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Sample records for lymph nodes lns

  1. The number of resected lymph nodes (nLNs) combined with tumor size as a prognostic factor in patients with pathologic N0 and Nx non-small cell lung cancer.

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    Yang, Miaomiao; Cao, Hongxin; Guo, Xi; Zhang, Tiehong; Hu, Pingping; Du, Jiajun; Liu, Qi

    2013-01-01

    The prognostic role of the number of resected lymph nodes (nLNs) in pathologic N0 (lymph node negative) and Nx (no lymph node examined) non-small cell lung cancer (NSCLC) patients remains uncertain. Guidelines for optimal nLNs have not been established. In the current study, we evaluated whether a higher number of resected lymph nodes (LNs) results in better survival in different tumor size categories among NSCLC patients without metastatic LNs. A retrospective study was conducted. Based on nLNs (LN = 0, 1-7, >7) and tumor size (Ta: ≤ 3.5 cm, Tb: >3.5 cm) during surgery, patients were categorized into 6 groups (LN0Ta, LN0Tb, LN1-7Ta, LN1-7Tb, LN7-Ta and LN7-Tb). Survival and multivariate analyses were carried out to determine whether nLNs combined with tumor size was significant for overall survival (OS) or disease free survival (DFS) after adjusting for potential confounders. A total of 428 patients were enrolled in the study. Multivariate analysis demonstrated that nLNs, tumor size and pathological stage were the independent prognosticators for OS and DFS. Data from our study suggested that lung cancer lymphadenectomy with more than 7 LNs removed should be considered a benchmark for surgery or pathology at an early stage. Survival was significantly better in the LN7-Ta group, compared with other 5 groups (pNx NSCLC. The validation of our finding is warranted in further investigation.

  2. 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 ...

  3. 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 ...

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

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    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

  5. 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.

  6. 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 ...

  7. 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 ...

  8. 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

  9. LIGHT regulates inflamed draining lymph node hypertrophy

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    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

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

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    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.

  11. 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

  12. 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...

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

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    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.

  14. Prognostic impact of dissected lymph node count on patients with node-negative gastric cancer

    Institute of Scientific and Technical Information of China (English)

    Chang-Ming Huang; Jian-Xian Lin; Chao-Hui Zheng; Ping Li; Jian-Wei Xie; Bi-Juan Lin; Hui-Shan Lu

    2009-01-01

    AIM: To investigate the long-term effect of the number of resected lymph nodes (LNs) on the prognosis of patients with node-negative gastric cancer. METHODS: Clinical data of 211 patients with gastric cancer, without nodal involvement, were analyzed retrospectively after D2 radical operation. We analyzed the relationship between the number of resected LNs with the 5-year survival, the recurrence rate and the post-operative complication rate.RESULTS: The 5-year survival of the entire cohort was 82.2%. The total number of dissected LNs was one of the independent prognostic factors. Among patients with comparable depth of invasion, the larger the number of resected LNs, the better the survival ( P 0.05).CONCLUSION: For node-negative gastric cancer,sufficient number of dissected LNs is recommended during D2 lymphadenectomy, to improve the long-term survival and reduce the recurrence. Suitable increments of the dissected LN count would not increase the postoperative complication rate.

  15. Intraoperative Sentinel Lymph Node Evaluation

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    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...

  16. Lymph node staging in prostate cancer.

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    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.

  17. 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...

  18. Lymph node topology dictates T cell migration behavior.

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    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).

  19. Fugue G Minor: Getting the Lymph Node Ensemble Together with Circadian Rhythm.

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    Silva-Sanchez, Aaron; Randall, Troy D

    2017-01-17

    A fugue is characterized by the systematic repetition of a principal theme in simultaneous melodic lines. In this issue of Immunity, Druzd et al. (2017) show that a similar phenomenon occurs in lymph nodes (LNs), in which lymphocyte entry and exit is governed by repetitive circadian rhythms.

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

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    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

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

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    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.

  2. VERIFICATION OF A TUMOR LESION OF INTRAPELVIC LYMPH NODES AFTER RADICAL PROSTATECTOMY. THE FIRST EXPERIENCE

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    V. V. Kapustin

    2014-08-01

    Full Text Available Objective: to study the possibilities of transrectal ultrasound scan (TRUS and magnetic resonance imaging (MRI in identifying and verifying a tumor lesion of intrapelvic lymph nodes (LN in patients with biochemical recurrence after radical prostatectomy.Subjects and methods. Metastatic tumor lesion of intrapelvic LNs was verified in 4 patients by transrectal ultrasound (US-guided needle biopsies. All the patients underwent multi-parametric MRI studies and TRUS.Results. The application of current MRI technologies (for qualitative and quantitative analysis of diffusion-weighted images and for postcontrast sequences could detect and judge with confidence the metastatic lesion of intrapelvic LNs. TRUS permits clearly visualizing pathologically altered LNs, by taking into account their MRI pattern and verifying their tumor lesion by US-guided core needle biopsy.Conclusion. The combined use of multi-parametric MRI and TRUS provides a means for diagnosing and verifying the tumor lesion of pelvic LNs in patients after prostatectomy.

  3. VERIFICATION OF A TUMOR LESION OF INTRAPELVIC LYMPH NODES AFTER RADICAL PROSTATECTOMY. THE FIRST EXPERIENCE

    Directory of Open Access Journals (Sweden)

    V. V. Kapustin

    2012-01-01

    Full Text Available Objective: to study the possibilities of transrectal ultrasound scan (TRUS and magnetic resonance imaging (MRI in identifying and verifying a tumor lesion of intrapelvic lymph nodes (LN in patients with biochemical recurrence after radical prostatectomy.Subjects and methods. Metastatic tumor lesion of intrapelvic LNs was verified in 4 patients by transrectal ultrasound (US-guided needle biopsies. All the patients underwent multi-parametric MRI studies and TRUS.Results. The application of current MRI technologies (for qualitative and quantitative analysis of diffusion-weighted images and for postcontrast sequences could detect and judge with confidence the metastatic lesion of intrapelvic LNs. TRUS permits clearly visualizing pathologically altered LNs, by taking into account their MRI pattern and verifying their tumor lesion by US-guided core needle biopsy.Conclusion. The combined use of multi-parametric MRI and TRUS provides a means for diagnosing and verifying the tumor lesion of pelvic LNs in patients after prostatectomy.

  4. 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.

  5. Loco-regional conformal radiotherapy of the breast: delineation of the regional lymph node clinical target volumes in treatment position.

    NARCIS (Netherlands)

    Dijkema, I.M.; Hofman, P.; Raaijmakers, C.P.; Lagendijk, J.J.; Battermann, J.J.; Hillen, B.

    2004-01-01

    BACKGROUND AND PURPOSE: As the location of the regional lymph nodes (LNs) of the breast varies largely between patients and may be dependant on the position of the arm, adequate localization of these nodes is mandatory in order to fully take advantage of optimized conformal radiotherapy. For this

  6. 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.

  7. Visceral Obesity Predicts Fewer Lymph Node Metastases and Better Overall Survival in Colon Cancer

    OpenAIRE

    Park, Se Woo; Lee, Hang Lak; Doo, Eun Young; Lee, Kang Nyeong; Jun, Dae Won; Lee, Oh Young; Han, Dong Soo; Yoon, Byung Chul; Choi, Ho Soon; Lee, Kang Hong

    2015-01-01

    Background The relationship between visceral obesity and colon cancer outcome has not been well studied. The goal of this study was to determine the impact of visceral obesity on lymph node (LN) metastasis and overall survival (OS) in colon cancer. Materials and Methods Metastatic LN ratio (MLR) was defined as the number of involved nodes by tumor divided by the total number of resected LNs. Visceral (VFA) and subcutaneous fat areas (SFA) were determined by measuring abdominal fat volume dist...

  8. Contrast enhanced ultrasound of sentinel lymph nodes

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    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.

  9. 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.

  10. Extended lymph node dissection for prostate cancer.

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    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.

  11. 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

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

    Directory of Open Access Journals (Sweden)

    A Dharaskar

    2011-01-01

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

  13. Mapping the distinctive populations of lymphatic endothelial cells in different zones of human lymph nodes.

    Directory of Open Access Journals (Sweden)

    Saem Mul Park

    Full Text Available The lymphatic sinuses in human lymph nodes (LNs are crucial to LN function yet their structure remains poorly defined. Much of our current knowledge of lymphatic sinuses derives from rodent models, however human LNs differ substantially in their sinus structure, most notably due to the presence of trabeculae and trabecular lymphatic sinuses that rodent LNs lack. Lymphatic sinuses are bounded and traversed by lymphatic endothelial cells (LECs. A better understanding of LECs in human LNs is likely to improve our understanding of the regulation of cell trafficking within LNs, now an important therapeutic target, as well as disease processes that involve lymphatic sinuses. We therefore sought to map all the LECs within human LNs using multicolor immunofluorescence microscopy to visualize the distribution of a range of putative markers. PROX1 was the only marker that uniquely identified the LECs lining and traversing all the sinuses in human LNs. In contrast, LYVE1 and STAB2 were only expressed by LECs in the paracortical and medullary sinuses in the vast majority of LNs studied, whilst the subcapsular and trabecular sinuses lacked these molecules. These data highlight the existence of at least two distinctive populations of LECs within human LNs. Of the other LEC markers, we confirmed VEGFR3 was not specific for LECs, and CD144 and CD31 stained both LECs and blood vascular endothelial cells (BECs; in contrast, CD59 and CD105 stained BECs but not LECs. We also showed that antigen-presenting cells (APCs in the sinuses could be clearly distinguished from LECs by their expression of CD169, and their lack of expression of PROX1 and STAB2, or endothelial markers such as CD144. However, both LECs and sinus APCs were stained with DCN46, an antibody commonly used to detect CD209.

  14. Prognostic Significance of the Number of Positive Lymph Nodes in Women With T1-2N1 Breast Cancer Treated With Mastectomy: Should Patients With 1, 2, and 3 Positive Lymph Nodes Be Grouped Together?

    Energy Technology Data Exchange (ETDEWEB)

    Dai Kubicky, Charlotte, E-mail: charlottedai@gmail.com [Department of Radiation Medicine and Knight Cancer Institute, Oregon Health and Science University, Portland, Oregon (United States); Mongoue-Tchokote, Solange [Biostatistics Shared Resource, Knight Cancer Institute, Oregon Health and Science University, Portland, Oregon (United States)

    2013-04-01

    Purpose: To determine whether patients with 1, 2, or 3 positive lymph nodes (LNs) have similar survival outcomes. Methods and Materials: We analyzed the Surveillance, Epidemiology, and End Results registry of breast cancer patients diagnosed between 1990 and 2003. We identified 10,415 women with T1-2N1M0 breast cancer who were treated with mastectomy with no adjuvant radiation, with at least 10 LNs examined and 6 months of follow-up. The Kaplan-Meier method and log–rank test were used for survival analysis. Multivariate analysis was performed using the Cox proportional hazard model. Results: Median follow-up was 92 months. Ten-year overall survival (OS) and cause-specific survival (CSS) were progressively worse with increasing number of positive LNs. Survival rates were 70%, 64%, and 60% (OS), and 82%, 76%, and 72% (CSS) for 1, 2, and 3 positive LNs, respectively. Pairwise log–rank test P values were <.001 (1 vs 2 positive LNs), <.001 (1 vs 3 positive LNs), and .002 (2 vs 3 positive LNs). Multivariate analysis showed that number of positive LNs was a significant predictor of OS and CSS. Hazard ratios increased with the number of positive LNs. In addition, age, primary tumor size, grade, estrogen receptor and progesterone receptor status, race, and year of diagnosis were significant prognostic factors. Conclusions: Our study suggests that patients with 1, 2, and 3 positive LNs have distinct survival outcomes, with increasing number of positive LNs associated with worse OS and CSS. The conventional grouping of 1-3 positive LNs needs to be reconsidered.

  15. 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.

  16. Tumor, Lymph node and Lymph Node-to-Tumor Displacements over a Radiotherapy Series: Analysis of Inter- and Intrafraction Variations using Active Breathing Control (ABC) in Lung Cancer

    Science.gov (United States)

    Weiss, Elisabeth; Robertson, Scott P.; Mukhopadhyay, Nitai; Hugo, Geoffrey D.

    2011-01-01

    Purpose To estimate errors in soft tissue-based image guidance due to relative changes between primary tumor (PT) and affected lymph node (LN) position and volume, and to compare the results to bony anatomy-based displacements of PTs and LNs during radiotherapy of lung cancer. Materials and Methods Weekly repeated breath hold CT scans were acquired in 17 lung cancer patients undergoing radiotherapy. PTs and affected LNs were manually contoured on all scans after rigid registration. Inter- and intrafraction displacements in the centers of mass of PTs and LNs relative to bone, and LNs relative to PTs (LN-PT) were calculated. Results The mean volume after 5 weeks was 65% for PTs and 63% for LNs. Systematic/random interfraction displacements were 2.6 – 4.6 mm/2.7 – 2.9 mm for PTs, 2.4 – 3.8 mm/1.4 – 2.7 mm for LNs, and 2.3 – 3.9 mm/1.9 – 2.8 mm for LN-PT. Systematic/random intrafraction displacements were 3 mm were observed in 67% of fractions and require a safety margin of 12 mm in lateral, 11 mm in anteroposterior and 9 mm in superior-inferior direction. LN-PT displacements displayed significant time trends (p<0.0001) and depended on the presence of pathoanatomical conditions of the ipsilateral lung, such as atelectasis. Conclusion Interfraction LN-PT displacements were mostly systematic and comparable to bony anatomy-based displacements of PTs or LNs alone. Time trends, large volume changes and the influence of pathoanatomical conditions underline the importance of soft tissue-based image guidance and the potential of plan adaptation. PMID:22197237

  17. Supine MRI for regional breast radiotherapy: imaging axillary lymph nodes before and after sentinel-node biopsy

    Science.gov (United States)

    van Heijst, Tristan C. F.; Eschbach-Zandbergen, Debora; Hoekstra, Nienke; van Asselen, Bram; Lagendijk, Jan J. W.; Verkooijen, Helena M.; Pijnappel, Ruud M.; de Waard, Stephanie N.; Witkamp, Arjen J.; van Dalen, Thijs; Desirée van den Bongard, H. J. G.; Philippens, Marielle E. P.

    2017-08-01

    Regional radiotherapy (RT) is increasingly used in breast cancer treatment. Conventionally, computed tomography (CT) is performed for RT planning. Lymph node (LN) target levels are delineated according to anatomical boundaries. Magnetic resonance imaging (MRI) could enable individual LN delineation. The purpose was to evaluate the applicability of MRI for LN detection in supine treatment position, before and after sentinel-node biopsy (SNB). Twenty-three female breast cancer patients (cTis-3N0M0) underwent 1.5 T MRI, before and after SNB, in addition to CT. Endurance for MRI was monitored. Axillary levels were delineated. LNs were identified and delineated on MRI from before and after SNB, and on CT, and compared by Wilcoxon signed-rank tests. LN locations and LN-based volumes were related to axillary delineations and associated volumes. Although postoperative effects were visible, LN numbers on postoperative MRI (median 26 LNs) were highly reproducible compared to preoperative MRI when adding excised sentinel nodes, and higher than on CT (median 11, p  <  0.001). LN-based volumes were considerably smaller than respective axillary levels. Supine MRI of LNs is feasible and reproducible before and after SNB. This may lead to more accurate RT target definition compared to CT, with potentially lower toxicity. With the MRI techniques described here, initiation of novel MRI-guided RT strategies aiming at individual LNs could be possible.

  18. 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.

  19. Pathological internal mammary lymph nodes in secondary and tertiary deep inferior epigastric perforator flap breast reconstructions.

    Science.gov (United States)

    Hofer, Stefan O P; Rakhorst, Hinne A; Mureau, Marc A M; Moolenburgh, Sanne E; van Huizum, Martine A; van Geel, Albert N

    2005-12-01

    Use of internal mammary vessels during breast reconstruction provides information on part of the internal mammary chain lymph nodes (LNs). It was evaluated whether our current practice of screening should be changed to identify those delayed breast reconstruction patients with tumor-positive internal mammary nodes (IMNs) and whether breast reconstruction should be continued, in case suspicious IMNs were found intraoperatively. From February 2002 to December 2004, 81 patients had received 98 deep inferior epigastric perforator flaps for delayed breast reconstruction. Prospectively collected data for suspicious internal mammary LNs were evaluated. In 13 patients (16%) who had received a delayed breast reconstruction, macroscopically suspicious LNs were detected in the course of the internal mammary chain. Three patients (4%) had a pathologic diagnosis of malignancy, which was found to match their primary tumor. No relationship between positive internal mammary chain LNs and location of the primary tumor, TNM-stage, or previously administered adjuvant therapy was found. Suspicious internal mammary chain LNs found during recipient vessel dissection for breast reconstruction can have important consequences for treatment of malignant disease in individual patients. Presented data do not support changing the current perioperative approach of delayed breast reconstruction.

  20. 2D View Aggregation for Lymph Node Detection Using a Shallow Hierarchy of Linear Classifiers

    OpenAIRE

    Seff, Ari; Lu, Le; Cherry, Kevin M.; Roth, Holger; Liu, Jiamin; Wang, Shijun; Hoffman, Joanne; Turkbey, Evrim B.; Summers, Ronald M.

    2014-01-01

    Enlarged lymph nodes (LNs) can provide important information for cancer diagnosis, staging, and measuring treatment reactions, making automated detection a highly sought goal. In this paper, we propose a new algorithm representation of decomposing the LN detection problem into a set of 2D object detection subtasks on sampled CT slices, largely alleviating the curse of dimensionality issue. Our 2D detection can be effectively formulated as linear classification on a single image feature type o...

  1. A minimum yield of twelve lymph nodes in rectal cancer remains valid in the era of neo-adjuvant treatment

    DEFF Research Database (Denmark)

    Lykke, Jakob; Jess, Per; Roikjær, Ole

    2015-01-01

    PURPOSE: The purpose of the study was to examine if a minimum of 12 lymph nodes (LNs) is still valid in rectal cancer after neo-adjuvant treatment. METHODS: An analysis was carried out in a nationwide Danish cohort of 6793 patients, treated by curative resection of stage I-III rectal cancer durin...

  2. A Methylene Blue–assisted Technique for Harvesting Lymph Nodes After Radical Surgery for Gastric Cancer

    Science.gov (United States)

    Aoyama, Toru; Fujikawa, Hirohito; Cho, Haruhiko; Ogata, Takashi; Shirai, Junya; Hayashi, Tsutomu; Rino, Yasushi; Masuda, Munetaka; Oba, Mari S.; Morita, Satoshi

    2015-01-01

    Harvesting lymph nodes (LNs) after gastrectomy is essential for accurate staging. This trial evaluated the efficiency and quality of a conventional method and a methylene blue–assisted method in a randomized manner. The key eligibility criteria were as follows: (i) histologically proven adenocarcinoma of the stomach; (ii) clinical stage I-III; (iii) R0 resection planned by gastrectomy with D1+ or D2 lymphadenectomy. The primary endpoint was the ratio of the pathologic number of harvested LNs per time (minutes) as an efficacy measure. The secondary endpoint was the number of harvested LNs, as a quality measure. Between August 2012 and December 2012, 60 patients were assigned to undergo treatment using the conventional method (n=29) and the methylene blue dye method (n=31). The baseline demographics were mostly well balanced between the 2 groups. The number of harvested LNs (mean±SD) was 33.6±11.9 in the conventional arm and 43.4±13.9 in the methylene blue arm (P=0.005). The ratio of the number of the harvested LNs per time was 1.12±0.46 LNs/min in the conventional arm and 1.49±0.59 LNs/min in the methylene blue arm (P=0.010). In the subgroup analyses, the quality and efficacy were both superior for the methylene blue dye method compared with the conventional method. The methylene blue technique is recommended for harvesting LNs during gastric cancer surgery on the basis of both the quality and efficacy. PMID:25356528

  3. Lymphoid Aggregates Remodel Lymphatic Collecting Vessels that Serve Mesenteric Lymph Nodes in Crohn Disease.

    Science.gov (United States)

    Randolph, Gwendalyn J; Bala, Shashi; Rahier, Jean-François; Johnson, Michael W; Wang, Peter L; Nalbantoglu, ILKe; Dubuquoy, Laurent; Chau, Amélie; Pariente, Benjamin; Kartheuser, Alex; Zinselmeyer, Bernd H; Colombel, Jean-Frederic

    2016-12-01

    Early pathological descriptions of Crohn disease (CD) argued for a potential defect in lymph transport; however, this concept has not been thoroughly investigated. In mice, poor healing in response to infection-induced tissue damage can cause hyperpermeable lymphatic collecting vessels in mesenteric adipose tissue that impair antigen and immune cell access to mesenteric lymph nodes (LNs), which normally sustain appropriate immunity. To investigate whether analogous changes might occur in human intestinal disease, we established a three-dimensional imaging approach to characterize the lymphatic vasculature in mesenteric tissue from controls or patients with CD. In CD specimens, B-cell-rich aggregates resembling tertiary lymphoid organs (TLOs) impinged on lymphatic collecting vessels that enter and exit LNs. In areas of creeping fat, which characterizes inflammation-affected areas of the bowel in CD, we observed B cells and apparent innate lymphoid cells that had invaded the lymphatic vessel wall, suggesting these cells may be mediators of lymphatic remodeling. Although TLOs have been described in many chronic inflammatory states, their anatomical relationship to preestablished LNs has never been revealed. Our data indicate that, at least in the CD-affected mesentery, TLOs are positioned along collecting lymphatic vessels in a manner expected to affect delivery of lymph to LNs. Copyright © 2016 American Society for Investigative Pathology. Published by Elsevier Inc. All rights reserved.

  4. 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.

  5. Significance of micrometastases in the calculation of the lymph node ratio for papillary thyroid cancer

    Science.gov (United States)

    Chang, Young Woo; Kim, Hwan Soo; Jung, Seung Pil; Kim, Hoon Yub; Lee, Jae Bok; Bae, Jeoung Won

    2017-01-01

    Purpose The lymph node ratio (LNR) is an important prognostic factor in papillary thyroid carcinoma (PTC), but micrometastases in cervical lymph nodes (LNs) are not of great clinical importance. In this study, we analyzed the accuracy of prediction of the prognosis depending on whether micrometastases were included in the number of metastatic LNs when calculating LNR. Methods The study included 353 PTC patients who underwent total thyroidectomy with neck LN dissection, and calculated LNR by 2 methods according to whether micrometastases were included in the number of metastatic LNs: Method 1 did not and method 2 did include. To compare the predictive values of LNR by the 2 methods, correlation coefficients and receiver operating characteristic (ROC) curves were analyzed. Results Positive correlations were found between LNR and preablation stimulated thyroglobulin (sTg) levels in both methods, but the correlation between method 1 LNR and preablation sTg level was significantly stronger than that for method 2 (Fisher z = 1.7, P = 0.045). The areas under these 2 independent ROC curves were analyzed; the prognostic efficacy of method 1 LNR was more accurate than that of method 2 LNR, and the difference was statistically significant (P = 0.0001). Conclusion Regional recurrence of PTC can be predicted more accurately by not including micrometastases in the number of metastatic LNs when calculating LNR.

  6. 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

  7. 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

  8. Clinicopathologic implication of meticulous pathologic examination of regional lymph nodes in gastric cancer patients

    Science.gov (United States)

    Koh, Jiwon; Lee, Hee Eun; Kim, Woo Ho

    2017-01-01

    Background We aimed to investigate effect of increased number of examined lymph nodes (LNs) to pN category, and compare various N categories in gastric cancer: American Joint Committee on Cancer (AJCC) 7th edition, metastatic LN ratio (MLR), and log odds of positive LNs (LODDS). Methods Four cohorts with a total of 2,309 gastric cancer patients were enrolled. For cohort 1 and 2, prognostic significance of each method by disease-specific survival was analyzed using Akaike and Bayesian information criterion (AIC and BIC). Results The total LNs in four cohorts significantly differed [median (range), 28 (6–97) in cohort 1, 37 (8–120) in cohort 2, 48 (7–122) in cohort 3, and 54 (4–221) in cohort 4; p0.05). The AIC and BIC varied according to different cut-off values for MLR; model by cut-offs of 0.2 and 0.5 being better for cohort 1, while cut-offs 0.1 and 0.25 was better for cohort 2. Conclusion Our study showed that the number of metastatic LNs did not increase with maximal pathologic examination of regional LNs. AJCC 7th system is suggested as the simplest method with single cut-off value, but prognostic significance of MLR may be influenced by various cut-offs. PMID:28362845

  9. 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.

  10. Precontrol of the pulmonary artery during thoracoscopic left upper lobectomy and systemic lymph node dissection

    Science.gov (United States)

    Ma, Lin; Mei, Jiandong; Liu, Chengwu

    2016-01-01

    The main reasons of emergent conversion during thoracoscopic lobectomy included tumor invasion, hilar lymph node (LN) metastasis, and lymphoid tuberculosis. We presented a video which depicted a three-portal thoracoscopic left upper lobectomy with dissection of large LNs. Severe adhesions between a large LN and the first branch of the left pulmonary artery (PA) were found during surgery. For safety reasons, the left main pulmonary artery (LMPA) was clamped with an endoscopic bulldog clamp prior to lymph nodal dissection. The strategy of precontrolling the LMPA during thoracoscopic lobectomy is useful for these patients with complicated hilum, and may assure the safety of the operation. PMID:27162690

  11. Lymph Nodes and Cancer Metastasis: New Perspectives on the Role of Intranodal Lymphatic Sinuses

    Directory of Open Access Journals (Sweden)

    Rui-Cheng Ji

    2016-12-01

    Full Text Available The lymphatic system is essential for transporting interstitial fluid, soluble antigen, and immune cells from peripheral tissues to lymph nodes (LNs. Functional integrity of LNs is dependent on intact lymphatics and effective lymph drainage. Molecular mechanisms that facilitate interactions between tumor cells and lymphatic endothelial cells (LECs during tumor progression still remain to be identified. The cellular and molecular structures of LNs are optimized to trigger a rapid and efficient immune response, and to participate in the process of tumor metastasis by stimulating lymphangiogenesis and establishing a premetastatic niche in LNs. Several molecules, e.g., S1P, CCR7-CCL19/CCL21, CXCL12/CXCR4, IL-7, IFN-γ, TGF-β, and integrin α4β1 play an important role in controlling the activity of LN stromal cells including LECs, fibroblastic reticular cells (FRCs and follicular dendritic cells (DCs. The functional stromal cells are critical for reconstruction and remodeling of the LN that creates a unique microenvironment of tumor cells and LECs for cancer metastasis. LN metastasis is a major determinant for the prognosis of most human cancers and clinical management. Ongoing work to elucidate the function and molecular regulation of LN lymphatic sinuses will provide insight into cancer development mechanisms and improve therapeutic approaches for human malignancy.

  12. 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.

  13. 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...

