scholarly journals Pedicled Transfer of the Superficial Inguinal Lymph Node Flap for Lymphedema

2017 ◽  
Vol 02 (01) ◽  
pp. e29-e34 ◽  
Author(s):  
Theodore Kung ◽  
Nicole Duggan ◽  
Peter Neligan
Keyword(s):  
Lymph Node ◽  
Lower Extremity ◽  
Lymph Nodes ◽  
Inguinal Lymph Node ◽  
Case Series ◽  
Free Tissue Transfer ◽  
Flap Transfer ◽  
Lymph Node Transfer ◽  
Superficial Inguinal Lymph Node ◽  
Potential Use

Background Vascularized lymph node transfer is performed for select patients with lymphedema who remain refractory to nonsurgical therapies. Typically, this involves a microvascular free tissue transfer of donor lymph nodes to the affected area. We describe our experience with the transfer of a pedicled adipofascial flap containing the superficial inguinal lymph nodes for lower extremity lymphedema or penoscrotal lymphedema. Methods In eight patients, a unilateral pedicled superficial inguinal lymph node flap was harvested. The flap consisted of subscarpal adipofascial tissue between the level of the inguinal ligament and the groin crease. Blood supply was from either the superficial circumflex iliac vessels or the superficial inferior epigastric vessels. In certain patients, concurrent lymphaticovenular anastomosis was attempted as well. Results Four patients underwent pedicled superficial inguinal lymph node flap transfer for lower extremity lymphedema and for the other four patients the indication was penoscrotal lymphedema. Seven of the eight study patients reported improvements in their lymphedema symptoms. Postoperative complications included cellulitis in one patient and hematoma in another patient; neither patient required reoperation. Conclusion The pedicled superficial inguinal lymph node flap is a feasible and safe treatment option for either lower extremity lymphedema or genital lymphedema. This case series provides the basis for additional studies regarding the potential use of this vascularized lymph node flap in select patients.

Subcutaneous sacrococcygeal ependymoma with inguinal lymph node metastastis

1988 ◽  
Vol 68 (3) ◽  
pp. 474-477 ◽  
Author(s):  
G. W. P. M. Kramer ◽  
E. Rutten ◽  
J. Sloof
Keyword(s):  
Lymph Node ◽  
Lymph Nodes ◽  
Inguinal Lymph Node ◽  
Content Type ◽  
Inguinal Lymph Nodes ◽  
Fine Print

✓ A patient with a subcutaneous sacrococcygeal ependymoma and metastasis to the inguinal lymph nodes is presented and his treatment is described. Previous reports on sacrococcygeal ependymoma are reviewed.

Quantity of lymph nodes correlates with improvement in lymphatic drainage in treatment of hind limb lymphedema with lymph node flap transfer in rats

Microsurgery ◽  
2015 ◽  
Vol 36 (3) ◽  
pp. 239-245 ◽  
Author(s):  
Dung H. Nguyen ◽  
Pan-Yu Chou ◽  
Yu-Hsuan Hsieh ◽  
Arash Momeni ◽  
Yu-Hua Dean Fang ◽  
...  
Keyword(s):  
Lymph Node ◽  
Lymph Nodes ◽  
Hind Limb ◽  
Lymphatic Drainage ◽  
Flap Transfer

scholarly journals A case series of Kimura’s disease: a diagnostic challenge

2018 ◽  
Vol 9 (7) ◽  
pp. 207-211 ◽  
Author(s):  
Vivek Kumar ◽  
Navneet Mittal ◽  
Yiwu Huang ◽  
Jasminka Balderracchi ◽  
Huo Xiang Zheng ◽  
...  
Keyword(s):  
Lymph Node ◽  
Lymph Nodes ◽  
Hodgkin's Disease ◽  
Immunoglobulin E ◽  
Hodgkin’S Disease ◽  
Case Series ◽  
Kimura’S Disease ◽  
Pathological Features ◽  
Diagnostic Challenge ◽  
First Case

