FDG uptake in axillary lymph nodes after COVID-19 vaccination – a pitfall in a case of highly suspicious lymph node metastases of malignant melanoma

Abstract Background Occult metastases in axillary lymph nodes have been reported to be associated with poor prognosis in patients with breast cancer. However, studies on the prognostic value of occult metastases have shown controversial results. This meta-analysis aimed to evaluate the prognostic significance of occult lymph node metastases in breast cancer. Methods Studies published until May, 2020, which retrospectively examined negative lymph nodes by stepsectioning and/or immunohistochemistry, were retrieved from MEDLINE, EMBASE, CNKI, and Cochrane Library databases. The pooled Relative Risk (RR) with 95% confidence interval (95% CI) for overall survival (OS) and disease-free survival (DFS) were calculated to examine the associations between occult metastases and prognosis. Results Patients with occult metastases in axillary lymph nodes had poorer five-year DFS (RR = 0.930; 95% CI = 0.907–0.954) and OS (RR = 0.972; 95% CI = 0.954–0.990). Furthermore, the DFS (RR = 0.887; 95% CI = 0.810–0.972) and OS (RR = 0.896; 95% CI = 0.856–0.939) of patients with occult metastases were significantly lower after a ten-year follow-up. Conclusions Occult metastases in the axillary lymph nodes are associated with poorer DFS andOS of patients with breast cancer. Occult metastases might serve as a predictive factor of survival outcomes in patients with breast cancer.

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Importance of number of examined axillary lymph nodes for assessing the risk of locoregional recurrence (LRR) among breast cancer patients with 1–3 lymph node metastases

European Journal of Cancer Supplements ◽

10.1016/s1359-6349(06)80299-5 ◽

2006 ◽

Vol 4 (2) ◽

pp. 128-129

Author(s):

P. Karisson ◽

Cole ◽

M. Castiglione-Gertsch ◽

B. Gusterson ◽

J. Lindtner ◽

...

Keyword(s):

Breast Cancer ◽

Lymph Node ◽

Lymph Nodes ◽

Cancer Patients ◽

Lymph Node Metastases ◽

Locoregional Recurrence ◽

Axillary Lymph Nodes ◽

Axillary Lymph ◽

Breast Cancer Patients ◽

Node Metastases

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Frequency and intensity of [18F]-PSMA-1007 uptake after COVID-19 vaccination in clinical PET

BJR|Open ◽

10.1259/bjro.20210084 ◽

2022 ◽

Author(s):

Alexander Maurer ◽

Helen Schiesser ◽

Stephan Skawran ◽

Antonio G. Gennari ◽

Manuel Dittli ◽

...

Keyword(s):

Lymph Node ◽

Mr Imaging ◽

Lymph Nodes ◽

Lymph Node Metastases ◽

Axillary Lymph Nodes ◽

Control Group ◽

Axillary Lymph ◽

Psma Pet ◽

Pet Ct ◽

Node Metastases

Objectives: To assess the frequency and intensity of [18F]-PSMA-1007 axillary uptake in lymph nodes ipsilateral to COVID-19 vaccination with BNT162b2 (Pfizer-BioNTech) or mRNA-1273 (Moderna) in patients with prostate cancer referred for oncological [18F]-PSMA PET/CT or PET/MR imaging. Methods: One hundred twenty six patients undergoing [18F]-PSMA PET/CT or PET/MR imaging were retrospectively included. [18F]-PSMA activity (SUVmax) of ipsilateral axillary lymph nodes was measured and compared with the non-vaccinated contralateral side-and with a non-vaccinated negative control group. [18F]-PSMA active lymph node metastases were measured to serve as quantitative reference. Results: There was a significant difference in SUVmax in ipsilateral and compared to contralateral axillary lymph nodes in the vaccination group (n = 63, p < 0.001) and no such difference in the non-vaccinated control group (n = 63, p = 0.379). Vaccinated patients showed mildly increased axillary lymph node [18F]-PSMA uptake as compared to non-vaccinated patients (p = 0.03). [18F]-PSMA activity of of lymph node metastases was significantly higher (p < 0.001) compared to axillary lymph nodes of vaccinated patients. Conclusions: Our data suggest mildly increased [18F]-PSMA uptake after COVID-19 vaccination in ipsilateral axillary lymph nodes. However, given the significantly higher [18F]-PSMA uptake of prostatic lymph node metastases compared to “reactive” nodes after COVID-19 vaccination, no therapeutic and diagnostic dilemma is to be expected. Advances in knowledge: No specific preparations or precautions (e.g., adaption of vaccination scheduling) need to be undertaken in patients undergoing [18F]-PSMA PET imaging after COVID-19 vaccination.

