs). Small inclusions were surrounded by double membrane, with a granular appearance or containing paracrystalline arrays; icosahedral VLPs were 8-17 nm in diameter. Large ICIs were double-membrane bounded or not and contained VLPs usually forming paracrystalline arrays. ICIs were often found next to mitochondria with severe swelling, and also inside them. INIs were not surrounded by membranes and contained virions of 10-13 nm diameter. Lymphocyte depletion was a striking finding of lymph nodes from PMWS-affected pigs. The inclusion bodies containing VLPs referred to in the present study should be classified as viral factories, suggesting that viral replication is probably a frequent event in macrophages, in which mitochondria might play a role.

  13. Clinicopathologic Factors and Thyroid Nodule Sonographic Features for Predicting Central Lymph Node Metastasis in Papillary Thyroid Microcarcinoma: A Retrospective Study of 1204 Patients.

    Science.gov (United States)

    Wang, Wen-Han; Xu, Shang-Yan; Zhan, Wei-Wei

    2016-11-01

    Preoperative prediction of lymph node metastasis is of clinical importance for the surgical treatment of thyroid tumor. The purpose of this study was to evaluate clinicopathologic factors and thyroid nodule sonographic features predictive of central lymph node metastasis in papillary thyroid microcarcinoma. Clinicopathologic factors and thyroid nodule sonographic features of 1204 patients with papillary thyroid microcarcinoma were retrospectively reviewed from January 2014 to June 2015. Central lymph node dissection was performed on each patient. Univariate and multivariate analyses were performed to analyze the clinicopathologic factors and thyroid nodule sonographic features associated with central lymph node metastasis in papillary thyroid microcarcinoma. Odds ratios (ORs) and 95% confidence intervals (CIs) were calculated to assess the relevance of all potential predictive factors. Central lymph node metastasis was detected in 395 of the 1204 patients (32.81%). By univariate and multivariate analyses, younger age (≤43 years), male sex, larger tumor size (≥7 mm), multifocal papillary thyroid microcarcinoma and microcalcification were independently associated with central lymph node metastasis in papillary thyroid microcarcinoma (P Central lymph node metastasis is highly prevalent in papillary thyroid microcarcinoma. Younger age (≤43 years), male sex, larger tumor size (≥7 mm), multifocal papillary thyroid microcarcinoma, and microcalcification were independent predictors of central lymph node metastasis. Surgeons and radiologists need to pay more attention to patients with papillary thyroid microcarcinoma who have these risk predictors. © 2016 by the American Institute of Ultrasound in Medicine.

  14. Clinical significance of post-treatment {sup 18}F-fluorodeoxyglucose uptake in cervical lymph nodes in patients with diffuse large B-cell lymphoma

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    An, Young-Sil; Yoon, Joon-Kee; Lee, Su Jin [Ajou University School of Medicine, Department of Nuclear Medicine and Molecular Imaging, Woncheon-dong, Yeongtong-gu, Gyeonggi-do, Suwon-si (Korea, Republic of); Jeong, Seong Hyun; Lee, Hyun Woo [Ajou University School of Medicine, Department of Hematology-Oncology, Woncheon-dong, Yeongtong-gu, Gyeonggi-do, Suwon (Korea, Republic of)

    2016-12-15

    We assessed the clinical significance of FDG uptake in cervical lymph nodes after treatment of patients with DLBCL. In total, 87 patients with DLBCL were enrolled. All patients had newly appeared FDG uptake in cervical lymph nodes on PET/CT during follow-up after cessation of therapy. Cervical lymph nodes were finally diagnosed as benign or malignant according to histopathological findings or follow-up PET. Clinical characteristics and PET findings were compared between groups and factors associated with malignant lesions were evaluated. Only 8 (9.2 %) patients with cervical lymph nodes with FDG uptake ultimately had malignancy. FDG uptake lymph nodes appeared significantly earlier in the malignant group than in patients with benign FDG uptake (p = 0.013). Primary nodal lymphoma was more frequent in patients with cancer spread than in those with benign FDG uptake in lymph nodes (p < 0.001). Most cervical lymph nodes with FDG uptake (about 91 %) appearing after treatment of malignant DLBCL were ultimately benign. The elapsed time between the end of therapy and the appearance of cervical lymph nodes with FDG uptake and the primary sites of lymphomas are helpful clues in determining which cases are malignant. (orig.)

  15. Role of Axillary Ultrasound, Fine Needle Aspiration Cytology and Sentinel Lymph Node Biopsy in clinically N0 Breast Cancer.

    Science.gov (United States)

    Goel, Gaurav; Janaki, P D; Smitha, N V; Anupama, Rajanbabu; Sundaram, P Shanmugha; Nataraj, Y S; Vijaykumar, D K

    2016-12-01

    This study evaluates the combined role of axillary ultrasound, fine needle aspiration cytology and sentinel lymph node biopsy in clinically N0 axilla. Between January 2014 and June 2015, 150 women with early breast cancer underwent axillary ultrasound as a first investigation for nodal status. Suspicious nodes were subjected to image guided fine needle aspiration cytology. Non-suspicious and fine needle aspiration cytology negative axillary nodes proceeded to sentinel lymph node biopsy at time of primary breast surgery. All confirmed positive (cytology and frozen) cases proceeded to axillary lymph node dissection. 52 women had positive axillary nodes at final histology. Axillary ultrasound with fine needle aspiration cytology identified 27 patients with positive axillary nodal status and had a sensitivity of 84.36 % (27/32) and specificity of 87.5 % (14/16). Intraoperative frozen analysis identified a further 13 cases with sensitivity of 56.52 % (13/23) and specificity of 97.56 % (80/82). Overall 76.92 % (40/52) patients with positive axillary metastasis were identified peri-operatively using combination of axillary ultrasound, cytology and sentinel lymph node biopsy.

  16. Adenocarcinoma arising at a colostomy site with inguinal lymph node metastasis: report of a case.

    Science.gov (United States)

    Iwamoto, Masayoshi; Kawada, Kenji; Hida, Koya; Hasegawa, Suguru; Sakai, Yoshiharu

    2015-02-01

    Inguinal lymph node metastasis from adenocarcinoma arising at a colostomy site is extremely rare, and the significance of surgical resection for metastatic inguinal lymph nodes has not been established. An 82-year-old woman who had undergone abdominoperineal resection 27 years earlier was admitted to our hospital complaining of bleeding from a colostomy. Physical examination revealed that a tumor at the colostomy site directly invaded into the peristomal skin, and that a left inguinal lymph node was firm and swollen. Positron emission tomography/computed tomography scan demonstrated accumulation of (18)F-fluorodeoxy glucose into both the colostomy tumor and the left swollen inguinal lymph node, while there was no evidence of metastasis to liver or lungs. She underwent open left hemicolectomy with wide local resection of the colostomy, and dissection of left inguinal lymph nodes. Histological diagnosis was a moderately differentiated adenocarcinoma that directly invaded into the surrounding skin and metastasized to the left inguinal lymph node. The patient has been followed up for >5 years without any sign of recurrence. In general, inguinal lymph node metastasis from colorectal cancers is regarded as a systemic disease with a poor prognosis, and so systemic chemotherapy and radiotherapy, but not surgical lymph node dissection, are recommended. Considering the lymphatic drainage route in the present case, inguinal lymph node metastasis does not represent a systemic disease but rather a sentinel nodal metastasis from adenocarcinoma at a colostomy site. Surgical dissection of metastatic inguinal lymph nodes should be considered to enable a favorable prognosis in the absence of distant metastasis to other organs.

