The neck

2018 ◽  
Author(s):  
Arangasamy Anbarasu ◽  
Jack I. Lane
Keyword(s):  
Lymph Nodes ◽  
Imaging Techniques ◽  
Retropharyngeal Space ◽  
Carotid Space

This section covers the neck in detail considering the imaging techniques in this area. The whole neck is discussed including the sublingual space, retropharyngeal space, perivertebral space, and carotid space, alongside areas such as the Larynx, Lymph nodes, and Cystic neck lesions.

A retropharyngealis nyirokcsomóáttétek klinikai jelentősége

2021 ◽  
Vol 162 (25) ◽  
pp. 997-1003
Author(s):  
Mónika Révész ◽  
Ferenc Oberna ◽  
Éva Remenár ◽  
Zoltán Takácsi-Nagy
Keyword(s):  
Lymph Node ◽  
Lymph Nodes ◽  
Delayed Diagnosis ◽  
Disease Free Survival ◽  
Multimodality Treatment ◽  
Retropharyngeal Space ◽  
Retropharyngeal Lymph Node ◽  
Close Proximity ◽  
Recurrent Nasopharyngeal Carcinoma ◽  
Disease Free

Összefoglaló. A retropharyngealis nyirokcsomóáttétek incidenciája a primer fej-nyaki daganat lokalizációjától függ. Leggyakrabban az előrehaladott vagy recidív nasopharynx-carcinomák esetén fordul elő, de III–IV. stádiumú oro- és hypopharynxtumorok esetén is megjelenhetnek. Non-nasopharyngealis primer tumoroknál a manifesztációjuk kedvezőtlen prognosztikai faktornak tekinthető, melynek hátterében a diagnosztikus nehézség miatti késői detektálás, a kifejezetten nehéz sebészi eltávolíthatóság, valamint az agresszív biológiai viselkedés állhat. Az esetismertetésünkben bemutatásra kerülő, 58 éves betegünknél bal oldali elülső szájfenéki primer tumort diagnosztizáltunk azonos oldali nyaki és retropharyngealis nyirokcsomó-metastasissal, mely a nemzetközi irodalom alapján extrém raritás, incidenciája kevesebb mint 1%. A retropharyngealis nyirokcsomók diagnosztikájában a lokalizáció miatt a képalkotóknak jut hangsúlyosabb szerep. Elhelyezkedésük nemcsak diagnosztikus, hanem sebésztechnikai kihívást is jelentenek az életfontosságú anatómiai képletek közelsége, illetve a szűk feltárási viszonyok miatt. Ilyenformán ezek a műtétek csak intenzív osztályos háttérrel és kellő jártassággal rendelkező centrumokban végezhetők. Az alapvetően rossz prognózist a korai diagnózis és a multimodális terápia kedvezően befolyásolja. Esetünkben a komplex kezeléssel (sebészi terápia és posztoperatív radiokemoterápia) sikerült lokoregionális tumormentességet elérni, és ezzel a teljes és a betegségmentes túlélési időt növelni. Orv Hetil. 2021; 162(25): 997–1003. Summary. The incidence of retropharyngeal lymph node metastasis depends on the localization of the primary head and neck cancer. Involved nodes are seen most commonly in cases of advanced or recurrent nasopharyngeal carcinoma, however, they might occur with stage III–IV oro- and hypopharyngeal tumours. The involvement of retropharyngeal lymph nodes has been associated with poor outcome of non-nasopharyngeal primary tumours, which might be explained by the delayed diagnosis, the difficult surgical procedure in the retropharyngeal space, and the aggressive nature of the disease. Here we present the case of a 58-year-old patient with an anterior oral cavity tumour on the left side with ipsilateral cervical lymph node and retropharyngeal lymph node metastases, which has been noted an extreme rarity in the literature with less than 1% incidence. Due to the localization of the retropharyngeal lymph nodes, the detection is based on imaging modalities. It represents a challenge for diagnosis and surgical treatment due to the close proximity of vital anatomical structures. Accordingly, these operations should only be performed in specialist surgical centres with intensive care units. The early diagnosis and the multimodality treatment might have a positive effect on the poor prognosis. In our case, we managed to achieve locoregional disease-free status with the complex treatment (surgical therapy and postoperative radiochemotherapy) and increase the overall and the disease-free survival. Orv Hetil. 2021; 162(25): 997–1003.