  14. Phase-Transition Nanodroplets for Real-Time Photoacoustic/Ultrasound Dual-Modality Imaging and Photothermal Therapy of Sentinel Lymph Node in Breast Cancer

    Science.gov (United States)

    Yang, Lu; Cheng, Juan; Chen, Yuli; Yu, Shengjie; Liu, Fengqiu; Sun, Yang; Chen, Yu; Ran, Haitao

    2017-01-01

    Pathological status of lymph nodes (LNs) plays a critical role in staging and treatment for the patients with breast cancer. Sentinel lymph node biopsy has become the standard method in determining pathological status of axillary LNs. Therefore, the determination of sentinel lymph nodes (SLNs) and therapy of metastatic LNs are highly desirable in clinic. Herein, an unprecedented carbon nanoparticles (CNs)-incorporated liquid-gas phase-transition nanodroplets (CNPs) with strong near-infrared (NIR) absorption, good biocompatibility, excellent photoacoustic (PA) and ultrasound (US) contrast, and high photothermal-conversion efficiency are reported in this study. Upon laser irradiation, liquid-gas phase transition of the CNPs has been demonstrated to provide excellent contrasts for PA/US dual-modality imaging both in vitro and in vivo. Additionally, the CNPs are capable of staining lymph nodes, which can contribute significantly to the identification of LNs with naked eyes. With increased laser energy, the CNPs exhibit the high performance in killing the breast cancer cells both in vitro and in vivo, due to the photothermal effect induced from the CNs within CNPs. These results suggest that the developed multifunctional phase-transition nanodroplets have high potential to act as the theranostic agents in both SLNs detection and therapy of metastatic LNs. PMID:28338071

  15. 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.

  16. 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

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    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

  17. 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.

  18. 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

  19. [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.

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

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

    2015-11-15

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

  1. Imaging Classification of Cervical Lymph Nodes

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    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.

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

    Science.gov (United States)

    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.

  3. Hormonal-receptor positive breast cancer: IL-6 augments invasion and lymph node metastasis via stimulating cathepsin B expression

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    Sherif A. Ibrahim

    2016-09-01

    Full Text Available Hormonal-receptor positive (HRP breast cancer patients with positive metastatic axillary lymph nodes are characterized by poor prognosis and increased mortality rate. The mechanisms by which cancer cells invade lymph nodes have not yet been fully explored. Several studies have shown that expression of IL-6 and the proteolytic enzyme cathepsin B (CTSB was associated with breast cancer poor prognosis. In the present study, the effect of different concentrations of recombinant human IL-6 on the invasiveness capacity of HRP breast cancer cell line MCF-7 was tested using an in vitro invasion chamber assay. The impact of IL-6 on expression and activity of CTSB was also investigated. IL-6 treatment promoted the invasiveness potential of MCF-7 cells in a dose-dependent manner. Furthermore, MCF-7 cells displayed elevated CTSB expression and activity associated with loss of E-cadherin and upregulation of vimentin protein levels upon IL-6 stimulation. To validate these results in vivo, the level of expression of IL-6 and CTSB in the carcinoma tissues of HRP-breast cancer patients with positive and negative axillary metastatic lymph nodes (pLNs and nLNs was assessed. Western blot and immunohistochemical staining data showed that expression of IL-6 and CTSB was higher in carcinoma tissues in HRP-breast cancer with pLNs than those with nLNs patients. ELISA results showed carcinoma tissues of HRP-breast cancer with pLNs exhibited significantly elevated IL-6 protein levels by approximately 2.8-fold compared with those with nLNs patients (P < 0.05. Interestingly, a significantly positive correlation between IL-6 and CTSB expression was detected in clinical samples of HRP-breast cancer patients with pLNs (r = 0.78, P < 0.01. Collectively, this study suggests that IL-6-induced CTSB may play a role in lymph node metastasis, and that may possess future therapeutic implications for HRP-breast cancer patients with pLNs. Further studies are necessary to fully

  4. Popliteal lymph node metastasis of tibial osteoblastic osteosarcoma

    Directory of Open Access Journals (Sweden)

    Yalın Dirik

    2014-01-01

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

  5. 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 ...

  6. Real-time elastography for the differentiation of benign and malignant superficial lymph nodes: A meta-analysis

    Energy Technology Data Exchange (ETDEWEB)

    Ying, Li, E-mail: ylskq@yahoo.com.cn [Department of Ultrasonography, the First Affiliated Hospital of Wenzhou Medical College, No. 2 Fuxue Lane, Wenzhou 325000 (China); Hou, Yao, E-mail: yaoyao1320@163.com [Department of Ultrasonography, the First Affiliated Hospital of Wenzhou Medical College, No. 2 Fuxue Lane, Wenzhou 325000 (China); Zheng, Hua-Min, E-mail: zhenghm_1982@163.com [Department of Ultrasonography, the First Affiliated Hospital of Wenzhou Medical College, No. 2 Fuxue Lane, Wenzhou 325000 (China); Lin, Xiao, E-mail: Xiaolin_1983@163.com [Department of Ultrasonography, the First Affiliated Hospital of Wenzhou Medical College, No. 2 Fuxue Lane, Wenzhou 325000 (China); Xie, Zuo-Liu, E-mail: llxie59@yahoo.com.cn [Department of Ultrasonography, the First Affiliated Hospital of Wenzhou Medical College, No. 2 Fuxue Lane, Wenzhou 325000 (China); Hu, Yuan-Ping, E-mail: yphu1380@yahoo.com.cn [Department of Ultrasonography, the First Affiliated Hospital of Wenzhou Medical College, No. 2 Fuxue Lane, Wenzhou 325000 (China)

    2012-10-15

    Background: Real-time elastography (RTE), as a non-invasive method, is used for the classification of benign and malignant lymph nodes (LNs) and developed as an alternative to biopsy. Elasticity score (ES) and strain ratio (SR) are used for the interpretation of RTE. We studied the performance of RTE for diagnosis of malignant LNs using meta-analysis. Methods: PubMed, the Cochrane Library, ISI Web of Knowledge, China National Knowledge Infrastructure were searched. The studies published in English or Chinese relating to the diagnostic value of RTE for superficial LNs were collected. Hierarchical summary receiver operating characteristic (HSROC) curve was used to examine the RTE accuracy. Clinical utility of RTE for LNs was evaluated by Fagan plot analysis. Results: A total of 9 studies which included 835 LNs were analyzed. The summary sensitivity and specificity for the diagnosis of malignant LNs were 0.74 (95% confidence interval (CI), 0.66–0.81) and 0.90 (95% CI, 0.82–0.94) for ES, and 0.88 (95% CI, 0.79–0.93) and 0.81 (95% CI, 0.49–0.95) for SR, respectively. Compared to ES, SR obviously improved the diagnostic sensitivity value. The HSROCs were 0.88 for ES and 0.91 for SR, respectively. After RTE results over the cut-off value for malignant LNs (“positive” result), the corresponding post-test probability for the presence (if pre-test probability was 50%) was 88% for ES and 82% for SR, respectively; while, in “negative” measurement, the post-test probability was 22% and 13%, respectively. Conclusion: RTE has a high accuracy in the classification of superficial LNs and can potentially help to select suspicious LNs for biopsy.

  7. 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.

  8. Single skip metastasis in sentinel lymph node: In an early gastric cancer.

    Science.gov (United States)

    Bara, Tivadar; Gurzu, Simona; Jung, Ioan; Kadar, Zoltan; Sugimura, Haruhiko; Bara, Tivadar

    2015-09-01

    Lymph node status is considered a key prognostic and predictive factor in patients with gastric cancer (GC). Although there is a practical approach to the intraoperative detection of sentinel lymph nodes (SLNs), such a procedure is not included in the European surgical protocol. In this report, we present a practical approach to SLN mapping in a representative case with early gastric cancer (EGC). A 74-year-old female was hospitalized with an endoscopically observed, superficially ulcerated tumor located in the antral region. Subtotal gastrectomy with D2 lymphadenectomy and SLN mapping was performed by injecting methylene blue dye into the peritumoral submucosal layer. An incidentally detected blue-stained lymph node located along the middle colic artery was also removed. This was detected 40 min after injection of the methylene blue. Histopathologic examination showed a pT1b-staged well-differentiated HER-2-negative adenocarcinoma. All of the 41 LNs located at the first, third, and fifth station of the regional LN compartments were found to be free of tumor cells. The only lymph node with metastasis was located along the middle colic artery and was considered a non-regional lymph node. This incidentally identified skip metastasis indicated stage IV GC. A classic chemotherapy regimen was given, and no recurrences were observed six months after surgery. In this representative case, low-cost SLN mapping, with a longer intraoperative waiting time, totally changed the stage of the tumor in a patient with EGC.

  9. 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.

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

    Energy Technology Data Exchange (ETDEWEB)

    Takiar, Vinita; Fontanilla, Hiral P.; Eifel, Patricia J.; Jhingran, Anuja; Kelly, Patrick [Department of Radiation Oncology, The University of Texas MD Anderson Cancer Center, Houston, Texas (United States); Iyer, Revathy B. [Department of Diagnostic Radiology, The University of Texas MD Anderson Cancer Center, Houston, Texas (United States); Levenback, Charles F. [Department of Gynecologic Oncology, The University of Texas MD Anderson Cancer Center, Houston, Texas (United States); Zhang, Yongbin; Dong, Lei [Department of Radiation Physics, The University of Texas MD Anderson Cancer Center, Houston, Texas (United States); Klopp, Ann, E-mail: aklopp@mdanderson.org [Department of Radiation Oncology, The University of Texas MD Anderson Cancer Center, Houston, Texas (United States)

    2013-03-15

    Purpose: Conformal treatment of para-aortic lymph nodes (PAN) in cervical cancer allows dose escalation and reduces normal tissue toxicity. Currently, data documenting the precise location of involved PAN are lacking. We define the spatial distribution of this high-risk nodal volume by analyzing fluorodeoxyglucose (FDG)-avid lymph nodes (LNs) on positron emission tomography/computed tomography (PET/CT) scans in patients with cervical cancer. Methods and Materials: We identified 72 PANs on pretreatment PET/CT of 30 patients with newly diagnosed stage IB-IVA cervical cancer treated with definitive chemoradiation. LNs were classified as left-lateral para-aortic (LPA), aortocaval (AC), or right paracaval (RPC). Distances from the LN center to the closest vessel and adjacent vertebral body were calculated. Using deformable image registration, nodes were mapped to a template computed tomogram to provide a visual impression of nodal frequencies and anatomic distribution. Results: We identified 72 PET-positive para-aortic lymph nodes (37 LPA, 32 AC, 3 RPC). All RPC lymph nodes were in the inferior third of the para-aortic region. The mean distance from aorta for all lymph nodes was 8.3 mm (range, 3-17 mm), and from the inferior vena cava was 5.6 mm (range, 2-10 mm). Of the 72 lymph nodes, 60% were in the inferior third, 36% were in the middle third, and 4% were in the upper third of the para-aortic region. In all, 29 of 30 patients also had FDG-avid pelvic lymph nodes. Conclusions: A total of 96% of PET positive nodes were adjacent to the aorta; PET positive nodes to the right of the IVC were rare and were all located distally, within 3 cm of the aortic bifurcation. Our findings suggest that circumferential margins around the vessels do not accurately define the nodal region at risk. Instead, the anatomical extent of the nodal basin should be contoured on each axial image to provide optimal coverage of the para-aortic nodal compartment.

  11. 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

  12. 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

  13. 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.

  14. Engineered Human Ferritin Nanoparticles for Direct Delivery of Tumor Antigens to Lymph Node and Cancer Immunotherapy

    Science.gov (United States)

    Lee, Bo-Ram; Ko, Ho Kyung; Ryu, Ju Hee; Ahn, Keum Young; Lee, Young-Ho; Oh, Se Jin; Na, Jin Hee; Kim, Tae Woo; Byun, Youngro; Kwon, Ick Chan; Kim, Kwangmeyung; Lee, Jeewon

    2016-01-01

    Efficient delivery of tumor-specific antigens (TSAs) to lymph nodes (LNs) is essential to eliciting robust immune response for cancer immunotherapy but still remains unsolved. Herein, we evaluated the direct LN-targeting performance of four different protein nanoparticles with different size, shape, and origin [Escherichia coli DNA binding protein (DPS), Thermoplasma acidophilum proteasome (PTS), hepatitis B virus capsid (HBVC), and human ferritin heavy chain (hFTN)] in live mice, using an optical fluorescence imaging system. Based on the imaging results, hFTN that shows rapid LN targeting and prolonged retention in LNs was chosen as a carrier of the model TSA [red fluorescence protein (RFP)], and the flexible surface architecture of hFTN was engineered to densely present RFPs on the hFTN surface through genetic modification of subunit protein of hFTN. The RFP-modified hFTN rapidly targeted LNs, sufficiently exposed RFPs to LN immune cells during prolonged period of retention in LNs, induced strong RFP-specific cytotoxic CD8+ T cell response, and notably inhibited RFP-expressing melanoma tumor growth in live mice. This suggests that the strategy using protein nanoparticles as both TSA-carrying scaffold and anti-cancer vaccine holds promise for clinically effective immunotherapy of cancer. PMID:27725782

  15. Detection of Lymph Nodes Metastasis in Biliary Carcinomas: Morphological Criteria by MDCT and the Clinical Impact of DWI-MRI.

    Science.gov (United States)

    Morine, Yuji; Shimada, Mitsuo; Imura, Satoru; Ikemoto, Tetsuya; Hanaoka, Jun; Kanamoto, Mami; Ishibashi, Hiroki; Utsunomiya, Tohru

    2015-06-01

    This study was conducted to assess the usefulness of multi-slice CT (MDCT) and diffusion weighted MR images (DWI-MRI) for diagnosis of metastatic lymph nodes (LNs) in biliary carcinomas. Eighteen patients with biliary carcinomas (total 121 LNs) underwent surgical resection were included. In MDCT, the following criteria were measured: the maximum diameter, the enhanced value and the long and short axis (L/S) ratio. In DWI-MRI, the apparent diffusion coefficients (ADCs) were measured from ADC maps. In ROC analysis, the maximum diameter has the highest diagnostic power with area under curves of 0.903. And when the maximum diameter 8 mm and L/S ratio is less than 2, the accuracy was improved with a sensitivity of 81%, positive predictive value (PPV) of 45%. In DWI-MRI, ADCs values of metastatic LNs significantly lower than that of non-metastatic LNs (mean: 1.65 vs. 2.11 x10 3mm2/s). When the ADC value of 1.8 x10(-3) was used as a cut-off value, the best results were obtained with sensitivity of 75%, PPV of 82%. Using MDCT, diagnosis of LNs metastasis should be more than 8mm diameter and less than 2 of L/S ratio. In addition, DWI-MRI is more useful modality for diagnosis of LNs metastasis.

  16. GSI Quantitative Parameters: Preoperative Diagnosis of Metastasis Lymph Nodes in Lung Cancer

    Directory of Open Access Journals (Sweden)

    Fengfeng YANG

    2016-11-01

    Full Text Available Background and objective Mediastinal involvement in lung cancer is an important prognostic factor affecting survival, and accurate staging of the mediastinum lymph node correctly identifies patients who can benefit the most from surgery. The aim of this study is to investigate the value of dual-energy spectral computed tomography (DEsCT imaging in differentiating metastatic from non-metastatic lymph nodes in lung cancer. Methods Forty-eight patients with non-small cell lung cancer (NSCLC underwent arterial (AP and portal venous (PP phase contrast-enhanced DEsCT imaging followed by surgical treatment. gemstone spectral imaging (GSI data images were reconstructed and transmitted to an offline workstation. GSI quantitative parameters, including lymph-node size, CT value, IC, water concentration, and spectral curve. Differences were tested for statistical significance using the two-sample t test. ROC analysis was performed to assess diagnostic performance. Results The mean short-axis diameter of metastatic LNs, slope of the spectral Hounsfield unit curve (λHU, normalized iodine concentration measured during, and both AP and PP were significantly higher in metastatic lymph node than that in benign lymph nodes. The best parameter for detecting metastatic lymph nodes was AP λHU when a threshold λHU of 2.75 was used; sensitivity, specificity, and accuracy were 88.2%, 88.4%, and 87.0%, respectively. Conclusion Quantitative assessment with gemstone spectral imaging quantitative parameters showed higher accuracy than the qualitative assessment of conventional CT imaging features for the preoperative diagnosis of metastatic lymph nodes in patients with lung cancer.

  17. 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.

  18. Structure-based programming of lymph-node targeting in molecular vaccines.

    Science.gov (United States)

    Liu, Haipeng; Moynihan, Kelly D; Zheng, Yiran; Szeto, Gregory L; Li, Adrienne V; Huang, Bonnie; Van Egeren, Debra S; Park, Clara; Irvine, Darrell J

    2014-03-27

    In cancer patients, visual identification of sentinel lymph nodes (LNs) is achieved by the injection of dyes that bind avidly to endogenous albumin, targeting these compounds to LNs, where they are efficiently filtered by resident phagocytes. Here we translate this 'albumin hitchhiking' approach to molecular vaccines, through the synthesis of amphiphiles (amph-vaccines) comprising an antigen or adjuvant cargo linked to a lipophilic albumin-binding tail by a solubility-promoting polar polymer chain. Administration of structurally optimized CpG-DNA/peptide amph-vaccines in mice resulted in marked increases in LN accumulation and decreased systemic dissemination relative to their parent compounds, leading to 30-fold increases in T-cell priming and enhanced anti-tumour efficacy while greatly reducing systemic toxicity. Amph-vaccines provide a simple, broadly applicable strategy to simultaneously increase the potency and safety of subunit vaccines.

  19. Topological Small-World Organization of the Fibroblastic Reticular Cell Network Determines Lymph Node Functionality

    Science.gov (United States)

    Abe, Jun; Bomze, David; Cremasco, Viviana; Scandella, Elke; Stein, Jens V.; Turley, Shannon J.; Ludewig, Burkhard

    2016-01-01

    Fibroblastic reticular cells (FRCs) form the cellular scaffold of lymph nodes (LNs) and establish distinct microenvironmental niches to provide key molecules that drive innate and adaptive immune responses and control immune regulatory processes. Here, we have used a graph theory-based systems biology approach to determine topological properties and robustness of the LN FRC network in mice. We found that the FRC network exhibits an imprinted small-world topology that is fully regenerated within 4 wk after complete FRC ablation. Moreover, in silico perturbation analysis and in vivo validation revealed that LNs can tolerate a loss of approximately 50% of their FRCs without substantial impairment of immune cell recruitment, intranodal T cell migration, and dendritic cell-mediated activation of antiviral CD8+ T cells. Overall, our study reveals the high topological robustness of the FRC network and the critical role of the network integrity for the activation of adaptive immune responses. PMID:27415420

  20. Topological Small-World Organization of the Fibroblastic Reticular Cell Network Determines Lymph Node Functionality.

    Science.gov (United States)

    Novkovic, Mario; Onder, Lucas; Cupovic, Jovana; Abe, Jun; Bomze, David; Cremasco, Viviana; Scandella, Elke; Stein, Jens V; Bocharov, Gennady; Turley, Shannon J; Ludewig, Burkhard

    2016-07-01

    Fibroblastic reticular cells (FRCs) form the cellular scaffold of lymph nodes (LNs) and establish distinct microenvironmental niches to provide key molecules that drive innate and adaptive immune responses and control immune regulatory processes. Here, we have used a graph theory-based systems biology approach to determine topological properties and robustness of the LN FRC network in mice. We found that the FRC network exhibits an imprinted small-world topology that is fully regenerated within 4 wk after complete FRC ablation. Moreover, in silico perturbation analysis and in vivo validation revealed that LNs can tolerate a loss of approximately 50% of their FRCs without substantial impairment of immune cell recruitment, intranodal T cell migration, and dendritic cell-mediated activation of antiviral CD8+ T cells. Overall, our study reveals the high topological robustness of the FRC network and the critical role of the network integrity for the activation of adaptive immune responses.

  1. Topological Small-World Organization of the Fibroblastic Reticular Cell Network Determines Lymph Node Functionality.

    Directory of Open Access Journals (Sweden)

    Mario Novkovic

    2016-07-01

    Full Text Available Fibroblastic reticular cells (FRCs form the cellular scaffold of lymph nodes (LNs and establish distinct microenvironmental niches to provide key molecules that drive innate and adaptive immune responses and control immune regulatory processes. Here, we have used a graph theory-based systems biology approach to determine topological properties and robustness of the LN FRC network in mice. We found that the FRC network exhibits an imprinted small-world topology that is fully regenerated within 4 wk after complete FRC ablation. Moreover, in silico perturbation analysis and in vivo validation revealed that LNs can tolerate a loss of approximately 50% of their FRCs without substantial impairment of immune cell recruitment, intranodal T cell migration, and dendritic cell-mediated activation of antiviral CD8+ T cells. Overall, our study reveals the high topological robustness of the FRC network and the critical role of the network integrity for the activation of adaptive immune responses.

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

    Directory of Open Access Journals (Sweden)

    Yu Liu

    2015-01-01

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

  3. 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.

  4. Direct in vivo evidence for increased proliferation of CLL cells in lymph nodes compared to bone marrow and peripheral blood

    DEFF Research Database (Denmark)

    Herndon, Thomas M; Chen, Shih-Ann; Saba, Nakhle S

    2017-01-01

    Chronic lymphocytic leukemia (CLL) is a progressive malignancy of mature B-cells that involves the peripheral blood (PB), lymph nodes (LNs) and bone marrow (BM). Although the majority of CLL cells are in a resting state, small populations of proliferating cells exist; however, the anatomical site...... of active cell proliferation remains to be definitively determined. Based on findings that CLL cells in LNs have increased expression of B-cell activation genes, we tested the hypothesis that the fraction of 'newly born' cells would be highest in the LNs. Using a deuterium oxide ((2)H) in vivo labeling...... method in which patients consumed deuterated (heavy) water ((2)H2O), we determined CLL cell kinetics in concurrently obtained samples from LN, PB and BM. The LN was identified as the anatomical site harboring the largest fraction of newly born cells, compared to PB and BM. In fact, the calculated birth...

  5. 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....

  6. [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.

  7. 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)

  8. Comparison of two treatment strategies for irradiation of regional lymph nodes in patients with breast cancer: Lymph flow guided portals versus standard radiation fields.

    Science.gov (United States)

    Novikov, Sergey Nikolaevich; Kanaev, Sergey Vasilevich; Semiglazov, Vladimir Fedorovich; Jukova, Ludmila Alekseevna; Krzhivitckiy, Pavel Ivanovich

    2015-01-01

    Radiotherapy being an essential part of breast cancer treatment, we evaluate various radiotherapy strategies in patients with breast cancer. Lymph node (LN) scintigraphy was performed in 172 primary patients with BC. LN visualization started 30-360 min after intratumoral injection of 75-150 MBq of 99mTc-nanocolloids. Our standard recommendation for postoperative radiotherapy in patients with LN invasion by BC were as follows: for patients with external localization of tumour - breast + axillary (Ax) + sub-supraclavicular (SSCL) regions; with internal localization - all above + internal mammary nodes (IM). Proposed strategy of lymph flow guided radiotherapy is based on the assumption that only regions that contain 'hot' LNs must be included in a treatment volume. Among 110 patients with external localization of BC, Ax LNs were visualized in all cases and in 62 patients it was the only region with 'hot' LN. Twenty-three patients (20.9%) had drainage to Ax + SSCL, 12 (10.9%) - Ax + IM, 13 (11.8%) - Ax + SSCL + IM regions. After the visualization of lymph flow patterns, standard treatment volume was changed in 87/110 cases (79.1%): in 56.4%, reduced, in 22.7%, enlarged or changed. In 62 patients with tumours in internal quadrants, we revealed the following patterns of lymph-flow: only to the Ax region in 23 (37.1%); Ax + IM, 13 (21%); Ax + SSCL, 15 (24.2%); Ax + IM + ISSCL, 11 (17.7%) cases. After lymph-flow visualization, the standard irradiation volume was reduced in 53/62 (85.5%) cases. Visualization of an individual lymph flow pattern from BC can be used for the optimization of standard fields used for irradiation of regional LNs.

  9. Lymph node size as a simple prognostic factor in node negative colon cancer and an alternative thesis to stage migration.

    Science.gov (United States)

    Märkl, Bruno; Schaller, Tina; Kokot, Yuriy; Endhardt, Katharina; Kretsinger, Hallie; Hirschbühl, Klaus; Aumann, Georg; Schenkirsch, Gerhard

    2016-10-01

    Stage migration is an accepted explanation for the association between lymph node (LN) yield and outcome in colon cancer. To investigate whether the alternative thesis of immune response is more likely, we performed a retrospective study. We enrolled 239 cases of node negative cancers, which were categorized according to the number of LNs with diameters larger than 5 mm (LN5) into the groups LN5-very low (0 to 1 LN5), LN5-low (2 to 5 LN5), and LN5-high (≥6 LN5). Significant differences were found in pT3/4 cancers with median survival times of 40, 57, and 71 months (P = .022) in the LN5-very low, LN5-low, and LN5-high groups, respectively. Multivariable analysis revealed that LN5 number and infiltration type were independent prognostic factors. LN size is prognostic in node negative colon cancer. The correct explanation for outcome differences associated with LN harvest is probably the activation status of LNs. Copyright © 2015 Elsevier Inc. All rights reserved.

  10. 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

  11. 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.

  12. 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...

  13. 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.

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

    Directory of Open Access Journals (Sweden)

    Mahsa Ghajarzadeh

    2014-01-01

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

  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. Axillary lymph node characterization in breast cancer patients using magnetic resonance mammography: A prospective comparative study with FDG PET-CT and healthy women

    Energy Technology Data Exchange (ETDEWEB)

    Krammer, J., E-mail: Julia.Krammer@medma.uni-heidelberg.de; Wasser, K.; Schnitzer, A.; Henzler, T.; Schoenberg, S.O.; Kaiser, C.G.

    2013-12-01

    Objective: The aim of this study was to evaluate the capability of dynamic contrast enhanced MR-mammography (MRM) for the interpretation of axillary lymph nodes (LNs) in patients with breast cancer. Material and methods: 25 patients with breast cancer preoperatively underwent both FDG positron emission computed tomography (PET-CT) and dynamic contrast enhanced MRM. The maximum signal increase (SI{sub max}) and curve shape (types I–III) of contrast enhanced LNs ≥0.5 cm (short-axis) were analyzed in MRM and correlated to the maximum standard uptake value (SUV{sub max}) of FDG PET-CT. 29 healthy women with MRM served as control group. Enhancement kinetics of all malignant LNs were compared to LN findings of the healthy control group. Results: Overall 33 contrast enhanced LNs on preoperative MRM had a corresponding FDG uptake on PET-CT. 30 of the PET positive LNs were classified as surely malignant (mean SUV{sub max} 7.3 (±5.4)). The mean SI{sub max} of these LNs was not significantly different to the control group (222% vs 197%), but malignant LNs had a significantly higher rate of type III curves with rapid washout (93% vs 66%, p = 0.008). Conclusion: The maximum signal increase is not capable of differentiating malignant from benign axillary LNs. However, since malignant LNs showed a higher frequency of rapid washout curves (type III curves) on corresponding MRM future studies should concentrate on the analysis of this parameter. In clinical routine the curve shape still should be taken with care as there is a high overlap with benign LNs.

  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. CCR7 Maintains Nonresolving Lymph Node and Adipose Inflammation in Obesity.

