scholarly journals Computed tomography and magnetic resonance imaging findings in a dog with apocrine gland anal sac adenocarcinoma with vertebral canal metastasis

2020 ◽  
Vol 8 (3) ◽  
pp. e001234
Author(s):  
Dan Kenny ◽  
Vasiliki Lantzaki ◽  
Rodney Ayl ◽  
David Barker
Keyword(s):  
Lymph Node ◽  
Lymph Nodes ◽  
Acute Onset ◽  
Apocrine Gland ◽  
Vertebral Canal ◽  
Poorly Differentiated Carcinoma ◽  
Internal Iliac ◽  
Poorly Differentiated ◽  
Anal Sac ◽  
Local Lymph Node

A 10-year-old male neutered cocker spaniel was presented for further investigation of an enlarged sublumbar lymph node, which was cytologically consistent with epithelial cell malignancy. CT revealed marked left medial and internal iliac and mild lumbo-aortic lymphadenomegaly. Surgical extirpation of the lymph nodes was performed, and histopathology was consistent with poorly differentiated carcinoma. Despite the absence of a discernible primary lesion, metastatic apocrine gland anal sac adenocarcinoma (AGASAC) was suspected and chemotherapy was started. Six days after starting chemotherapy, the patient developed acute-onset paraparesis and trembling. MRI revealed a left-sided extradural mass at the level of T11–T13. CT imaging revealed mild enlargement of multiple left sided lumbo-aortic lymph nodes. The dog was euthanised 3 days later due to neurological deterioration. Postmortem examination confirmed a diagnosis of left AGASAC with local lymph node and T11–T13 vertebral canal metastasis.

scholarly journals Apocrine Gland Anal Sac Adenocarcinoma in Dogs: 22 Cases (2015-2020)

2021 ◽  
Author(s):  
A.K. Sahoo ◽  
I. Nath ◽  
S.B. Senapati ◽  
S.K. Panda ◽  
M.R. Das ◽  
...  
Keyword(s):  
Lymph Node ◽  
Lymph Nodes ◽  
Regional Lymph Node ◽  
Clinical Signs ◽  
Clinical Staging ◽  
Apocrine Gland ◽  
Survival Times ◽  
Regional Lymph Nodes ◽  
Iliac Lymph Node ◽  
Anal Sac

Background: Apocrine gland anal sac adenocarcinoma (AGASACA) is a highly malignant disease mostly invading regional lymph nodes at the time of disease diagnosis.Methods: Twenty- two cases of Apocrine gland anal sac adenocarcinoma (AGASACA) were treated during five years. Contrast radiography with Iohexol and Lipidol were carried out to detect primary anal sac mass and regional lymph node through indirect lymphography technique. For clinical staging, ultrasonography, fine-needle aspiration cytology, histopathology of both primary tumor mass and regional lymph node were performed. Closed anal Sacculectomy was performed as curative therapy for anal sac adenocarcinoma.Result: The median age and weight of dogs at presentation were 8.4 years and 20.9 kg, respectively. Diagnostic radiology, histopathology and biochemical assay confirm twenty-two cases of anal sac adenocarcinoma and medial iliac lymph node to be sentinel lymph node. Carcinoma was of unilateral occurrence in all the dogs. Four (18%) dogs had hypercalcemia and twelve (54%) had metastases to the regional lymph nodes with clinical signs of tenesmus or constipation, polyuria -polydipsia and anorexia. Apocrine gland Adenocarcinoma of anal sac was found to initially metastasize to the medial iliac lymph node. Survival times of dogs treated with the surgical procedure only (8 out of 22 dogs) were appreciably longer than the dogs with therapeutic only. Animals with metastasis to regional lymph nodes or lymphadenopathy had poor prognosis.