scholarly journals From aneurysmal bone cyst to telangiectatic osteosarcoma with metastasis in inguinal lymph nodes: Case report

2015 ◽  
Vol 68 (3-4) ◽  
pp. 127-132 ◽  
Author(s):  
Vesna Janevska ◽  
Liljana Spasevska ◽  
Milan Samardziski ◽  
Violeta Nikodinovska ◽  
Julija Zhivadinovik ◽  
...  
Keyword(s):  
Case Report ◽  
Lymph Nodes ◽  
Aneurysmal Bone Cyst ◽  
Imaging Techniques ◽  
Bone Cyst ◽  
Bone Lesion ◽  
Rare Event ◽  
Metatarsal Bone ◽  
Team Work ◽  
Tumor Mass

Introduction. Aneurysmal bone cyst is a benign bone lesion composed of blood filled cystic cavities lined by fibrous septa. Its malignant transformation of is a rare event. Case report. We report a case of a lesion in the second metatarsal bone in a 29-year-old male, presented as a slight swelling of the right foot. After the curettage had been done, the diagnosis of aneurysmal bone cyst was made but the recurrence occurred 4 years later. The biopsy of the recurrent tumor showed compact neoplastic tissue consistent with diagnosis of giant cell tumor with malignancy. The malignant component was recognized as a high grade sarcoma with osteoid production. A tumor mass with the whole II metatarsal bone was extirpated and a resected part of fibula was transplanted. A year later, another recurrence occurred, an amputation was performed and a teleangiectatic osteosarcoma with ingvinal lymph nodes metastases was diagnosed. No other tumor mass was confirmed, either clinically or by imaging techniques at the time of his third operation. He died 4 months later with multiple pulmonary metastases. Conclusion. We emphasize the importance of team work in order to achieve the accurate diagnosis, highlighting careful radiological examinations, good sampling and awareness of unusual cases in bone tumor pathology.

scholarly journals Miniature low-cost γ-radiation sensor for localization of radioactively marked lymph nodes

2021 ◽  
pp. 095441192110589
Author(s):  
Merlin Behling ◽  
Felix Wezel ◽  
Peter P Pott
Keyword(s):  
Minimally Invasive ◽  
Lymph Nodes ◽  
Early Stage ◽  
Imaging Techniques ◽  
Low Cost ◽  
In Vitro Tests ◽  
Γ Radiation ◽  
Sensor Head ◽  
Radiation Sensor ◽  
Validation Experiment

Detection of metastasis spread at an early stage of disease in lymph nodes can be achieved by imaging techniques, such as PET and fluoride-marked tumor cells. Intraoperative detection of small metastasis can be problematic especially in minimally invasive surgical settings. A γ-radiation sensor can be inserted in the situs to facilitate intraoperative localization of the lymph nodes. In the minimally invasive setting, the sensor must fit through the trocar and for robot-aided interventions, a small, capsule-like device is favorable. Size reduction could be achieved by using only a few simple electronic parts packed in a single-use sensor-head also leading to a low-cost device. This paper first describes the selection of an appropriate low-cost diode, which is placed in a sensor head (Ø 12 mm) and characterized in a validation experiment. Finally, the sensor and its performance during a detection experiment with nine subjects is evaluated. The subjects had to locate a 137Cs source (138 kBq activity, 612 keV) below a wooden plate seven times. Time to accomplish this task and error rate were recorded and evaluated. The time needed by the subjects to complete each run was 95 ± 68.1 s for the first trial down to 40 ± 23.9 s for the last. All subjects managed to locate the 137Cs source precisely. Further reduction in size and a sterilizable housing are prerequisites for in vitro tests on explanted human lymph nodes and finally in vivo testing.

scholarly journals Upper airway obstruction caused by primary lymphoplasmacytic lymphoma of the retropharyngeal space: a case report