Kimura’s disease (KD) is a rare, benign disorder characterized by subcutaneous masses with regional lymph-node enlargement. It is considered to be due to chronic inflammation of unclear etiology. Most cases have been reported in young, 20–30-year-old men of Asian descent. The diagnosis of KD is based on pathological features and elevated immunoglobulin E levels. Characteristic pathological features include intact lymph-node architecture, florid germinal center hyperplasia, extensive eosinophilic infiltrates, and proliferation of postcapillary venules. However, these features can also be seen in Hodgkin’s disease or T-cell lymphoma, therefore, cases presenting as KD pose a diagnostic challenge. We report a case series of two cases with suspected KD at initial presentation, with one patient eventually diagnosed with Hodgkin’s disease after clinical progression. The first case was a 45-year-old Asian man who presented with bilateral thigh masses and significantly enlarged inguinal lymph nodes. The histopathology was characteristic and the patient had stable disease on treatment with cetirizine for 20 months. The second case was a 29-year-old African-American man who had progressive enlargement of the right neck lymph nodes extending into the mediastinum, with the original biopsy suggestive of KD. An initial search for Reed–Sternberg cells using immunohistochemical staining for CD15 and CD30 was negative. However, the patient developed neurological symptoms corresponding to tumor extension to the cervical and thoracic neural foramina. A repeat biopsy showed a lack of nodal structure and atypical large cells that were positive for CD30 staining. The patient was treated with chemotherapy with good response. We emphasize the importance of following the clinical course to render an accurate diagnosis. Both cases showed extensive eosinophilic infiltration and other KD-like pathological features. However, KD is rare; not missing a malignant diagnosis lies in high clinical suspicion and repeated exhaustive work up.

scholarly journals Omental Vascularized Lymph Node Flap: A Radiographic Analysis

2018 ◽  
Vol 34 (07) ◽  
pp. 472-477 ◽  
Author(s):  
Sarah Sasor ◽  
Sunil Tholpady ◽  
Michael Chu ◽  
Julia Cook
Keyword(s):  
Lymph Node ◽  
Lymph Nodes ◽  
Donor Site ◽  
Gaussian Mixture ◽  
Omental Flap ◽  
Node Number ◽  
Lymph Node Size ◽  
Lymph Node Transfer ◽  
Node Size ◽  
Vascularized Lymph Node Transfer

Background Vascularized lymph node transfer is an increasingly popular option for the treatment of lymphedema. The omental donor site is advantageous for its copious soft tissue, well-defined collateral circulation, and large number of available nodes, without the risk of iatrogenic lymphedema. The purpose of this study is to define the anatomy of the omental flap in the context of vascularized lymph node harvest. Methods Consecutive abdominal computed tomography angiography (CTA) images performed at a single institution over a 1-year period were reviewed. Right gastroepiploic artery (RGEA) length, artery caliber, lymph node size, and lymph node location in relation to the artery were recorded. A two-tailed Z-test was used to compare means. A Gaussian Mixture Model confirmed by normalized entropy criterion was used to calculate three-dimensional lymph node cluster locations along the RGEA. Results In total, 156 CTA images met inclusion criteria. The RGEA caliber at its origin was significantly larger in males compared with females (p < 0.001). An average of 3.1 (1.7) lymph nodes were present per patient. There was no significant gender difference in the number of lymph nodes identified. Average lymph node size was significantly larger in males (4.9 [1.9] × 3.3 [0.6] mm in males vs. 4.5 [1.5] × 3.1 [0.5] mm in females; p < 0.001). Three distinct anatomical variations of the RGEA course were noted, each with a distinct lymph node clustering pattern. Total lymph node number and size did not differ among anatomical subgroups. Conclusion The omentum is a reliable lymph node donor site with consistent anatomy. This study serves as an aid in preoperative planning for vascularized lymph node transfer using the omental flap.

scholarly journals Feasibility of pedicled vascularized inguinal lymph node transfer in a mouse model: A preliminary study

Microsurgery ◽  
2018 ◽  
Vol 39 (3) ◽  
pp. 247-254 ◽  
Author(s):  
Kosuke Ishikawa ◽  
Taku Maeda ◽  
Emi Funayama ◽  
Toshihiko Hayashi ◽  
Naoki Murao ◽  
...  
Keyword(s):  
Lymph Node ◽  
Mouse Model ◽  
Inguinal Lymph Node ◽  
Preliminary Study ◽  
Lymph Node Transfer
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