Primary Clitoral Adenocarcinoma With Secondary Hypercalcemia of Malignancy in a Dog

2010 ◽  
Vol 46 (3) ◽  
pp. 193-196 ◽  
Author(s):  
Steven A. Neihaus ◽  
Jennifer E. Winter ◽  
Robert L. Goring ◽  
F. A. Kennedy ◽  
Matti Kiupel
Keyword(s):  
Lymph Node ◽  
Lymph Node Metastasis ◽  
Abdominal Ultrasound ◽  
Apocrine Gland ◽  
Hypercalcemia Of Malignancy ◽  
Node Metastasis ◽  
Iliac Lymph Node ◽  
Internal Iliac ◽  
Anal Sac ◽  
Anal Sacs

This report describes a primary clitoral adenocarcinoma in a dog with secondary hypercalcemia of malignancy. A 10-year-old, spayed female basset hound was evaluated for a mass protruding from the vulva. The mass was excised, and a histological diagnosis of clitoral adenocarcinoma was made. No evidence of metastasis on thoracic radiographs or abdominal ultrasound was seen. Preoperative hypercalcemia resolved following excision of the mass. Cellular features were similar to an apocrine gland anal sac adenocarcinoma, and immunohistochemistry exhibited features noted with apocrine gland anal sac adenocarcinoma. No further treatment was elected by the owner. Internal iliac lymph-node metastasis was identified 4 weeks postoperatively, and hypercalcemia recurred 8 weeks postoperatively. The dog was euthanized 22 weeks postoperatively for signs related to hypercalcemia, including polyuria/polydipsia, lethargy, and weakness. A necropsy was performed and confirmed the presence of internal iliac lymph-node metastasis. The colon, rectum, and anal sacs were grossly and histologically normal. To our knowledge, this is the first reported case of clitoral neoplasia in the dog.

scholarly journals Progression of Papillary Thyroid Carcinoma to Anaplastic Carcinoma in Metastatic Lymph Nodes: Solid/Insular Growth and Hobnail Cell Change in Lymph Nodes Are Predictors of Subsequent Anaplastic Transformation

2021 ◽  
Author(s):  
Toru Odate ◽  
Naoki Oishi ◽  
Masataka Kawai ◽  
Ippei Tahara ◽  
Kunio Mochizuki ◽  
...  
Keyword(s):  
Lymph Node ◽  
Lymph Nodes ◽  
Control Group ◽  
Promoter Mutation ◽  
Primary Tumors ◽  
Nodal Recurrence ◽  
Node Metastasis ◽  
Poorly Differentiated Carcinoma ◽  
Anaplastic Transformation ◽  
Poorly Differentiated

AbstractMost anaplastic thyroid carcinomas (ATCs) arise from papillary thyroid carcinoma (PTC). This process is also called anaplastic transformation, and the morphological harbingers of this phenomenon in nodal recurrence have not been assessed systematically. For this reason, the current study focused on features of 10 PTCs with regional lymph node recurrence that was accompanied with disease progression due to anaplastic transformation in at least one of the nodal recurrences. The findings of additional 19 PTCs which recurred without anaplastic transformation after ≥ 10 years of follow-up served as the control group. There were no clinicopathological differences between the two groups at initial surgery including age, gender, tumor size, lymph node metastasis, distant metastasis, extrathyroidal extension, histologic subtype, and treatment. The median time from the initial thyroid surgery to anaplastic transformation in the nodal recurrence was 106 months (range 6 to 437 months). Mutational analyses showed recurrent PTCs with anaplastic transformation had a high prevalence of BRAFV600E mutation (8/9) and TERT promoter mutation (9/9), both of which were detected in primary tumors. PIK3CAH1047R mutation was detected in one case. No case had RAS mutation. Nineteen recurrent PTCs without anaplastic transformation harbored BRAFV600E mutation and seventeen of these had TERT promoter mutation. Unlike primary tumors with subsequent nodal anaplastic transformation, TERT promoter mutation was only present in the metastatic nodal recurrence from 4 patients without transformation. No patients had neither high-grade features (necrosis and increased mitotic activity) nor solid/insular growth or hobnail cell features in their primary tumors. In the group of patients with transformation, 3 had solid/insular growth in the lymph node metastasis at the time of primary tumor resection (one displaying nuclear features of PTC and solid growth with increased mitotic activity, one with insular component consistent with poorly differentiated carcinoma component, and one displaying nuclear features of PTC and solid growth), and additional 2 patients had solid/insular growth with no high-grade features or poorly differentiated carcinoma component at the time of subsequent nodal recurrence prior to anaplastic transformation. Hobnail cell features were exclusively seen in subsequent metastatic lymph nodes prior to anaplastic transformation. The control group lacked solid/insular growth and hobnail cell features in the metastatic nodal disease. Aberrant p53 expression and loss of TTF-1 featured tumor components with anaplastic transformation. This series identified a subset of recurrent PTCs with TERT promoter mutation was prone to undergo anaplastic transformation, and that solid/insular growth and hobnail cell features were morphological predictors of anaplastic transformation in the nodal recurrence.