2021 ◽  
Vol 37 (1) ◽  
Author(s):  
Chinyere N. Asoegwu ◽  
Okezie O. Kanu ◽  
Clement C. Nwawolo
Keyword(s):  
Lymph Nodes ◽  
Airway Obstruction ◽  
Upper Airway ◽  
Upper Airway Obstruction ◽  
Retropharyngeal Space ◽  
Histopathological Diagnosis ◽  
Lymphoplasmacytic Lymphoma ◽  
Malignant Tumours ◽  
Post Surgery ◽  
Emergency Tracheostomy

Abstract Background Primary malignant tumours of the retropharyngeal space are rare with only a few case reports in the literature. Lymphoplasmacytic lymphoma is a rare subtype of non-Hodgkin lymphoma and is very rarely found as a primary tumour of the retropharyngeal space. Case presentation We report the case of progressive upper airway obstruction in a 49-year-old male caused by a primary malignant tumour of the retropharyngeal space lymph nodes. He had an emergency tracheostomy to relieve the upper airway obstruction followed a week later by an elective surgical excision of the tumour via the trans-cervical route. A mixed population of lymphocytes, with a marked presence of Dutcher bodies, was noted on histopathology and positive CD20 on immunohistochemistry, confirming the lymphoplasmacytic lymphoma of the retropharyngeal space. The watchful waiting treatment method for the lymphoma was employed for him since he had no symptoms relating to lymphoma and no serum Waldenström’s macroglobulinemia. He has remained symptom-free 3 years post-surgery. Conclusion Primary malignant tumours involving the retropharyngeal space lymph nodes are very rare. They can rarely grow to a size huge enough to cause obstructive upper aerodigestive symptoms. Primary lymphoma of the retropharyngeal space should be considered in the diagnosis of the tumours involving the retropharyngeal space lymph nodes. Excisional biopsy is important to obtain tissue for histopathological diagnosis and the relief of upper aerodigestive tract obstruction when present.

SAVING LYMPHADENECTOMY IN PATIENTS WITH RECURRENT PROSTATE CANCER AFTER RADICAL PROSTATECTOMY

2017 ◽  
Vol 63 (1) ◽  
pp. 62-68
Author(s):  
Aleksandr Vasilev ◽  
Aleksandr Govorov ◽  
Dmitriy Pushkar
Keyword(s):  
Prostate Cancer ◽  
Radical Prostatectomy ◽  
Lymph Nodes ◽  
Imaging Techniques ◽  
Emission Tomography ◽  
Recurrent Prostate Cancer ◽  
Resonance Imaging ◽  
Robot Assisted ◽  
Multiparametric Magnetic Resonance Imaging ◽  
Positron Emission

A separate group of patients who underwent radical prostatectomy are patients with isolated recurrence of cancer in lymph nodes limited by regional and/or retroperitoneal lymph nodes. As one method of treatment of this patient group it could be applied lymphadenectomy by open or laparoscopic (robot-assisted) approach. The analysis of literature references indicates an increase of overall survival in this group of patients after lymphadenectomy. Imaging techniques such as multiparametric magnetic resonance imaging and positron emission tomography allow more accurately identifying lymph nodes damage in patients with biochemical recurrence of prostate cancer after radical prostatectomy.

scholarly journals Adult Retropharyngeal Abscess: A Retrospective Case Series

2015 ◽  
Vol 7 (2) ◽  
pp. 100-103
Author(s):  
Naveen Kumar
Keyword(s):  
Lymph Nodes ◽  
Sore Throat ◽  
Case Series ◽  
Retropharyngeal Abscess ◽  
Esophageal Wall ◽  
Retropharyngeal Space ◽  
Retrospective Case ◽  
X Ray ◽  
Presenting Symptoms ◽  
Retrospective Case Series