  17. Correlation of Lymph Node Density With Negative Outcome Predictors in Oral and Maxillofacial Squamous Cell Carcinoma.

    Science.gov (United States)

    Kim, Roderick Youngdo; Ward, Brent Benson; Brockhoff, Hans C; Helman, Joseph I; Braun, Thomas M; Skouteris, Christos A

    2016-10-01

    Lymph node density is defined as the number of positive lymph nodes per total number of excised lymph nodes. In oral and maxillofacial cancer, there are recent data showing that increased lymph node density leads to worse outcomes for patients. However, data correlating lymph node density with other known risk parameters are lacking. This study investigated whether a direct correlation exists among cervical lymph node density, depth of invasion, perineural invasion, and extracapsular tumor spread. A retrospective chart review was undertaken to include all patients who underwent neck dissection with resection of primary oral and maxillofacial squamous cell carcinoma from January 2009 through July 2014. After applying the exclusion criteria, 286 patients were identified. Primary tumor depth of invasion, perineural invasion, and lymph node status, including extracapsular spread, were obtained from the standard pathology report. Descriptive statistics were applied. The association between 2 continuous tumor characteristics was summarized with the Pearson correlation coefficient, and the association between a continuous and a binary tumor characteristic was summarized with 2-sample t test. Statistical significance for the study was set at a P value less than .05. Mean age at time of surgery was 63.9 ± 12.5 years. The final study included 169 men and 117 women (N = 286). The mean depth of invasion was 12.3 ± 11 mm (range, 1 to 69 mm). Mean lymph node density was 0.04 ± 0.1 (range, 0 to 0.81). There was a positive association between lymph node density and depth of tumor invasion (Pearson correlation coefficient, r = 0.21; P negative; P negative; P correlated with other known prognostic features that lead to poor outcomes. Lymph node density could be an important feature to capture in future prospective trials. Pathology standards would be crucial in this endeavor. Copyright © 2016 American Association of Oral and Maxillofacial Surgeons. Published by Elsevier Inc

  18. 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.

  19. Laparoscopic Sentinel Lymph Node Biopsy for Prostate Cancer: The Relevance of Locations Outside the Extended Dissection Area

    Directory of Open Access Journals (Sweden)

    W. Meinhardt

    2012-01-01

    Full Text Available Objective. To assess the relevance of sentinel lymph nodes (SNs outside the extended pelvic lymph node dissection area (e-PLND. Patients and Methods. Evaluation of our laparoscopic SN procedures for prostate cancer patients of intermediate prognosis. Retrospective data collection on the exact location of the excised SNs and the pathology results were analyzed. Results and Limitations. Of the 121 patients, 49 had positive lymph nodes. 37 patients (31% had SNs outside the e-PLND template. Five of these nodes were tumor bearing but only twice exclusively so. Of the 14 patients considered for salvage treatment, 6 were node positive. 7 of these 14 patients (50% had SNs outside the extended dissection area, yet none of these nodes were tumor positive. Limitations are those of a retrospective study. Conclusions. Laparoscopic SN biopsy may show SNs outside the e-PLND template in 31% of the patients. However, nodes that are exclusively positive in one of these areas are rare. For the dichotomy positive or negative nodes, the locations outside the e-PLND area are not often relevant. Nevertheless, when all positive nodes are to be treated by resection or radiotherapy, these locations are relevant. When considering salvage treatment for prostate cancer, the method is feasible.

  20. [Anatomo-topographic features of parasternal lymph nodes in adult humans].

    Science.gov (United States)

    Shvedavchenko, A I

    1981-08-01

    The parasternal lymph nodes have been revealed in corpses of person died at the age 22-85 years by the method of preparation after Gerota's blue had been interstitially injected into the tissue of the mammary gland, the diaphragm, the diaphragmal surface of the liver, the pleura and the pericardium. The mass has also been injected into the lymph nodes and vessels revealed by means of the interstitial injection. Most of the parasternal lymph nodes are situated in interposal places, their number varying from 2 to 20 in the parasternal lymphatic chain. At the level of the costal cartilage they are found much more seldom. Maximal number of the parasternal lymph nodes situating behind one costal cartilage is 4. Behind the IV and the V costal cartilage, left to the sternum no lymph nodes have been revealed. The most removed from the sternal edge, the lymph nods in the V and the VI intercostal spaces, both to the left and to the right have been found. As to the position of blood vessels, the lymph nodes occur mostly medially and laterally but not anterior or posterior to them or between them. The size of the lymph nodes varies from 1 to 25 mm.

  1. Thyroglobulin measurement in the fine-needle aspiration washout for diagnosing cervical lymph node metastasis in the patients with differentiated papillary thyroid cancer

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    Kim, Byung Moon [Kangbuk Samsung Hospital, Seoul (Korea, Republic of); Kim, Eun Kyung; Kim, Min Jung [Yonsei University College of Medicine, Seoul (Korea, Republic of)

    2006-11-15

    We wanted to evaluate the utility of thyroglobulin measurement in the washout of the needle (FNA-Tg) used for fine needle biopsy for detecting lymph node metastasis in patients with differentiated papillary thyroid carcinoma (DPTC). We performed ultrasonography-guided fine-needle aspiration cytology (FNAC) and FNA-Tg for 50 ultrasonographically suspicious lymph nodes in 45 DPTC patients. Eighteen patients underwent thyroidectomy before FNA and the remaining 27 patients underwent fine-needle aspiration prior to surgery. The final diagnoses were determined based on the results of histological examination of the excised specimens (n = 21) or on the follow-up examination that was done least 12 months after surgery. Lymph node metastases were confirmed in 19 patients. FNAC detected 14 metastatic lymph nodes in 14 patients, and FNA-Tg detected 18 metastatic lymph nodes in 18 patients. While none of 3 cystic lymph nodes metastasis was detected via FNAC, they all revealed positive results via FNA-Tg. One patient with a negative result on both methods had one metastatic lymph node among 9 excised lymph nodes, and this one node had not been sampled via FNAC or Tg. The sensitivities and specificities of FNAC and FNA-Tg were 73.6% (14/19) and 100% (27/27), and 94.7% (18/19) and 96.2% (26/27), respectively. FNA-Tg is a useful technique for the early detection of lymph node metastasis, and especially for detecting cystic lymph node metastasis in patients with DPTC.