    Science.gov (United States)

    Hellmann, Jason; Sansbury, Brian E; Holden, Candice R; Tang, Yunan; Wong, Blenda; Wysoczynski, Marcin; Rodriguez, Jorge; Bhatnagar, Aruni; Hill, Bradford G; Spite, Matthew

    2016-08-01

    Accumulation of immune cells in adipose tissue promotes insulin resistance in obesity. Although innate and adaptive immune cells contribute to adipose inflammation, the processes that sustain these interactions are incompletely understood. Here we show that obesity promotes the accumulation of CD11c(+) adipose tissue immune cells that express C-C chemokine receptor 7 (CCR7) in mice and humans, and that CCR7 contributes to chronic inflammation and insulin resistance. We identified that CCR7(+) macrophages and dendritic cells accumulate in adipose tissue in close proximity to lymph nodes (LNs) (i.e., perinodal) and visceral adipose. Consistent with the role of CCR7 in regulating the migration of immune cells to LNs, obesity promoted the accumulation of CD11c(+) cells in LNs, which was prevented by global or hematopoietic deficiency of Ccr7 Obese Ccr7(-/-) mice had reduced accumulation of CD8(+) T cells, B cells, and macrophages in adipose tissue, which was associated with reduced inflammatory signaling. This reduction in maladaptive inflammation translated to increased insulin signaling and improved glucose tolerance in obesity. Therapeutic administration of an anti-CCR7 antibody phenocopied the effects of genetic Ccr7 deficiency in mice with established obesity. These results suggest that CCR7 plays a causal role in maintaining innate and adaptive immunity in obesity.

  20. 2D view aggregation for lymph node detection using a shallow hierarchy of linear classifiers.

    Science.gov (United States)

    Seff, Ari; Lu, Le; Cherry, Kevin M; Roth, Holger R; Liu, Jiamin; Wang, Shijun; Hoffman, Joanne; Turkbey, Evrim B; Summers, Ronald M

    2014-01-01

    Enlarged lymph nodes (LNs) can provide important information for cancer diagnosis, staging, and measuring treatment reactions, making automated detection a highly sought goal. In this paper, we propose a new algorithm representation of decomposing the LN detection problem into a set of 2D object detection subtasks on sampled CT slices, largely alleviating the curse of dimensionality issue. Our 2D detection can be effectively formulated as linear classification on a single image feature type of Histogram of Oriented Gradients (HOG), covering a moderate field-of-view of 45 by 45 voxels. We exploit both max-pooling and sparse linear fusion schemes to aggregate these 2D detection scores for the final 3D LN detection. In this manner, detection is more tractable and does not need to perform perfectly at instance level (as weak hypotheses) since our aggregation process will robustly harness collective information for LN detection. Two datasets (90 patients with 389 mediastinal LNs and 86 patients with 595 abdominal LNs) are used for validation. Cross-validation demonstrates 78.0% sensitivity at 6 false positives/volume (FP/vol.) (86.1% at 10 FP/vol.) and 73.1% sensitivity at 6 FP/vol. (87.2% at 10 FP/vol.), for the mediastinal and abdominal datasets respectively. Our results compare favorably to previous state-of-the-art methods.

  1. Extended Salvage Pelvic Lymph Node Dissection in Patients with Recurrent Prostate Cancer

    Directory of Open Access Journals (Sweden)

    Daniar K. Osmonov

    2014-01-01

    Full Text Available Background. Treatment of patients with a biochemical recurrence (BCR of prostate cancer (PCa is generally difficult and without valid treatment options. Since 2004 we have been developing therapeutic possibilities for these patients. Methods. We retrospectively analyzed a cohort of 41 patients with a BCR of PCa and a mean followup of 40.3±20.8 months. Group 1 (n=10: salvage radical prostatectomy (sRP with SePLND (salvage extended pelvic lymph nodes dissection (initial treatment: combined brachytherapy. Group 2 (n=22: SePLND (initial treatment: radical prostatectomy (RP. Group 3 (n=9: SePLND (initial treatment: RP and adjuvant radiation therapy (RT. We observed PSA, PSA-velocity, localization of LNs and LNs+, BCR-free period, and BR (biochemical response. Results. Group 1: 60% with BCR-freedom (mean 27.2 months. Group 2: 63.6% with BCR-freedom (mean 17.5 months. Group 3: 33.3% with BCR-freedom (mean 17.6 months. In total, BCR-freedom was observed in 23 of 41 patients (56.1% after salvage surgery. 75.6% of all patients showed a BR. 765 LNs were removed and 14.8% of these were LN+. Conclusions. The BCR-free period and BR are comparable in all three groups. Sensibility to ADT can be reestablished and prolonged as a result of SePLND. Multicenter studies are needed for a reliable output.

  2. 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.

  3. 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

  4. [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.

  5. 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 

  6. Most frequent location of the sentinel lymph nodes

    Directory of Open Access Journals (Sweden)

    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.

  7. [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.

  8. A strategy for supraclavicular lymph node dissection using recurrent laryngeal nerve lymph node status in thoracic esophageal squamous cell carcinoma.

    Science.gov (United States)

    Taniyama, Yusuke; Nakamura, Takanobu; Mitamura, Atsushi; Teshima, Jin; Katsura, Kazunori; Abe, Shigeo; Nakano, Toru; Kamei, Takashi; Miyata, Go; Ouchi, Noriaki

    2013-06-01

    The desirability of supraclavicular lymph node (LN) dissection, which is the cervical part of three-field LN dissection, has been discussed for a long time. In this study, we examine the pattern of supraclavicular LN metastasis in esophageal cancer, with a particular focus on the correlation between recurrent laryngeal nerve (RLN) LN and supraclavicular LN metastasis. In all, 220 cases of R0 resected T1 to T3 squamous cell carcinomas were retrospectively examined. All of these patients underwent bilateral RLN LNs dissection; none received cancer treatment before surgery. Of 21 upper esophageal cancer cases, 33.3% of the patients had metastasis in the supraclavicular LN. Every patient in whom supraclavicular LN metastasis developed had metastasis in the RLN LN. Of 141 cases of middle esophageal cancer, 19.1% had metastasis in the supraclavicular LN. Among the patients whose RLN LN metastasized, 38.3% had metastasis in the supraclavicular LN. A similar correlation between RLN LN and supraclavicular LN metastasis was observed in lower esophageal cancer cases, especially in T3 cases. When considering cancers of the esophagus and patients who had metastasis in the supraclavicular LN, our data demonstrated that RLN LN metastasis did not always lead to metastasis on the same side of the supraclavicular LN. The status of the RLN LN can be an indicator of supraclavicular LN dissection in upper esophageal cancer patients and advanced cases of middle and lower esophageal cancer patients. Bilateral supraclavicular LN dissection should be recommended even when only unilateral RLN LN metastasis occurs. Copyright © 2013 The Society of Thoracic Surgeons. Published by Elsevier Inc. All rights reserved.

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

    Science.gov (United States)

    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. 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.

  11. 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)

  12. Influence of negative lymph node in No 7 on survival of patients with middle thoracic esophageal squamous cell carcinoma

    Directory of Open Access Journals (Sweden)

    Zhang JL

    2016-03-01

    Full Text Available Jinling Zhang,1 Xueyuan Heng,1 Yi Luo,2 Qingxi Fu,1 Zhengrong Li,1 Fengyuan Che,1 Baosheng Li31Cancer Center, LinYi People Hospital, Affiliated to Shandong University, School of Medicine, Jinan, Shandong Province, People’s Republic of China; 2Department of Radiation Oncology, University of Michigan, Ann Arbor, MI, USA; 3Department of Radiation Oncology (Chest Section, Shandong’s Key Laboratory of Radiation Oncology, Shandong Cancer Hospital, Shandong Academy of Medical Sciences, Jinan, Shandong Province, People’s Republic of ChinaBackground: The overall survival (OS of patients with thoracic esophageal cancer is poor because of the high rate of lymph node metastases. However, recent studies found that the negative lymph node (LN may also influence the patients’ OS. The purpose of this study is to investigate which negative LN stations play a key role in OS prediction.Method: Our study included the retrospective records of 99 patients, who were identified with middle thoracic esophageal squamous cell cancer after esophagectomy. The maximum follow-up time was 6 years. Cox regression models were employed to determine the association between the negative LN and OS of patients. After applying Kaplan–Meier method to calculate OS of patients with positive and negative LNs, the log-rank tests were used to assess the difference between them.Result: The hazard ratio of the total number of negative LNs was 0.937 (P=0.001, and the length of tumor was 1.166 (P=0.038. Multivariate regression results showed that the numbers of positive LNs in No 3 and 7 stations and negative LNs in No 109 and 7 stations were significantly related to OS, and their P-values were 0.017, 0.001, 0.020, and 0.022, respectively. The OS of the patients who had positive and negative LNs in No 7 station was significantly different (P=0.028.Conclusion: No 7 is the most important among the negative LN stations which prolong OS. More attention should be paid to this area when

  13. TH-A-BRF-05: MRI of Individual Lymph Nodes to Guide Regional Breast Radiotherapy

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    Heijst, T van; Asselen, B van; Lagendijk, J; Bongard, D van den; Philippens, M [University Medical Center Utrecht, Utrecht (Netherlands)

    2014-06-15

    Purpose: In regional radiotherapy (RT) for breast-cancer patients, direct visualization of individual lymph nodes (LNs) may reduce target volumes and Result in lower toxicity (i.e. reduced radiation pneumonitis, arm edema, arm morbidity), relative to standard CT-based delineations. To this end, newly designed magnetic resonance imaging (MRI) sequences were optimized and assessed qualitatively and quantitatively. Methods: In ten healthy female volunteers, a scanning protocol was developed and optimized. Coronal images were acquired in supine RT position positioned on a wedge board on a 1.5 T Ingenia (Philips) wide-bore MRI. In four volunteers the optimized MRI protocol was applied, including a 3-dimensional (3D) T1-weighted (T1w) fast-field-echo (FFE). T2w sequences, including 3D FFE, 3D and 2D fast spin echo (FSE), and diffusion-weighted single-shot echo-planar imaging (DWI) were also performed. Several fatsuppression techniques were used. Qualitative evaluation parameters included LN contrast, motion susceptibility, visibility of anatomical structures, and fat suppression. The number of visible axillary and supraclavicular LNs was also determined. Results: T1 FFE, insensitive to motion, lacked contrast of LNs, which often blended in with soft tissue and blood. T2 FFE showed high contrast, but some LNs were obscured due to motion. Both 2D and 3D FSE were motion-insensitive having high contrast, although some blood remained visible. 2D FSE showed more anatomical details, while in 3D FSE, some blurring occurred. DWI showed high LN contrast, but suffered from geometric distortions and low resolution. Fat suppression by mDixon was the most reliable in regions with magnetic-field inhomogeneities. The FSE sequences showed the highest sensitivity for LN detection. Conclusion: MRI of regional LNs was achieved in volunteers. The FSE techniques were robust and the most sensitive. Our optimized MRI sequences can facilitate direct delineation of individual LNs. This can Result

  14. Supraclavicular lymph nodes detected by 18F-FDG PET/CT in cancer patients: assessment with 18F-FDG PET/CT and sonography.

    Science.gov (United States)

    Lee, Jae-hoon; Kim, Jinna; Moon, Hee Jung; Cho, Arthur; Yun, Mijin; Lee, Jong Doo; Kang, Won Jun

    2012-01-01

    The purposes of this study were to assess the diagnostic accuracy of 18F-FDG PET (FDG PET) for the detection of metastatic supraclavicular lymph nodes (LNs) and to propose an optimal diagnostic strategy with additional sonography, contrast-enhanced CT (CECT), or both. One hundred supraclavicular LNs initially detected using FDG PET were examined using sonography. Regardless of the imaging findings, all 100 supraclavicular LNs underwent sonography-guided fine-needle aspiration biopsy. The maximum standardized uptake values (SUVsmax) of the supraclavicular LNs were measured, and a receiver operating characteristic (ROC) analysis was performed to determine the cutoff SUVmax. Then we evaluated the diagnostic performance of FDG PET and figured out the optimal combination of FDG PET and sonography or CECT to improve the diagnostic accuracy of the imaging studies and minimize procedures. In total, 86 of 100 PET-detected supraclavicular LNs were malignant. With application of the cutoff value obtained by ROC analysis (SUVmax=3.0), the diagnostic accuracy of FDG PET was 75.0% with a sensitivity of 74.4% and specificity of 78.6%. For supraclavicular LNs with an SUVmax of more than 3.0, FDG PET showed a positive predictive value of 95.5%; for supraclavicular LNs with an SUVmax of 3.0 or less, sonography excluded all false-negative FDG PET cases and showed a high negative predictive value of 100%. When sonography was selectively applied to cases with an SUVmax of 3.0 or less, the overall diagnostic accuracy increased to 92%. Our study revealed a high incidence rate of metastasis in PET-detected supraclavicular LNs in cancer patients. We believe that our proposed diagnostic workflow could decrease unnecessary diagnostic procedures in the evaluation of PET-positive supraclavicular LNs in cancer patients with reliability.

  15. 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.

  16. Consideration of myocardial FDG uptake in differentiation of mediastinal lymph node of non-small cell lung cancer

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    Eo, Jae Seon; Lee, Won Woo; Chung, Jin Haeng; So, Young; Lee, Dong Soo; Chung, June Key; Lee, Myung Chul; Kim, Sang Eun [College of Medicine, Seoul National University, Seoul (Korea, Republic of)

    2004-07-01

    The whole body FDG PET suffers from poor diagnostic competency in differentiation of mediastinal lymph node (LN) in non-small cell lung cancer. In addition to LN FDG uptake. We considered myocardial FDG uptake in mediastinal lymph node staging. Thirty-nine non-small cell lung cancer patients (male: female = 32: 7, age = 63{+-}11 years) who underwent preoperative whole body FDG PET were enrolled. There were 18 squamous cell cancer, 13 adenocarcinoma, and 8 others. Maximum standard uptake values (maxSUVs) of myocardium and LNs using lean body weight were measured and compared with pathological results. Among 187 LNs which were confirmed postoperatively, 31 were malignant, and 156 benign. Of 31 malignant LNs, only 11 were visible on FDG PET (sensitivity : 35.5% = 11/31) but majority of 20 nonvisible metastatic LNs had relevant cause of false negative (11 peribroncheal, 3 mucine producing adenocarcinoma, or 6 low amount of tumor cells). Of 156 benign LNs, 137 were nonvisible (specificity : 87.8% 137/156) and 19 visible. Under subgroup analysis of 30 visible LNs on whole body FDG PET (11 malignant, and 19 benign), maxSUV of myocardium (p = 0.020) as well as maxSUV of LN (p = 0.002) were significant predictor of malignant LN in multivariate analysis. Using the ROC curve, a cut-off value of LN maxSUV > 2.4 provided sensitivity of 81.8% and specificity of 63.2% (AUC 0.775, 95% confidence interval = 0.586 to 0.906). Meanwhile, the composite criterion of LN maxSUV plus square root of myocardial maxSUV > 4.65 provided slightly improved diagnostic competencies (sensitivity 90.9%, specificity 84.2%, AUC 0.876, 95% confidence interval 0.704 to 0.966) (p = 0.08). Taking into consideration myocardial FDG uptake may improve the diagnostic competency of whole body FDG PET in differentiation of mediastinal LNs of non-small cell lung cancer.

  17. 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.

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

    Science.gov (United States)

    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.

  19. 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.

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

    Directory of Open Access Journals (Sweden)

    Luca Giovanella

    2011-01-01

    Full Text Available Aim. Enlarged cervical lymph nodes (LNs in patients with thyroid cancer are usually assessed by fine-needle aspiration cytology (FNAC. Thyroglobulin (Tg is frequently elevated in malignant FNAC needle wash specimens (FNAC-Tg. The objectives of the study were to (1 determine an appropriate diagnostic cut-off for FNAC-Tg levels (2 compare FNAC and FNAC-Tg results in a group of 108 patients affected by differentiated thyroid carcinoma (DTC. Methods. A total of 126 consecutive FNACs were performed on enlarged LNs and the final diagnosis was confirmed by surgical pathology examination or clinical follow-up. The best FNAC-Tg cut-off level was selected by receiver operating curve analysis, and diagnostic performances of FNAC and FNAC-Tg were compared. Results. The rate of FNAC samples adequate for cytological examination was 77% in contrast FNAC-Tg available in 100% of aspirates (<.01. The sensitivity, specificity, and accuracy of FNAC were 71%, 80%, 74%, 100%, 80%, and 94%, respectively. The most appropriate cut-off value for the diagnosis of thyroid cancer metastatic LN was 1.1 ng/mL (sensitivity 100%, specificity 100%. Conclusions. The diagnostic performance of needle washout FNAC-Tg measurement with a cut-off of 1.1 ng/mL compared favorably with cytology in detecting DTC node metastases.

  1. Pathologic features of metastatic lymph nodes identified from prophylactic central neck dissection in patients with papillary thyroid carcinoma.

    Science.gov (United States)

    Lee, Hyoung Shin; Park, Chanwoo; Kim, Sung Won; Noh, Woong Jae; Lim, Soo Jin; Chun, Bong Kwon; Kim, Beom Su; Hong, Jong Chul; Lee, Kang Dae

    2016-10-01

    The importance of pathologic features of metastatic lymph nodes (LNs), such as size, number, and extranodal extension, has been recently emphasized in patients with papillary thyroid carcinoma (PTC). We evaluated the characteristics of metastatic LNs identified after prophylactic central neck dissection (CND) in patients with PTC. We performed a retrospective review of 1,046 patients who underwent unilateral or bilateral thyroidectomy with ipsilateral prophylactic CND. We reviewed the characteristics of the metastatic LNs and analyzed their correlation to the clinicopathologic characteristics of the primary tumor. Cervical LN metastasis after prophylactic CND was identified in 280 out of 1046 patients (26.8 %). The size of metastatic foci (≥2 mm) was independently correlated with primary tumor size (≥1 cm) (p = 0.016, OR = 1.88). Primary tumor size (≥1 cm) was also correlated to the number of metastatic LNs (≥5) (p = 0.004, OR = 3.14) and extranodal extension (p = 0.021, OR = 2.41) in univariate analysis. The size of the primary tumor affects pathologic features of subclinical LN metastasis in patients with PTC. Patients with primary tumors ≥1 cm have an increased risk of larger LN metastases (≥2 mm), an increased number of LN metastases (≥5), and a higher incidence of ENE, which should be considered in decision for prophylactic CND.

  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 diagnostic ability of {sup 18}F-FDG PET/CT for mediastinal lymph node staging using {sup 18}F-FDG uptake and volumetric CT histogram analysis in non-small cell lung cancer

    Energy Technology Data Exchange (ETDEWEB)

    Lee, Jeong Won [Catholic Kwandong University College of Medicine, Department of Nuclear Medicine, International St. Mary' s Hospital, Incheon (Korea, Republic of); Kim, Eun Young [Yonsei University College of Medicine, Division of Pulmonology, Department of Internal Medicine, Seoul (Korea, Republic of); Kim, Dae Joon [Yonsei University College of Medicine, Department of Thoracic and Cardiovascular Surgery, Seoul (Korea, Republic of); Lee, Jae-Hoon [Yonsei University College of Medicine, Department of Nuclear Medicine, Seoul (Korea, Republic of); Yonsei University College of Medicine, Department of Nuclear Medicine, Gangnam Severance Hospital, Seoul (Korea, Republic of); Kang, Won Jun; Yun, Mijin [Yonsei University College of Medicine, Department of Nuclear Medicine, Seoul (Korea, Republic of); Lee, Jong Doo [Catholic Kwandong University College of Medicine, Department of Radiology, International St. Mary' s Hospital, Incheon (Korea, Republic of)

    2016-12-15

    To evaluate the clinical implications of lymph node (LN) density on {sup 18}F-FDG PET/CT for mediastinal LN characterization in non-small cell lung cancer (NSCLC). One hundred and fifty-two patients with 271 mediastinal LNs who underwent PET/CT and endobronchial ultrasound-guided transbronchial needle aspiration for staging were enrolled. Maximum standardized uptake value (SUVmax), short axis diameter, LN-to-primary cancer ratio of SUVmax, and median Hounsfield unit (HU) based on CT histogram were correlated to histopathology. Of 271 nodes, 162 (59.8 %) were malignant. SUVmax, short axis diameter, and LPR of malignant LNs were higher than those of benign nodes. Among malignant LNs, 71.0 % had median HU between 25 and 45, while 78.9 % of benign LNs had values <25 HU or >45 HU. Using a cutoff value of 4.0, SUVmax showed the highest diagnostic ability for detecting malignant LNs with a specificity of 94.5 %, but showing a sensitivity of 70.4 %. Using additional density criteria (median HU 25-45) in LNs with 2.0< SUVmax ≤4.0, the sensitivity increased to 88.3 % with the specificity of 82.6 %. LN density is useful for the characterization of LNs with mild {sup 18}F-FDG uptake. The risk of mediastinal LN metastasis in NSCLC patients could be further stratified using both {sup 18}F-FDG uptake and LN density. (orig.)

  5. 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.

  6. 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.

  7. Ultrasound elastography for evaluation of cervical lymph nodes

    Directory of Open Access Journals (Sweden)

    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.

  8. 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  

  9. 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.

  10. 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...

  11. 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.

  12. 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.

  13. 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.

  14. 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.

  15. A methylene blue-assisted technique for harvesting lymph nodes after radical surgery for gastric cancer: a prospective, randomized, controlled study.

    Science.gov (United States)

    Aoyama, Toru; Fujikawa, Hirohito; Cho, Haruhiko; Ogata, Takashi; Shirai, Junya; Hayashi, Tsutomu; Rino, Yasushi; Masuda, Munetaka; Oba, Mari S; Morita, Satoshi; Yoshikawa, Takaki

    2015-02-01

    Harvesting lymph nodes (LNs) after gastrectomy is essential for accurate staging. This trial evaluated the efficiency and quality of a conventional method and a methylene blue-assisted method in a randomized manner. The key eligibility criteria were as follows: (i) histologically proven adenocarcinoma of the stomach; (ii) clinical stage I-III; (iii) R0 resection planned by gastrectomy with D1+ or D2 lymphadenectomy. The primary endpoint was the ratio of the pathologic number of harvested LNs per time (minutes) as an efficacy measure. The secondary endpoint was the number of harvested LNs, as a quality measure. Between August 2012 and December 2012, 60 patients were assigned to undergo treatment using the conventional method (n=29) and the methylene blue dye method (n=31). The baseline demographics were mostly well balanced between the 2 groups. The number of harvested LNs (mean±SD) was 33.6±11.9 in the conventional arm and 43.4±13.9 in the methylene blue arm (P=0.005). The ratio of the number of the harvested LNs per time was 1.12±0.46 LNs/min in the conventional arm and 1.49±0.59 LNs/min in the methylene blue arm (P=0.010). In the subgroup analyses, the quality and efficacy were both superior for the methylene blue dye method compared with the conventional method. The methylene blue technique is recommended for harvesting LNs during gastric cancer surgery on the basis of both the quality and efficacy.

  16. 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- ...

  17. Long-term oncological outcomes in patients with limited nodal disease undergoing radical prostatectomy and pelvic lymph node dissection without adjuvant treatment.

    Science.gov (United States)

    Mandel, Philipp; Rosenbaum, Clemens; Pompe, Raisa S; Steuber, Thomas; Salomon, Georg; Chun, Felix K; Graefen, Markus; Huland, Hartwig; Tilki, Derya

    2017-08-21

    This study aimed at analysing long-term oncologic outcomes in prostate cancer patients with limited nodal disease (1-2 positive lymph nodes) without adjuvant therapy after radical prostatectomy (RP). We retrospectively analysed data of 209 pN1 patients who underwent RP between January 1998 and 2010 with one (160) or two (49) histologically proven positive lymph nodes (LNs) without adjuvant treatment. Biochemical recurrence-free survival, metastasis-free survival and cancer-specific survival (CSS) were reported. In multivariable regression analyses further prognosticators of oncologic outcome in these patients were analysed. Median follow-up was 60.2 months. There was no significant difference in oncologic outcome between patients with one and two positive LNs. 73.1% (76.7%) of patients with one (two) positive LNs had biochemical recurrence during the follow-up period, 20.0% (25.6%) developed metastasis and 8.1% (6.1%) died of their disease. The only factors significantly associated with oncologic outcome in multivariable analysis were Gleason score and pT-stage. Patients with limited nodal disease (1-2 positive LNs) without adjuvant therapy showed favourable CSS-rates above 94% after 5 years. A subgroup of these patients (37%) remained metastasis-free without need of salvage treatment.

  18. Comparison of two treatment strategies for irradiation of regional lymph nodes in patients with breast cancer: Lymph flow guided portals versus standard radiation fields

    Science.gov (United States)

    Novikov, Sergey Nikolaevich; Kanaev, Sergey Vasilevich; Semiglazov, Vladimir Fedorovich; Jukova, Ludmila Alekseevna; Krzhivitckiy, Pavel Ivanovich

    2014-01-01

    Aim and Background Radiotherapy being an essential part of breast cancer treatment, we evaluate various radiotherapy strategies in patients with breast cancer. Materials and methods Lymph node (LN) scintigraphy was performed in 172 primary patients with BC. LN visualization started 30–360 min after intratumoral injection of 75–150 MBq of 99mTc-nanocolloids. Our standard recommendation for postoperative radiotherapy in patients with LN invasion by BC were as follows: for patients with external localization of tumour – breast + axillary (Ax) + sub-supraclavicular (SSCL) regions; with internal localization – all above + internal mammary nodes (IM). Proposed strategy of lymph flow guided radiotherapy is based on the assumption that only regions that contain ‘hot’ LNs must be included in a treatment volume. Results Among 110 patients with external localization of BC, Ax LNs were visualized in all cases and in 62 patients it was the only region with ‘hot’ LN. Twenty-three patients (20.9%) had drainage to Ax + SSCL, 12 (10.9%) – Ax + IM, 13 (11.8%) – Ax + SSCL + IM regions. After the visualization of lymph flow patterns, standard treatment volume was changed in 87/110 cases (79.1%): in 56.4%, reduced, in 22.7%, enlarged or changed. In 62 patients with tumours in internal quadrants, we revealed the following patterns of lymph-flow: only to the Ax region in 23 (37.1%); Ax + IM, 13 (21%); Ax + SSCL, 15 (24.2%); Ax + IM + ISSCL, 11 (17.7%) cases. After lymph-flow visualization, the standard irradiation volume was reduced in 53/62 (85.5%) cases. Conclusion Visualization of an individual lymph flow pattern from BC can be used for the optimization of standard fields used for irradiation of regional LNs. PMID:25535581

  19. Intraoperative 3-D imaging improves sentinel lymph node biopsy in oral cancer

    Energy Technology Data Exchange (ETDEWEB)

    Bluemel, Christina; Herrmann, Ken; Buck, Andreas K.; Lapa, Constantin [University Hospital Wuerzburg, Department of Nuclear Medicine, Wuerzburg (Germany); Kuebler, Alexander; Hartmann, Stefan; Linz, Christian; Mueller-Richter, Urs [University Hospital Wuerzburg, Department of Oral and Maxillofacial Plastic Surgery, Wuerzburg (Germany); Geissinger, Eva; Wild, Vanessa [University Wuerzburg, Institute of Pathology, Wuerzburg (Germany)

    2014-12-15

    The aim of this study was to prospectively evaluate the feasibility and potential advantages of freehand single-photon emission computed tomography (fhSPECT) compared with conventional intraoperative localization techniques for sentinel lymph node biopsy (SLNB) in oral cancer. Between November 2012 and February 2014, 23 consecutive patients with clinical T1/T2 oral squamous cell carcinoma and a cN0 neck were recruited. All patients underwent SLNB followed by elective neck dissection (END). All patients received preoperative lymphoscintigraphy. To detect the SLNs intraoperatively, fhSPECT with a combination of conventional acoustic SLN localization and 3-D visual navigation was used. All but one of the SLNs detected by preoperative imaging were successfully mapped intraoperatively by fhSPECT (detection rate 98 %), including those in six patients with a tumour in the floor of the mouth. A histopathology analysis revealed positive SLNs in 22 % of patients. No further metastases were found in LNs resected during END. SLNB correctly predicted the final LN stage in all patients (accuracy 100 %). Additional radioactive LNs, which were not present on preoperative lymphoscintigraphy, were observed in three patients. FhSPECT is a feasible technology that allows the accurate identification of SLNs in oral cancer. FhSPECT overcomes the shine-through phenomenon, one of the most important limitations of SLNB, thereby confirming the importance of SLNB in patients with cN0 oral cancer. (orig.)