scholarly journals Prognostic Value of Ki67 and Other Clinical and Histopathological Factors in Canine Apocrine Gland Anal Sac Adenocarcinoma

Animals ◽  
2021 ◽  
Vol 11 (6) ◽  
pp. 1649
Author(s):  
Emanuela Maria Morello ◽  
Marzia Cino ◽  
Davide Giacobino ◽  
Arturo Nicoletti ◽  
Selina Iussich ◽  
...  
Keyword(s):  
Lymph Nodes ◽  
Vascular Invasion ◽  
Apocrine Gland ◽  
Regional Lymph Nodes ◽  
Disease Free Interval ◽  
Lymph Nodes Metastasis ◽  
Free Interval ◽  
Histologic Pattern ◽  
Anal Sac ◽  
Disease Free

Apocrine gland anal sac adenocarcinoma (AGASACA) is locally aggressive and highly metastatic to regional lymph nodes. The aim of this study was to evaluate the prognostic significance of Ki67 in surgically excised AGASACA. Prognostic impact of size, regional lymph nodes metastasis, hypercalcemia, histologic pattern, mitotic count, necrosis, inflammatory and lympho-vascular invasion, anisokaryosis and anisocytosis was also evaluated. Thirty-five dogs were included, twenty-four of which also had metastatic lymph nodes. When the entire population was evaluated, only metastatic disease spread to regional lymph nodes, and necrosis and inflammatory infiltration were correlated to prognosis. When only dogs with metastatic disease were evaluated, size, solid histologic pattern, presence of lymphatic and vascular invasion showed influence on prognosis. Ki67 index was not associated with survival time and disease free interval in any case. The results of this study showed that lymph nodes metastasis at diagnosis reduced disease free interval. Moreover, tumor size greater than 5.25 cm, presence of lymphatic and vascular invasion and a solid histologic pattern were associated with a shorter survival time in dogs with metastasis to regional lymph nodes. Ki67 expression was not significantly associated with prognosis, therefore it could not be considered as a prognostic factor in this tumor type, while the role of hypercalcemia remained unclear.

Identification of risk factors associated with pelvic lymph node metastasis in patients with stage IB1 cervical cancer.

2020 ◽  
Vol 38 (15_suppl) ◽  
pp. e18005-e18005
Author(s):  
Ping Jiang ◽  
Jing Cai ◽  
Xiaoqi He ◽  
Hongbo Wang ◽  
Weihong Dong ◽  
...  
Keyword(s):  
Risk Factors ◽  
Cervical Cancer ◽  
Lymph Node ◽  
Lymph Node Metastasis ◽  
Lymph Nodes ◽  
Tumor Size ◽  
Node Metastasis ◽  
Parametrial Invasion ◽  
Pelvic Lymph Node Metastasis ◽  
Internal Iliac