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Abstract P3-01-14: Nomogram predicting axillary lymph node metastases to skip intraoperative analysis of sentinel lymph nodes

10.1158/1538-7445.sabcs17-p3-01-14 ◽

2018 ◽

Author(s):

JH Park ◽

YW Ju ◽

KE Kim ◽

J Rhu ◽

Y Kim ◽

...

Keyword(s):

Lymph Node ◽

Lymph Nodes ◽

Lymph Node Metastases ◽

Axillary Lymph Node ◽

Sentinel Lymph Nodes ◽

Axillary Lymph ◽

Axillary Lymph Node Metastases ◽

Node Metastases

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Breast Tumors: Immunoglobulins in Axillary Lymph Nodes

Tumori Journal ◽

10.1177/030089168607200606 ◽

1986 ◽

Vol 72 (6) ◽

pp. 575-579 ◽

Cited By ~ 2

Author(s):

Mariano Urdiales-Viedma ◽

Francisco Nogales-Fernandez ◽

Sebastian Martos-Padilla ◽

Emilio Sanchez-Cantalejo

Keyword(s):

Lymph Node ◽

Lymph Nodes ◽

Breast Tumors ◽

Lymphoid Cells ◽

Axillary Lymph Nodes ◽

Axillary Lymph ◽

Lymphoid Follicles ◽

Node Metastases ◽

High Histologic Grade

The immnuohistochemical determination of immunoglobulins IgA, IgG and IgM in axillary lymph nodes from 50 unselected breast ductal carcinomas disclosed that lymph nodes with IgG-positive lymphoid follicles and/or metastasized lymph nodes with IgM-positive lymphoid cells are statistically related to breast tumors with a high histologic grade and more than 3 lymph node metastases.

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Malignant Melanoma of the Vulva

Tumori Journal ◽

10.1177/030089167005600604 ◽

1970 ◽

Vol 56 (6) ◽

pp. 345-352 ◽

Cited By ~ 8

Author(s):

Natale Cascinelli ◽

Francesco Di Re ◽

Giovanni Lupi ◽

Gian Paolo Balzarini

Keyword(s):

Lymph Node ◽

Malignant Melanoma ◽

Lymph Nodes ◽

Lymph Node Metastases ◽

Primary Melanoma ◽

Regional Lymph Nodes ◽

Regional Metastases ◽

Anatomical Extent ◽

Node Metastases ◽

Labium Majus

Many aspects of malignant melanoma of the vulva are still open questions and only appropriate clinical trials can supply the answers. However, we believe that the reporting of case-material can be of some use. Our series consists of 14 cases, that is 2% of all the melanomas observed. Most of the patients were past middle age, the average age being 59.7 years. The most frequent sites were the labium majus and the clitoris (5 cases per site); in 2 cases the urethral meatus was affected and in 2 cases the labium minus. There are virtually no subjective symptoms except for occasional reports of a burning sensation or pruritus. Terminal stranguria may be present in cases in which the urethral papilla is affected. The clinical diagnosis does not usually present serious difficulties. Cytomorphologic examination of the cells exfoliated by the tumor is highly reliable, sure in ulcerated cases. The histology of malignant melanoma of the vulva does not differ from that of other sites. Metastatisation to the regional lymph nodes is frequent; 8 of our cases already had lymph node metastases when first seen. Treatment depends on the anatomical extent of the disease. In cases without lymph node metastases the data of our series seem to indicate that radiotherapy can be at least a valid alternative to surgical removal. With regard to the treatment of clinically intact regional lymph nodes, a regional approach is ilioinguinal lymphadenectomy in the event of surgical attack on the primary melanoma, whereas if the primary melanoma is to be treated by radiotherapy lymphadenectomy should be performed only if lymph node metastases appear. As to whether lymphadenectomy should be uni- or bilateral, our data indicate that the cases in which the melanoma lies on the midline (urethral meatus and clitoris) have a high incidence of bilateral metastases and so in these cases lymphadenectomy should be bilateral. On the other hand, when the labium majus is affected, unilateral lymph node dissection is sufficient. In cases with clinically detectable regional metastases enlarged vulvectomy is always indicated. Cases with distant metastases should receive chemotherapy. The drug that has so far yielded the greatest number of regressions is 5-imidazolcarboxamide. The prognosis depends on the anatomical extent of the disease. In this series 2 of the 4 cases without metastases to the regional lymph nodes are living 5 years after surgery whereas none of the 7 patients with regional metastases is alive after 5 years.

