scholarly journals An unexpected surprise: rare association of neuroendocrine tumours in inflammatory bowel disease

2020 ◽  
Vol 2020 (9) ◽  
Author(s):  
Jackson J Pat ◽  
Muhammad Rafaih Iqbal ◽  
Christopher Wright
Keyword(s):  
Lymph Node ◽  
Neuroendocrine Tumours ◽  
Metastatic Lymph Node ◽  
Primary Source ◽  
Neuroendocrine Neoplasms ◽  
Resected Lymph Node ◽  
Rare Association ◽  
Reactive Lymph Node ◽  
Inflammatory Bowel ◽  
Active Disease

Abstract Neuroendocrine neoplasms are rare malignancies, more so when cancerous metastasis occurs without a known primary source. Here we discuss a case of an ulcerative colitis sufferer, 43-year-old lady presented with what was thought to be a flare up. Situation deteriorated and was taken to theatre to find a significantly ischaemic colon, secondary to extensive venous thrombosis. The ischaemic bowel was resected alongside with what was thought to be a large, reactive lymph node. To our surprise, the resected lymph node returned with evidence of neuroendocrine neoplastic metastasis. Multiple laboratory and imaging investigations were performed in hope to identify the primary source. A second metastatic lymph node was identified and subsequently resected but the primary remains elusive. Currently, there are no visible evidences of active disease.

Silent and formidable foe: neuroendocrine tumours of the gallbladder

2020 ◽  
Vol 13 (12) ◽  
pp. e237063
Author(s):  
Darshan S Randhawa ◽  
Sami Shoucair ◽  
Edward McCarron
Keyword(s):  
African American ◽  
Lymph Node ◽  
Hepatic Resection ◽  
Neuroendocrine Tumours ◽  
African American Woman ◽  
American Woman ◽  
Late Presentation ◽  
Neuroendocrine Neoplasms ◽  
Node Dissection ◽  
Carcinoma Gallbladder

Neuroendocrine neoplasms of the gallbladder occur infrequently, with the diagnosis being incidental in most cases. We present a case of an 81-year-old African American woman who initially presented with acute suppurative cholecystitis, found on pathology to have a moderately differentiated infiltrating adenocarcinoma. A partial hepatic resection with periportal lymph node dissection was planned which was subsequently aborted intraoperatively due to the presence of diffuse carcinomatosis. Pathology of the cancerous lesions revealed neuroendocrine carcinoma. Gallbladder neuroendocrine tumours demonstrate no specific clinical features. Given its often late presentation, neuroendocrine tumours of the gallbladder pose a therapeutic and prognostic challenge.

Modern Radiodiagnostics Technology of Metastasises in Pelvic Lymph Nodes

2017 ◽  
pp. 100-108
Author(s):  
V. N. Diomidova ◽  
O. A. Еfimova
Keyword(s):  
Lymph Node ◽  
Magnetic Resonance ◽  
Lymph Nodes ◽  
Metastatic Lymph Node ◽  
Magnetic Resonance Tomography ◽  
Visual Images ◽  
Pelvic Lymph Nodes ◽  
High Information Content ◽  
Pelvic Cancer ◽  
High Information

The analysis of the diagnostic informativeness of modern radiodiagnosticis methods in determining metastatic lymph node of pelvic cancer gynecological organs according to domestic and foreign publications. At the present stage methods of obtaining visual images pelvic lymph nodes are radiodiagnostics technologies (radiological, ultrasound, magnetic resonance tomography, scintigraphic). The analysis has shown that the researches devoted to diagnostic informational content of modern methods of radiodiagnosis in a differentiation of nature of damage of pelvic lymph nodes aren't enough. According to the literature, the most rational and perspective method for radiodiagnosis metastatics lymph node is a magnetic resonance imaging due to the high information content and thus specificity. At the same time, the continued relevance of further study of methods of radiodiagnostics in order to find the optimal one for the assessment of pelvic lymph nodes.

scholarly journals Crohn’s disease and ulcerative colitis patient-reported outcomes signs and symptoms for the remote management of inflammatory bowel disease during the COVID-19 pandemic

2021 ◽  
Vol 5 (1) ◽  
Author(s):  
Sergio Pinto ◽  
Erica Loddo ◽  
Salvatore Paba ◽  
Agnese Favale ◽  
Fabio Chicco ◽  
...  
Keyword(s):  
Ulcerative Colitis ◽  
Inflammatory Bowel Disease ◽  
Crohn’S Disease ◽  
Bowel Disease ◽  
Patient Reported Outcomes ◽  
Signs And Symptoms ◽  
Patient Reported ◽  
Inflammatory Bowel ◽  
Active Patients ◽  
Active Disease