e18005 Background: Evaluation the distribution of nodal metastases in the stage IB1 cervical cancer and the risk factors associated with pelvic lymph node metastasis (LNM) at each anatomic location. Methods: 728 patients with stage IB1 cervical cancer who underwent radical hysterectomies and systemic pelvic lymphadenectomies from January 2008 to December 2017 were retrospectively studied. All removed pelvic lymph nodes were pathologically examined, and the risk factors for LNM at the obturator, internal iliac, external iliac, and common iliac regions were evaluated by univariate and multivariate logistic regression analyses. Results: 20,134 lymph nodes were analysed with the average number of 27.80 (± SD 9.43) lymph nodes per patient. Nodal metastases were present in 266 (14.6%) patients. The obturator was the most common site for nodal metastasis (42.5%) followed by the internal iliac nodes (20.3%) and the external iliac nodes (19.9%), while the common iliac (9.8%) and parametrial (7.5%) nodes were the least likely to be involved. Tumor size more than 2 cm, histologically proven lymphovascular space involvement (LVSI) and parametrial invasion correlated independently significantly with the higher risk of the lymphatic metastasis. Obesity (BMI≥25) was independently significantly negatively correlated with the risk of lymphatic metastases. All the positive common iliac nodes were found in patients with tumors greater than 2 cm. The multivariate analysis showed that tumor size greater than 3 cm was associated with a 16.6-fold increase in the risk for common iliac LNM. Interestingly, tumor size was not an independent risk factor for pelvic LNM in the lower regions, i.e., the obturator, internal iliac and external iliac areas, where LVSI was the most significant predictor for LNM. In addition, parametrial invasion was related to external and internal iliac LNM; deep stromal invasion and age less than 50 years were associated with obturator LNM. Conclusions: The incidence of lymph node metastasis in patients with stage IB1 cervical cancer is low but prognostically relevant. The data offer the opportunity for tailored individual treatment in selected patients with small tumors and obesity.

scholarly journals Evidence of Long-range nerve pathways connecting and coordinating activity in secondary lymph organs

2020 ◽  
Vol 6 (1) ◽  
Author(s):  
Victoria Cotero ◽  
Tzu-Jen Kao ◽  
John Graf ◽  
Jeffrey Ashe ◽  
Christine Morton ◽  
...  
Keyword(s):  
Lymph Node ◽  
Lymph Nodes ◽  
Long Range ◽  
Nerve Stimulation ◽  
Immune Cells ◽  
Immune Cell ◽  
Immune Organs ◽  
Organ Systems ◽  
Local Lymph Node ◽  
Stimulation Of

Abstract Background Peripheral nerve reflexes enable organ systems to maintain long-term physiological homeostasis while responding to rapidly changing environmental conditions. Electrical nerve stimulation is commonly used to activate these reflexes and modulate organ function, giving rise to an emerging class of therapeutics called bioelectronic medicines. Dogma maintains that immune cell migration to and from organs is mediated by inflammatory signals (i.e. cytokines or pathogen associated signaling molecules). However, nerve reflexes that regulate immune function have only recently been elucidated, and stimulation of these reflexes for therapeutic effect has not been fully investigated. Methods We utilized both electrical and ultrasound-based nerve stimulation to activate nerve pathways projecting to specific lymph nodes. Tissue and cell analysis of the stimulated lymph node, distal lymph nodes and immune organs is then utilized to measure the stimulation-induced changes in neurotransmitter/neuropeptide concentrations and immune cellularity in each of these sites. Results and conclusions In this report, we demonstrate that activation of nerves and stimulated release of neurotransmitters within a local lymph node results in transient retention of immune cells (e.g. lymphocytes and neutrophils) at that location. Furthermore, such stimulation results in transient changes in neurotransmitter concentrations at distal organs of the immune system, spleen and liver, and mobilization of immune cells into the circulation. This report will enable future studies in which stimulation of these long-range nerve connections between lymphatic and immune organs can be applied for clinical purpose, including therapeutic modulation of cellularity during vaccination, active allergic response, or active auto-immune disease.

Is local lymph node involvement a prognostic factor in paediatric renal cell carcinoma?