  2. Sentinel lymph node biopsy for breast cancer patients using fluorescence navigation with indocyanine green

    Directory of Open Access Journals (Sweden)

    Aoyama Kei

    2011-12-01

    Full Text Available Abstract Background There are various methods for detecting sentinel lymph nodes in breast cancer. Sentinel lymph node biopsy (SLNB using a vital dye is a convenient and safe, intraoperatively preparative method to assess lymph node status. However, the disadvantage of the dye method is that the success rate of sentinel lymph node detection depend on the surgeon's skills and preoperative mapping of the sentinel lymph node is not feasible. Currently, a vital dye, radioisotope, or a combination of both is used to detect sentinel nodes. Many surgeons have reported successful results using either method. In this study we have analyzed breast lymphatic drainage pathways using indocyanine green (ICG fluorescence imaging. Methods We examined the lymphatic courses, or lymphatic vessels, in the breast using ICG fluorescence imaging, and applied this method to SLNB in patients who underwent their first operative treatment for breast cancer between May 2006 and April 2008. Fluorescence images were obtained using a charge coupled device camera with a cut filter used as a detector, and light emitting diodes at 760 nm as a light source. When ICG was injected into the subareola and periareola, subcutaneous lymphatic vessels from the areola to the axilla became visible by fluorescence within a few minutes. The sentinel lymph node was then dissected with the help of fluorescence imaging navigation. Results The detection rate of sentinel nodes was 100%. 0 to 4 states of lymphatic drainage pathways from the areola were observed. The number of sentinel nodes was 3.41 on average. Conclusions This method using indocyanine green (ICG fluorescence imaging may possibly improve the detection rate of sentinel lymph nodes with high sensitivity and compensates for the deficiencies of other methods. The ICG fluorescence imaging technique enables observation of breast lymph vessels running in multiple directions and easily and accurately identification of sentinel lymph nodes

  3. Three-dimensional atlas of lymph node topography based on the visible human data set.

    Science.gov (United States)

    Qatarneh, Sharif M; Kiricuta, Ion-Christian; Brahme, Anders; Tiede, Ulf; Lind, Bengt K

    2006-05-01

    Comprehensive atlases of lymph node topography are necessary tools to provide a detailed description of the lymphatic distribution in relation to other organs and structures. Despite the recent developments of atlases and guidelines focusing on definitions of lymphatic regions, a comprehensive and detailed description of the three-dimensional (3D) nodal distribution is lacking. This article describes a new 3D atlas of lymph node topography based on the digital images of the Visible Human Male Anatomical (VHMA) data set. About 1,200 lymph nodes were localized in the data set and their distribution was compared with data from current cross-sectional lymphatic atlases. The identified nodes were delineated and then labeled with different colors that corresponded to their anatomical locations. A series of 2D illustrations, showing discrete locations, description, and distribution of major lymph nodes, was compiled to form a cross-sectional atlas. The resultant contours of all localized nodes in the VHMA data set were superimposed to develop a volumetric model. A 3D reconstruction was generated for the lymph nodes and surrounding structures. The volumetric lymph node topography was also integrated into the existing VOXEL-MAN digital atlas to obtain an interactive and photo-realistic visualization of the lymph nodes showing their proximity to blood vessels and surrounding organs. The lymph node topography forms part of our whole body atlas database, which includes organs, definitions, and parameters that are related to radiation therapy. The lymph node topography atlas could be utilized for visualization and exploration of the 3D lymphatic distribution to assist in defining the target volume for treatment based on the lymphatic spread surrounding the primary tumor.

  4. Characteristics of Metastatic Mediastinal Lymph Nodes of Non-Small Cell Lung Cancer on Preoperative F-18 FDG PET/CT

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    Lee, Ah Young; Choi, Su Jung; Jung, Kyung Pyo; Park, Ji Sun; Lee, Seok Mo; Bae, Sang Kyun [Inje Univ. College of Medicine, Gimhae (Korea, Republic of)

    2014-03-15

    The aim of this study was to evaluate the characteristics of PET and CT features of mediastinal metastatic lymph nodes on F-18 FDG PET/CT and to determine the diagnostic criteria in nodal staging of non-small cell lung cancer. One hundred four non-small cell lung cancer patients who had preoperative F-18 FDG PET/CT were included. For quantitative analysis, the maximum SUV of the primary tumor, maximum SUV of the lymph nodes (SUVmax), size of the lymph nodes, and average Hounsfield units (aHUs) and maximum Hounsfield units (mHUs) of the lymph nodes were measured. The SUVmax, SUV ratio of the lymph node to blood pool (LN SUV/blood pool SUV), SUV ratio of the lymph node to primary tumor (LN SUV/primary tumor SUV), size, aHU, and mHU were compared between the benign and malignant lymph nodes. Among 372 dissected lymph node stations that were pathologically diagnosed after surgery, 49 node stations were malignant and 323 node stations benign. SUVmax, LN SUV/blood pool SUV, and size were significantly different between the malignant and benign lymph node stations (P <0.0001). However, there was no significant difference in LN SUV/primary tumor SUV (P =0.18), mHU (P =0.42), and aHU (P =0.98). Using receiver-operating characteristic curve analyses, there was no significant difference among these three variables (SUVmax, LN SUV/blood pool SUV, and size). The optimal cutoff values were 2.9 for SUVmax, 1.4 for LN SUV/blood pool SUV, and 5 mm for size. When the cutoff value of SUVmax≥2.9 and size≥5 mm were used in combination, the positive predictive value was 44.2%, and the negative predictive value was 90.9 %. When we evaluated the results based on the histology of the primary tumor, the negative predictive value was 92.3 % in adenocarcinoma (cutoff values of SUVmax≥2.3 and size≥5 mm) and 97.2 % in squamous cell carcinoma (cutoff values of SUVmax≥3.6 and size≥8 mm), separately. In the lymph node staging of non-small cell lung cancer, SUVmax, LN SUV/blood pool SUV

  5. 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.