Abstract Background and aims The COVID-19 pandemic has led to a deep reorganization of hospital services including inflammatory bowel disease (IBD) units. In this situation, conversion of in-person routine follow-up visits into phone consultations might be necessary. Here we explored the feasibility of using the validated Crohn’s Disease (CD) or Ulcerative Colitis (UC) Patient-Reported Outcomes Signs and Symptoms (CD- and UC-PRO/SS) to collect data about abdominal symptoms (abdominal/S) and bowel signs and symptoms (bowel/SS) remotely. Methods CD- and UC-PRO/SS were collected during phone consultations and compared among patients with active and inactive disease. The effectiveness of therapeutic intervention in patients with active disease was assessed by PRO/SS variation. Results Twenty-one CD and 56 UC patients were evaluated by phone. Six (28.6%) CD and 15 (26.8%) UC patients were considered to have active disease. In CD the bowel/SS but not the abdominal/S module was significantly higher in active patients (mean bowel/SS 2.50 [SE ± 0.44] active vs 0.76 [SE ± 0.18] remission, p = 0.008, AUC 0.87; mean abdominal/S 1.11 [SE ± 0.38] active vs 0.24 [SE ± 0.13] remission, p = 0.066). UC-PRO/SS measures were significantly higher in active patients as compared to patients in remission (median bowel/SS 1.63 [SE ± 0.24] active vs 0.33 [SE ± 0.04] remission; p < 0.0001, AUC 0.91; mean abdominal/S 1.03 [SE ± 0.24] vs 0.37 [SE ± 0.12]; p = 0.009, AUC 0.71). Therapy was escalated in 12 patients (3 CD and 9 UC) due to disease relapse. Therapy escalation resulted in the reduction of PRO/SS as evaluated at the subsequent phone consultation. Conclusions PRO/SS might represent a feasible tool to evaluate disease activity and therapy outcome in IBD patients during periods of limited access to outpatient clinics.

scholarly journals IMPACT OF DIET ON INFLAMMATORY BOWEL DISEASE SYMPTOMS: AN ADOLESCENT VIEWPOINT

2021 ◽  
Vol 27 (Supplement_1) ◽  
pp. S58-S59
Author(s):  
Megan Zangara ◽  
Natalie Bhesania ◽  
Wei Liu ◽  
Gail Cresci ◽  
Jacob Kurowski ◽  
...  
Keyword(s):  
Inflammatory Bowel Disease ◽  
Bowel Disease ◽  
Dietary Habits ◽  
Therapeutic Option ◽  
Current Status ◽  
Dietary Modification ◽  
Continue Development ◽  
Disease Symptoms ◽  
Inflammatory Bowel ◽  
Active Disease

Abstract Background Dietary modification shows promise as therapy in inflammatory bowel disease (IBD); however, it is unknown whether adolescents are interested in a dietary approach. Methods Cross-sectional survey of adolescents with IBD ages 14–21 on disease knowledge, dietary habits, and perceptions of diet therapy. Results A total of 132 subjects (48.5% female), mean age of 17.8 years and median disease length of 5 years (range 0, 16), completed the survey. Diet was perceived as a symptom trigger by 59.8% of subjects, and 45.4% had tried using diet as a treatment for symptom resolution, often without physician supervision and with limited success. Overall, subjects reported following a diet significantly more often than documented in the electronic medical record (EMR) by the physician (25.0% vs. 15.0%, p=0.033), with 72% agreement between subject response and EMR documentation on current status of diet modification (AC1=0.59, CI=0.45, 0.73). Subjects experiencing active disease symptoms as determined by Manitoba IBD Index were more likely to be currently modifying their diet compared to subjects without active disease symptoms (OR = 4.11, CI=1.58, 10.73, p=0.003). The subjects reporting unsuccessful dietary modification compliancy (25.7%, n=34) most commonly cited perceived lack of improvement in their IBD symptoms as the primary reason for stopping the diet (48.4%, n=15). Conclusions Adolescents with IBD perceive a relationship between diet and disease symptoms and are interested in dietary modification as a symptom management option. Our study suggests that a large proportion of adolescent IBD patients may already be attempting dietary modification, and therefore would be receptive to a modified dietary plan under the guidance of their gastroenterologist and dietitian. Much is still unknown about how dietary modification will fit in with current treatment regimens, but patient interest informs us that it is necessary to continue development and research of this promising therapeutic option.