  20. Chemokine-Releasing Nanoparticles for Manipulation of the Lymph Node Microenvironment

    Directory of Open Access Journals (Sweden)

    Taissia G. Popova

    2015-03-01

    Full Text Available Chemokines (CKs secreted by the host cells into surrounding tissue establish concentration gradients directing the migration of leukocytes. We propose an in vivo CK gradient remodeling approach based on sustained release of CKs by the crosslinked poly(N-isopropylacrylamide hydrogel open meshwork nano-particles (NPs containing internal crosslinked dye affinity baits for a reversible CK binding and release. The sustained release is based on a new principle of affinity off-rate tuning. The NPs with Cibacron Blue F3G-A and Reactive Blue-4 baits demonstrated a low-micromolar affinity binding to IL-8, MIP-2, and MCP-1 with a half-life of several hours at 37 °C. The capacity of NPs loaded with IL-8 and MIP-1α to increase neutrophil recruitment to lymph nodes (LNs was tested in mice after footpad injection. Fluorescently-labeled NPs used as tracers indicated the delivery into the sub-capsular compartment of draining LNs. The animals administered the CK-loaded NPs demonstrated a widening of the sub-capsular space and a strong LN influx of leukocytes, while mice injected with control NPs without CKs or bolus doses of soluble CKs alone showed only a marginal neutrophil response. This technology provides a new means to therapeutically direct or restore immune cell traffic, and can also be employed for simultaneous therapy delivery.

  1. Vaccine priming is restricted to draining lymph nodes and controlled by adjuvant-mediated antigen uptake.

    Science.gov (United States)

    Liang, Frank; Lindgren, Gustaf; Sandgren, Kerrie J; Thompson, Elizabeth A; Francica, Joseph R; Seubert, Anja; De Gregorio, Ennio; Barnett, Susan; O'Hagan, Derek T; Sullivan, Nancy J; Koup, Richard A; Seder, Robert A; Loré, Karin

    2017-06-07

    The innate immune mechanisms by which adjuvants enhance the potency and protection of vaccine-induced adaptive immunity are largely unknown. We introduce a model to delineate the steps of how adjuvant-driven innate immune activation leads to priming of vaccine responses using rhesus macaques. Fluorescently labeled HIV-1 envelope glycoprotein (Env) was administered together with the conventional aluminum salt (alum) adjuvant. This was compared to Env given with alum with preabsorbed Toll-like receptor 7 (TLR7) ligand (alum-TLR7) or the emulsion MF59 because they show superiority over alum for qualitatively and quantitatively improved vaccine responses. All adjuvants induced rapid and robust immune cell infiltration to the injection site in the muscle. This resulted in substantial uptake of Env by neutrophils, monocytes, and myeloid and plasmacytoid dendritic cells (DCs) and migration exclusively to the vaccine-draining lymph nodes (LNs). Although less proficient than monocytes and DCs, neutrophils were capable of presenting Env to memory CD4(+) T cells. MF59 and alum-TLR7 showed more pronounced cell activation and overall higher numbers of Env(+) cells compared to alum. This resulted in priming of higher numbers of Env-specific CD4(+) T cells in the vaccine-draining LNs, which directly correlated with increased T follicular helper cell differentiation and germinal center formation. Thus, strong innate immune activation promoting efficient vaccine antigen delivery to infiltrating antigen-presenting cells in draining LNs is an important mechanism by which superior adjuvants enhance vaccine responses. Copyright © 2017, American Association for the Advancement of Science.

  2. 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.

  3. 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

  4. The Diagnostic Value of Cervical Lymph Node Metastasis in Head and Neck Squamous Carcinoma by Using Diffusion-Weighted Magnetic Resonance Imaging and Computed Tomography Perfusion

    Directory of Open Access Journals (Sweden)

    Jin Zhong

    2014-01-01

    Full Text Available Purpose. The aim of this study was to compare diffusion-weighted magnetic resonance imaging (DWI with computed tomography perfusion (CTP for preoperative detection of metastases to lymph nodes (LNs in head and neck squamous cell carcinoma (SCC. Methods. Between May 2010 and April 2012, 30 patients with head and neck SCC underwent preoperative DWI and CTP. Two radiologists measured apparent diffusion coefficient (ADC values and CTP parameters independently. Surgery and histopathologic examinations were performed on all patients. Results. On DWI, 65 LNs were detected in 30 patients. The mean ADC value of metastatic nodes was lower than benign nodes and the difference was statistically significant (P<0.05. On CTP images, the mean value in metastatic nodes of blood flow (BF and blood volume (BV was higher than that in benign nodes, and mean transit time (MTT in metastatic nodes was lower than that in benign nodes. There were significant differences in BF and MTT values between metastatic and benign LNs (P<0.05. There were significant differences between the AUCs of DWI and CTP (Z=4.612, P<0.001. Conclusion. DWI with ADC value measurements may be more accurate than CTP for the preoperative diagnosis of cervical LN metastases.

  5. 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...

  6. The Addition of SPECT/CT Lymphoscintigraphy to Breast Cancer Radiation Planning Spares Lymph Nodes Critical for Arm Drainage

    Energy Technology Data Exchange (ETDEWEB)

    Cheville, Andrea L., E-mail: Cheville.andrea@mayo.edu [Department of Physical Medicine and Rehabilitation, Mayo Clinic, Rochester, Minnesota (United States); Brinkmann, Debra H.; Ward, Shelly B. [Department of Radiation Oncology, Mayo Clinic, Rochester, Minnesota (United States); Durski, Jolanta [Department of Radiology, Nuclear Medicine Program, Mayo Clinic, Rochester, Minnesota (United States); Laack, Nadia N.; Yan, Elizabeth; Schomberg, Paula J.; Garces, Yolanda I. [Department of Radiation Oncology, Mayo Clinic, Rochester, Minnesota (United States); Suman, Vera J. [Department of Health Sciences Research, Mayo Clinic, Rochester, Minnesota (United States); Petersen, Ivy A. [Department of Radiation Oncology, Mayo Clinic, Rochester, Minnesota (United States)

    2013-03-15

    Background: This prospective cohort study was designed to determine whether the amount of radiation delivered to the nonpathological lymph nodes (LNs) that drain the arm can be significantly reduced by integrating single-photon emission computed tomography (SPECT)/computed tomography (CT) scans into radiation treatment planning. Methods: SPECT-CT scans were acquired for the 28 patients with stage I or II breast cancer and fused with the routinely obtained radiation oncology planning CT scans. Arm-draining LNs were contoured with 0.5-cm margins automatically using a threshold of 50% maximum intensity. Two treatment plans were generated: 1 per routine clinical practice (standard; STD) and the second (modified; MOD) with treatment fields modified to minimize dose to the arm-draining LNs visible on SPECT/CT images without interfering with the dosage delivered to target tissues. Participants were treated per the MOD plans. Arm volumes were measured prior to radiation and thereafter at least three subsequent 6-month intervals. Results: Sixty-eight level I-III arm-draining LNs were identified, 57% of which were inside the STD plan fields but could be blocked in the MOD plan fields. Sixty-five percent of arm-draining LNs in the STD versus 16% in the MOD plans received a mean of ≥10 Gy, and 26% in the STD versus 4% in the MOD plans received a mean of ≥40 Gy. Mean LN radiation exposure was 23.6 Gy (standard deviation 18.2) with the STD and 7.7 Gy (standard deviation 11.3) with the MOD plans (P<.001). No participant developed lymphedema. Conclusions: The integration of SPECT/CT scans into breast cancer radiation treatment planning reduces unnecessary arm-draining LN radiation exposure and may lessen the risk of lymphedema.

  7. 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.

  8. 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.

  9. FDG-PET/CT lymph node staging after neoadjuvant chemotherapy in patients with adenocarcinoma of the esophageal-gastric junction.

    Science.gov (United States)

    Fencl, Pavel; Belohlavek, Otakar; Harustiak, Tomas; Zemanova, Milada

    2016-11-01

    The aim of the analysis was to assess the accuracy of various FDG-PET/CT parameters in staging lymph nodes after neoadjuvant chemotherapy. In this prospective study, 74 patients with adenocarcinoma of the esophageal-gastric junction were examined by FDG-PET/CT in the course of their neoadjuvant chemotherapy given before surgical treatment. Data from the final FDG-PET/CT examinations were compared with the histology from the surgical specimens (gold standard). The accuracy was calculated for four FDG-PET/CT parameters: (1) hypermetabolic nodes, (2) large nodes, (3) large-and-medium large nodes, and (4) hypermetabolic or large nodes. In 74 patients, a total of 1540 lymph nodes were obtained by surgery, and these were grouped into 287 regions according to topographic origin. Five hundred and two nodes were imaged by FDG-PET/CT and were grouped into these same regions for comparison. In the analysis, (1) hypermetabolic nodes, (2) large nodes, (3) large-and-medium large nodes, and (4) hypermetabolic or large nodes identified metastases in particular regions with sensitivities of 11.6%, 2.9%, 21.7%, and 13.0%, respectively; specificity was 98.6%, 94.5%, 74.8%, and 93.6%, respectively. The best accuracy of 77.7% reached the parameter of hypermetabolic nodes. Accuracy decreased to 62.0% when also smaller nodes (medium-large) were taken for the parameter of metastases. FDG-PET/CT proved low sensitivity and high specificity. Low sensitivity was based on low detection rate (32.6%) when compared nodes imaged by FDG-PET/CT to nodes found by surgery, and in inability to detect micrometastases. Sensitivity increased when also medium-large LNs were taken for positive, but specificity and accuracy decreased.

  10. 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.)

  11. Pelvic Radiotherapy versus Radical Prostatectomy with Limited Lymph Node Sampling for High-Grade Prostate Adenocarcinoma

    Directory of Open Access Journals (Sweden)

    Christopher B. Baker

    2016-01-01

    Full Text Available Purpose. To compare oncologic outcomes for patients with Gleason score (GS ≥ 8 prostate adenocarcinoma treated with radical prostatectomy (RP versus external beam radiotherapy combined with androgen deprivation (RT + ADT. Methods. Between 2001 and 2014, 121 patients with GS ≥ 8 were treated at our institution via RT + ADT (n=71 or RP (n=50 with ≥ 1 year of biochemical follow-up. Endpoints included biochemical failure (BF, distant metastasis, and initiation of salvage ADT. Results. The RT + ADT group was older, had higher biopsy GS, and had greater risk of lymph node involvement. All other pretreatment characteristics were similar between groups. Mean number of lymph nodes (LNs sampled for patients undergoing RP was 8.2 (±6.18. Mean biochemical follow-up for all patients was 61 months. Five-year estimates of BF for the RT + ADT and RP groups were 7.2% versus 42.3%, (p<0.001. The RT + ADT group also had lower rates of distant metastasis (2% versus 7.8% and salvage ADT (8% versus 33.8%. Conclusion. In this analysis, RT + ADT was associated with improved biochemical and metastatic control when compared to RP with limited LN sampling. How RT + ADT compares with more aggressive lymphadenectomy, as is currently our institutional standard, remains an important unanswered question.

  12. 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.

  13. 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.

  14. 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.

  15. 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...

  16. 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.

  17. 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

  18. Evaluation of lymph node reactivity in differentiated thyroid carcinoma

    Directory of Open Access Journals (Sweden)

    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.

  19. Value of PET/CT and MR Lymphography in Treatment of Prostate Cancer Patients With Lymph Node Metastases

    Energy Technology Data Exchange (ETDEWEB)

    Fortuin, Ansje S., E-mail: A.Fortuin@rad.umcn.nl [Department of Radiology, Radboud University Nijmegen Medical Centre, Nijmegen (Netherlands); Deserno, Willem M.L.L.G. [Department of Radiology, Radboud University Nijmegen Medical Centre, Nijmegen (Netherlands); Meijer, Hanneke J.M. [Department of Radiation Oncology, Radboud University Nijmegen Medical Centre, Nijmegen (Netherlands); Jager, Gerrit J. [Department of Radiology, Jeroen Bosch Hospital' s, Hertogenbosch (Netherlands); Takahashi, Satoru; Debats, Oscar A. [Department of Radiology, Radboud University Nijmegen Medical Centre, Nijmegen (Netherlands); Reske, Sven N.; Schick, Christian [Department of Nuclear Medicine, University of Ulm, Ulm (Germany); Krause, Bernd J. [Department of Nuclear Medicine, Technische Universitaet Muenchen, Muenchen (Germany); Oort, Inge van; Witjes, Alfred J. [Department of Urology, Radboud University Nijmegen Medical Centre, Nijmegen (Netherlands); Hoogeveen, Yvonne L. [Department of Radiology, Radboud University Nijmegen Medical Centre, Nijmegen (Netherlands); Lin, Emile N.J.Th. van [Department of Radiation Oncology, Radboud University Nijmegen Medical Centre, Nijmegen (Netherlands); Barentsz, Jelle O. [Department of Radiology, Radboud University Nijmegen Medical Centre, Nijmegen (Netherlands)

    2012-11-01

    Purpose: To determine the clinical value of two novel molecular imaging techniques: {sup 11}C-choline positron emission tomography (PET)/computed tomography (CT) and ferumoxtran-10 enhanced magnetic resonance imaging (magnetic resonance lymphography [MRL]) for lymph node (LN) treatment in prostate cancer (PCa) patients. Therefore, we evaluated the ability of PET/CT and MRL to assess the number, size, and location of LN metastases in patients with primary or recurrent PCa. Methods and Materials: A total of 29 patients underwent MRL and PET/CT for LN evaluation. The MRL and PET/CT data were analyzed independently. The number, size, and location of the LN metastases were determined. The location was described as within or outside the standard clinical target volume for elective pelvic irradiation as defined by the Radiation Therapy Oncology Group. Subsequently, the results from MRL and PET/CT were compared. Results: Of the 738 LNs visible on MRL, 151 were positive in 23 of 29 patients. Of the 132 LNs visible on PET/CT, 34 were positive in 13 of 29 patients. MRL detected significantly more positive LNs (p < 0.001) in more patients than PET/CT (p = 0.002). The mean diameter of the detected suspicious LNs on MRL was significantly smaller than those detected by PET/CT, 4.9 mm and 8.4 mm, respectively (p < 0.0001). In 14 (61%) of 23 patients, suspicious LNs were found outside the clinical target volume with MRL and in 4 (31%) of 13 patients with PET/CT. Conclusion: In patients with PCa, both molecular imaging techniques, MRL and {sup 11}C-choline PET/CT, can detect LNs suspicious for metastasis, irrespective of the existing size and shape criteria for CT and conventional magnetic resonance imaging. On MRL and PET/CT, 61% and 31% of the suspicious LNs were located outside the conventional clinical target volume. Therefore, these techniques could help to individualize treatment selection and enable image-guided radiotherapy for patients with PCa LN metastases.

  20. Visualization of fluid drainage pathways in lymphatic vessels and lymph nodes using a mouse model to test a lymphatic drug delivery system

    Science.gov (United States)

    Kodama, Tetsuya; Hatakeyama, Yuriko; Kato, Shigeki; Mori, Shiro

    2014-01-01

    Curing/preventing micrometastasis to lymph nodes (LNs) located outside the surgically resected area is essential for improving the morbidity and mortality associated with breast cancer and head and neck cancer. However, no lymphatic therapy system exists that can deliver drugs to LNs located outside the dissection area. Here, we demonstrate proof of concept for a drug delivery system using MXH10/Mo-lpr/lpr mice that exhibit systemic lymphadenopathy, with some peripheral LNs being as large as 10 mm in diameter. We report that a fluorescent solution injected into the subiliac LN (defined as the upstream LN within the dissection area) was delivered successfully to the proper axillary LN (defined as the downstream LN outside the dissection area) through the lymphatic vessels. Our results suggest that this approach could be used before surgical resection to deliver drugs to downstream LNs outside the dissection area. We anticipate that our methodology could be applied clinically, before surgical resection, to cure/prevent micrometastasis in LNs outside the dissection area, using techniques such as ultrasound-guided internal jugular vein catheterization. PMID:25657881

  1. 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.

  2. 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.

  3. 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.

  4. Mapping Sentinel Lymph Node Metastasis by Dual-probe Optical Imaging

    Science.gov (United States)

    Yang, Xiangyu; Wang, Zhe; Zhang, Fuwu; Zhu, Guizhi; Song, Jibin; Teng, Gao-Jun; Niu, Gang; Chen, Xiaoyuan

    2017-01-01

    Purpose: Sentinel lymph node biopsy (SLNB) has emerged as the preferred standard procedure in patients with breast cancer, melanoma and other types of cancer. Herein, we developed a method to intra-operatively map SLNs and differentiate tumor metastases within SLNs at the same time, with the aim to provide more accurate and real-time intraoperative guidance. Experimental Design: Hyaluronic acid (HA), a ligand of lymphatic vessel endothelial hyaluronan receptor (LYVE)-1, is employed as a SLN mapping agent after being conjugated with a near-infrared fluorophore (Cy5.5). Different sized HAs (5, 10 and 20K) were tested in normal mice and mice with localized inflammation to optimize LN retention time and signal to background ratio. Cetuximab, an antibody against epidermal growth factor receptor (EGFR), and trastuzumab, an antibody against human epidermal growth factor receptor 2 (HER2), were labeled with near-infrared fluorophore (IRDye800) for detecting metastatic tumors. LN metastasis model was developed by hock injection of firefly luciferase engineered human head neck squamous carcinoma cancer UM-SCC-22B cells or human ovarian cancer SKOV-3 cells. The metastases within LNs were confirmed by bioluminescence imaging (BLI). IRDye800-Antibodies were intravenously administered 24 h before local administration of Cy5.5-HA. Optical imaging was then performed to identify nodal metastases. Results: Binding of HA with LYVE-1 was confirmed by ELISA and fluorescence staining. HA with a size of 10K was chosen based on the favorable migration and retention profile. After sequential administration of IRDye800-antibodies intravenously and Cy5.5-HA locally to a mouse model with LN metastases and fluorescence optical imaging, partially metastasized LNs were successfully distinguished from un-metastasized LNs and fully tumor occupied LNs, based on the different signal patterns. Conclusions: Fluorophore conjugated HA is a potential lymphatic mapping agent for SLNB. Dual-tracer imaging

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

    Science.gov (United States)

    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.

  6. 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.

  7. 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.

  8. Comparative analysis of immune activation markers of CD8+ T cells in lymph nodes of different origins in SIV-infected Chinese rhesus macaques

    Directory of Open Access Journals (Sweden)

    Jinbiao Liu

    2016-09-01

    Full Text Available Altered T-cell homeostasis, such as expansion of CD8+ T cells to the secondary lymphatic compartments has been suggested as a mechanism of HIV/SIV-pathogenesis. However, the role of immune activation of CD8+ T cells in the CD4/CD8 turnover and viral replication in these tissues is not completely understood. In the present study, we compared the expression of immune activation markers (CD69 and HLA-DR on CD8+ T cells in the peripheral blood and lymph nodes (LNs of SIV-infected/uninfected Chinese rhesus macaques. SIV-infected macaques had significantly higher percentages of CD8+CD69+ and CD8+HLA-DR+ T cells in all these anatomical compartments than uninfected macaques except for CD8+HLA-DR+ T cells in peripheral blood. LNs that located close to the gastrointestinal (GI tract (colon, mesenteric and iliac LNs of SIV-infected macaques had profoundly lower numbers of CD4+ T cells, but no significantly difference in expression of activation marker (CD8+CD69+ and CD8+HLA-DR+ as compared with the peripheral lymphatic tissues (axillary and inguinal LNs. The CD4/CD8 ratios were negatively correlated with the activation of CD8 T cells in the overall LNs, with further associations with CD8+HLA-DR+ in GI LNs while CD8+CD69+ in peripheral LNs. These observations demonstrate that the increase of CD8+ T cell activation is a contributing factor for the decline of CD4/CD8 ratios in GI system.

  9. 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.

  10. 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.

  11. 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.

  12. 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....

  13. Lack of survival benefit of post-operative radiation therapy in prostate cancer patients with positive lymph nodes.

    Science.gov (United States)

    Johnstone, P A S; Assikis, V; Goodman, M; Ward, K C; Riffenburgh, R H; Master, V

    2007-01-01

    Randomized data from SWOG 8794 and EORTC 22911 confirm the benefit of post-operative radiation therapy (RT) for selected patients with pT3 prostate cancer (CaP) after radical prostatectomy (RP). However, data regarding the potential benefit of RT for patients post-RP with positive lymph node (+LN) involvement are limited. We analyzed the Surveillance Epidemiology End Results (SEER) registry for population-based data on efficacy of post-operative RT for +LN patients after RP. As LN data have only been captured by SEER since 1988, we analyzed data for 1988-1992, with specific attention to 10-year relative survival (defined as observed survival divided by the survival of a gender-, age- and race-matched population cohort without disease). Specifically analyzed were data for 1921 patients with nonmetastatic prostate cancer who underwent surgery alone, or surgery followed by RT, and who had +LNs documented. SEER does not code the interval between surgery and RT, so the ratio of patients receiving salvage versus adjuvant therapy is unknown. Using follow-up data through 2002, post-diagnosis survival was examined by number of +LNs. There was no significant relative survival benefit for +LN patients receiving post-operative RT (chi(2)P=0.270). These data do not support routine use of post-operative RT for patients with +LNs in the surgical specimen.

  14. Preoperative multidetector CT manifestations of perigastric lymph nodes in patients with early gastric cancer and pN0

    Energy Technology Data Exchange (ETDEWEB)

    Kang, Jung Hyun; Yu, Jeong Sik; Chung, Jae Joon; Lim, Joo Hee; Cho, Eun Suk; Kim, Ki Whang [Dept. of Radiology, Yonsei University College of Medicine, Gangnam Severance Hospital, Seoul (Korea, Republic of)

    2013-11-15

    To find the determinant of lymph node (LN) manifestations on preoperative multidetector CT (MDCT) in early gastric cancer (EGC) patients with pN0. One hundred and eighty-six consecutive patients with pT1pN0, the largest perigastric LN on preoperative MDCT, were categorized into two groups according to 8 different parameters [short (SD) and long diameter (LD) 4/6/8 mm, average attenuation 100 Hounsfield unit, short-to-long diameter-ratio (SLR) 0.7], and correlated with the size, gross type, depth of invasion and microscopic type of their primary lesions by the chi-square test and multiple logistic regression analysis. When the primary lesion was larger than 3 cm, the LNs were larger in 4 parameters (SD or LD, 4/6 mm; p < 0.05); gross type IIb patients showed smaller LNs in 5 parameters (SD 4/6 mm, LD 4/6/8 mm; p < 0.05); and patients with microscopically-undifferentiated lesions showed larger LNs in SD 4 mm or LD 8 mm by the chi-square test and multiple logistic regression analysis. The depth of invasion showed no significant difference in LN size. No factors revealed significant difference in LN attenuation or SLR. Benign regional LN enlargement is more frequent in EGC patients with larger size primary lesions or lesion with poor microscopic differentiation. However, this condition is less frequent in gross type IIb patients.

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

    Directory of Open Access Journals (Sweden)

    Otakar Kraft

    2012-08-01

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

  16. Multidetector CT Assessment of Lymph Node Size for Nodal Staging in Patients with Potentially Operable Squamous Esophageal Cancer and the 18F-FDG Positron Emission Tomography CT Correlation

    Energy Technology Data Exchange (ETDEWEB)

    Yoom, Soo Kyung; Jung, Jung Im; Ahn, Myeong Im; Park, Jae Gil; Yoo, Ie Ryung; Park, Seog Hee [Catholic University Seoul St. Mary' s Hospital, Seoul (Korea, Republic of); Park, Mi Jung [Gyeongsang National University Hospital, Junju (Korea, Republic of); Park, Hyun Jin [Catholic University St. Vincent Hospital, Suwon (Korea, Republic of)

    2010-03-15

    To investigate the size criteria of multidetector computed tomography (MDCT) for the evaluation metastatic lymph nodes (LNs) for potentially operable squamous esophageal cancer, and to compare this information with the results of positron emission tomography-CT (PET-CT). Twenty-four patients who underwent radical esophagectomy for esophageal cancer were studied. All patients had preoperative MDCT and PET-CT. The MDCT findings were compared with those of PET-CT and were correlated with the surgical records. The receiver operating characteristic (ROC) curve method was used to determine the appropriate cut-off value to distinguish benign from metastatic LNs. The size of metastatic LNs (9.35 {+-} 3.41 mm) was significantly larger than that of benign LNs (5.74 {+-} 1.64 mm) (p<0.001). The best cut-off value was 7 mm (81.8% sensitivity, 80.8% specificity). PET-CT detected all metastatic LNs except for four in the peritumoral region. The sensitivity and specificity of metastatic LN evaluation on PET-CT were 82.6% and 99.4%, respectively. Only one LN without metastasis showed increased fluoro-2-deoxy-D-glucose uptake on PET-CT. Size of metastatic LNs can typically be < 10 mm. For MDCT, the short diameter of 7 mm may be the optimal criterion. PET-CT is very accurate for the assessment of metastatic LNs except for those in the peritumoral region.

  17. 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.

  18. 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.

  19. Reliable EGFR mutation testing in ultrasound-guided supraclavicular lymph node fine-needle aspirates: a cohort study with diagnostic performance analysis.

    Science.gov (United States)

    Awwad, Amir; Tiwari, Sandeep; Sovani, Vishakha; Baldwin, David R; Kumaran, Maruti

    2015-01-01

    15-30% of patients with lung cancer will have supraclavicular and cervical lymphadenopathy (SCLN). Ultrasound (US)-guided fine-needle aspiration (FNA) cytology is regarded as an effective diagnostic tool in small size lymph nodes (LNs) and impalpable positron emission tomography detected nodes. We evaluated our diagnostic service performance in relation to the adequacy of samples for epidermal growth factor receptor (EGFR) mutation. Retrospective data analysis from electronic records, searching for all suspected lung cancer referrals that underwent US of the neck±FNA, over a continuous period of 4 years. Of 306 cases with suspected lung cancer referred to our department for US FNA of SCLN, 228 patients underwent the procedure. Of the remaining 78 patients, LNs were not detected in 52 cases and appeared benign in 26. Cytological diagnosis was established in 171 patients (75%) for treatment decisions without further investigations. The remaining 57 patients had further investigations; 45 reconfirmed the US-guided FNA diagnosis. The average LN size was 12.9 mm, and positive cytology was obtained in LNs ranging from 3 to 45 mm. Of 57 adenocarcinoma cases, 34 were tested for EGFR confirming 4 positive, 25 negative and 5 insufficient samples. No complications were recorded. US-guided FNA of SCLN remains an important diagnostic tool in lung cancer. Adequate tissue can be obtained for reliable diagnosis from LNs and for EGFR mutational analysis, without the need for more invasive and expensive investigations in more than 80% of cases.

  20. 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.

  1. [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.