  6. Lymph node transfer and perinodal lymphatic growth factor treatment for lymphedema.

    Science.gov (United States)

    Honkonen, Krista M; Visuri, Mikko T; Tervala, Tomi V; Halonen, Paavo J; Koivisto, Mari; Lähteenvuo, Markku T; Alitalo, Kari K; Ylä-Herttuala, Seppo; Saaristo, Anne M

    2013-05-01

    Our objective was to define the optimal growth factor treatment to be used in combination with lymph node transfer to normalize lymphatic vascular anatomy. In the lymph node transfer method, lymphatic anastomoses are expected to form spontaneously. However, lymphangiogenic growth factor therapies have shown promising results in preclinical models of lymphedema. The inguinal lymphatic vasculature of pigs was surgically destroyed around the inguinal lymph node. To enhance the regrowth of the lymphatic network in the defected area, adenoviral vascular endothelial growth factor C (VEGF-C) was administered intranodally or perinodally. Control animals received injections of saline or control vector. The lymphangiogenic effect of the growth factor therapy and any potential adverse effects associated with the 2 alternative delivery routes were examined 2 months postoperatively. Both routes of growth factor administration induced robust growth of lymphatic vessels and helped to preserve the structure of the transferred lymph nodes in comparison with the controls. The lymph nodes of the control treated animals regressed in size and their nodal structure was partly replaced by fibro-fatty scar tissue. Intranodally injected adenoviral VEGF-C and adenoviral vector encoding control gene LacZ induced macrophage accumulation inside the node, whereas perinodal administration of VEGF-C did not have this adverse effect. Lymphangiogenic growth factors improve lymphatic vessel regeneration and lymph node function after lymph node transfer. The perinodal route of delivery provides a basis for future clinical trials in lymphedema patients.

  7. 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.

  8. Diagnostic accuracy of apparent diffusion coefficient value in differentiating metastatic form benign axillary lymph nodes in cancer breast

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    Ahmed A. Azeem Ismail

    2014-09-01

    Conclusion: Compared with lymph node size or routine magnetic resonance sequences, DWI and ADC are promising techniques for differentiating metastatic and non metastatic axillary lymph nodes in known breast cancer patients.

  9. Diagnosis of Cervical Metastatic Lymph Nodes in Papillary Thyroid Carcinoma: Is CT Enhancement Useful for Diagnosing Lymph Node Metastasis?

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    Shin, Hyun Joo; Kim, Eun Kyung; Moon, Hee Jung; Kwak, Jin Young [Yonsei University College of Medicine, Seoul (Korea, Republic of)

    2011-09-15

    We wanted to determine the utility of CT enhancement for diagnosing metastatic lymphadenopathy in patients with papillary thyroid carcinoma (PTC), and especially in the lymph nodes (LNs) of the lateral neck level and that are not suspicious for metastasis on ultrasonography (US). Our study population included 34 consecutive LNs of 31 patients (25 females and 6 males, mean age: 46.7 yrs) with PTC and who had no suspicious metastatic lateral cervical LN on preoperative US, but enhancement of the lateral cervical LNs was seen on CT. To objectify the degree of enhancement, the difference of Hounsfield units between the suspicious LN and that of the ipsilateral SCM muscle was calculated. For the node-by-node analysis, marking of the corresponding LN with CT enhancement on the second look US was performed. The final assessment was attained by surgical dissection of the marked LNs. The medical records were reviewed for the patients' age and gender and the size of the LNs. Among the 34 LNs, 17 LNs were diagnosed as metastasis and 17 were benign. There was no difference in the size of the LNs between two the groups (benign and metastatic). The patients who had metastatic LNs were younger than those patients with benign LNs (p = 0.037). The incidence of metastatic LN was higher in the male patients than in the female patients (F:M = 38.5%:100%, p = 0.018). There was no statistical difference between the metastatic LNs and benign LNs according to the degree of enhancement (p = 0.953). The degree of CT enhancement is not feasible to use for diagnosing metastatic LNs in the lateral neck level in patients with PTC

  10. Knowledge of pathologically versus clinically negative lymph nodes is associated with reduced use of radioactive iodine post-thyroidectomy for low-risk papillary thyroid cancer.

    Science.gov (United States)

    Ruel, Ewa; Thomas, Samantha; Dinan, Michaela A; Perkins, Jennifer M; Roman, Sanziana A; Sosa, Julie Ann

    2016-06-01

    Cervical lymph node metastases are common in papillary thyroid cancer (PTC). Clinically negative lymph nodes confer uncertainty about true lymph node status, potentially prompting empiric postoperative radioactive iodine (RAI) administration even in low-risk patients. We examined the association of clinically (cN0) versus pathologically negative (pN0) lymph nodes with utilization of RAI for low-risk PTC. Using the National Cancer Database 1998-2011, adults with PTC who underwent total thyroidectomy for Stage I/II tumors 1-4 cm were evaluated for receipt of RAI based on cN0 versus pN0 status. Cut-point analysis was conducted to determine the number of pN0 nodes associated with the greatest decrease in the odds of receipt of RAI. Survival models and multivariate analyses predicting RAI use were conducted separately for all patients and patients negative surgical margins and multifocal disease (all p negative nodes reported in surgical pathology specimens was 4; ≥5 pathologically negative lymph nodes provided the best cut-point associated with reduced RAI administration (OR 0.91, CI 0.85-0.97). After multivariable adjustment, pN0 patients with ≥5 nodes examined were less likely to receive RAI compared to cN0 patients across all ages (OR 0.89, p negative lymph nodes in patients with PTC appears to influence the decision to administer postoperative RAI if ≥5 negative lymph nodes are removed. It is possible that fewer excised lymph nodes may be viewed by clinicians as incidentally resected and thus may suboptimally represent the true nodal status of the central neck. Further research is warranted to determine if there is an optimal number of lymph nodes that should be resected to standardize pathological diagnosis.

  11. Associations between the expression of MTA1 and VEGF-C in esophageal squamous cell carcinoma with lymph angiogenesis and lymph node metastasis.

    Science.gov (United States)

    Liu, Jianping; Xia, Juan; Zhang, Yongheng; Fu, Maoyong; Gong, Sheng; Guo, Yulong

    2017-09-01

    The aim of the present study was to investigate the association between the expression levels of metastasis-related gene 1 (MTA1) and vascular endothelial growth factor C (VEGF-C) in esophageal squamous cell carcinoma (ESCC) with lymph angiogenesis and lymph node metastasis. The paraffin-embedded tissue samples of 107 cases of ESCC and 56 cases of normal esophageal tissues were collected from the Department of Cardiothoracic Surgery, Suining Central Hospital from March 2013 to January 2014. Immunohistochemical assays were performed to detect the expression levels of MTA1, VEGF-C and D2-40 in ESCC, and the micro-lymphatic vessel density (LVD) was evaluated. Their associations with various clinicopathological parameters were also analyzed. The protein expression levels of MTA1 and VEGF-C in ESCC were significantly higher compared with those in normal esophageal tissues (PC in ESCC tissues at various tumor-node-metastasis stages exhibited statistically significant differences, as revealed by the Kruskal-Wallis test (PC in ESCC exhibited positive correlations (Spearman's ρ, r=0.512; P=0.000); the LVD level in the group with high expression of MTA1 and VEGF-C was significantly higher compared with in the low expression group (PC protein expression levels in the group with a high rate of lymph node metastasis demonstrated statistically significant differences when compared with in the low lymph node metastasis group (PC in ESCC exhibited a positive correlation in ESCC, which may co-promote lymph angiogenesis and lymph node metastasis in ESCC; therefore, they may be used as biomarkers for determining the prognosis of ESCC.