scholarly journals Sustained signaling by canonical helper T cell cytokines throughout the reactive lymph node

2010 ◽  
Vol 11 (6) ◽  
pp. 520-526 ◽  
Author(s):  
Georgia Perona-Wright ◽  
Katja Mohrs ◽  
Markus Mohrs
Keyword(s):  
Lymph Node ◽  
T Cell ◽  
Helper T Cell ◽  
Reactive Lymph Node

Localization of tumor-reactive lymph node lymphocytes in vivo using radiolabeled monoclonal antibody

Cancer ◽  
1994 ◽  
Vol 73 (3) ◽  
pp. 580-589 ◽  
Author(s):  
Pierre L. Triozzi ◽  
Julian A. Kim ◽  
Wayne Aldrich ◽  
Donn C. Young ◽  
James W. Sampsel ◽  
...  
Keyword(s):  
Monoclonal Antibody ◽  
Lymph Node ◽  
Reactive Lymph Node

236 Evaluation of PD-L1 expression in primary lung tumor and metastatic lymph nodes in the presence of immune cells

2020 ◽  
Vol 8 (Suppl 3) ◽  
pp. A253-A253
Author(s):  
Chris Hansis ◽  
Xiaomei Wang ◽  
Tao Wang ◽  
Gerald Feldman
Keyword(s):  
Lung Cancer ◽  
Squamous Cell Carcinoma ◽  
Lymph Node ◽  
Tumor Cells ◽  
Squamous Cell ◽  
Immune Cells ◽  
Lymph Node Metastases ◽  
Metastatic Lymph Node ◽  
Metastatic Lymph ◽  
Node Metastases

BackgroundImmunotherapies against programmed death ligand-1 (PD-L1) have been established as an effective treatment for a subset of lung cancer patients. Even though it is critical for a successful therapy to know prevalent PD-L1 expression patterns in all affected tissues, information on matching lymph node metastases and immune cells is particularly limited. The purpose of this study was thus to evaluate comparative PD-L1 expression profiles in those tissues.MethodsFDA-approved IHC assays for PD-L1 (Dako 22C3) were performed on a lung tissue array (LC814A, US Biomax) according to manufacturer’s instructions. Histopathological analysis by H-scoring was performed to determine the rate and intensity of positive tumor and immune cell staining for each of the 80 cores. The H score was calculated as follows: A total of up to 300 cells were assessed, per specimen, at 40x high-power magnification (typically over 7–10 fields). A staining level of 0–3 was then assigned to each cell, to designate the intensity of specific positive membranous-to-cytoplasmic staining. The H score was subsequently calculated as% cells staining at level 1 (x1) +% cells staining at level 2 (x2) +% cells staining at level 3 (x3) = total H score per sample. This resulted in a maximum possible H score of 300.ResultsOf the 16 adenocarcinoma tumor samples with a valid staining, 7 (44%) showed positive PD-L1 staining for tumor cells and 10 (63%) for primary immune cells. Importantly, 9 matching metastatic lymph node samples out of the 16 samples (56%) showed an increased PD-L1 H score compared to primary tumors for both tumor cells and immune cells (figure 1). Of the 15 squamous cell carcinoma samples with a valid staining, 11 (73%) showed detectable PD-L1 expression levels in the primary tumor and 12 (80%) in the primary immune cells, while 7 (47%) and 9 (60%) showed lower scores in matching metastatic lymph node tumor cells and their immune cells, respectively (figure 2). Very low or no expression of PD-L1 was detected in small cell lung cancer, as to be expected from previous studies.Abstract 236 Figure 1PD-L1 Staining in adenocarcinomaAbstract 236 Figure 2PD-L1 Staining in squamous cell carcinomaConclusionsSquamous cell carcinomas and adenocarcinomas display significant heterogeneity with regard to PD-L1 expression in associated lymph node metastases. While the reasons for this frequent discordant PD-L1 expression pattern involving both tumor and immune cells need to be investigated further, our findings may help guide the proper interpretation of PD-L1 companion diagnostic test results and subsequent therapeutic decisions.AcknowledgementsThe views in this Abstract have not been formally disseminated by the U.S. Food and Drug Administration and should not be construed to represent any agency determination or policy.

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