  2. Preoperative axillary imaging with percutaneous lymph node biopsy is valuable in the contemporary management of patients with breast cancer.

    Science.gov (United States)

    Hieken, Tina J; Trull, Brent C; Boughey, Judy C; Jones, Katie N; Reynolds, Carol A; Shah, Sejal S; Glazebrook, Katrina N

    2013-10-01

    ACOSOG Z11 and other studies showing little benefit to axillary dissection (ALND) for early-stage breast cancers with limited nodal disease have led to questioning the value of preoperative axillary imaging ± ultrasound-guided needle biopsy (USNB). Data are lacking on the value of this approach in identifying cases that fall outside Z11 guidelines. We studied 988 consecutive patients with invasive breast cancers who underwent operation including axillary surgery in 2010-2011. Preoperative axillary ultrasonography (AUS) was performed in 92% and breast/axillary magnetic resonance imaging (MRI) in 51%; 82 (33.5%) of 245 patients with suspicious lymph nodes (LN) were USNB-positive. Regarding nodal status, AUS, MRI, and USNB had negative and positive predictive values of 78%, 76%, 70% and 54%, 58%, 100%, respectively. AUS/MRI visualization of one versus multiple abnormal LNs visualized predicted >2LN+ on final pathology (13.5%/15.1% % vs 30.8%/32.6%, P 2LN+, P = .001. In our contemporary series, preoperative AUS±USNB streamlined surgical care for 29% of node-positive patients. Two-thirds of T1/T2 USNB-LN+ patients with multiple AUS-suspicious LNs had >2LN+, suggesting they should undergo ALND without SLNB. AUS±USNB helps identify node-positive breast cancer patients who fall outside Z11 guidelines. Copyright © 2013 Mosby, Inc. All rights reserved.

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

    Directory of Open Access Journals (Sweden)

    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.

  4. 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.

  5. 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...

  6. 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.

  7. 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.

  8. Prognostic Value of the Number of Retrieved Lymph Nodes in Pathological Nx or N0 Classical Papillary Thyroid Carcinoma.

    Science.gov (United States)

    Sung, Tae-Yon; Yoon, Jong Ho; Song, Dong Eun; Lee, Yu-Mi; Kim, Tae-Yong; Chung, Ki-Wook; Kim, Won Bae; Shong, Young Kee; Hong, Suck Joon

    2016-08-01

    This study evaluated the clinical implications of the number of retrieved central lymph nodes (LN) for the recurrence and recurrence-free survival (RFS) outcomes in patients with pathological Nx (pNx) or N0 classical papillary thyroid carcinoma (PTC). In total, 464 patients were enrolled following total thyroidectomy with central LN dissection. The risk factors related to recurrence and RFS were evaluated and compared between these groups. Age, primary tumor size, and number of retrieved central LNs were independent risk factors for recurrence according to multivariate analysis (p < 0.05). The cut-off value for the number of retrieved central LNs related to recurrence was 4.5. Group 2 (pN0; ≥5 nodes) demonstrated a significantly higher proportion of patients with an ablation-stimulated thyroglobulin (sTg) level <2.0 ng/mL (84.9 vs 61.1 %; p < 0.050) and control sTg level <1.0 ng/mL (92.1 vs 79.6 %; p < 0.050) in comparison with patients in group 1 (pNx or pN0; 1-4 nodes). Perioperative complication rates were comparable between groups. The number of retrieved central LNs is an independent risk factor for recurrence, even among patients with pNx or pN0 classical PTC. A thorough central LN dissection may therefore improve the long-term RFS rate.

  9. 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.

  10. 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

  11. Visceral Obesity Predicts Fewer Lymph Node Metastases and Better Overall Survival in Colon Cancer.

    Science.gov (United States)

    Park, Se Woo; Lee, Hang Lak; Doo, Eun Young; Lee, Kang Nyeong; Jun, Dae Won; Lee, Oh Young; Han, Dong Soo; Yoon, Byung Chul; Choi, Ho Soon; Lee, Kang Hong

    2015-08-01

    The relationship between visceral obesity and colon cancer outcome has not been well studied. The goal of this study was to determine the impact of visceral obesity on lymph node (LN) metastasis and overall survival (OS) in colon cancer. Metastatic LN ratio (MLR) was defined as the number of involved nodes by tumor divided by the total number of resected LNs. 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. In a multivariate analysis among 186 patients, there were inverse associations between V/T and MLR (OR = 0.413, 95% CI = 0.216-0.789, P = 0.007). Furthermore, patients with visceral obesity tended to have significantly better OS than patients with non-visceral obesity. Higher V/T ratios which indicate referring to visceral obesity was significantly associated with decreased MLR and better OS for CRC.

  12. 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,

  13. 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...

  14. 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....

  15. 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

  16. 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.

  17. 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...

  18. 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.

  19. 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.

  20. 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...

  1. 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.

  2. [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

  3. Impact of Lymphoid Follicles and Histiocytes on the False Positive FDG Uptake of Lymph Nodes in Non Small Cell Lung Cancer

    Energy Technology Data Exchange (ETDEWEB)

    Kwon, Seong Young; Min, Jung Joon; Song, Ho Chun; Choi, Chan; Na, Kook Joo; Bom, Hee Seung [Chonnam National Univ. Hwasun Hospital, Hwasun (Korea, Republic of)

    2011-09-15

    Although {sup 18F} fluorodeoxyglucose (FDG) PET/CT has improved the accuracy of evaluating lymph node (LN) staging in non small cell lung cancer (NSCLC), false positive results remain a problem. The reason why benign LNs show high FDG uptake is still unclear. The aim of this study was to identify molecular and pathological characteristics of benign LNs showing high FDG uptake. We studied 108 mediastinal LNs of pathologically benign nature obtained from 43 patients with NSCLC who underwent FDG PET/CT and surgery. We measured the following parameters in each LN: maximum standardized uptake value (maxSUV), short diameter, maximum Hounsfield unit (maxHU) value, occupied proportions of lymphoid follicles, histiocytes in extrafollicular space and the degree of glucose transporter 1 (Glut1) expression. We compared the parameters between two LN groups according to maxSUV. There were 74 LNs showing maxSUV{>=}3.0 (group 1) and 34 LNs with maxSUV<3.0 (group 2). The size of LN (p<0.001) and maxHU (p=0.003) in group 1 was higher than that in group 2. Histologically, the occupied proportions of lymphoid follicles (p=0.031) or histiocytes (p=0.004) were higher in group 1. The Glut1 expression of lymphoid follicles (p=0.035) or histiocytes (p=0.005) was also higher in group 1. Lymphoid follicular hyperplasia and histiocyte infiltration associated with Glut1 overexpression are important molecular and pathological mechanisms for false positive FDG uptake in benign mediastinal LNs in patients with NSCLC.

  4. 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.

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    Lifescience Database Archive (English)

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  12. File list: Pol.Bld.10.AllAg.Lymph_node_metastasis [Chip-atlas[Archive

    Lifescience Database Archive (English)

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  16. File list: Unc.Bld.05.AllAg.Lymph_node_metastasis [Chip-atlas[Archive

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  18. File list: Oth.Bld.10.AllAg.Lymph_node_metastasis [Chip-atlas[Archive

    Lifescience Database Archive (English)

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  1. File list: His.Bld.50.AllAg.Lymph_node_metastasis [Chip-atlas[Archive

    Lifescience Database Archive (English)

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  2. File list: DNS.Bld.50.AllAg.Lymph_node_metastasis [Chip-atlas[Archive

    Lifescience Database Archive (English)

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  3. File list: DNS.Bld.20.AllAg.Lymph_node_metastasis [Chip-atlas[Archive

    Lifescience Database Archive (English)

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  4. File list: Pol.Bld.05.AllAg.Lymph_node_metastasis [Chip-atlas[Archive

    Lifescience Database Archive (English)

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  5. File list: Unc.Bld.50.AllAg.Lymph_node_metastasis [Chip-atlas[Archive

    Lifescience Database Archive (English)

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  6. File list: His.Bld.20.AllAg.Lymph_node_metastasis [Chip-atlas[Archive

    Lifescience Database Archive (English)

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

    Lifescience Database Archive (English)

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  8. 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.

  9. 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.

  10. 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.

  11. 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.

  12. 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.

  13. 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.

  14. LyP-1-conjugated doxorubicin-loaded liposomes suppress lymphatic metastasis by inhibiting lymph node metastases and destroying tumor lymphatics

    Energy Technology Data Exchange (ETDEWEB)

    Yan Zhiqiang; Zhan Changyou; Wen Ziyi; Feng Linglin; Wang Fei; Liu Yu; Yang Xiangkun; Dong Qing; Liu Min; Lu Weiyue, E-mail: wylu@shmu.edu.cn [Key Laboratory of Smart Drug Delivery, Ministry of Education and PLA, Department of Pharmaceutics, School of Pharmacy, Fudan University, Shanghai 201203 (China)

    2011-10-14

    Lymphatic metastasis can be greatly promoted by metastases growth and lymphangiogenesis in lymph nodes (LNs). LyP-1, a cyclic peptide, is able to specifically bind with tumor cells and tumor lymphatics in metastatic LNs. This work aimed to use LyP-1-conjugated liposomes (L-LS) loaded with doxorubicin (DOX) (L-LS/DOX) to suppress lymphatic metastasis by inhibiting both metastases and tumor lymphatics in LNs. L-LS were prepared and exhibited sizes around 90 nm and spherical morphology as characterized by transmission electron microscopy. The in vitro cellular studies showed that LyP-1 modification obviously increased liposome uptake by MDA-MB-435 tumor cells and enhanced the cytotoxicity of liposomal DOX. A popliteal and iliac LN metastases model was successfully established by subcutaneous inoculation of tumor cells to nude mice. The immunofluorescence staining analysis indicated that LyP-1 modification enabled specific binding of liposome with tumor lymphatics and enhanced the destroying effect of liposomal DOX on tumor lymphatics. The in vivo fluorescence imaging and pharmacodynamic studies showed that LyP-1 modification increased liposome uptake by metastatic LNs and that L-LS/DOX significantly decreased metastatic LN growth and LN metastasis rate. These results suggested that L-LS/DOX were an effective delivery system for suppressing lymphatic metastasis by simultaneously inhibiting LN metastases and tumor lymphatics.

  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. 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.

  17. 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.

  18. 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...

  19. 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 ...

  20. 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.

  1. 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...

  2. 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.

  3. 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.

  4. Comparative analysis of diagnostic adequacy rate between aspiration and nonaspiration techniques of fine-needle cytology in patients with thyroid cancer and ultrasonographically suspicious cervical lymph nodes.

    Science.gov (United States)

    Aydin, Cevdet; Dellal, Fatma Dilek; Tam, Abbas Ali; Ogmen, Berna; Kilicarslan, Aydan; Topaloglu, Oya; Ersoy, Reyhan; Cakir, Bekir

    2017-08-18

    We aimed to compare nonaspiration (NAS) and aspiration (AS) techniques in the evaluation of fine-needle cytology of lymph node (FNC-LN) in terms of diagnostic adequacy of cytologic material. One hundred and twenty-three superficial cervical LNs in 75 patients who underwent NAS and AS-FNC-LN in the same visit were evaluated. Cytological results were categorized as diagnostic and nondiagnostic. The rates of malignancy were 13.8% in AS versus 16.3% in NAS technique, whereas nondiagnostic cytology was detected in 43.1% and 25.2%, respectively (P = .549 and P < .01). The diagnostic adequacy rate in NAS-FNC-LN was significantly higher than AS-FNC-LN. However, NAS technique seems to be more simple and comfortable. We suggest both NAS and AS-FNC-LN in cytologic evaluation of suspicious cervical LNs until the diagnostic accuracy is determined with prospective studies. © 2017 Wiley Periodicals, Inc.

  5. 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...

  6. 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.

  7. 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.

  8. 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.

  9. 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.

  10. [Recurrence of bladder cancer in remnant urethra and inguinal lymph node metastasis nine years after total cystectomy: a case report].

    Science.gov (United States)

    Obata, Jun; Kikuchi, Eiji; Kaneko, Gou; Miyajima, Akira; Kameyama, Kaori; Jinzaki, Masahiro; Oya, Mototsugu

    2011-01-01

    A 68-year-old man underwent total cystectomy, urethrectomy preserving fossa navicularis, and an Indiana pouch urinary diversion in 1997. The histopathology was UC, G3, pT4 (prostate). Nine years after the operation, he had multiple metastases to the inguinal and paraaortic lymph nodes (LNs), and he complained of erosion around the glans. Histological diagnosis of the glans revealed recurrent UC to the urethra of the glans. We considered the possibility that the inguinal LN metastasis was due to lymphatic spread from a remnant urethral recurrence. Thus, a partial penectomy and inguinal LN dissection were undertaken. Systemic chemotherapy was administered. Remnant urethral recurrence after urethrectomy preserving the fossa navicularis and inguinal LN metastasis are rare.

  11. 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

  12. 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

  13. 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.

  14. 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...

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

    Energy Technology Data Exchange (ETDEWEB)

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

    2012-11-15

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

  16. 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.

  17. A mathematical model using computed tomography for the diagnosis of metastatic central compartment lymph nodes in papillary thyroid carcinoma

    Energy Technology Data Exchange (ETDEWEB)

    Liu, Tianrun [The Sixth Affiliated Hospital of Sun Yat-sen University, Guangzhou (China); Su, Xuan; Chen, Weichao; Zheng, Lie; Li, Li; Yang, AnKui [Sun Yat-sen University Cancer Center, Guangzhou (China)

    2014-11-15

    The purpose of this study was to establish a potential mathematical model for the diagnosis of the central compartment lymph node (LN) metastases of papillary thyroid carcinoma (PTC) using CT imaging. 303 patients with PTC were enrolled. We determined the optimal cut-off points of LN size and nodal grouping by calculating the diagnostic value of each cut-off point. Then, calcification, cystic or necrotic change, abnormal enhancement, size, and nodal grouping were analysed by univariate and multivariate statistical methods. The mathematical model was obtained using binary logistic regression analysis, and a scoring system was developed for convenient use in clinical practice. 30 mm{sup 2} for LNs area (size) and two LNs as the nodal grouping criterion had the best diagnostic value. The mathematical model was: p = e{sup y} /(1+ e {sup y}), y = -0.670-0.087 x size + 1.010 x cystic or necrotic change + 1.371 x abnormal enhancement + 0.828 x nodal grouping + 0.909 x area. We assigned the value for cystic or necrotic change, abnormal enhancement, size and nodal grouping value as 25, 33, 20, and 22, respectively, yielding a scoring system. This mathematical model has a high diagnostic value and is a convenient clinical tool. (orig.)

  18. Modeling the envelope statistics of three-dimensional high-frequency ultrasound echo signals from dissected human lymph nodes

    Science.gov (United States)

    Bui, Thanh Minh; Coron, Alain; Mamou, Jonathan; Saegusa-Beecroft, Emi; Yamaguchi, Tadashi; Yanagihara, Eugene; Machi, Junji; Bridal, S. Lori; Feleppa, Ernest J.

    2014-01-01

    This work investigates the statistics of the envelope of three-dimensional (3D) high-frequency ultrasound (HFU) data acquired from dissected human lymph nodes (LNs). Nine distributions were employed, and their parameters were estimated using the method of moments. The Kolmogorov Smirnov (KS) metric was used to quantitatively compare the fit of each candidate distribution to the experimental envelope distribution. The study indicates that the generalized gamma distribution best models the statistics of the envelope data of the three media encountered: LN parenchyma, fat and phosphate-buffered saline (PBS). Furthermore, the envelope statistics of the LN parenchyma satisfy the pre-Rayleigh condition. In terms of high fitting accuracy and computationally efficient parameter estimation, the gamma distribution is the best choice to model the envelope statistics of LN parenchyma, while, the Weibull distribution is the best choice to model the envelope statistics of fat and PBS. These results will contribute to the development of more-accurate and automatic 3D segmentation of LNs for ultrasonic detection of clinically significant LN metastases. PMID:25346951

  19. Modeling the envelope statistics of three-dimensional high-frequency ultrasound echo signals from dissected human lymph nodes.

    Science.gov (United States)

    Bui, Thanh Minh; Coron, Alain; Mamou, Jonathan; Saegusa-Beecroft, Emi; Yamaguchi, Tadashi; Yanagihara, Eugene; Machi, Junji; Bridal, S Lori; Feleppa, Ernest J

    2014-01-01

    This work investigates the statistics of the envelope of three-dimensional (3D) high-frequency ultrasound (HFU) data acquired from dissected human lymph nodes (LNs). Nine distributions were employed, and their parameters were estimated using the method of moments. The Kolmogorov Smirnov (KS) metric was used to quantitatively compare the fit of each candidate distribution to the experimental envelope distribution. The study indicates that the generalized gamma distribution best models the statistics of the envelope data of the three media encountered: LN parenchyma, fat and phosphate-buffered saline (PBS). Furthermore, the envelope statistics of the LN parenchyma satisfy the pre-Rayleigh condition. In terms of high fitting accuracy and computationally efficient parameter estimation, the gamma distribution is the best choice to model the envelope statistics of LN parenchyma, while, the Weibull distribution is the best choice to model the envelope statistics of fat and PBS. These results will contribute to the development of more-accurate and automatic 3D segmentation of LNs for ultrasonic detection of clinically significant LN metastases.

  20. Follicular dendritic cells, conduits, lymphatic vessels, and high endothelial venules in tertiary lymphoid organs: Parallels with lymph node stroma

    Directory of Open Access Journals (Sweden)

    Sharon eStranford

    2012-11-01

    Full Text Available In this communication, the contribution of stromal, or non-hematopoietic, cells to the structure and function of lymph nodes (LNs, as canonical secondary lymphoid organs (SLOs, is compared to that of tertiary lymphoid tissue or organs (TLOs, also known as ectopic lymphoid tissues. TLOs can arise in non-lymphoid organs during chronic inflammation, as a result of autoimmune responses, graft rejection, atherosclerosis, microbial infection, and cancer. The stromal components found in SLOs including follicular dendritic cells, fibroblast reticular cells, lymphatic vessels, and high endothelial venules and possibly conduits are present in TLOs; their molecular regulation mimics that of LNs. Advances in visualization techniques and the development of transgenic mice that permit in vivo real time imaging of these structures will facilitate elucidation of their precise functions in the context of chronic inflammation. A clearer understanding of the inflammatory signals that drive non lymphoid stromal cells to reorganize into TLOs could allow the design of therapeutic interventions to impede the progression of autoimmune activity, or alternatively, to enhance anti-tumor responses.

  1. 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.

  2. 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

  3. 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....

  4. 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.

  5. 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.

  6. 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.

  7. 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.

  8. 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

  9. 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.

  10. 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.

  11. 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.

  12. 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

  13. 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.

  14. 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%.

  15. 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.)

  16. 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

  17. 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...

  18. 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.

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

    Directory of Open Access Journals (Sweden)

    K Chandramohan

    2003-04-01

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

  20. 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

  1. 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...

  2. 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...

  3. 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.

  4. 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.)

  5. 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.

  6. 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.

  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. 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.

  9. 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.

  10. 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.

  11. 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

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

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    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. 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

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    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.

  14. 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

  15. 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

  16. 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.

  17. Is diagnostic accuracy of 18F - FDG PET/CT different according to anatomical levels of cervical lymph node in restaging of papillary thyroid cancer?

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    Ha, J. M.; Kwon, S. Y.; Seo, Y. S.; Chong, A. R.; Jeong, S. Y.; Jeong, Y. Y.; Min, J. J.; Song, H. C.; Bom, H. S. [Chonnam National University Hospital, Gwangju (Korea, Republic of)

    2007-07-01

    To restage of thyroid papillary cancer, accurate detection of metastatic cervical lymph node (LN) is important. Therefore, we assessed the diagnostic accuracy of restaging 18F-FDG PET/CT according to anatomical levels of cervical LN. Thirty patients (F 19, M 11, mean age 49.2 y) with total thyroidectomy and regional LN dissection were included for restaging thyroid papillary carcinoma. We analyzed lymph node metastases according to anatomical level by AJCC 1996. Sixty nine LNs from these patients were analyzed by comparing PET/CT results with surgical pathology. We determined the cut-off value as maxSUV = 3.0 using ROC curve analysis. Overall sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV) and diagnostic accuracy of PET/CT was 81.1%, 59.4%, 69.8%, 73.1% and 71.1%, respectively. In each LN levels, level II showed 72.7%, 50%, 44.4%, 76.9%, 58%, level III 100%, 50%, 90%, 100%, 90.9%, level IV, 80%, 66.7%, 88.9%, 50%, 77%, level V 100%, 66.7%, 75%, 100%, 83.3%. Level I showed specificity of 100%, NPV of 80%, diagnostic accuracy of 80%. Level VI showed sensitivity of 100%, PPV of 100%, diagnostic accuracy of 100%. Out of total 14 false-positive, 10 was located in level II. There was no significant difference of maxSUV between benign and malignant lesion in level II LN group (p>0.05). But there were significant difference of maxSUV in other LN levels (p<0.01). PET/CT was useful for detecting metastatic or recurred cervical LNs in restaging of thyroid papillary cancer. However, because there can be many false-positive lesions in level II as compared to other levels, we need to apply different cut-off value of FDG uptake or consider other imaging modalities when we evaluate level II LNs.

  18. 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.

  19. 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

  20. 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.

  1. 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.

  2. 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.

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

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    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.

  4. Relationship Between HIV Coinfection, Interleukin 10 Production, and Mycobacterium tuberculosis in Human Lymph Node Granulomas

    Science.gov (United States)

    Diedrich, Collin R.; O'Hern, Jennifer; Gutierrez, Maximiliano G.; Allie, Nafiesa; Papier, Patricia; Meintjes, Graeme; Coussens, Anna K.; Wainwright, Helen; Wilkinson, Robert J.

    2016-01-01

    Background. Human immunodeficiency virus type 1 (HIV)–infected persons are more susceptible to tuberculosis than HIV–uninfected persons. Low peripheral CD4+ T-cell count is not the sole cause of higher susceptibility, because HIV–infected persons with a high peripheral CD4+ T-cell count and those prescribed successful antiretroviral therapy (ART) remain more prone to active tuberculosis than HIV–uninfected persons. We hypothesized that the increase in susceptibility is caused by the ability of HIV to manipulate Mycobacterium tuberculosis–associated granulomas. Methods. We examined 71 excised cervical lymph nodes (LNs) from persons with HIV and M. tuberculosis coinfection, those with HIV monoinfection, and those with M. tuberculosis monoinfection with a spectrum of peripheral CD4+ T-cell counts and ART statuses. We quantified differences in M. tuberculosis levels, HIV p24 levels, cellular response, and cytokine presence within granulomas. Results. HIV increased M. tuberculosis numbers and reduced CD4+ T-cell counts within granulomas. Peripheral CD4+ T-cell depletion correlated with granulomas that contained fewer CD4+ and CD8+ T cells, less interferon γ, more neutrophils, more interleukin 10 (IL-10), and increased M. tuberculosis numbers. M. tuberculosis numbers correlated positively with IL-10 and interferon α levels and fewer CD4+ and CD8+ T cells. ART reduced IL-10 production. Conclusions. Peripheral CD4+ T-cell depletion correlated with increased M. tuberculosis presence, increased IL-10 production, and other phenotypic changes within granulomas, demonstrating the HIV infection progressively changes these granulomas. PMID:27462092

  5. 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.

  6. 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.

  7. Positive lymph-node breast cancer patients – activation of NF-κB in tumor-associated leukocytes stimulates cytokine secretion that promotes metastasis via C-C chemokine receptor CCR7.

    Science.gov (United States)

    El-Ghonaimy, Eslam A; El-Shinawi, Mohamed; Ibrahim, Sherif A; El-Ghazaly, Hisham; Abd-El-Tawab, Reda; Nouh, Mohamed A; El-Mamlouk, Tahani; Mohamed, Mona M

    2015-01-01

    Tumor metastasis to lymph nodes is most deadly complication among breast cancer patients. Herein, we investigated the molecular mechanism by which tumor-associated leukocytes (TALs) mediate lymph node metastasis. The density of different leukocyte subtypes infiltrating the tumor microenvironment of negative and positive lymph nodes (nLNs, pLNs) in breast cancer patients was measured using immunohistochemistry. In addition, we isolated TALs from blood drained from the axillary tributaries of nLN and pLN patients during breast surgery. Secretions of TALs were subjected to cytokine profiling using a cytokine antibody array. Our results showed an increase in the number of infiltrated CD45+ cells in the carcinoma tissues of pLN patients with the major proportion being myeloid subsets compared with nLN patients. Furthermore, TALs of pLN patients show a significant fivefold increase in the secretion of interleukin (IL)-1α, interferon-γ, IL-5, IL-3 and tumor necrosis factor-β, and are characterized by enhanced constitutive NF-κB/p65 signaling compared with TALs isolated from nLN patients. Using an invasion assay, cytokines secreted by TALs of pLN patients were shown to augment the invasive phenotype of breast cancer MCF-7 and SKBR3 cells compared with nLN patients. Using flow cytometry, we found that C-C chemokine receptor 7 (CCR7) is significantly overexpressed in breast carcinoma of pLN patients compared with nLNs patients. Intriguingly, CCR7, a mechanistic clue for metastasis, is upregulated in MCF-7 cells upon stimulation with TAL-conditioned media of pLN patients. Our findings show that the molecular cues secreted by TALs alone or in combination with CCR7 may emerge as future therapeutic targets for lymph node metastasis in breast cancer patients.

  8. 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

  9. 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.

  10. 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...

  11. 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

  12. 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.

  13. 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

  14. 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

  15. 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....

  16. 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.

  17. 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.

  18. 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.

  19. 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...

  20. [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.

  1. 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...

  2. 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.

  3. 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

  4. 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...

  5. 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...

  6. 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

  7. 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...

  8. 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.

  9. 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.

  10. 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.

  11. 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.

  12. 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.

  13. 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.

  14. 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.

  15. 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.

  16. 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.

  17. Characterization of cervical lymph-nodes using a multi-parametric and multi-modal approach for an early prediction of tumor response to chemo-radiotherapy.

    Science.gov (United States)

    Scalco, Elisa; Marzi, Simona; Sanguineti, Giuseppe; Vidiri, Antonello; Rizzo, Giovanna

    2016-12-01

    In the treatment of Head-and-Neck Squamous Cell Carcinoma (HNSCC), the early prediction of residual malignant lymph nodes (LNs) is currently required. Here, we investigated the potential of a multi-modal characterization (combination of CT, T2w-MRI and DW-MRI) at baseline and at mid-treatment, based on texture analysis (TA), for the early prediction of LNs response to chemo-radiotherapy (CRT). 30 patients with pathologically confirmed HNSCC treated with CRT were considered. All patients underwent a planning CT and two serial MR examinations (including T2w and DW images), one before and one at mid-CRT. For each patient the largest malignant LN was selected and within each LN, morphological and textural features were estimated from T2w-MRI and CT, besides a quantification of the apparent diffusion coefficient (ADC) from DW-MRI. After a median follow-up time of 26.6months, 19 LNs showed regional control, while 11 LNs showedregional failure at a median time of 4.6months. Linear discriminant analysis was used to test the accuracy of the image-based features in predicting the final response. Pre-treatment features showed higher predictive power than mid-CRT features, the ADC having the highest accuracy (80%); CT-based indices were found not predictive. When ADC was combined with TA, the classification performance increased (accuracy=82.8%). If only T2w-MRI features were considered, the best combination of pre-CRT indices and their variation reached an equivalent accuracy (81.8%). Our results may suggest that TA on T2w-MRI and ADC can be combined together to obtain a more accurate prediction of response to CRT. Copyright © 2016 Associazione Italiana di Fisica Medica. Published by Elsevier Ltd. All rights reserved.