  12. Usefulness of semi-automatic volumetry compared to established linear measurements in predicting lymph node metastases in MSCT

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    Buerke, Boris; Puesken, Michael; Heindel, Walter; Wessling, Johannes (Dept. of Clinical Radiology, Univ. of Muenster (Germany)), email: buerkeb@uni-muenster.de; Gerss, Joachim (Dept. of Medical Informatics and Biomathematics, Univ. of Muenster (Germany)); Weckesser, Matthias (Dept. of Nuclear Medicine, Univ. of Muenster (Germany))

    2011-06-15

    Background Volumetry of lymph nodes potentially better reflect asymmetric size alterations independently of lymph node orientation in comparison to metric parameters (e.g. long-axis diameter). Purpose To distinguish between benign and malignant lymph nodes by comparing 2D and semi-automatic 3D measurements in MSCT. Material and Methods FDG-18 PET-CT was performed in 33 patients prior to therapy for malignant melanoma at stage III/IV. One hundred and eighty-six cervico-axillary, abdominal and inguinal lymph nodes were evaluated independently by two radiologists, both manually and with the use of semi-automatic segmentation software. Long axis (LAD), short axis (SAD), maximal 3D diameter, volume and elongation were obtained. PET-CT, PET-CT follow-up and/or histology served as a combined reference standard. Statistics encompassed intra-class correlation coefficients and ROC curves. Results Compared to manual assessment, semi-automatic inter-observer variability was found to be lower, e.g. at 2.4% (95% CI 0.05-4.8) for LAD. The standard of reference revealed metastases in 90 (48%) of 186 lymph nodes. Semi-automatic prediction of lymph node metastases revealed highest areas under the ROC curves for volume (reader 1 0.77, 95%CI 0.64-0.90; reader 2 0.76, 95%CI 0.59-0.86) and SAD (reader 1 0.76, 95%CI 0.64-0.88; reader 2 0.75, 95%CI 0.62-0.89). The findings for LAD (reader 1 0.73, 95%CI 0.60-0.86; reader 2 0.71, 95%CI 0.71, 95%CI 0.57-0.85) and maximal 3D diameter (reader 1 0.70, 95%CI 0.53-0.86; reader 2 0.76, 95%CI 0.50-0.80) were found substantially lower and for elongation (reader 1 0.65, 95%CI 0.50-0.79; reader 2 0.66, 95%CI 0.52-0.81) significantly lower (p < 0.05). Conclusion Semi-automatic analysis of lymph nodes in malignant melanoma is supported by high segmentation quality and reproducibility. As compared to established SAD, semi-automatic lymph node volumetry does not have an additive role for categorizing lymph nodes as normal or metastatic in malignant

  13. Ultrasonographic features of metastatic lymph nodes in papillary thyroid microcarinomas and macrocarcinomas

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    Shin, Young Gyung; Kang, Hee; Joh, Young Doc; Jeong, Kyung Soon; Kim, Beom Su [Dept. of Radiology, Kosin University Gospel Hospital, Busan(Korea, Republic of)

    2015-02-15

    To analyze ultrasonographic (US) features of metastatic lymph nodes (LNs) in papillary thyroid microcarcinomas (PTMC) and in papillary thyroid macrocarcinomas. The study reviewed US findings of 273 patients with pathologically confirmed papillary thyroid carcinoma (PTC) and metastatic LNs based on the US examination. Patients were divided into two groups: PTMC and papillary thyroid macrocarcinomas. The 273 patients with PTC included 87 with PTMC and 186 with papillary thyroid macrocarcinoma. No significant difference of US features in patients with lateral neck node metastasis was found between PTMC (n = 96) and macrocarcinoma (n = 29). In central neck node metastasis, round shape was the most frequent findings in both groups (p < 0.001). There was no significant difference in US features of metastatic LNs between PTMC and papillary thyroid macrocarcinomas. Therefore, careful evaluation of the whole neck should be made.

  14. 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.

  15. TOPOGRAPHIC CHARACTERISTICS OF THE LYMPH NODES OF THE DROMEDARY (Camelus dromedarius

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    P. Gavrylin

    2016-05-01

    Full Text Available 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 efferent lymphatics. In approximately half of nodes examined, there was extra nodal communications between the lymphatic vessels (afferent and efferent, allowing to bypass the lymph node. Lymph nodes are characterized by their dromedary lobule appearance and size. This lobulated appearance is acquired with age. Indeed in a camel one day we noticed that although the lymph nodes are large, but rather the lobulation is not clear. All forms are possible was lymph nodes ovoid, flattened, elongated, notched, triangular or rounded in some cases.

  16. PREDICTION OF NON-SENTINEL LYMPH NODE METASTASES IN BREAST CANCER

    Institute of Scientific and Technical Information of China (English)

    张杰; 沈坤炜; 尼尔马; 柳光宇; 吴炅; 邵志敏; 沈镇宙

    2003-01-01

    Objective. To identify a subset of breast cancer patients in whom metastatic disease is confined on- ly to the sentinel lymph node(SLn). Methods. Sentinel lymph node biopsy is performed with the injecetion of Tc99m-SC, and a gamma probe. Sentinel node biopsy was compared with standard axillary dissection for its ability to reflect the final pathological status of the axillary nodes. The factors associated with non-SLN metastases were assessed in the univariate and multivariate analysis. Result. We successfully identified 91 out of 95 patients for SLN(95.8%). The accuracy of sentinel lymph node to predict the axillary lymph node status was 93.4%. Clinical tumor size and tumor grade were proved to be the independent predictive factors for non-SLN metastases by logistic regression model. Conclusio.In most cases, the gamma probe guided method is technically feasible for detecting sentinel nodes, accurately predicting the axillary lymph node status. A subset of the patients identified who have a low risk of non-SLN metastases may not require axillary lymph node dissection.