2007 ◽  
Vol 25 (18_suppl) ◽  
pp. 20014-20014
Author(s):  
P. Indolfi ◽  
G. Bisogno ◽  
G. Cecchetto ◽  
A. Ferrari ◽  
L. Piva ◽  
...  
Keyword(s):  
Renal Cell Carcinoma ◽  
Lymph Node ◽  
Lymph Nodes ◽  
Cell Carcinoma ◽  
Renal Cell ◽  
Lymph Node Involvement ◽  
Number Of Patients ◽  
Node Involvement ◽  
Local Lymph Node

20014 Background: RCC in childhood is rare. Children with RCC tend to have a similar overall prognosis when compared with adults, where prognosis worsens with increasing stage, although direct comparisons of adult and paediatric data isn’t easy. The aim of our study is to identify the prognostic significance of local lymph node involvement in children with Renal Cell Carcinoma (RCC). Methods: On the basis of a retrospective study, the recently founded Italian Association for Paediatric Hematology and Oncology-Rare Tumors Paediatric Age (AIEOP-TREP) identified 16 patients (9 females) with RCC and local lymph node involvement at 10 of these centers. The cases were observed among 59 paediatric RCC, corresponding to 27.1% of RCC presenting in Italy from January 1973 to May 2006. Results: Overall, 9 patients were alive and disease free at last follow-up: eight patients had regional lymph node dissection (RLND) from the diaphragm at the aortic bifurcation, and one had the para-aortic lymph nodes removal. Six patients died: one had RLND (died from progression of disease), three had the renal hilum lymph nodes removal, and two the para-aortic lymph nodes dissection. One patient was lost to follow-up after relapse: this patient had para-aortic lymph node removal at diagnosis. Estimated 25-year DFS and OS rates for all patients were 64.2% and 50.5%, respectively. Given the small number of patients, little can be said about the value, if any, of adjuvant immunotherapy in this group of RCC. Conclusions: Children with lymph node positive RCC had a relatively unfavourable long- term prognosis. In our experience the RLND improves the prognosis. Further investigation of the biologic differences is warranted. Because of the very low incidence of paediatric RCC, an international clinical trial will be required to establish optimal therapy for children with RCC. No significant financial relationships to disclose.

scholarly journals Axillary Lymph Nodal Metastasis from Carcinoma of Unknown Primary (CUPAx)- An Orphan Disease

2021 ◽  
Author(s):  
Renuka Bangalore Nagaraj ◽  
MD Khursid Alam Ansari
Keyword(s):  
Lymph Node ◽  
Primary Tumour ◽  
Nodal Metastasis ◽  
Unknown Primary ◽  
Axillary Lymph ◽  
Poorly Differentiated Carcinoma ◽  
Ultrasound Sonography ◽  
Metastatic Nodule ◽  
Poorly Differentiated

Metastasis to axillary lymph node occurs in adenocarcinoma or poorly differentiated carcinoma, and is a rare clinical entity that needs to be understood for management and its clinical outcome. The present case is of 72-year-old female patient who had a metastatic nodule in the axilla. No breast mass was palpable. Histology identified as metastatic adenocarcinoma, however mammography and Ultrasound Sonography test (USg) failed to detect the primary tumour. Immunohistochemistry showed that the excised lymph node was positive for Estrogen Receptor (ER) and negative for Progesterone Receptor (PR), suggesting the breast as the site for the primary tumour. Since the patient refused surgery, she was under follow-up for eight months. Now, she presented with recurrence of similar axillary swelling for two months.

Cisplatin-based combination chemotherapy in the treatment of poorly differentiated carcinoma and poorly differentiated adenocarcinoma of unknown primary site: results of a 12-year experience.