  18. 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.

  19. 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.

  20. 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

  1. 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.

  2. [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.

  3. 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

  4. Investigation into Possible Differences in Salmonella Prevalence in the Peripheral Lymph Nodes of Cattle Derived from Distinct Production Systems and of Different Breed Types.

    Science.gov (United States)

    Brown, T R; Edrington, T S; Loneragan, G H; Hanson, D L; Malin, K; Ison, J J; Nisbet, D J

    2015-11-01

    Previous research demonstrated significant variation in the prevalence of Salmonella in peripheral lymph nodes (LNs) of feedlot cattle and cull cows, with greater prevalence in feedlot cattle. Therefore, we performed experiments to investigate whether these differences in Salmonella prevalence in subiliac LNs are due to, or influenced by, breed, which in many respects is a proxy for the production system in which the animal is derived. Holstein steers are a by-product of dairy systems, and beef steers are an intended product of commercial beef operations. For the first experiment, Holstein and beef steers originating from the same feedlot and harvested on the same day were sampled. Of the 467 Holstein and 462 beef cattle LNs collected, 62.1% of Holstein and 59.7% of beef cattle samples harbored Salmonella (P = 0.46; qualitative culture), with 51.2 and 48.9% of samples containing quantifiable concentrations (P = 0.49), respectively. The concentration of Salmonella within the LN followed a decreasing trend over the collection period (May to October), averaging 1.4 log CFU/g of LN for both Holstein and beef cattle samples (P = 0.78). In a second experiment, we compared 100% Brahman cattle to their beef cattle counterparts, as we hypothesized that the resistance of Brahman cattle to insects may reduce Salmonella transmission via biting insects. Of the 42 Brahman and 31 beef cattle LNs collected, the concentration of Salmonella within the LN averaged 3.0 log CFU/g for Brahman cattle and 2.9 log CFU/g for beef cattle samples (P = 0.30). Using qualitative culture, we recovered Salmonella from 100% of LNs from Brahman cattle and 97% of beef cattle samples (P = 0.25). Results of this research indicate that the differences observed are not due to breed and are likely a function of age, immune function, or other factors yet to be identified. Understanding which cattle are more likely to harbor Salmonella within LNs will aid in targeting both pre- and postharvest intervention

  5. The Role of Convex Probe Endobronchial Ultrasound Guided Transbronchial Needle Aspiration in the Diagnosis of Malignant Mediastinal and Hilar Lymph Nodes

    Directory of Open Access Journals (Sweden)

    Benan Caglayan

    2012-01-01

    Full Text Available Background: In the diagnosis of malignant lymph nodes (LNs and staging of lung cancer, sampling of mediastinal and hilar LNs is essential. Mediastinoscopy is known as the gold standard. Convex probe (CP endobronchial ultrasound (EBUS-guided transbronchial needle aspiration (TBNA is a noninvasive and highly sensitive diagnostic method in mediastinal and hilar LN sampling.Objectives: Evaluating the role of CP-EBUS-guided TBNA in the diagnosis of mediastinal and hilar LNs suspicious of malignancy.Patients and Methods: One hundred twenty patients with a known lung malignancy or hilar/mediastinal LNs detected by thoracic computed tomography (CT and/or positron emission tomography (PET-CT suspicious for malignancy were included in this prospective study. The procedure was performed by Olympus 7.5 MHz CP endoscope and EU C2000 processor by the oral route under topical anesthesia and conscious sedation. After visualization of LNs, their dimensions were recorded. Aspiration was considered as “insufficient” if there were inadequate lymphocytes on the smears. Diagnosis of “malignancy” on cytologic examination was considered as the “final diagnosis”. If diagnosis was negative for malignancy, more invasive procedures were performed to confirm the diagnosis.Results: Twenty four females and 96 male patients (mean age, 57.8 ± 9.1 were included. A total of 177 LN stations were aspirated in 120 patients. In 82 patients, the diagnosis was malignant by EBUS-guided TBNA and in the remaining 38; the diagnosis was established by further invasive procedures. Of the 38 EBUS-guided TBNA negative patients, 28 were diagnosed as non-malignant and 10 were malignant. The sensitivity, diagnostic accuracy and negative predictive value of CP EBUS-guided TBNA were 89.1%, 91.6% and 73.6%, respectively. No major complications were seen.Conclusion: As an alternative method to mediastinoscopy, EBUS-guided TBNA is a safe and noninvasive procedure with high sensitivity in

  6. 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

  7. 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.

  8. 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

  9. 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

  10. 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.

  11. 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.)

  12. 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.

  13. Diagnostic accuracy of apparent diffusion coefficient value in differentiating metastatic form benign axillary lymph nodes in cancer breast

    Directory of Open Access Journals (Sweden)

    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.

  14. 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...

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

    Energy Technology Data Exchange (ETDEWEB)

    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.

  16. A new 2.5D representation for lymph node detection using random sets of deep convolutional neural network observations.

    Science.gov (United States)

    Roth, Holger R; Lu, Le; Seff, Ari; Cherry, Kevin M; Hoffman, Joanne; Wang, Shijun; Liu, Jiamin; Turkbey, Evrim; Summers, Ronald M

    2014-01-01

    Automated Lymph Node (LN) detection is an important clinical diagnostic task but very challenging due to the low contrast of surrounding structures in Computed Tomography (CT) and to their varying sizes, poses, shapes and sparsely distributed locations. State-of-the-art studies show the performance range of 52.9% sensitivity at 3.1 false-positives per volume (FP/vol.), or 60.9% at 6.1 FP/vol. for mediastinal LN, by one-shot boosting on 3D HAAR features. In this paper, we first operate a preliminary candidate generation stage, towards -100% sensitivity at the cost of high FP levels (-40 per patient), to harvest volumes of interest (VOI). Our 2.5D approach consequently decomposes any 3D VOI by resampling 2D reformatted orthogonal views N times, via scale, random translations, and rotations with respect to the VOI centroid coordinates. These random views are then used to train a deep Convolutional Neural Network (CNN) classifier. In testing, the CNN is employed to assign LN probabilities for all N random views that can be simply averaged (as a set) to compute the final classification probability per VOI. We validate the approach on two datasets: 90 CT volumes with 388 mediastinal LNs and 86 patients with 595 abdominal LNs. We achieve sensitivities of 70%/83% at 3 FP/vol. and 84%/90% at 6 FP/vol. in mediastinum and abdomen respectively, which drastically improves over the previous state-of-the-art work.

  17. Lymph node density in muscle-invasive transitional cell carcinoma of the urinary bladder; De novo versus progressive disease.

    Science.gov (United States)

    Elabbady, Ahmed; Hashad, Mohamed Mohieeldin; Kotb, Ahmed Fouad; Abdullah, Dina Mohamed; Beltagy, Ahmad

    2017-01-01

    The prognosis of bladder cancer patients with positive lymph node (LN) disease is affected by both the extent of lymphadenectomy and LN density retrieved during radical cystectomy. This study aimed at assessing the differences in LN metastasis between patients who presented primarily with muscle-invasive transitional cell carcinoma of the bladder "de novo disease" versus "progressive disease." The latter is defined as patients who progressed to muscle-invasive bladder cancer (MIBC) following prior conservative management of a non-muscle-invasive disease. Data were prospectively collected from consecutive 41 radical cystectomies that were divided into two groups: Group I included de novo MIBC cases and Group II included progressive MIBC cases. The median age was 60 years (44-75). Thirty-four patients exhibited de novo disease versus 7 patients who presented as progressive MIBC with a median duration of 9 months between the resection of the first non-invasive tumor and the diagnosis of progressive MIBC (range: 6-56 months). The median number of retrieved LNs in both groups was 15 LNs (range: 4-36). Ten patients (24.39%) had positive pathological LN disease; distributed as 9 patients in Group I and 1 patient in Group II. The median LN density of LN-positive patients was 15.73% (6.46 % in Group I, 28.57% in Group II). Five patients had LN density >20%. Although non-muscle-invasive urothelial bladder tumor may progress to muscle-invasive disease, it still carries less aggressive course than de novo MIBC based on differences in LN metastasis and density.

  18. Active dissemination of cellular antigens by DCs facilitates CD8(+) T-cell priming in lymph nodes.

    Science.gov (United States)

    Gurevich, Irina; Feferman, Tali; Milo, Idan; Tal, Orna; Golani, Ofra; Drexler, Ingo; Shakhar, Guy

    2017-09-05

    Antigen (Ag)-specific activation of naïve T cells by migrating dendritic cells (DCs) is a highly efficient process, although the chances for their co-localization in lymph nodes (LNs) appear low. Ag presentation may be delegated from Ag-donor DCs to the abundant resident DCs, but the routes of Ag transfer and how it facilitates T-cell activation remain unclear. We visualized CD8(+) T cell-DC interactions to study the sites, routes and cells mediating Ag transfer in mice. In vitro, Ag transfer from isolated ovalbumin (OVA)(+) bone marrow (BM)-DCs triggered widespread arrest, Ca(2+) flux and CD69 upregulation in OT-I T cells contacting recipient DCs. Intravital two-photon imaging revealed that survival of Ag-donor DCs in LNs was required for Ag dissemination among resident CD11c(+) DCs. Upon interaction with recipient DCs, CD8(+) T cells clustered, upregulated CD69, proliferated and differentiated into effectors. Few DCs sufficed for activation, and for efficient Ag dissemination LFA-1 expression on recipient DCs was essential. Similar findings characterized DCs infected with a replication-deficient OVA-expressing Vaccinia virus known to downregulate MHC-I. Overall, active Ag dissemination from live incoming DCs helped activate CD8(+) T cells by increasing the number of effective presenting cells and salvaged T-cell priming when Ag-donor DCs could not present Ag. This article is protected by copyright. All rights reserved. This article is protected by copyright. All rights reserved.

  19. 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.

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

    Directory of Open Access Journals (Sweden)

    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.

  1. 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.

  2. Diagnostic performance of diffusion-weighted MRI for detection of pelvic metastatic lymph nodes in patients with cervical cancer: a systematic review and meta-analysis.

    Science.gov (United States)

    Shen, G; Zhou, H; Jia, Z; Deng, H

    2015-08-01

    In recent years, diffusion-weighted (DW) MRI has emerged as a new technique for detecting the pelvic lymph metastases in patients with cervical cancer. The aim of this meta-analysis was to assess the diagnostic value of DW imaging (DWI) for benign/malignant discrimination of pelvic lymph nodes (LNs). Studies about DWI for the detection of metastatic LNs were searched in the PubMed, EMBASE, Web of Science, EBSCO, the Cochrane Library and three Chinese databases. Based on the extracted data, we determined pooled sensitivities, specificities and diagnostic odds ratios (DORs) across studies, calculated positive and negative likelihood ratios (LRs) and constructed summary receiver operating characteristic curves with area under the curve (AUC) and Q* obtained. We also analysed the heterogeneity between studies based on subgroup analysis, threshold effect and publication bias. In total, 15 studies involving 1021 patients met the inclusion criteria. The pooled sensitivity, specificity and DOR of DWI were 0.86 [95% confidence interval (CI), 0.84-0.89], 0.84 (95% CI, 0.83-0.86) and 47.21 (95% CI, 25.67-86.81), respectively. LR syntheses yielded overall positive LR of 6.55 (95% CI, 4.77-9.01) and negative LR of 0.17 (95% CI, 0.12-0.23). The AUC and Q* index were 0.9384 and 0.8754, respectively. The heterogeneity was relatively high between studies; however, there was no evidence for threshold effect and publication bias. DWI is beneficial in the pelvic nodal assessment in patients with cervical cancer. Large-scale, high-quality trials with standard protocols are required to evaluate its clinical value for discrimination of metastatic from non-metastatic pelvic LNs in patients with cervical cancer. Advances in knowledge include providing evidence to assess the role of DWI in nodal staging of cervical cancer.

  3. Influence of colloid particle profile on sentinel lymph node uptake

    Energy Technology Data Exchange (ETDEWEB)

    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.

  4. Detection of occult tumor cells in regional lymph nodes is associated with poor survival in pN0 non-small cell lung cancer: a meta-analysis

    Science.gov (United States)

    He, Zhicheng; Xia, Yang; Tang, Shaowen; Chen, Yijiang

    2016-01-01

    Background patients of pN0 non-small cell lung cancer (NSCLC) with occult tumor cells (OTCs) in regional lymph nodes (LNs) are reported to have controversial prognostic outcomes. Method We pooled pN0 NSCLC patients with OTCs in LNs and compared with those without OTCs. Patient characteristics, hazard ratios (HRs) and 95% confidence intervals (CIs) for overall survival (OS) and/or disease-free survival (DFS) were analyzed. HR greater than 1 conferred an increased hazard for patients with OTCs. Results Eighteen articles were finally enrolled in the meta-analysis and 15 studies provided sufficient data for extracting HRs for OS, resulting to 5 articles available for DFS analysis. The combined HRs of OS was 2.22 (95% CI, 1.87 to 2.64) and 2.4 (95% CI, 1.71 to 3.36) for analysis of DFS. The similar trend was obtained in the subgroup analyses regarding detection methods and study type. Interestingly, even in the analysis of mean numbers of LNs dissection (MLND) intraoperatively, both subgroups (LNs/Pts. <12 and ≥12) illustrated significant HRs of OS (HR: 3.13, 95% CI, 2.17 to 4.52 in LNs/Pts. <12 subgroup and HR: 2.09, 95% CI, 1.63 to 2.68 in LNs/Pts. ≥12). The combined HR of OS in this section was 2.37 (95% CI, 1.63 to 2.68). No publication bias was detected in all the meta-analysis sections. The prognosis of patients with OTCs is inferior to those without OTCs in the terms of OS and DFS regardless of detection methods, study types and MLND. Conclusions The prognosis of patients with OTCs is inferior to those without OTCs in the terms of OS and DFS regardless of detection methods, study types and MLND. PMID:27076932

  5. Can calcification predict {sup 131}I accumulation on metastatic lymph nodes in papillary thyroid carcinoma patients receiving {sup 131}I therapy? Comparison of CT, {sup 131}I WBS and {sup 18}F-FDG PET/CT

    Energy Technology Data Exchange (ETDEWEB)

    Kaneko, Koichiro; Abe, Koichiro; Baba, Shingo; Tanabe, Yoshitaka; Yabuuchi, Hidetake; Hatakenaka, Masamitsu; Honda, Hiroshi [Kyushu University, Department of Clinical Radiology, Graduate School of Medical Sciences, Fukuoka (Japan); Sasaki, Masayuki [Kyushu University, Department of Health Sciences, School of Medicine, 3-1-1 Maidashi, Higashi-ku, Fukuoka (Japan)

    2010-02-15

    The aim of this study was to clarify the predictive significance of nodal calcification in terms of the therapeutic option of {sup 131}I therapy in papillary thyroid carcinoma (PTC) patients. We reviewed 19 computed tomography (CT) examinations of PTC patients on receiving {sup 131}I therapy for the presence of nodal calcification, and compared the {sup 131}I whole-body scintigraphy and {sup 18}F-2-fluoro-2-deoxy-D-glucose (FDG) positron emission tomography (PET)/CT findings. The metastatic lymph nodes (mLNs) were divided into three groups: A, those with calcification; B, those without calcification but belonging to patients who had calcified mLNs; C, those without calcification and belonging to patients who had no calcified mLNs. The incidences of {sup 131}I accumulation and maximum standardised uptake values (SUV max) in the three groups were compared. A total of 70 mLNs were evaluated. Twelve mLNs belonged to group A, 13 to group B and 45 to group C. The incidences of {sup 131}I accumulation were significantly higher in groups A (100%) and B (100%) than in group C (11.1%) (p < 0.0001 for both). The SUVmax was significantly lower in groups A (4.1 {+-} 1.9) and B (3.9 {+-} 1.4) than in group C (7.1 {+-} 4.4) (p = 0.01, p = 0.002, respectively). Our results indicated that calcification in mLNs related to the ability of {sup 131}I accumulation and less dedifferentiation. (orig.)

  6. 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

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

    Directory of Open Access Journals (Sweden)

    Gabriel Andres Tafur Gomez

    2013-01-01

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

  8. 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.

  9. 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.

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

    Energy Technology Data Exchange (ETDEWEB)

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

    2009-07-01

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

  11. [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.

  12. 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.

  13. 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.

  14. 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.

  15. 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.

  16. 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.

  17. [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.

  18. 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.

  19. 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 expression (P<0.01) and lymph node metastasis (P<0.01). The percentage of IMPC in the tumor was not associated with the incidence of lymph node metastasis. The metastatic foci in lymph nodes were either pure or predominant micropapillary carcinoma.CONCLUSION The results suggested that VEGF-C overexpression stimulated tumor lymphangiogenesis, and the increased lymphatic vessel density may be the key factor that influenced lymph node metastasis of IMPC.

  20. Tumor micrometastases in mesorectal lymph nodes and their clinical significance in patients with rectal caner

    Institute of Scientific and Technical Information of China (English)

    Yang-Chun Zheng; Yu-Ying Tang; Zong-Guang Zhou; Li Li; Tian-Cai Wang; Yi-Ling Deng; Dai-Yun Chen; Wei-Ping Liu

    2004-01-01

    AIM: To investigate the number, size, and status of lymph nodes within the mesorectum and to explore the prognostic significance of lymph node micrometastases in patients with rectal cancer.METHODS: Thirty-one patients with rectal cancer undergone total mesorectal excision between October 2001 and October 2002 were included. Mesorectal nodes retrieved from the resected specimens were detected with a combination of haematoxylin and eosin (HE) staining and immunohistochemistry (IHC). The relations between lymph node metastases,micrometastases and postoperative recurrence were analyzed.RESULTS: A total of 548 lymph nodes were harvested,with 17.7±8.2 nodes per case. The average number of metastatic nodes in HE-positive patients and micrometastatic nodes in IHC-positive patients was 5.2±5.1 per case and2.2±1.3 per case, respectively. The mean size of all nodes and metastatic nodes was 4.1±1.8 mm and 5.2±1.7 mm in diameter, respectively. The mean size of micrometastatic nodes was 3.9±1.4 mm in diameter. The size of the majority of mesorectal nodes (66.8%), metastatic nodes (52.6%), and micrometastatic nodes (79.5%) was less than 5 mm in diameter.During a median follow-up period of 24.6±4.7 mo, 5 patients(16.7%) had recurrence, of them 2 died and 3 survived.Another case died of tumor unrelated cause and was excluded.All 5 recurrent cases had 3 or more nodes involved, and one of them developed only lymph node micrometastases. The mean number of both metastatic and micrometastatic nodes per case differed significantly between the recurrent and non-recurrent groups (P<0.01 and P= 0.01, respectively).CONCLUSION: The majority of lymph nodes, metastatic,and micrometastatic lymph nodes within the mesorectum are smaller than 5 mm in diameter. The nodal status and the number of lymph nodes involved with tumor metastases and micrometastases are related to the rapid postoperative recurrence.

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  9. DNA methylation profile of triple negative breast cancer-specific genes comparing lymph node positive patients to lymph node negative patients.

    Science.gov (United States)

    Mathe, Andrea; Wong-Brown, Michelle; Locke, Warwick J; Stirzaker, Clare; Braye, Stephen G; Forbes, John F; Clark, Susan J; Avery-Kiejda, Kelly A; Scott, Rodney J

    2016-09-27

    Triple negative breast cancer (TNBC) is the most aggressive breast cancer subtype with no targeted treatment available. Our previous study identified 38 TNBC-specific genes with altered expression comparing tumour to normal samples. This study aimed to establish whether DNA methylation contributed to these expression changes in the same cohort as well as disease progression from primary breast tumour to lymph node metastasis associated with changes in the epigenome. We obtained DNA from 23 primary TNBC samples, 12 matched lymph node metastases, and 11 matched normal adjacent tissues and assayed for differential methylation profiles using Illumina HumanMethylation450 BeadChips. The results were validated in an independent cohort of 70 primary TNBC samples. The expression of 16/38 TNBC-specific genes was associated with alteration in DNA methylation. Novel methylation changes between primary tumours and lymph node metastases, as well as those associated with survival were identified. Altered methylation of 18 genes associated with lymph node metastasis were identified and validated. This study reveals the important role DNA methylation plays in altered gene expression of TNBC-specific genes and lymph node metastases. The novel insights into progression of TNBC to secondary disease may provide potential prognostic indicators for this hard-to-treat breast cancer subtype.

  10. Detection and significance of lymph node micro-Metastases in patients with node-negative gastric carcinoma

    Institute of Scientific and Technical Information of China (English)

    2000-01-01

    To study micrometastases in lymph nodes from patients with node-negative gastric carcinoma by routine histologic examination and discuss their prognostic significance and the relationship between micrometastases and each of the clinicopathologic factors. Methods: A total of 1245 perigastric lymph nodes from 105 patients with node-negative gastric carcinoma was immunohistochemically detected using a monoclonal antibody against low molecular weight cytokeratin AE1. The characteristics of the micrometastases, their related factors and effect on patients' survival after surgery were analysed and tested with statistical methods. Results: Micrometastases were observed in 81 lymph nodes (6.5%) of 31 patients (29.5%). The incidence of lymph node micrometastases was significantly higher in the diffuse type (41.5%) than in the intestinal type gastric carcinoma (17.6%, P<0.01, x2 test). In addition, the presence of micrometastases was closely correlated with the size and invasion depth of the primary tumor, but had no relation to patient's age, sex and the location of primary tumor. The patients with micrometastases had significantly worse prognosis shown by Log-rank test. Their five-year survival rate after surgery was 61.29%; for those without micrometastases the rate was 82.43%, P=0.0116. When the number of patient's lymph nodes with micrometastases was three or more, the five-year survival rate of these patients was much lower (41.67%, P=0.0012). Conclusion: The detection of lymph node micrometastases is necessary to more accurately determine the prognosis and clinical staging of patients with node- negative gastric carcinoma by routine histologic examination. The presence of micrometastases may be regarded as one of the clues in adjuvant therapy of those patients.

  11. The Value and Association of CCR7 Expression in NSCLC with Lymph Node Metastasis

    Directory of Open Access Journals (Sweden)

    Xing LI

    2008-04-01

    Full Text Available Background and Objective It has became a hotspot research about the target metastasis of malignant tumor in recent years. It has been proven that metastasis of malignant tumor is a nonrandom but highly-organized and selective process. The aim of this study is by analysing the expression of CC Chemokine Receptor 7 (CCR7 in pulmonary tumor tissue and metastasized lymph nodes in NSCLC, to explore the relationship between the expression of CCR7 in pulmonary tumor tissue and metastasized lymph nodes, and explore the significance. Methods SABC immunohitochemcal staining was used to investigate the expression of CCR7 by rabbit anti-human CCR7 monoclonal antibody, and the specimens were 17 cases of adenocarcinoma, 17 cases of Squamous cell Carcinoma, 12 cases of Adenosquamous Carcinoma, 4 cases of large cell carcinoma and 28 cases of metastasized lymph nodes of lung cancer. Negative control sections use 5 cases of inflammatory pseudotumor and 20 cases of normal lung tissue. Two independent pathologists observed all the specimens in the high power field (×400 of microscope by double blind method. Results 1. The expression of CCR7 in pulmonary tumor tissue was remarkably higher than normal lung tissue (P<0.005; 2. The expression of CCR7 between pulmonary tumor tissue and metastasized lymph nodes had no significant differences (P=0.177; 3. The expression of CCR7 had correlation with lymph nodes metastasis, The expression level in lymph nodes metastasis group was significantly higher than that in no lymph nodes metastasis group (P=0.016; 4. Along with the increment that clinical stage, the CCR7 expression had increases the high trend (P=0.003. Conclusion CCR7 is over-expression in carcinoma cell nests and lymph node metastasis. It demonstrates that CCR7 may be related to the development of lymph node metastasis in NSCLC.

  12. [Sentinel lymph node biopsy in breast cancer. Experience of the Rome Breast Cancer Study Group].

    Science.gov (United States)

    Fortunato, Lucio; Drago, Stefano; Vitelli, Carlo Eugenio; Santoni, Marcello; Gucciardo, Giacomo; Cabassi, Alessandro; Farina, Massimo; La Pinta, Massimo; Remedi, Massimiliano; Pagano, Giovanni; Silipod, Teresa; Terribile, Daniela; Stagnitto, Daniela; Grassi, Giovanni Battista

    2006-01-01

    We report our multicentric experience with sentinel lymph node biopsy for breast cancer patients. Patients with breast cancer operated on from January 1999 to March 2005 in 6 different institutions in the Rome area were retrospectively reviewed. All patients gave written informed consent. 1440 consecutive patients were analysed, with a median age of 59 years (range: 33-81) and a median tumour diameter of 1.3 cm (range: 0.1-5). Patients underwent lymphatic mapping with Tc99 nanocolloid (N = 701; 49%), with Evans Blue (N = 70; 5%), or with a combined injection (N = 669, 46%). The majority of patients were mapped with an intradermal or subdermal injection (N = 1193; 84%), while an intraparenchymal or peritumoral injection was used in 41 (3%) and 206 patients (13%), respectively. Sentinel lymph nodes were identified in 1374/1440 cases (95.4%), and 2075 sentinel lymph nodes were analysed (average 1.5/patient). A total of 9305 additional non-sentinel lymph-nodes were removed (median 6/patient). Correlations between sentinel lymph nodes and final lymph node status were found in 1355/1374 cases (98.6%). There were 19 false-negative cases (5%). Lymph node metastases were diagnosed in 325 patients (24%). In this group, micrometastases (< 2 mm in diameter) were diagnosed in 103 cases (7.6%). Additionally, isolated tumour cells were reported in 61 patients (4,5%). In positive cases, additional metastases in non-sentinel lymph-nodes were identified in 117/325 cases after axillary dissection (36%). Axillary dissection was avoided in 745/1440 patients (52%). At a median follow-up of 36 months, only 1 axillary recurrence has been reported. Sentinel lymph node biopsy improves staging in women with breast cancer because it is accurate and reproducible, and allows detection of micrometastases and isolated tumour cells that would otherwise be missed. Our multicentric study confirms that this is the preferred axillary staging procedure in women with breast cancer.

  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. Incidence and Risk Factors for Occult Level 3 Lymph Node Metastases in Papillary Thyroid Cancer

    NARCIS (Netherlands)

    Fraser, Sheila; Zaidi, Nisar; Norlen, Olov; Glover, Anthony; Kruijff, Schelto; Sywak, Mark; Delbridge, Leigh; Sidhu, Stan B.

    2016-01-01

    Papillary thyroid cancer (PTC) frequently disseminates into cervical lymph nodes. Lateral node involvement is described in up to 50 % patients undergoing prophylactic lateral neck dissection. This study aimed to assess this finding and identify which factors predict for occult lateral node disease.

  16. 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

  17. Imaging of metastatic lymph nodes by X-ray phase-contrast micro-tomography

    DEFF Research Database (Denmark)

    Jensen, Torben Haugaard; Bech, Martin; Binderup, Tina

    2013-01-01

    whether malignancy could be revealed by non-invasive x-ray phase-contrast tomography in lymph nodes from breast cancer patients. Seventeen formalin-fixed paraffin-embedded lymph nodes from 10 female patients (age range 37-83 years) diagnosed with invasive ductal carcinomas were analyzed by X-ray phase......-contrast tomography. Ten lymph nodes had metastatic deposits and 7 were benign. The phase-contrast images were analyzed according to standards for conventional CT images looking for characteristics usually only visible by pathological examinations. Histopathology was used as reference. The result of this study...