  17. Influence of colloid particle profile on sentinel lymph node uptake

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    Fernandez Nunez, Eutimio Gustavo [Radiopharmacy Center, Institute of Energetic and Nuclear Research, Sao Paulo, SP 05508-000 (Brazil)], E-mail: eutimiocu@yahoo.com; Linkowski Faintuch, Bluma; Teodoro, Rodrigo; Pereira Wiecek, Danielle [Radiopharmacy Center, Institute of Energetic and Nuclear Research, Sao Paulo, SP 05508-000 (Brazil); Martinelli, Jose Roberto [Center of Materials Science and Technology, Institute of Energetic and Nuclear Research, Sao Paulo, SP 05508-000 (Brazil); Gomes da Silva, Natanael; Castanheira, Claudia E. [Radiopharmacy Center, Institute of Energetic and Nuclear Research, Sao Paulo, SP 05508-000 (Brazil); Santos de Oliveira Filho, Renato [Faculty of Medicine, Federal University of Sao Paulo, SP 04020-041 (Brazil); Pasqualini, Roberto [CIS bio international, Research and Development, Gif sur Yvette, 91192 (France)

    2009-10-15

    Introduction: Particle size of colloids employed for sentinel lymph node (LN) detection is not well studied. This investigation aimed to correlate particle size and distribution of different products with LN uptake. Methods: All agents (colloidal tin, dextran, phytate and colloidal rhenium sulfide) were labeled with {sup 99m}Tc according to manufacturer's instructions. Sizing of particles was carried out on electron micrographs using Image Tool for Windows (Version 2.0). Biodistribution studies in main excretion organs as well as in popliteal LN were performed in male Wistar rats [30 and 90 min post injection (p.i.)]. The injected dose was 0.1 ml (37 MBq) in the footpad of the left posterior limb. Dynamic images (0-15 min p.i.) as well as static ones (30 and 90 min) were acquired in gamma camera. Results: Popliteal LN was clearly reached by all products. Nevertheless, particle size remarkably influenced node uptake. Colloidal rhenium sulfide, with the smallest diameter (5.1x10{sup -3}{+-}3.9x10{sup -3} {mu}m), permitted the best result [2.72{+-}0.64 percent injected dose (%ID) at 90 min]. Phytate displayed small particles (<15 {mu}m) with favorable uptake (1.02{+-}0.14%ID). Dextran (21.4{+-}12.8 {mu}m) and colloidal tin (39.0{+-}8.3 {mu}m) were less effective (0.55{+-}0.14 and 0.06{+-}0.03%ID respectively). Particle distribution also tended to influence results. When asymmetric, it was associated with biphasic uptake which increased over time; conversely, symmetric distribution (colloidal tin) was consistent with a constant pattern. Conclusion: The results are suggesting that particle size and symmetry may interfere with LN radiopharmaceutical uptake.

  18. Infrared micro-spectral imaging: distinction of tissue types in axillary lymph node histology

    Directory of Open Access Journals (Sweden)

    Stone Nicholas

    2008-08-01

    Full Text Available Abstract Background Histopathologic evaluation of surgical specimens is a well established technique for disease identification, and has remained relatively unchanged since its clinical introduction. Although it is essential for clinical investigation, histopathologic identification of tissues remains a time consuming and subjective technique, with unsatisfactory levels of inter- and intra-observer discrepancy. A novel approach for histological recognition is to use Fourier Transform Infrared (FT-IR micro-spectroscopy. This non-destructive optical technique can provide a rapid measurement of sample biochemistry and identify variations that occur between healthy and diseased tissues. The advantage of this method is that it is objective and provides reproducible diagnosis, independent of fatigue, experience and inter-observer variability. Methods We report a method for analysing excised lymph nodes that is based on spectral pathology. In spectral pathology, an unstained (fixed or snap frozen tissue section is interrogated by a beam of infrared light that samples pixels of 25 μm × 25 μm in size. This beam is rastered over the sample, and up to 100,000 complete infrared spectra are acquired for a given tissue sample. These spectra are subsequently analysed by a diagnostic computer algorithm that is trained by correlating spectral and histopathological features. Results We illustrate the ability of infrared micro-spectral imaging, coupled with completely unsupervised methods of multivariate statistical analysis, to accurately reproduce the histological architecture of axillary lymph nodes. By correlating spectral and histopathological features, a diagnostic algorithm was trained that allowed both accurate and rapid classification of benign and malignant tissues composed within different lymph nodes. This approach was successfully applied to both deparaffinised and frozen tissues and indicates that both intra-operative and more conventional

  19. Breast Cancer Subtype as a Predictor of Lymph Node Metastasis according to the SEER Registry

    Science.gov (United States)

    Bhatia, Jay K.; Metzger, Daniel; Ashamalla, Hani; Katsoulakis, Evangelia

    2015-01-01

    Purpose Breast cancer subtype correlates with response to systemic therapy and overall survival (OS), but its impact on lymphatic spread is incompletely understood. In this study, we used the Surveillance, Epidemiology, and End Results registry to assess whether the subtype can predict the presence of nodal metastasis or advanced nodal stage in breast cancer. Methods A total of 7,274 eligible patients diagnosed with T1-3 infiltrating ductal carcinoma with known estrogen or progesterone hormone receptor (HR) and human epidermal growth factor receptor 2 (HER2) status, who underwent surgical excision of the primary tumor and pathologic lymph node evaluation, were included in this analysis. Patients were categorized into four breast cancer subtypes: HR+/HER2-; HR+/HER2+; HR-/HER2+; and HR-/HER2-. Binary logistic regression analysis was used to determine whether breast cancer subtype, tumor size, tumor grade, patient race, and patient age at diagnosis are independently predictive of lymph node positivity or advanced nodal stage. The Pearson chi-square test was used to determine whether progesterone receptor (PR) status had an impact on the incidence of lymph node positivity in estrogen receptor (ER) positive patients. Results Independent predictors of nodal positivity included breast cancer subtype (p=0.040), tumor size (p<0.001), tumor grade (p<0.001), and patient age (p<0.001), whereas only tumor size (p<0.001), grade (p=0.001), and patient age (p=0.005) predicted advanced nodal stage. Triple-negative cancers had a significantly lower risk of nodal positivity than the HR+/HER2- subtype (odds ratio, 0.686; p=0.004), but no other significant differences between subtypes were observed. There was also no difference in lymph node positivity between PR+ and PR- tumors amongst ER+/HER2- (p=0.228) or ER+/HER2+ tumors (p=0.713). Conclusion The HR+/HER2-breast cancer subtype has a higher rate of lymph node involvement at diagnosis than the triple-negative subtype. These