1992 ◽  
Vol 10 (6) ◽  
pp. 912-922 ◽  
Author(s):  
J D Hainsworth ◽  
D H Johnson ◽  
F A Greco
Keyword(s):  
Prognostic Factors ◽  
Lymph Nodes ◽  
Tumor Location ◽  
Primary Site ◽  
Unknown Primary ◽  
Unknown Primary Site ◽  
Poorly Differentiated Adenocarcinoma ◽  
Poorly Differentiated Carcinoma ◽  
Peripheral Lymph ◽  
Poorly Differentiated

PURPOSE We previously reported excellent responses to cisplatin-based chemotherapy in a minority of patients with poorly differentiated carcinoma (PDC) or poorly differentiated adenocarcinoma (PDA) of unknown primary site. We have continued to study and to treat these patients, and now report clinical characteristics, treatment results, and prognostic factors in a large group of patients identified prospectively. PATIENTS AND METHODS Between February 1978 and December 1989, we treated 220 patients with PDC or PDA of unknown primary site. The median age was 39 years; 48% of patients had predominant tumor location in the mediastinum, retroperitoneum, or peripheral lymph nodes. Specialized pathologic studies resulted in the identification of specific tumor types in only a few cases. All patients received cisplatin-based chemotherapy; between 1978 and 1984, 116 patients received cisplatin, vinblastine, and bleomycin (PVeB) +/- doxorubicin, and 104 patients treated since January 1985 received cisplatin and etoposide +/- bleomycin. RESULTS One hundred thirty-eight patients (63%) had objective responses to therapy, and 58 (26%) had complete response. Thirty-six patients (16%) are currently disease-free at a median of 61 months following therapy (range, 11 to 142 months). Actuarial 10-year survival is 16%. Favorable prognostic factors identified by Cox regression analysis include: (1) predominant tumor location in the retroperitoneum or peripheral lymph nodes, (2) tumor limited to one or two metastatic sites, (3) no history of cigarette use, and (4) younger age. CONCLUSION Patients with PDC or PDA of unknown primary site represent another group of patients for whom potentially curative therapy is available. Patients with this syndrome should be distinguished from patients with well-differentiated adenocarcinoma of unknown primary site, and should receive a trial of cisplatin-based chemotherapy.

scholarly journals Effective dissection for rectal cancer with lateral lymph node metastasis based on prognostic factors and recurrence type

2021 ◽  
Author(s):  
Hajime Morohashi ◽  
Yoshiyuki Sakamoto ◽  
Takuya Miura ◽  
Daichi Ichinohe ◽  
Kotaro Umemura ◽  
...  
Keyword(s):  
Rectal Cancer ◽  
Prognostic Factors ◽  
Lymph Node ◽  
Lymph Node Metastasis ◽  
Lymph Nodes ◽  
Univariate Analysis ◽  
Lateral Lymph Node Metastasis ◽  
Lateral Lymph Node ◽  
Node Metastasis ◽  
Internal Iliac

Abstract Purpose There are no reports showing the significance and effective range of dissection for patients with lateral lymph node metastasis (LLNM). This study aimed to investigate the indications for lateral lymph node dissection (LLND) in patients with LLNM based on prognostic factors and recurrence types. Methods We reviewed 379 patients with advanced rectal cancer who were treated with total mesorectal excision plus LLND. We analyzed background factors and survival times of patients who had LLNM to determine prognostic factors and recurrence types. Results Pathological LLNM occurred in 44 (11.6%). Among patients with LLNM, the predictors of poor prognoses, according to univariate analysis, were > 3 node metastases, the presence of node metastasis on both sides, and spreading beyond the internal iliac lymph nodes. Moreover, LLNM beyond the internal iliac region was found to be an independent prognostic risk factor. Twenty-eight of the 44 patients with lateral lymph node metastasis (64%) relapsed, 22 of whom had distant metastases and 11 of whom experienced local recurrences. Among the latter group, nine (20%) and two (5%) had recurrences in the central and lateral pelvis, respectively. Conclusion The therapeutic benefit of resection was high, especially in patients with ≤ 3 positive lateral lymph nodes, one-sided bilateral lymph node areas, and positive nodes localized near the internal iliac artery.

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