  18. Endosalpingiosis of Axillary Lymph Nodes: A Rare Histopathologic Pitfall with Clinical Relevance for Breast Cancer Staging

    Directory of Open Access Journals (Sweden)

    Laila Nomani

    2016-01-01

    Full Text Available Establishment of accurate axillary lymph node status is of essential importance in determining both prognosis and the potential need for adjuvant therapy in patients with invasive breast cancer. Axillary lymph node heterotopias can in some cases result in overdiagnosis of metastatic disease. Nodal endosalpingiosis is perhaps the least commonly reported type of axially lymph node heterotopia. We herein illustrate a case in which second opinion pathologic interpretation combined with ancillary immunohistochemical studies allowed for a specific diagnosis of axillary nodal müllerian-type inclusions, confirming ypN0 staging and resulting in appropriate disease management and prognostication.

  19. Endosalpingiosis of Axillary Lymph Nodes: A Rare Histopathologic Pitfall with Clinical Relevance for Breast Cancer Staging

    Science.gov (United States)

    Nomani, Laila; Calhoun, Benjamin C.; Biscotti, Charles V.; Grobmyer, Stephen R.; Sturgis, Charles D.

    2016-01-01

    Establishment of accurate axillary lymph node status is of essential importance in determining both prognosis and the potential need for adjuvant therapy in patients with invasive breast cancer. Axillary lymph node heterotopias can in some cases result in overdiagnosis of metastatic disease. Nodal endosalpingiosis is perhaps the least commonly reported type of axially lymph node heterotopia. We herein illustrate a case in which second opinion pathologic interpretation combined with ancillary immunohistochemical studies allowed for a specific diagnosis of axillary nodal müllerian-type inclusions, confirming ypN0 staging and resulting in appropriate disease management and prognostication. PMID:27088025

  20. 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

  1. 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.

  2. Sentinel lymph node biopsy in bladder cancer: Systematic review and technology update

    OpenAIRE

    Liss, Michael A.; Noguchi, Jonathan; Lee, Hak J.; Vera, David R.; Kader, A. Karim

    2015-01-01

    A sentinel lymph node (SLN) is the first lymph node to drain a solid tumor and likely the first place metastasis will travel. SLN biopsy has been well established as a staging tool for melanoma and breast cancer to guide lymph node dissection (LND); its utility in bladder cancer is debated. We performed a systematic search of PubMed for both human and animal studies that looked at SLN detection in cases of urothelial carcinoma of the bladder. We identified a total of nine studies that assesse...

  3. Gastrointestinal stromal tumor of stomach with inguinal lymph nodes metastasis: A case report

    Institute of Scientific and Technical Information of China (English)

    2010-01-01

    Gastrointestinal stromal tumor (GIST) is the most common mesenchymal tumor in the alimentary tract. To the best of our knowledge, few cases have been reported in the literature about the peripheral lymph node metastasis of GIST. Here we report an unusual case of gastric GIST with inguinal lymph nodes metastasis. After the metastatic lymph nodes were resected, the. patient started to take imatinib 400 mg/d for 12 mo. There were no signs of tumor recurrence at follow-up after 29 mo. This case suggests that th...

  4. Exosomes released by melanoma cells prepare sentinel lymph nodes for tumor metastasis.

    Science.gov (United States)

    Hood, Joshua L; San, Roman Susana; Wickline, Samuel A

    2011-06-01

    Exosomes are naturally occurring biological nanovesicles utilized by tumors to communicate signals to local and remote cells and tissues. Melanoma exosomes can incite a proangiogenic signaling program capable of remodeling tissue matrices. In this study, we show exosome-mediated conditioning of lymph nodes and define microanatomic responses that license metastasis of melanoma cells. Homing of melanoma exosomes to sentinel lymph nodes imposes synchronized molecular signals that effect melanoma cell recruitment, extracellular matrix deposition, and vascular proliferation in the lymph nodes. Our findings highlight the pathophysiologic role and mechanisms of an exosome-mediated process of microanatomic niche preparation that facilitates lymphatic metastasis by cancer cells.

  5. 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.

  6. 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.

  7. Interval Sentinel Lymph Nodes: An Unusual Localization in Patients with Cutaneous Melanoma

    Directory of Open Access Journals (Sweden)

    A. M. Manganoni

    2011-01-01

    Full Text Available Background. Recent studies have demonstrated that there exists a great variation in the lymphatic drainage in patients with malignant melanoma. Some patients have drainage to lymph nodes outside of conventional nodal basins. The lymph nodes that exist between a primary melanoma and its regional nodal basin are defined “interval nodes”. Interval node occurs in a small minority of patients with forearm melanoma. We report our experience of the Melanoma Unit of University Hospital Spedali Civili Brescia, Italy. Methods. Lymphatic mapping using cutaneous lymphoscintigraphy (LS has become a standard preoperative diagnostic procedure to locate the sentinel lymph nodes (SLNs in cutaneous melanoma. We used LS to identify sentinel lymph nodes biopsy (SLNB in 480 patients. Results. From over 2100 patients affected by cutaneous melanoma, we identified 2 interval nodes in 480 patients with SLNB . The melanomas were both located in the left forearm. The interval nodes were also both located in the left arm. Conclusion. The combination of preoperative LS and intraoperative hand-held gamma detecting probe plays a remarkable role in identifying these uncommon lymph node locations. Knowledge of the unusual drainage patterns will help to ensure the accuracy and the completeness of sentinel nodes identification.

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

    Energy Technology Data Exchange (ETDEWEB)

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

    2006-06-15

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

  9. 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.

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

    Science.gov (United States)

    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

  11. 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.

  12. 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.

  13. 淋巴结清扫数目对无淋巴结转移非小细胞肺癌患者预后的影响%Prognostic value of the number of negative lymph nodes in non-small cell lung cancer without lymphatic metastasis after pulmonary resection

    Institute of Scientific and Technical Information of China (English)

    解明然; 徐世斌; 梅新宇; 张正华; 田界勇; 王君; 马冬春

    2014-01-01

    Objective:This study aims to investigate the correlation between the number of resected lymph nodes (LNs) and the prognosis of patients with node-negative non-small cell lung cancer (NSCLC). Methods:A retrospective review of 305 patients with NSCLC, who received curative resection between January 2004 and December 2009, was conducted. All patients were proved without lymph node involvement histopathologically. The prognostic impact of the number of negative LNs and the clinicopathologic factors were analyzed. Results:The overall median survival time and the 1-, 3-, and 5-year overall survival rates were 60.0 months, 76.1%, 59.3%, and 47.1%, respectively. Survival analysis confirmed that the number of negative LNs, T staging and the stations of the mediasti-nal lymph nodes dissected were showed to be independent prognostic factors. Patients with a high number of negative LNs had better overall survival than patients with a low number of negative LNs (P0.05). Conclusion:The number of negative lymph nodes is an independent prognostic predicting factor for node-negative NSCLC. Sufficient dissection of LNs is recommended to improve the survival of the patients with node-negative NSCLC.%目的:探讨淋巴结清扫数目对无淋巴结转移非小细胞肺癌患者预后的影响。方法:回顾性分析305例无淋巴结转移非小细胞肺癌患者临床病理资料。结果:全组患者中位生存期和5年生存率分别为60.0个月和47.1%。T分期、淋巴结清扫数目和清扫站数是影响本组患者预后的独立预后因素。相同T分期患者生存率随淋巴结清扫数目增加而增高(P0.05)。结论:淋巴结清扫数目是无淋巴结转移非小细胞肺癌患者预后的独立预后因素。术中应清扫足够数目的淋巴结,进而提高患者生存率。

  14. Cooccurrence of Metastatic Papillary Thyroid Carcinoma and Salmonella Induced Neck Abscess in a Cervical Lymph Node

    Science.gov (United States)

    Kim, Jae-Myung; Jung, Eun Jung; Song, Eun Jin; Kim, Dong Chul; Jeong, Chi-Young; Ju, Young-Tae; Lee, Young-Joon; Hong, Soon-Chan; Choi, Sang-Kyung; Ha, Woo-Song

    2017-01-01

    Cervical lymph node metastasis is common in patients with papillary thyroid carcinoma (PTC). Salmonella species are rarely reported as causative agents in focal infections of the head and neck. The cooccurrence of lymph node metastasis from PTC and a bacterial infection is rare. This report describes a 76-year-old woman with a cervical lymph node metastasis from PTC and Salmonella infection of the same lymph node. The patient presented with painful swelling in her left lateral neck region for 15 days, and neck ultrasonography and computed tomography showed a cystic mass along left levels II–IV. The cystic mass was suspected of being a metastatic lymph node; modified radical neck dissection was performed. Histopathological examination confirmed the presence of PTC in the resected node and laboratory examination of the combined abscess cavity confirmed the presence of Salmonella Typhi. Following antibiotic sensitivity testing of the cultured Salmonella Typhi, she was treated with proper antibiotics. Cystic lesions in lymph nodes with metastatic cancer may indicate the presence of cooccurring bacterial infection. Thus, culturing of specimen can be option to make accurate diagnosis and to provide proper postoperative management. PMID:28261270

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

    Directory of Open Access Journals (Sweden)

    Claudio A Quadros

    2010-12-01

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

  16. [Long-term survival of a patient with lung cancer with skip metastasis to supraclavicular lymph nodes].

    Science.gov (United States)

    Ohta, Y; Nakaizumi, H; Furukawa, S; Ushijima, S; Mori, Y; Sato, H; Kurumaya, H

    1995-04-01

    A case of lung cancer with skip metastasis to supraclavicular lymph nodes is described. The patient had undergone radical resection for gastric cancer about nine years ago. For about one year, chemotherapy had been done by Tegafur (600 mg/day) after operation. Radical resection for lung cancer (p/d squamous cell carcinoma) was performed about seven years ago. Pathologically, mediastinal lymph node metastasis could not be detected. The needle aspiration biopsy of supraclavicular lymph node revealed metastasis. Then, radical neck lymph nodes dissection involving supraclavicular lymph nodes and radiation therapy were added. There has been no sign of recurrence so far.

  17. 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.

  18. 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...

  19. Current status of sentinel lymph node mapping in the management of cervical cancer.

    Science.gov (United States)

    Rob, Lukas; Lukas, Rob; Robova, Helena; Helena, Robova; Halaska, Michael Jiri; Jiri, Halaska Michael; Hruda, Martin; Martin, Hruda; Skapa, Petr; Petr, Skapa

    2013-07-01

    The status of regional lymph nodes is the most important prognostic factor in early cervical cancer patients. Pelvic lymph node dissections are routinely performed as a part of standard surgical treatment. Systematic pelvic lymphadenectomy is associated with short- and long-term morbidities. This review discusses single components of the sentinel lymph node mapping (SLNM) technique and results of the detection of sentinel lymph nodes. SLNM biopsy performed by an experienced team for small volume tumors (<2 cm) has high specific side detection rate, excellent negative-predictive value and high sensitivity. Uncommon lymphatic drainage has been reported in 15% of cervical cancer patients. There is sufficient data now to suggest that SLNM with 99mTc plus blue dye in the hands of a surgeon with extensive experience should prove to be an important part of individualized cervical cancer surgery and increase the safety of less radical or fertility-sparing surgery.

  20. A mechanistic breast cancer survival modelling through the axillary lymph node chain.

    Science.gov (United States)

    Cobre, Juliana; Castro Perdoná, Gleici S; Peria, Fernanda M; Louzada, Francisco

    2013-04-30

    In this paper, we proposed a mechanistic breast cancer survival model based on the axillary lymph node chain structure, considering lymph nodes as a potential dissemination arrangement. We assume a naive breast cancer treatment protocol consisting of exposing patients first to a chemotherapy treatment on r intervals at k-cycles separated by equal time intervals, and then they proceed to surgery. Our model, different from former ones, accommodates a quantity of contaminated lymph nodes, which is observed during surgery. We assume a generalised negative binomial survival distribution for the unknown number of contaminated lymph nodes after surgery, which, during an unknown period, may potentially propagate the disease. Estimation is based on a maximum likelihood approach. A simulation study assesses the coverage probability of asymptotic confidence intervals when small or moderate samples are considered. A Brazilian breast cancer data illustrate the applicability of our modelling.

  1. 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....

  2. 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.

  3. 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.

  4. Male Occult Breast Cancer First Manifesting as a Supraclavicular Lymph Node Metastasis: A Case Report

    National Research Council Canada - National Science Library

    Maoyuan Zhao; Qiuyang Jing; Yuyi Wang; Feng Luo

    2017-01-01

    ... and a lack of public awareness. We report a 64 year old male patient presenting with palpable masses in his left cervical region, in whom imaging was unremarkable, except for slightly enlarged axillary lymph nodes without increased...

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

    Directory of Open Access Journals (Sweden)

    Grangeiro Maria do Patrocínio F.

    2004-01-01

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

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

    Directory of Open Access Journals (Sweden)

    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.

  7. 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...

  8. Lymph Node Counts in Indians in Relation to Lymphadenectomy for Carcinoma of the Oesophagus and Stomach

    Directory of Open Access Journals (Sweden)

    Dhananjaya Sharma

    2005-04-01

    Conclusion: This anatomical study addresses the dual issues of determining the number of dissectable lymph nodes in a particular population as well as assessing the quality of nodal dissection by providing quantitative surgical guidelines.

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

    Science.gov (United States)

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

  10. Lymph node dissection in patients with malignant melanoma is associated with high risk of morbidity

    DEFF Research Database (Denmark)

    Ul-Mulk, Jamshaid; Hölmich, Lisbet Rosenkrantz

    2012-01-01

    Malignant melanoma is one of the most rapidly increasing cancer types globally, and it is by far the most serious skin cancer. Patients with a melanoma ≥ 1 mm in Breslow thickness are offered sentinel node (SN) biopsy and subsequent radical lymph node dissection if the biopsy is positive. The obj......Malignant melanoma is one of the most rapidly increasing cancer types globally, and it is by far the most serious skin cancer. Patients with a melanoma ≥ 1 mm in Breslow thickness are offered sentinel node (SN) biopsy and subsequent radical lymph node dissection if the biopsy is positive...

  11. New approach to anal cancer: Individualized therapy based on sentinel lymph node biopsy

    Institute of Scientific and Technical Information of China (English)

    Paola De Nardi; Michele Carvello; Carlo Staudacher

    2012-01-01

    Oncological treatment is currently directed toward a tailored therapy concept.Squamous cell carcinoma of the anal canal could be considered a suitable platform to test new therapeutic strategies to minimize treatment morbidity.Standard of care for patients with anal canal cancer consists of a combination of radiotherapy and chemotherapy.This treatment has led to a high rate of local control and a 60% cure rate with preservation of the anal sphincter,thus replacing surgical abdominoperineal resection.Lymph node metastases represent a critical independent prognostic factor for local recurrence and survival.Mesorectal and iliac lymph nodes are usually included in the radiation field,whereas the inclusion of inguinal regions still remains controversial because of the subsequent adverse side effects.Sentinel lymph node biopsies could clearly identify inguinal node-positive patients eligible for therapeutic groin irradiation.A sentinel lymph node navigation procedure is reported here to be a feasible and effective method for establishing the true inguinal node status in patients suffering from anal canal cancer.Based on the results of sentinel node biopsies,a selective approach could be proposed where node-positive patients could be selected for inguinal node irradiation while node-negative patients could take advantage of inguinal sparing irradiation,thus avoiding toxic side effects.

  12. [METHODOLOGIC PROBLEMS OF SENTINEL LYMPH NODE BIOPSY IN PATIENTS WITH BREAST CANCER].

    Science.gov (United States)

    Krivorotko, P V; Kanaev, S V; Semiglazov, V F; Novikov, S N; Krzhivitsky, P I; Semenov, I I; Turkevich, E A; Busko, E A; Donskikh, R V; Bryantseva, Zh V; Piskunov, E A; Trufanova, E S; Chernaya, A V

    2015-01-01

    The study included data on 168 patients with breast cancer, surgical treatment of whom was supplemented by axillary dissection (133 patients or 79.2%) or biopsy of sentinel lymph nodes (35 patients or 20.8%). The examination included ultrasound, planar scintigraphy of the breast and zones of regional lymph drainage. In 122 patients with primary breast cancer stage cT1-2N0M0 retrospective analysis of radionuclide imaging sentinel lymph node was performed. In 89 patients the introduction of colloidal radiopharmaceutical was carried out using a particle diameter of not more than 80-100 nm, in 33 patients study was conducted after administration of radiocolloid with a particle diameter of 200 to 1000 nm. Based on the data obtained by scintigraphy and ultrasonography of zones of regional lymph drainage there were offered two diagnostics models: the first, in which the presence of metastatic axillary lymph nodes was established when there were changes according to at least one of the diagnostic methods--scintigraphy or ultrasound; the second, in which the defeat of lymph nodes was determined only in the case of simultaneous detection of ultrasound and scintigraphic evidence of axillary lymph nodes. Sensitivity, specificity, and overall accuracy of the combination of ultrasound and planar scintigraphy axillary lymph nodes using the first model accounted for 82.7%, 67.7% and 74.4%, respectively. In the second model, the specificity was 94.6%, sensitivity--56%. Rapid transport of radiopharmaceuticals from the injection site, a high gradient of radiopharmaceuticals accumulation in sentinel lymph nodes, effective their visualization, approaching to 100%, were undoubted advantages of radiocolloids having a particle diameter up to 100 nm.

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

    Directory of Open Access Journals (Sweden)

    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.

  14. In-situ and invasive carcinoma within a phyllodes tumor associated with lymph node metastases

    OpenAIRE

    Ross Joan; O'Malley Frances; Armstrong Chris; Parfitt Jeremy R; Tuck Alan B

    2004-01-01

    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 ...

  15. Survival analysis of pure seminoma at post-chemotherapy retroperitoneal lymph node dissection.

    Science.gov (United States)

    Rice, Kevin R; Beck, Stephen D W; Bihrle, Richard; Cary, K Clint; Einhorn, Lawrence H; Foster, Richard S

    2014-11-01

    Viable seminoma encountered at post-chemotherapy retroperitoneal lymph node dissection for pure testicular seminoma is rare due to the chemosensitivity of this germ cell tumor. In this study we define the natural history of viable seminoma at post-chemotherapy retroperitoneal lymph node dissection. The Indiana University testis cancer database was queried from 1988 to 2011 to identify all patients with primary testicular or retroperitoneal pure seminoma and who were found to have pure seminoma at post-chemotherapy retroperitoneal lymph node dissection. Clinical characteristics were reviewed and survival analysis was performed. A total of 36 patients met the study inclusion criteria. All patients received standard first line cisplatin based chemotherapy and 17 received salvage chemotherapy. The decision to proceed to retroperitoneal lymph node dissection was based on enlarging retroperitoneal mass and/or positron emission positivity in the majority of cases. Seven patients had undergone previous retroperitoneal lymph node dissection. Additional surgical procedures were required in 19 patients to achieve a complete resection. The 5-year cancer specific survival rate was 54%. However, only 9 of 36 patients remained continuously free of disease and of these patients 4 received adjuvant chemotherapy. Mean time from post-chemotherapy retroperitoneal lymph node dissection to death was 6.9 months. Second line chemotherapy, reoperative retroperitoneal lymph node dissection and earlier era of treatment were associated with poorer cancer specific survival. A total of 36 patients with pure seminoma were found to have viable pure seminoma at post-chemotherapy retroperitoneal lymph node dissection. While 5-year cancer specific survival was 54%, these surgeries are technically demanding and only a minority of patients achieves a durable cure from surgery alone. Copyright © 2014 American Urological Association Education and Research, Inc. Published by Elsevier Inc. All rights

  16. [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.

  17. Impact of the obesity on lymph node status in operable breast cancer patients.

    Science.gov (United States)

    Keskin, O; Aksoy, S; Babacan, T; Sarici, F; Kertmen, N; Solak, M; Turkoz, F P; Arik, Z; Esin, E; Petekkaya, I; Altundag, K

    2013-01-01

    Although many studies have shown association of obesity and tumor size, the association with the lymph node status is not clear. We examined the relationship of the lymph node status and obesity and other possible factors in early breast cancer patients. In this retrospective cohort study, 1295 breast cancer patients who had axillary dissection were included. Patients were grouped according to their body mass index (BMI) values at the time of diagnosis. We analyzed the relationship between BMI and patient and tumor characteristics, especially lymph node status. The median patient age was 48 years (range 20- 84). Of the patients 69.6% had modified radical mastectomy and the remaining 30.4% had breast-conserving surgery and axillary dissection. Median BMI of the patients was 27.2 kg/m(2) and 33.1% (N-429) of them had normal BMI, 36% (N-471) were overweight and 30.5% (N=395) were obese at the time of the diagnosis. Of the patients, 44.2% had N0 disease, and 55.8% had lymph node metastasis. N1 disease had 28.3% (N=367), 13.8% (N=179) had N2 and 13.7% (N=177) had N3 disease. When patients were classified as normal (≤24.9 kg/m(2)) and obese (>24.9 kg/m(2)) group, the total number of lymph nodes removed was higher in the obese group and this difference was statistically significant (18.12±10.48 and 20.36±11.37, respectively, p= 0.001). There was strong correlation between the number of the dissected lymph nodes and BMI (r=0.11; pobese patients but there was no correlation between metastatic lymph node number and BMI. The number of the dissected and involved lymph nodes was higher in the HER2 positive group.

  18. The prognostic significance of extramural deposits and extracapsular lymph node invasion in colon cancer.

    LENUS (Irish Health Repository)

    Al Sahaf, Osama

    2011-08-01

    The status of resected lymph nodes in colon cancer determines prognosis and further treatment. The American Joint Committee on Cancer staging system has designated extramural nodules as nonnodal disease and classified them as extensions of the T category in the sixth edition and as site-specific tumor deposits in the seventh edition. Extracapsular lymph node extension is an established poor prognostic indicator in many cancers. Its significance in colon cancer has not been extensively investigated.

  19. Synchronous Pulmonary Squamous Cell Carcinoma and Mantle Cell Lymphoma of the Lymph Node

    Directory of Open Access Journals (Sweden)

    Yu Sun

    2011-01-01

    Full Text Available Synchronous occurrence of pulmonary squamous cell carcinoma and malignant lymphoma of the lymph node is not reported in the literature. We report a case of pulmonary squamous cell carcinoma coexisting with a mantle cell lymphoma involving cervical and mediastinal lymph node. It is important to recognize this synchronous occurrence histopathologically and to be aware of the existence of “in situ” MCL.

  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. 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

  2. Clinical significance of the negative lymph node count after the axillary dissection of breast cancer patients

    Institute of Scientific and Technical Information of China (English)

    Yufeng Yao; Jinhai Tang; Jianwei Qin; Jianping Gong

    2012-01-01

    Objective: The purpose of this study was to evaluate the impact of the negative lymph node (LN) count on the survival of the breast cancer patients in early stage after the axillary dissection. Methods: The breast cancer patients with T1–2N0–1M0 stage between January 2001 and December 2005 in Jiangsu Cancer Hospital, who underwent the axillary LNs dissection, were enrolled in this study. We analyzed the data of these patients including information of follow-up and postop-erative pathological results. All patients were divided into two groups according to the axillary LN status and each group was divided into four subgroups according to the negative LN count. Cox regression analysis was performed to screen the patho-logical factor including the negative LN count on the survival and to compare the different negative LN count on the survival. Results: COX proportional hazard regression model showed that the survival of the breast cancer was significantly associ-ated with the negative LN count. In T1–2N0 group, when the negative LN count was 3 or less, 4 to 5, 6 to 9 and 10 or more, the median survival time was (82.6 ± 4.1) months, (101.5 ± 1.3) months, (104.7 ± 1.0) months, and (110.5 ± 0.9) months respectively (P < 0.05). In T1–2N1 group, when the negative LN count was 6 or less, 7 to 8, 9 to 10 and 11 or more, the median survival time was (95.4 ± 1.9) months, (101.8 ± 1.1) months, (104.9 ± 1.0) months, and (106.5 ± 0.9) months respectively (P < 0.05). Conclusion: The negative LN count can reflect the adequacy of the axillary dissection. Increasing negative LN count is independently associated with improved survival in pT1–2N0M0 or pT1–2N1M0 staging breast cancer patients. The negative LN count should be considered for incorporation into staging for breast cancer with the axillary LN dissection.

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

    Science.gov (United States)

    Ciupilan, Corina; Stan, C I

    2016-01-01

    The almost constant local regional development of the cancers of upper aero digestive organs requires the same special attention to cervical lymph node metastases, as well as to the primary neoplastic burning point. The surgical therapy alone or associated has a mutilating, damaging character, resulting in loss of an organ and function, most of the times with social implications, involving physical distortions with aesthetic consequences, which make the reintegration of the individual into society questionable. The problem of cervical lymph node metastases is vast and complex, reason why we approached several anatomical and physiological aspects of lymph vessels of the aero digestive organs. Among the available elements during treatment, the headquarters of the tumour, its histologic degree, and its infiltrative nature, each of them significantly influences the possibility of developing metastases.

  4. Non-malignant T-cells lacking multiple pan-T markers can be found in lymph nodes.

    Science.gov (United States)

    Wang, Wei; Gao, Li; Gong, Ming; Tang, Yin; Li, Yan; Zhang, Wen-Tao; Huang, Fan-Zhou; Zhang, Chun-Xia; Chen, Yan-Rong; Gao, Ya-Yue; Li, Zhen-Ling; Ma, Yi-Gai

    2018-01-01

    In order to observe and ascertain the properties of a sub-group of T cells in the lymph node (LN) from seven patients who did not suffer from T cell lymphoproliferative disorders (T-LPDs), the expression levels of several pan-T markers were evaluated by multiparameter flow cytometry (FC) and the clonality of these T-cells was evaluated by both FC analysis and PCR assessment. It turned out that multiple pan-T-cell markers such as CD2, CD5 and CD7 were found to be lost in these T cells. The majority of them were positive for TCRαβ, only a minority of them being positive for TCRγδ. A subset of these T-cells were positive for CD4 or CD8 or dual-negative for CD4 and CD8. Oligoclonality was detected in one case by FC, while clonal TCR rearrangement was detected in three cases. Absence of multiple pan-T-cell markers could be found in benign T cells in LNs.

  5. The Lymphatic Endothelial mCLCA1 Antibody Induces Proliferation and Growth of Lymph Node Lymphatic Sinuses.

    Directory of Open Access Journals (Sweden)

    Kimberly L Jordan-Williams

    Full Text Available Lymphocyte- and leukocyte-mediated lymph node (LN lymphatic sinus growth (lymphangiogenesis is involved in immune responses and in diseases including cancer and arthritis. We previously discovered a 10.1.1 Ab that recognizes the lymphatic endothelial cell (LEC surface protein mCLCA1, which is an interacting partner for LFA1 and Mac-1 that mediates lymphocyte adhesion to LECs. Here, we show that 10.1.1 Ab treatment specifically induces LEC proliferation, and influences migration and adhesion in vitro. Functional testing by injection of mice with 10.1.1 Ab but not control hamster Abs identified rapid induction of LN LEC proliferation and extensive lymphangiogenesis within 23 h. BrdU pulse-chase analysis demonstrated incorporation of proliferating LYVE-1-positive LEC into the growing medullary lymphatic sinuses. The 10.1.1 Ab-induced LN remodeling involved coordinate increases in LECs and also blood endothelial cells, fibroblastic reticular cells, and double negative stroma, as is observed during the LN response to inflammation. 10.1.1 Ab-induced lymphangiogenesis was restricted to LNs, as mCLCA1-expressing lymphatic vessels of the jejunum and dermis were unaffected by 23 h 10.1.1 Ab treatment. These findings demonstrate that 10.1.1 Ab rapidly and specifically induces proliferation and growth of LN lymphatic sinuses and stroma, suggesting a key role of mCLCA1 in coordinating LN remodeling during immune responses.