  20. Sentinel Lymph Node Biopsy Results in Early-Stage Breast Cancer

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    Ahmet Kocakuflak

    2011-06-01

    Full Text Available Aim: Sentinel lymph node biopsy (SLNB in breast cancer patients targets the evaluation of the initial lymph node (SLN which drains the primary tumor. The morbidity of unnecessary axillary dissection can be avoided by intensive preoperative assessment of SLN. Methods: Twenty-six consecutive patients who had been surgically treated for early-stage breast cancer between March 2005 and August 2007 were evaluated. Blue dye (methylene blue method was used to detect SLN. All patients underwent axillary lymph node dissection following SLNB. NCSS program was used for statistical analysis. Chi-square test was used in the comparison of binary groups. Results: Except for one, all patients were female. The mean age of the patients was 56 (29-76 years. While 13 patients underwent modified radical mastectomy (=mastectomy+axillary dissection, the remaining 13 patients underwent breast preserving surgery (lumpectomy+axillary dissection. SLN could not be found in 2 patients (7.6%.The male patient was one of these 2 patients and both of them were positive for axillary node metastases. The detection rate of SLN, specificity, negative predictive value, positive predictive value, sensitivity, false negativity, and reliability were 92.3%, 92.8%, 86%, 90.9%, 83.3%, 16.6%, and 88.4%, respectively. Conclusion: Our result support the hypothesis that SLNB with blue dye alone is a reliable technique and, surgery clinics should use it prior to axillary dissection to test their own success during the learning curve. (The Medical Bulletin of Haseki 2011; 49: 67-72

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

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    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.

  2. Lymph node topology dictates T cell migration behavior.

    Science.gov (United States)

    Beltman, Joost B; Marée, Athanasius F M; Lynch, Jennifer N; Miller, Mark J; de Boer, Rob J

    2007-04-16

    Adaptive immunity is initiated by T cell recognition of foreign peptides presented on dendritic cells (DCs) by major histocompatibility molecules. These interactions take place in secondary lymphoid tissues, such as lymph nodes (LNs) and spleen, and hence the anatomical structure of these tissues plays a crucial role in the development of immune responses. Two-photon microscopy (2PM) imaging in LNs suggests that T cells walk in a consistent direction for several minutes, pause briefly with a regular period, and then take off in a new, random direction. Here, we construct a spatially explicit model of T cell and DC migration in LNs and show that all dynamical properties of T cells could be a consequence of the densely packed LN environment. By means of 2PM experiments, we confirm that the large velocity fluctuations of T cells are indeed environmentally determined rather than resulting from an intrinsic motility program. Our simulations further predict that T cells self-organize into microscopically small, highly dynamic streams. We present experimental evidence for the presence of such turbulent streams in LNs. Finally, the model allows us to estimate the scanning rates of DCs (2,000 different T cells per hour) and T cells (100 different DCs per hour).

  3. The lymph node as a new site for kidney organogenesis.

    Science.gov (United States)

    Francipane, Maria Giovanna; Lagasse, Eric

    2015-03-01

    The shortage of organs for kidney transplantation has created the need to develop new strategies to restore renal structure and function. Given our recent finding that the lymph node (LN) can serve as an in vivo factory to generate or sustain complex structures like liver, pancreas, and thymus, we investigated whether it could also support kidney organogenesis from mouse renal embryonic tissue (metanephroi). Here we provide the first evidence that metanephroi acquired a mature phenotype upon injection into LN, and host cells likely contributed to this process. Urine-like fluid-containing cysts were observed in several grafts 12 weeks post-transplantation, indicating metanephroi transplants' ability to excrete products filtered from the blood. Importantly, the kidney graft adapted to a loss of host renal mass, speeding its development. Thus, the LN might provide a unique tool for studying the mechanisms of renal maturation, cell proliferation, and fluid secretion during cyst development. Moreover, we provide evidence that inside the LN, short-term cultured embryonic kidney cells stimulated with the Wnt agonist R-Spondin 2 gave rise to a monomorphic neuron-like cell population expressing the neuronal 200-kDa neurofilament heavy marker. This finding indicates that the LN might be used to validate the differentiation potential of candidate stem cells in regenerative nephrology.

  4. Acral lentiginous melanoma: who benefits from sentinel lymph node biopsy?

    Science.gov (United States)

    Ito, Takamichi; Wada, Maiko; Nagae, Konosuke; Nakano-Nakamura, Misa; Nakahara, Takeshi; Hagihara, Akihito; Furue, Masutaka; Uchi, Hiroshi

    2015-01-01

    There are significant clinicopathological, genetic, and biological differences between acral lentiginous melanoma (ALM) and other types of melanoma. We sought to investigate the use of sentinel lymph node (SLN) biopsy for patients with ALM. This was a retrospective review of 116 patients with primary ALM. Melanoma-specific and disease-free survival were estimated using the Kaplan-Meier method, together with multivariate analyses using the Cox proportional hazards regression model. All patients were Japanese (48 male and 68 female). Metastases in SLN were noted in 13 of 84 patients who underwent SLN biopsy. No patients with thin ALM (≤1 mm) and only 2 patients with nonulcerated ALM had tumor-positive SLN. Patients with positive SLN had significantly shorter melanoma-specific survival (5-year survival rate, 37.5% vs 84.3%; P 1 mm) ALM, the influence of SLN positivity on melanoma-specific survival was increased (5-year survival, 22.7% vs 80.8%; P = .0005). This was a retrospective study and had a small sample size. SLN biopsy should be considered for patients with thick or ulcerated ALM. For patients with thin or nonulcerated ones, it may be of limited importance. Copyright © 2014 American Academy of Dermatology, Inc. Published by Elsevier Inc. All rights reserved.

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

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

    2009-07-01

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

  6. [Sentinel lymph node biopsy in melanoma patients: methods, indications, and clinical significance].

    Science.gov (United States)

    Kaikaris, Vygintas; Valiukeviciene, Skaidra; Rimdeika, Rytis; Gollnick, Harald; Ulrich, Jens

    2003-01-01

    The incidence of melanoma in Lithuania has doubled over the last decade. Sentinel lymph node biopsy, currently becoming a standard method in the US and Europe, is a minimal invasive and highly sensitive surgical procedure. It can be used for the detection of melanoma micrometastasis in regional lymph nodes in cases when non-invasive methods fail to reveal them. Both disease-free survival and disease-specific survival were significantly better for patients with a negative sentinel lymph node biopsy. A. Breslow thickness, W. H. Clark level, and ulceration of the melanoma were strong predictors, but not as strong as the histological status of the sentinel lymph node. The procedure for sentinel lymph node biopsy is nowadays standardized, including preoperative dynamic lymphoscintigraphy combined with intraoperative gamma probe guidance and blue-dye injection. The aim of this article is to present an update of the sentinel lymph node biopsy method and the prognostic significance of this procedure on the basis of more than 400 sentinel lymph node biopsy's carried out at the Department of Dermatology of the Otto-von-Guericke University, Magdeburg since 1997 and the results of recently published studies in the literature.