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Axillary Lymph Node Metastases from Occult Carcinoma of the Breast

Tumori Journal ◽

10.1177/030089167906500109 ◽

1979 ◽

Vol 65 (1) ◽

pp. 87-91 ◽

Cited By ~ 14

Author(s):

Paolo Vezzoni ◽

Alberto Balestrazzi ◽

Paola Bignami ◽

Francesco Concolino ◽

Leandro Gennari ◽

...

Keyword(s):

Breast Cancer ◽

Lymph Node ◽

Lymph Node Metastases ◽

Axillary Lymph Nodes ◽

Axillary Lymph ◽

Pathologic Examination ◽

Carcinoma Of The Breast ◽

Axillary Lymph Node Metastases ◽

Node Metastases ◽

Better Than

From the case records of the Istituto Nazionale Tumori of Milan from 1956 to 1976, 49 cases of metastases in axillary lymph nodes from an occult carcinoma of the breast were selected. Forty-four patients underwent removal of the suspicious breast. In 11 patients no tumor was found at the pathologic examination. The survival of these patients was no different from the survival of those in whom the tumor was found. The 5-year survival of the total series was 87%, confirming that this type of presentation of breast cancer has a prognosis that is better than that generally reported for stage II carcinoma of the breast.

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Lymph Scintigraphy and Pre- and Intraoperative Gamma Prone Measurements for Localization of Sentinel Lymph Nodes (SLN) in Breast Cancer

Nuklearmedizin ◽

10.1055/s-0038-1632250 ◽

2000 ◽

Vol 39 (03) ◽

pp. 82-87 ◽

Cited By ~ 1

Author(s):

H. Ostertag ◽

N. Czech ◽

U. zum Felde ◽

W. U. Kampen ◽

S. Klutmann ◽

...

Keyword(s):

Breast Cancer ◽

Nuclear Medicine ◽

Lymph Node ◽

Lymph Nodes ◽

Lymph Node Metastases ◽

Gamma Probe ◽

Daily Routine ◽

Axillary Lymph ◽

Node Metastases ◽

Probe Measurements

Summary Aim of this study was to prove the clinical value of nuclear medicine procedures to detect the sentinel lymph node (SLN) for SLN biopsy. Methods: In 132 patients with breast cancer we performed lymph scintigraphy of the breast as well as both pre- and intraoperative gamma probe measurements correlating the results with the findings of histopathology. Results: SLN were detectable in 62 of 110 patients according to a sensitivity of 56% when scanning was performed only at 1-2 h p.i. while the sensitivity increased to 86% (19 of 22 pts.) if sequential images were acquired up to 2 h p.i. One or more SLN were identified by a handheld gamma probe transcutaneously prior to surgery in 96% (113 of 118 pts.) of the patients who showed up with no clinically suspected lymph node metastases. Intraoperatively, in additionally 2 patients the SLN could be found resulting in a sensitivity of 97% (115 of 118 pts.). In only 3 patients with clinically no tumor spread to axillary lymph nodes no SLN could be identified by the probe. Skip lesions, i.e. lymph node metastases in patients with tumorfree SLN, occured in 2 cases: due to SLN biopsy in these patients lymph node staging was false negative compared to conventional staging by means of axillary lymph node dissection. Conclusion: The results demonstrate a high preoperative detection rate of SLN in patients with breast cancer using lymph scintigraphy and gamma probe measurements. Thus, nuclear medicine is capable of providing the basic requirements for SLN biopsy in the daily routine.

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Lymphographic Evaluation of 116 Cases of Malignant Melanoma

Tumori Journal ◽

10.1177/030089167205800101 ◽

1972 ◽

Vol 58 (1) ◽

pp. 1-12 ◽

Cited By ~ 2

Author(s):

Renato Musumeci ◽

Luigi Acerbi ◽

Gian Paolo Balzarini ◽

Sergio Orefice ◽

Ferdinando Preda ◽

...

Keyword(s):

Lymph Node ◽

Malignant Melanoma ◽

Lymph Nodes ◽

Lymph Node Metastases ◽

Lower Limbs ◽

Histologic Examination ◽

Node Metastases ◽

The Individual

The use and limitations of lymphography in malignant melanoma are evaluated on the basis of 116 cases, nearly all of the lower limbs, and the possibilities of use both preoperatively and during follow-up are discussed. In 53.5% of the cases lymphography revealed lymph node metastases in the inguino-iliac-lumboaortic chains, a datum that justifies the use of lymphography. Histologic examination of the lymph nodes removed at operation proved to be just as important. The two investigations agreed in 89.1% of the cases, taking the material as a whole, and in 90.5%, taking the individual lymph chains (157).

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