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

    DEFF Research Database (Denmark)

    Mohamed, Sandy M I; Aagaard, Torben; Fokdal, Lars U

    2015-01-01

    PURPOSE: This study evaluated the dose delivered to lymph nodes (LNs) by brachytherapy (BT) and the effect of BT image-guided optimization on the LN dose. METHODS AND MATERIALS: Twenty-five patients with locally advanced cervical cancer were retrospectively analyzed, 16 patients of them had LN...... involvement. The patients received whole pelvis intensity-modulated radiation therapy (45-50 Gy/25-30 fx) to whole pelvis and two fractions of MRI pulsed-dose-rate BT. The delineated LN groups were para-aortic, inguinal, common iliac (CI), external iliac, internal iliac, obturator, and presacral. For each LN...... group, D98%, D50%, and D2% (the dose that covers 98%, 50%, and 2% of the volume, respectively) were evaluated for optimized and standard BT plans. The correlation between total reference air kerma (TRAK) and D50% of the LN groups was evaluated. RESULTS: BT contributed considerable dose (mean D50% was 3...

  7. Supraclavicular and/or celiac lymph node metastases from thoracic esophageal squamous cell carcinoma did not compromise survival following neoadjuvant chemoradiotherapy and surgery

    Science.gov (United States)

    Ahn, Yong Chan; Shim, Young Mog; Zo, Jae Ill; Sun, Jong-Mu; Ahn, Myung-Ju; Park, Keunchil

    2017-01-01

    This study is to evaluate the prognostic significance of supraclavicular and/or celiac lymph node (LN) metastases in locally advanced thoracic esophageal squamous cell carcinoma (ESCC) patients treated with neoadjuvant chemoradiotherapy (NACRT) and surgery. Among the total 199 patients, 75 (37.7%) had supraclavicular and/or celiac LN metastasis. Surgery was performed following NACRT in 168 patients (84.4%). After the median 18.7 (1.0-147.2) months’ follow-up, 2-year rates of progression-free survival (PFS) and overall survival (OS) in all patients were 48.1% and 65.7%, respectively. In multivariate analyses, negative surgical margin (p supraclavicular and/or celiac LNs was significant factor neither for PFS (p = 0.311) nor OS (p = 0.515). Supraclavicular and/or celiac LN metastasis did not compromise the clinical outcomes following NACRT and surgery. PMID:27682879

  8. Neutrophil recruitment to lymph nodes limits local humoral response to Staphylococcus aureus.

    Directory of Open Access Journals (Sweden)

    Olena Kamenyeva

    2015-04-01

    Full Text Available Neutrophils form the first line of host defense against bacterial pathogens. They are rapidly mobilized to sites of infection where they help marshal host defenses and remove bacteria by phagocytosis. While splenic neutrophils promote marginal zone B cell antibody production in response to administered T cell independent antigens, whether neutrophils shape humoral immunity in other lymphoid organs is controversial. Here we investigate the neutrophil influx following the local injection of Staphylococcus aureus adjacent to the inguinal lymph node and determine neutrophil impact on the lymph node humoral response. Using intravital microscopy we show that local immunization or infection recruits neutrophils from the blood to lymph nodes in waves. The second wave occurs temporally with neutrophils mobilized from the bone marrow. Within lymph nodes neutrophils infiltrate the medulla and interfollicular areas, but avoid crossing follicle borders. In vivo neutrophils form transient and long-lived interactions with B cells and plasma cells, and their depletion augments production of antigen-specific IgG and IgM in the lymph node. In vitro activated neutrophils establish synapse- and nanotube-like interactions with B cells and reduce B cell IgM production in a TGF-β1 dependent manner. Our data reveal that neutrophils mobilized from the bone marrow in response to a local bacterial challenge dampen the early humoral response in the lymph node.

  9. [A successful treatment by surgery for axillary lymph node recurrence of lung cancer].

    Science.gov (United States)

    Oda, Goshi; Kobayashi, Toshiko; Yokosuka, Tetsuya; Yasuno, Masamichi

    2012-11-01

    This case concerns a 78-year-old man, who was diagnosed with lung cancer at the age of 73. He underwent right lobectomy and lymph node dissection, and pathological analysis revealed a poorly differentiated adenocarcinoma, pT1N0M0 pStage IA. 15 months after surgery, computed tomography showed recurrence of lung cancer at the apex of thoracic cavity. He underwent radiation to the recurrence site, and 33 months after surgery, fluorodeoxyglucose uptake was observed at the axillary and infraclavicular lymph nodes in positron emission tomography examination. Treatment with pemetrexed was started because carcinomatous pericarditis was also found. Although pericardial effusion disappeared, the patient complained of the enlarged size of the axillary and infraclavicular lymph nodes and severe numbness in an arm. Beyond lymph node involvement, no other metastatic sites were found. An operation was performed to relieve the pain and the pathological analysis of lymph nodes showed metastases of lung cancer. The operation successfully reduced the pain experienced by the patient. There has been no further recurrence in the 9 months following surgery. Axillary lymph node metastasis is thought to be a distant metastasis; however, this is a case where local control was needed and was effective.

  10. 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.

  11. Dendritic cells control fibroblastic reticular network tension and lymph node expansion.

    Science.gov (United States)

    Acton, Sophie E; Farrugia, Aaron J; Astarita, Jillian L; Mourão-Sá, Diego; Jenkins, Robert P; Nye, Emma; Hooper, Steven; van Blijswijk, Janneke; Rogers, Neil C; Snelgrove, Kathryn J; Rosewell, Ian; Moita, Luis F; Stamp, Gordon; Turley, Shannon J; Sahai, Erik; Reis e Sousa, Caetano

    2014-10-23

    After immunogenic challenge, infiltrating and dividing lymphocytes markedly increase lymph node cellularity, leading to organ expansion. Here we report that the physical elasticity of lymph nodes is maintained in part by podoplanin (PDPN) signalling in stromal fibroblastic reticular cells (FRCs) and its modulation by CLEC-2 expressed on dendritic cells. We show in mouse cells that PDPN induces actomyosin contractility in FRCs via activation of RhoA/C and downstream Rho-associated protein kinase (ROCK). Engagement by CLEC-2 causes PDPN clustering and rapidly uncouples PDPN from RhoA/C activation, relaxing the actomyosin cytoskeleton and permitting FRC stretching. Notably, administration of CLEC-2 protein to immunized mice augments lymph node expansion. In contrast, lymph node expansion is significantly constrained in mice selectively lacking CLEC-2 expression in dendritic cells. Thus, the same dendritic cells that initiate immunity by presenting antigens to T lymphocytes also initiate remodelling of lymph nodes by delivering CLEC-2 to FRCs. CLEC-2 modulation of PDPN signalling permits FRC network stretching and allows for the rapid lymph node expansion--driven by lymphocyte influx and proliferation--that is the critical hallmark of adaptive immunity.

  12. 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.

  13. Misdiagnosis of left supraclavicular lymph node metastasis of hepatocellular carcinoma: a case report.

    Science.gov (United States)

    Liu, Tao; Gao, Jun-Fang; Yi, Yong-Xiang; Ding, Hai; Liu, Wei

    2013-02-14

    Left supraclavicular lymph node metastasis is a rare presentation of hepatocellular carcinoma (HCC). This phenomenon is easily neglected in the clinic. A 56-year-old man presented with HCC. On examination, a 1cm long left supraclavicular lymph node was palpated. Auxiliary examination indicated a lesion located in the right lobe of the liver. Fine needle aspiration cytology (FNAC) of the enlarged lymph node was performed; however, only necrosis was found. Hepatectomy was performed and HCC was confirmed by Hematoxylin-Eosin staining. However, 14 d after surgery, significantly enlarged left supraclavicular lymph nodes, a new intrahepatic lesion, and pulmonary and mediastinal metastasis appeared. An excisional biopsy of the left supraclavicular lymph node was performed, and its findings confirmed metastatic HCC. The patient's HCC rapidly progressed and he died one month later. It is possible for HCC to metastasize to the left supraclavicular lymph node. Surgeons should always consider an overall physical examination. When left supraclavicular lymphadenopathy of unknown origin is encountered, FNAC should be performed initially. If the results are negative, an excisional biopsy and subsequent Positron emission tomography - computed tomography scanning should be performed. These are very important for making the correct diagnosis and for selecting reasonable therapies.

  14. A new method in thoracoscopic inferior mediastinal lymph node biopsy: a case report

    Directory of Open Access Journals (Sweden)

    Sanlı Maruf

    2009-11-01

    Full Text Available Abstract Introduction We performed video-thoracoscopy with a video-mediastinoscope to conduct a mediastinal lymph node biopsy. Here, we discuss the various advantages of the method. Case presentation A 56-year-old Turkish Caucasian man had been complaining of dyspnea on exertion, hacking cough, fever and continuous sweating for one and a half months. Thoracic computed tomography revealed enlarged paratracheal and aorticopulmonary lymph nodes, the largest of which was 1 cm in diameter and reticulo-micronodular interstitial infiltration extending symmetrically to the pleural surfaces in both pulmonary perihilar areas. Computed tomography supported positron emission tomography showed increased fluorodeoxyglucose retention in lymph nodes in both hilar areas (10R and 10L (maximum standardized uptake values 5.6 and 5.7, and in the right lower paratracheal (4R (maximum standardized uptake value 4.1 and right para-esophageal (8 (maximum standardized uptake value 8.9 lymph nodes. Pathological examination of the right lymph node number 8 biopsy using the video-mediastinoscope revealed the presence of granulomatous inflammation. No problems were observed during the postoperative period. Conclusion The use of the video-mediastinoscope for inferior lymph node biopsy in thoracoscopy is an easy, safe and practical method, especially in patients with pleural adhesions.

  15. Clinicopathological Characteristics as Predictive Factrs for Lymph Node Metastasis in Submucosal Gastric Cancer

    Institute of Scientific and Technical Information of China (English)

    2007-01-01

    OBJECTIVE To identify clinicopathological characteristics as predictive factors for lymph node metastasis in submucosal gastric cancer, and in addition to establish objective criteria as indications for endoscopic submucosal dissection (ESD).METHODS Data from 130 patients with submucosal gastric cancer were collected, and the relationship between their clinicopathological characteristics and the presence of lymph node metastasis was retrospectively analyzed by multivariate analysis.RESULTS In the multivariate logistic regression model, a tumor size of 2 cm or more and an undifferentiated histologic type were found to be independent risk clinicopathological characteristics for lymph node metastasis.Among 130 patients with submucosal carcinoma, no lymph node metastases were observed in 17 patients who showed neither of the two risk clinicopathological characteristics. Lymph node metastasis occurred in 61.1% (22/36) of the patients who had both risk clinicopathological characteristics.CONCLUSION A tumor size of 2 cm or more and an undifferentiated histologic type were significantly and independently related to lymph node metastasis in submucosal gastric cancer. It is rational for the paitients with neither of these two independent risk clinicopathological characteristics to undergo an ESD.

  16. Super natural killer cells that target metastases in the tumor draining lymph nodes.

    Science.gov (United States)

    Chandrasekaran, Siddarth; Chan, Maxine F; Li, Jiahe; King, Michael R

    2016-01-01

    Tumor draining lymph nodes are the first site of metastasis in most types of cancer. The extent of metastasis in the lymph nodes is often used in staging cancer progression. We previously showed that nanoscale TRAIL liposomes conjugated to human natural killer cells enhance their endogenous therapeutic potential in killing cancer cells cultured in engineered lymph node microenvironments. In this work, it is shown that liposomes decorated with apoptosis-inducing ligand TRAIL and an antibody against a mouse natural killer cell marker are carried to the tumor draining inguinal lymph nodes and prevent the lymphatic spread of a subcutaneous tumor in mice. It is shown that targeting natural killer cells with TRAIL liposomes enhances their retention time within the tumor draining lymph nodes to induce apoptosis in cancer cells. It is concluded that this approach can be used to kill cancer cells within the tumor draining lymph nodes to prevent the lymphatic spread of cancer. Copyright © 2015 Elsevier Ltd. All rights reserved.

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

    Energy Technology Data Exchange (ETDEWEB)

    Rischke, Hans Christian [University of Freiburg, Department of Radiation Oncology, Freiburg (Germany); University of Freiburg, Department of Nuclear Medicine, Freiburg (Germany); Schultze-Seemann, Wolfgang; Kroenig, Malte; Schlager, Daniel; Jilg, Cordula Annette [University of Freiburg, Department of Urology, Freiburg (Germany); Wieser, Gesche [University of Freiburg, Department of Nuclear Medicine, Freiburg (Germany); Drendel, Vanessa [University of Freiburg, Department of Pathology, Freiburg (Germany); Stegmaier, Petra; Henne, Karl; Volegova-Neher, Natalia; Grosu, Anca-Ligia [University of Freiburg, Department of Radiation Oncology, Freiburg (Germany); Krauss, Tobias; Kirste, Simon [University of Freiburg, Department of Radiology, Freiburg (Germany)

    2015-04-01

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

  18. Results of optical Monte Carlo simulations of a compact γ camera for the detection of sentinel lymph nodes

    Science.gov (United States)

    Lowe, Dean; Truman, Andrew; Kwok, Harry; Bergman, Alanah

    2001-07-01

    Breast cancer is most often treatable when detected in the early stages, before the primary disease spreads to sentinel lymph nodes in the axilla and supraclavicular region. A sentinel lymph node is the closest adjacent lymph node to receive lymphatic drainage from a primary breast tumour. It is from these nodes that cancer cells metastasise throughout the lymphatic system, spreading the disease. This work details the optical Monte Carlo modelling of an ultra compact, nuclear medicine γ camera that will be used intra-operatively to detect malignant sentinel lymph nodes. This development will improve the identification and localisation of these sentinel nodes, thereby facilitating improved techniques for axillary lymph node dissection, and sentinel lymph node biopsy.

  19. Results of optical Monte Carlo simulations of a compact {gamma} camera for the detection of sentinel lymph nodes

    Energy Technology Data Exchange (ETDEWEB)

    Lowe, Dean; Truman, Andrew E-mail: atruman@bccancer.bc.ca; Kwok, Harry; Bergman, Alanah

    2001-07-11

    Breast cancer is most often treatable when detected in the early stages, before the primary disease spreads to sentinel lymph nodes in the axilla and supraclavicular region. A sentinel lymph node is the closest adjacent lymph node to receive lymphatic drainage from a primary breast tumour. It is from these nodes that cancer cells metastasise throughout the lymphatic system, spreading the disease. This work details the optical Monte Carlo modelling of an ultra compact, nuclear medicine {gamma} camera that will be used intra-operatively to detect malignant sentinel lymph nodes. This development will improve the identification and localisation of these sentinel nodes, thereby facilitating improved techniques for axillary lymph node dissection, and sentinel lymph node biopsy.

  20. 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

  1. 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.

  2. [Treatment outcomes of patients with cervical lymph node recurrence after esophagectomy for esophageal cancer].

    Science.gov (United States)

    Takemura, Masashi; Kaibe, Nobuaki; Takii, Mamiko; Yoshida, Kayo; Niwa, Hirotaka; Oshima, Tsutomu; Kikuchi, Shoujiro; Sasako, Mitsuru

    2014-11-01

    Herein, we report the treatment outcomes of patients with limited cervical lymph node recurrence after esophagectomy for esophageal cancer. Between April 2010 and December 2013, 8 patients with cervical lymph nodes recurrence were diagnosed and treated in our department. All patients were detected with recurrent disease by using positron emission tomography computed tomography(PET-CT), and among these, 5 patients had solitary node recurrence. Initial treatments were irradiation therapy in 5 patients and lymphadenectomy in 3 patients. Four of 5 patients underwent irradiation therapy and lymphadenectomy. Four of 5 patients with solitary node recurrence are still alive without relapse of disease. In conclusion, PET-CT can be useful for early detection of recurrent disease after esophagectomy. Appropriate therapy for patients with solitary cervical lymph node recurrence is associated with long-term survival after recurrence.

  3. 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.

  4. Portable gamma camera guidance in sentinel lymph node biopsy: prospective observational study of consecutive cases.

    Science.gov (United States)

    Peral Rubio, F; de La Riva, P; Moreno-Ramírez, D; Ferrándiz-Pulido, L

    2015-06-01

    Sentinel lymph node biopsy is the most important tool available for node staging in patients with melanoma. To analyze sentinel lymph node detection and dissection with radio guidance from a portable gamma camera. To assess the number of complications attributable to this biopsy technique. Prospective observational study of a consecutive series of patients undergoing radioguided sentinel lymph node biopsy. We analyzed agreement between nodes detected by presurgical lymphography, those detected by the gamma camera, and those finally dissected. A total of 29 patients (17 women [62.5%] and 12 men [37.5%]) were enrolled. The mean age was 52.6 years (range, 26-82 years). The sentinel node was dissected from all patients; secondary nodes were dissected from some. In 16 cases (55.2%), there was agreement between the number of nodes detected by lymphography, those detected by the gamma camera, and those finally dissected. The only complications observed were seromas (3.64%). No cases of wound dehiscence, infection, hematoma, or hemorrhage were observed. Portable gamma-camera radio guidance may be of use in improving the detection and dissection of sentinel lymph nodes and may also reduce complications. These goals are essential in a procedure whose purpose is melanoma staging. Copyright © 2014 Elsevier España, S.L.U. and AEDV. All rights reserved.

  5. Proximal gastric cancer: lymph node metastatic patterns according to different T stages dictate surgical approach

    Institute of Scientific and Technical Information of China (English)

    Song Wu; Liu Yuyi; Ye Jinning; Peng Jianjun; He Weiling; Chen Jianhui; Chen Chuangqi

    2014-01-01

    Background As a common form of gastric cancer migration,lymph node metastasis largely affects the surgical treatment and prognosis of gastric cancer.Surgery is the fundamental curative option for gastric cancer that varies depending on different stages.The study aimed to compare the clinicopathological characteristics and lymph node metastatic patterns in patients of proximal gastric cancer with different T stages and investigate a reasonable radical gastrectomy approach in terms of the range of lymphadenectomy for proximal gastric cancer.Methods In our retrospective study,the data of 328 patients of proximal gastric cancer with different T stages were analyzed.By comparing the differences of lymph node metastatic rate and ratio,we investigated the clinicopathological characteristics and metastatic patterns of lymph nodes.Also,we were especially interested in the differences in survival rates between patients with and without No.5 and 6 group metastasis with the same TNM stage.Results The overall lymph node metastatic rate and ratio of advanced proximal gastric cancer were 73.4% and 23.3%,respectively.The tumors of different T stages were statistically significant in size and differentiation degree (P <0.05),multivariate analysis showed that the depth of tumor invasion was an independent risk factor for lymph node metastasis in proximal gastric cancer (RR,12.025; 95% CI,2.326 to 62.157; P=0.003).The overall survival rate of patients with No.5,6 group lymph node metastasis and those without was significantly different,but the differences in survival rates between patients with and without No.5 and 6 group metastasis with the same TNM stage were not statistically significant.Conclusions Different T stages in proximal gastric cancer showed different patterns and characteristics of lymph node metastasis.D2 lymphadenectomy in patients with early gastric cancer had little survival benefit because metastasis to level 2 nodes was rare.Therefore the range of the

  6. Changes in human lymphocyte subpopulations in tonsils and regional lymph nodes of human head and neck squamous carcinoma compared to control lymph nodes

    Directory of Open Access Journals (Sweden)

    González-Femandez África

    2001-04-01

    Full Text Available Abstract Background Lymphoid tissues constitute basic structures where specific immune responses take place. This leads to the development of germinal centres (GCs, migration of cells and the generation of memory cells. Here, we have compared human tumour reactive lymph nodes and tonsils with control lymph nodes. Results The study by flow cytometry shows that in control lymph nodes the majority of cells were naive T-lymphocytes (CD45RA+/CD7+. In reactive nodes, although the percentage of CD45RO+ T cells remains constant, there is an increase in the number of B-lymphocytes, and a reduction in naive T cells. The percentage of cells expressing CD69 was similar in reactive nodes and in controls. In both cases, we have found two populations of B cells of either CD69- or CD69dull. Two populations of T cells, which are either negative for CD69 or express it in bright levels (CD69bright, were also found. The analysis of tissue sections by confocal microscopy revealed differences between control, tonsils and tumor reactive lymph nodes. In control lymph nodes, CD19 B cells are surrounded by a unique layer of CD69bright/CD45RO+ T cells. GCs from tonsils and from tumour reactive nodes are mainly constituted by CD19 B cells and have four distinct layers. The central zone is composed of CD69- B cells surrounded by CD69bright/CD45RO+ T cells. The mantle region has basically CD69dull B-lymphocytes and, finally, there is an outer zone with CD69-/CD45RO+ T cells. Conclusions Human secondary lymphoid organs react with an increase in the proportion of B lymphocytes and a decrease in the number of CD45RA+ T cells (naive. In tonsils, this is due to chronic pathogen stimulation, whereas in lymph nodes draining head and neck carcinomas the reaction is prompted by surrounded tumors. During this process, secondary lymphoid organs develop secondary follicles with a special organization of T and B cells in consecutive layers, that are described here by confocal microscopy

  7. [Interest of preoperative lymphoscintigraphy on sentinel lymph node identification in patients with breast cancer].

    Science.gov (United States)

    Tulpin, L; Morel, O; Akerman, G; Malartic, C; Desfeux, P; Barranger, E

    2008-01-01

    Sentinel lymph node biopsy is nowadays an accepted method of staging breast cancer patients. In case of an injection of radioactive colloid, preoperative lymphoscintigraphy is recommended to establish a lymphatic mapping and to predict the number of sentinel lymph nodes identified during surgery. Preoperative lymphoscintigraphy does not decrease the false-negative rate. However, positive preoperative lymphoscintigraphy significantly improves the identification rate of intraoperative sentinel nodes comparing with negative preoperative lymphoscintigraphy. Detecting extra-axillary sentinel lymph nodes, because of its minimal therapeutic consequences, does not appear to be an indication for preoperative lymphoscintigraphy. Given logistics and cost required, preoperative lymphoscintigraphy should be only performed for patients with a high risk of intraoperative failed localization. In case of negative preoperative lymphoscintigraphy, sentinel lymph node biopsy must be tried because sentinel nodes are still identified in the majority of these patients. Another possibility, with important cost and logistic, should consist in performing a later lymphoscintigraphy on the day after radioactive injection to ameliorate sentinel lymph nodes identification.

  8. Episodic edema in type 2 lepra reaction can be caused by transient lymphatic obstruction in the lymph node.

    Science.gov (United States)

    Stanley, J N; Pearson, J M; Ridley, D B

    1986-06-01

    Fourteen patients with lepromatous leprosy developed attacks of edema of the hands and/or feet associated with attacks of type 2 lepra reaction (erythema nodosum leprosum). The regional lymph nodes were enlarged and often tender when edema was present. Lymph node biopsies in five cases showed compression of the subcapsular sinus against the thickened fibrotic capsule of the inflamed node. It is suggested that this obstructs the inflow of lymph into the regional nodes, thereby causing the edema.

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

    Science.gov (United States)

    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.

  10. Lymph node imaging in breast cancer lymph node metastasis%淋巴结影像学在乳腺癌淋巴结转移的应用

    Institute of Scientific and Technical Information of China (English)

    张延伟; 周伟生

    2011-01-01

    Research in lymph node imaging has made great progress in recent years. With the increasing in-depth researches and clinical applications of MRI, PET and molecular imaging, the sensitivity, specificity and accuracy of detecting lymph node metastases have also been improved. Incorporating techniques such as various pulse sequences, contrast enhancement and lymph-node contrast agents has made MRI a superior method for detecting lymph node metastasis of breast cancer in clinical settings.%随着磁共振成像(MRI)、正电子发射体层摄影(PET)及分子成像的不断深入研究及应用,诊断淋巴结转移的敏感性、特异性及准确性日益提高,其中MRI可应用不同序列、增强扫描、淋巴结对比剂等多种技术评估淋巴结状态,对判断乳腺癌淋巴结转移具有很大优势及良好的临床应用价值.

  11. Arm morbidity following sentinel lymph node biopsy or axillary lymph node dissection: a study from the Danish Breast Cancer Cooperative Group

    DEFF Research Database (Denmark)

    Husted, Madsen A.; Haugaard, K.; Soerensen, J.;

    2008-01-01

    BACKGROUND: Sentinel lymph node biopsy was implemented in the treatment of early breast cancer with the aim of reducing shoulder and arm morbidity. Relatively few prospective studies have been published where the morbidity was assessed by clinical examination. Very few studies have examined the i...

  12. Metastatic squamous cell carcinoma urinary bladder coexisting with tuberculosis in pelvic lymph nodes.

    Science.gov (United States)

    Karthikeyan, Vilvapathy Senguttuvan; Manikandan, Ramanitharan; Jacob, Sajini Elizabeth; Murugan, P Puvai

    2013-12-02

    Squamous cell carcinoma (SCC) of the urinary bladder is usually associated with Schistosoma haematobium and chronic bladder irritation. We report a case of coexistent metastatic SCC and tuberculosis in obturator lymph nodes in radical cystoprostatectomy and pelvic lymphadenectomy specimens. Though tubercular iliac lymphadenitis and metastatic transitional carcinoma following intravesical BCG has been reported, the concurrent presence of non-transitional cell cancer and primary lymph nodal tuberculosis in regional lymph nodes is rare. This case is reported to highlight the paucity of management guidelines available presently in the treatment of such patients who require systemic chemotherapy and antitubercular therapy.

  13. Methylene blue injection into the rectal artery as a simple method to improve lymph node harvest in rectal cancer.

    Science.gov (United States)

    Märkl, Bruno; Kerwel, Therese G; Wagner, Theodor; Anthuber, Matthias; Arnholdt, Hans M

    2007-07-01

    Adequate lymph node assessment in colorectal cancer is crucial for prognosis estimation and further therapy stratification. However, there is still an ongoing debate on required minimum lymph node numbers and the necessity of advanced techniques such as immunohistochemistry or PCR. It has been proven in several studies that lymph node harvest is often inadequate under routine analysis. Lymph nodes smaller than 5 mm are especially concerning as they can carry the majority of metastases. These small, but affected lymph nodes may escape detection in routine analysis. Therefore, fat-clearing protocols and sentinel techniques have been developed to improve accuracy of lymph node staging. We describe a novel and simple method of ex vivo methylene blue injection into the superior rectal artery of rectal cancer specimens, which highlights lymph nodes and makes them easy to detect during manual dissection. Initially, this method was developed for proving accuracy of total mesorectal excision. We performed a retrospective study comparing lymph node recovery of 12 methylene blue stained and an equal number of unstained cases. Lymph node recovery differed significantly with average lymph node numbers of 27+/-7 and 14+/-4 (Pmethylene blue and the unstained group, respectively. The largest differe