  7. RELATIONSHIP BETWEEN LYMPH NODE METASTASES IN ESOPHAGEAL CARCINOMA AND ITS PROGNOSIS

    Institute of Scientific and Technical Information of China (English)

    肖小炜

    2002-01-01

    Objective: To study the relationship between lymph node metastases in esophageal carcinoma and its prognosis. Methods: We obtained 1500 resected lymph nodes from the specimen of 86 patients with resected esophageal carcinoma and checked these lymph nodes by routine histopathology. Additiionally, frozen tissue sections of 540 lymph nodes classified as tumor-free by routine histopathology werescreened for micrometastases by immunohistology with the monoclonal antibody Ber-EP4. Results: Forty-two patients (49%) had pN0 disease, and 61 patients (71%) had lymph node micrometastases detected by immunohistochemistry, skip metastasesdetected by routine histopathology were present in 26%(11/42) of pN0 and 41%(18/44) of pN1 patients. Skipping of micrometastases detected by immunohistochemistry was found in 71%(61/86). Twenty-six of 42 patients (62%) with tumor staged aspN0 and 35 of 44 patients (80%) with stage pN1 had nodal micrometastasis. The presence of micrometastases was associated with a significantly decreased relapse-free time and overall survival (P<0.0001 and P=0.004, respectively). Conclusion: Lymph node skip metastases are a frequent event in esophageal carcinoma. Extensive lymph node sampling, in conjunction with immunohistochemical detection, will lead to accurate staging and prognosis.

  8. 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.

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

    Directory of Open Access Journals (Sweden)

    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.

  10. Endobronchial ultrasound guided transbronchial needle aspiration of enlarged mediastinal lymph nodes

    Directory of Open Access Journals (Sweden)

    Nadja Triller

    2005-01-01

    Full Text Available Background: Conventional transbronchial needle aspiration (TBNA of enlarged mediastinal lymph nodes is a fairly blind technique. Endobronchial ultrasound (EBUS guided TBNA resulted in higher success rate. The needle can be inserted safely into the lymph node. We examined the diagnostic yield of EBUS guided TBNA in clinical circumstances.Patients and methods: Patients with enlarged mediastinal lymph nodes, detected on chest X-ray and/or CT scan, underwent bronchoscopy. The exact location of lymph nodes was established by EBUS. 20 MHz ultrasound probe with a balloon catheter was used.Results: Seventy-five patients aged between 20 and 79 years (median age 55 years, underwent EBUS examination followed by TBNA of the target lymph node. Lymph nodes pathology was correctly diagnosed in 65 (87% of them. In 52 (70% patients the lymph nodes were infiltrated with malignoma, 13 (17% had benign diseases and in 10 (13% patients with non definitive disease the final diagnosis was obtained by surgery or by follow up. No major complication was encountered after EBUS-guided TBNA.Conclusions: Diagnostic yield of EBUS-guided TBNA is high. There were no major complications and the procedure was tolerated well.

  11. [The efficacy of superselective intra-arterial chemo-radiotherapy for cervical neck lymph node metastases].

    Science.gov (United States)

    Mada, Yusuke; Koshitsuka, Keiichi; Ihara, Fumie; Ueki, Yuji; Konno, Akiyoshi

    2014-06-01

    We report herein on 32 cases of head and neck carcinoma with cervical lymph node metastases treated by radiotherapy and concomitant intraarterial cisplatin (RADPLAT) from April 2009 to May 2013. N3 cases revealed residual disease of the cervical lymph nodes in 7/9 cases. Among the 22 patients excluding N1 and N3 cases, the pathological CR rate was 63.6%. Among the 13 patients in whom the anticancer drug was directly infused into the cervical lymph nodes, the pathological CR rate was 76.9%, whereas in the 9 patients without direct infusion of the cervical lymph nodes, the pathological CR rate was 44.4%. Therefore, we recommend the direct infusion into cervical lymph node metastases for not only N3 cases but also N2 cases if a feeding artery is identified easily. When clinical examination after RADPLAT leads to suspected residual disease, neck dissection should be adapted. If the clinical examination leads to a diagnosis of CR, we recommend a biopsy of the original cervical lymph nodes because the cases which we diagnosed as CR revealed residual disease of the cervical lymph nodes in 4/16.

  12. A CLINICOPATHOLOGICAL STUDY OF MEDIASTINAL LYMPH NODE METASTASIS OF LUNG CANCER

    Institute of Scientific and Technical Information of China (English)

    2000-01-01

    Objective:To investigate pathologically the characteristics of lung cancer metastasis by mediastinal lymph node ways (N2). Methods: Of 398 lung cancer patients who underwent radical pulmonectomy and extensive lymph node dissection, 160 patients were diagnosed as with N2 metastasis, their 352 groups of mediastinal lymph nodes invaded were subject to the pathological study. Results: Evidences showed that the N2 metastasis of lung cancer was very active. It appears as single group or multi-group or jumping-form metastasis, rating 41.2%, 58.8% and 29.3% respectively. In addition, the extension of N2 metastasis was large, the most concentrated site was the 7th group lymph node (48.8%), then the 4th, 3rd and 5th group, rating 45.6%, 31.3% and 25.6% respectively. The occurrence of N2 metastasis was highly correlated with the site, size, histopathological type and the grade of differentiation of the cancer. An another feature of N2 metastasis was the invasion of metastasized lymph node into the bronchial wall, especially in adenocarcinoma. Conclusion: In order to achieve the radical removal of tumor, it is necessary to dissect the lymph nodes of the hilar and upper and lower mediastinum at the homolateral thoracic cavity actively and completely; beside, attention may be paid to the bronchial wall invasion caused by the lymph nodes metastasized.

  13. Relationship between Lymphatic Vessel Density and Lymph Node Metastasis of Invasive Micropapillary Carcinoma of the Breast

    Institute of Scientific and Technical Information of China (English)

    Xiaojing Guo; Ling Chen; Ronggang Lang; Yu Fan; Li Fu

    2006-01-01

    OBJECTIVE To investigate the relationship between lymphatic vessel density and lymph node metastasis of invasive micropapillary carcinoma (IMPC) of the breast.METHODS The immunohistochemical study for vascular endothelial growth factor-c (VEGF-C), VEGF Receptor-3 (VEGFR-3) and lymphatic vessel density of 51 cases of IMPC were performed, and lymph node metastases were examined by microscopic analysis of these cases.RESULTS In IMPC, VEGF-C was expressed in the cytoplasm and/or on the membrane of the tumor cells, and the expression of VEGF-C showed a positive correlation with lymph node metastasis (P<0.01). Lymphatic vessel density was determined by the number of micro-lymphatic vessels with VEGFR-3 positive staining. Lymphatic vessel density was positively correlated with VEGF-C expre