ABSTRACT Introduction Retropharyngeal abscess (RPA), is a deep tissue neck infection. It is a serious and occasionally life-threatening infection due to the anatomic location and the potential for obstruction of the upper airway. The retropharyngeal space is found posterior to the esophageal wall and anterior to the prevertebral fascia. Lymph nodes found in this space drain the nasopharynx, paranasal sinuses and middle ear. Often infections of these areas will lead to infection in the retropharyngeal space. Atrophy of these lymph nodes at or before puberty has been found as an explanation of the predominance of RPAs in young children. In fact, some believe that they atrophy after 4 years of age. Once almost exclusively a disease of children, is observed with increasing frequency in adults. Retropharyngeal abscess poses a diagnostic challenge for the ENT surgeon because of its infrequent occurrence and variable presentation. Materials and methods Ten cases of adult retropharyngeal abscess were reviewed. The diagnostic criteria were radiological evidence of widening of pre-vertebral soft tissue shadow and presence of pus in the swelling. Results Sore throat, fever, muffled speech, painful swallow and stiffness of the neck were common presenting symptoms. Lateral X-ray of the neck was diagnostic. Commonest organism isolated was Streptococcus pyogenes. Airway obstruction was the commonest complication. Discussion Most of the patients had history of trauma prior to the development of RPA. Computed tomography (CT) scan of neck and thorax has an important role in planning the management in addition to lateral X-ray of the neck. Transoral surgical drainage in association with antibiotics is the treatment of choice in abscesses confined to the retropharyngeal space. Conclusion Tuberculosis is no longer the commonest cause of adult retropharyngeal abscess. Sore throat or dysphagia, disproportionate to clinical findings in the throat should arouse suspicion of RPA. Early intervention with antibiotics reduces the chances of the development of complications. How to cite this article Kumar N. Adult Retropharyngeal Abscess: A Retrospective Case Series. Int J Otorhinolaryngol Clin 2015;7(2):100-103.

scholarly journals Molecular targets for diagnostic and intraoperative imaging of pancreatic ductal adenocarcinoma after neoadjuvant FOLFIRINOX treatment

2020 ◽  
Vol 10 (1) ◽  
Author(s):  
F. A. Vuijk ◽  
L. D. A. N. de Muynck ◽  
L. C. Franken ◽  
O. R. Busch ◽  
J. W. Wilmink ◽  
...  
Keyword(s):  
Molecular Imaging ◽  
Lymph Nodes ◽  
Pancreatic Ductal Adenocarcinoma ◽  
Metastatic Lymph Node ◽  
Imaging Techniques ◽  
Intraoperative Imaging ◽  
Neoadjuvant Treatment ◽  
Radical Resection ◽  
Ductal Adenocarcinoma ◽  
Primary Tumors

Abstract Neoadjuvant systemic treatment is increasingly being integrated in the standard treatment of pancreatic ductal adenocarcinoma (PDAC) patients to improve oncological outcomes. Current available imaging techniques remain unreliable in assessing response to therapies, as they cannot distinguish between (vital) tumor tissue and therapy induced fibrosis (TIF). Consequently, resections with tumor positive margins and subsequent early post-operative recurrences occur and patients eligible for potential radical resection could be missed. To optimize patient selection and monitor results of neoadjuvant treatment, PDAC-specific diagnostic and intraoperative molecular imaging methods are required. This study aims to evaluate molecular imaging targets for PDAC after neoadjuvant FOLFIRINOX treatment. Expression of integrin αvβ6, carcinoembryonic antigen cell adhesion molecule 5 (CEACAM5), mesothelin, prostate-specific membrane antigen (PSMA), urokinase-type plasminogen activator receptor, fibroblast activating receptor, integrin α5 subunit and epidermal growth factor receptor was evaluated using immunohistochemistry. Immunoreactivity was determined using the semiquantitative H-score. Resection specimens from patients after neoadjuvant FOLFIRINOX treatment containing PDAC (n = 32), tumor associated pancreatitis (TAP) and TIF (n = 15), normal pancreas parenchyma (NPP) (n = 32) and tumor positive (n = 24) and negative (n = 56) lymph nodes were included. Integrin αvβ6, CEACAM5, mesothelin and PSMA stainings showed significantly higher expression in PDAC compared to TAP and NPP. No expression of αvβ6, CEACAM5 and mesothelin was observed in TIF. Integrin αvβ6 and CEACAM5 allow for accurate metastatic lymph node detection. Targeting integrin αvβ6, CEA, mesothelin and PSMA has the potential to distinguish vital PDAC from fibrotic tissue after neoadjuvant FOLFIRINOX treatment. Integrin αvβ6 and CEACAM5 detect primary tumors and tumor positive lymph nodes.

scholarly journals A Straightforward Method for 3D Visualization of B Cell Clusters and High Endothelial Venules in Lymph Nodes Highlights Differential Roles of TNFRI and -II

2021 ◽  
Vol 12 ◽  
Author(s):  
Kim C. M. Jeucken ◽  
Jasper J. Koning ◽  
Jan Piet van Hamburg ◽  
Reina E. Mebius ◽  
Sander W. Tas
Keyword(s):  
Lymph Nodes ◽  
B Cell ◽  
Structural Changes ◽  
3D Visualization ◽  
Imaging Techniques ◽  
High Endothelial Venules ◽  
Cell Clusters ◽  
Straightforward Method ◽  
Branching Points ◽  
Whole Mount

Whole mount tissue immunolabeling and imaging of complete organs has tremendous benefits in characterizing organ morphology. Here, we present a straightforward method for immunostaining, clearing and imaging of whole murine peripheral lymph nodes (PLNs) for detailed analysis of their architecture and discuss all procedures in detail in a step-by-step approach. Given the importance of tumor necrosis factor receptor (TNFR) signaling in development of PLNs we used TNFRI-/- and TNFRII-/- mice models as proof-of-concept for this technique by visualizing and analyzing structural changes in PLN B cell clusters and high endothelial venules (HEVs). Samples were subjected to de- and rehydration with methanol, labeled with antibodies for B cells, T cells and high endothelial venules (HEVs) and optically cleared using benzyl alcohol-benzyl benzoate. Imaging was done using LaVision light sheet microscope and analysis with Imaris software. Using these techniques, we confirmed previous findings that TNFRI signaling is essential for formation of individual B cell clusters. In addition, Our data suggest that TNFRII signaling is also to some extent involved in this process as TNFRII-/- PLNs had a B cell cluster morphology reminiscent of TNFRI-/- PLNs. Moreover, visualization and objective quantification of the complete PLN high endothelial vasculature unveiled reduced volume, length and branching points of HEVs in TNFRI-/- PLNs, revealing an earlier unrecognized contribution of TNFRI signaling in HEV morphology. Together, these results underline the potential of whole mount tissue staining and advanced imaging techniques to unravel even subtle changes in lymphoid tissue architecture.

scholarly journals Navigation-guided biopsy of retropharyngeal lymph nodes

2019 ◽  
Vol 12 (3) ◽  
pp. bcr-2018-227201
Author(s):  
Bassel Hallak ◽  
Sonia Von Wihl ◽  
Franciscus Boselie ◽  
Salim Bouayed
Keyword(s):  
Lymph Node ◽  
Lymph Nodes ◽  
Navigation System ◽  
3D Imaging ◽  
Three Dimensional ◽  
Retropharyngeal Space ◽  
Open Biopsy ◽  
Retropharyngeal Lymph Node ◽  
Pulmonary Cancer ◽  
The Impact

The impact of metastasis to the retropharyngeal lymph node group is poorly understood because of the difficult access to the retropharyngeal space (RPS). In 20%–50% of surgically treated oropharyngeal, hypopharyngeal, and cervical oesophageal carcinomas, we can find metastases to the retropharyngeal lymph nodes (RPLNs). 1 The use of a three-dimensional (3D)-imaging-guided navigation system to perform a biopsy for a suspicion of metastasis in an RPLN can provide advantages in terms of better precision and 3D orientation with protection of the surrounding critical structures. We report two cases of an open biopsy by transoral and transnasal approaches for a suspicion of metastasis in a retropharyngeal lymph node in two patients with oropharyngeal and pulmonary cancer, respectively, by using the 3D imaging-guided navigation system. In the both cases, the biopsies performed were very accurate and allowed to get a full histological analysis and diagnosis. The use of the navigation system as a means to perform biopsies in the soft tissue of the neck is rarely reported and up to date few reports can be found in the literature. This technique can provide multiple advantages when compared with other conventional methods. The procedure is simple, safe and minimally invasive.

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