scholarly journals Five-Year Long-Term Followup of a Primary Lymph node Gastrinoma: Is a Pancreaticoduodenectomy Justified?

2009 ◽  
Vol 2009 ◽  
pp. 1-4 ◽  
Author(s):  
Bernd Jaenigen ◽  
Gian Kayser ◽  
Berthold Steinke ◽  
Oliver Thomusch
Keyword(s):  
Lymph Node ◽  
Lymph Nodes ◽  
Somatostatin Receptor ◽  
Gastrin Level ◽  
Receptor Scintigraphy ◽  
Biochemical Cure ◽  
Primary Lymph Node ◽  
Partial Pancreatoduodenectomy ◽  
Typical Localization

Background. Gastrinoma-positive lymph nodes and failed localization of the primary tumor during surgical exploration are described. Specialists suppose that these lymph nodes are metastases rather than a primary gastrinoma.Methods. Case report with a five-year long-term followup. A 60-year-old patient with an confirmed gastrinoma was treated in our department. All preoperative evaluations including somatostatin-receptor-scintigraphy and F-Dopa PET failed to localize the gastrinoma. Explorative laparotomy revealed a gastrinoma in two peripancreatic lymph nodes. Despite extensive intraoperative exploration, no primary gastrinoma could be detected in typical localization.Results. Over a period of 5 years, the patient's gastrin level stayed in the normal range and the patient seems to be completely cured.Conclusion. A prophylactic partial pancreatoduodenectomy is not indicated to avoid recurrence, since complete biochemical cure by local resection of the lymph node gastrinoma is possible.

scholarly journals Examination of main lymph node (No.253) metastasis in left colorectal cancer: A retrospective analysis of a single-institution cohort

2021 ◽  
Author(s):  
Takefumi Yoshida ◽  
Fumihiko Fujita ◽  
Dai Shida ◽  
Kenichi Koushi ◽  
Kenji Fujiyoshi ◽  
...  
Keyword(s):  
Colorectal Cancer ◽  
Risk Factors ◽  
Lymph Node ◽  
Lymph Nodes ◽  
Poor Prognosis ◽  
Advanced Colorectal Cancer ◽  
D3 Lymphadenectomy ◽  
Positive Group ◽  
Factors Associated

Abstract Background. The extent of lymph node dissection in advanced colorectal cancer varies according to regional guidelines. D3 lymphadenectomy is routinely performed in Japan but is associated with several risk factors. Metastases of the main lymph nodes (No.253 lymph nodes), which are located at the root of the inferior mesenteric artery, are rare in left-sided colorectal cancer. Tumor depth (T4) is an identifier of No.253 lymph node metastasis (LNM) risk, but other risk factors associated with No.253 LNM are unclear. This study was undertaken to investigate the frequency of No.253 LNM and to identify other clinicopathological risk factors associated with No.253 LNM in left-sided colorectal cancer. In this study, we aimed to evaluate the clinical benefit of routine D3 lymphadenectomy in surgically treated advanced colorectal cancer. Methods. A retrospective database of patients with colorectal cancer who underwent D3 dissection and R0 resection at Kurume University Hospital from 1978 to 2017 was constructed and used to search for the frequency and risk factors of No.253 LNM to investigate long-term prognosis. Clinicopathological factors associated with No.253 LNM, including age, sex, tumor location, T stage, tumor diameter, carcinoembryonic antigen levels, and various dissected lymph nodes, were analyzed. Results. Among 1,614 consecutive patients, No.253 LNM was observed in 23 cases (1.4%). The presence of three or more regional LNMs was an independent risk factor for No.253 LNM (odds ratio: 26.8). The 5-year overall survival rate was 49.1% in the No.253 LNM-positive group and 78.4% in the No.253 LNM-negative group (p=0.002). Conclusion. In left-sided colorectal cancer, No.253 LNM was a poor prognosis factor, and three or more regional LNMs were a risk factor for No.253 LNM. The No.253 LNM-positive group had a poor prognosis, but there are cases of long-term survival, with a 5-year survival rate of 49%. D3 lymphadenectomy is suitable when three or more metastatic LNs are identified prior to surgery.

scholarly journals Enriched LPS Staining within the Germinal Center of a Lymph Node from an HIV-Infected Long-Term Nonprogressor but Not from Progressors

2020 ◽  
Vol 2020 ◽  
pp. 1-5
Author(s):  
Lei Huang ◽  
Jianning Deng ◽  
Ren Lang ◽  
Guoyang Liao ◽  
Wei Jiang
Keyword(s):  
Lymph Node ◽  
Immune Responses ◽  
Lymph Nodes ◽  
Germinal Center ◽  
Host Response ◽  
Microbial Translocation ◽  
Collagen Deposition ◽  
Immunohistochemistry Staining ◽  
Hiv Negative

An increased level of microbial translocation has been observed in HIV-infected individuals. The host response to microbial translocation is compromised in HIV-infected progressors but remains unknown in HIV-infected long-term nonprogressors (LTNPs). To evaluate microbial translocation in HIV, we assessed lipopolysaccharide (LPS) immunohistochemistry staining in lymph nodes. We found enriched bacterial LPS immunohistochemistry staining in the germinal center of a lymph node from an HIV-infected LTNP, evenly distributed from three progressors with impaired germinal center structures and rarely detected from two HIV-negative individuals. The impaired germinal center structures were consistent with collagen deposition in lymph nodes using immunohistochemistry staining. These results suggest greater immune responses against bacterial LPS translocation in LTNPs, which may reveal an important mechanism in controlling microbial translocation and disease progression in HIV LTNPs.

scholarly journals Vesicular Stomatitis Virus Genomic RNA Persists In Vivo in the Absence of Viral Replication

2009 ◽  
Vol 84 (7) ◽  
pp. 3280-3286 ◽  
Author(s):  
Ian D. Simon ◽  
Nico van Rooijen ◽  
John K. Rose
Keyword(s):  
Lymph Node ◽  
Lymph Nodes ◽  
Viral Replication ◽  
Vesicular Stomatitis Virus ◽  
Genomic Rna ◽  
Intramuscular Inoculation ◽  
Vesicular Stomatitis ◽  
High Level

ABSTRACT Our previous studies using intranasal inoculation of mice with vesicular stomatitis virus (VSV) vaccine vectors showed persistence of vector genomic RNA (gRNA) for at least 60 days in lymph nodes in the absence of detectable infectious virus. Here we show high-level concentration of virus and gRNA in lymph nodes after intramuscular inoculation of mice with attenuated or single-cycle VSV vectors as well as long-term persistence of gRNA in the lymph nodes. To determine if the persistence of gRNA was due to ongoing viral replication, we developed a tagged-primer approach that was critical for detection of VSV mRNA specifically. Our results show that VSV gRNA persists long-term in the lymph nodes while VSV mRNA is present only transiently. Because VSV transcription is required for replication, our results indicate that persistence of gRNA does not result from continuing viral replication. We also performed macrophage depletion studies that are consistent with initial trapping of VSV gRNA largely in lymph node macrophages and subsequent persistence elsewhere in the lymph node.

scholarly journals Anatomic Extent of Pelvic Lymph Node Dissection: Impact on Long-term Cancer-specific Outcomes in Men With Positive Lymph Nodes at Time of Radical Prostatectomy

Urology ◽  
2013 ◽  
Vol 82 (3) ◽  
pp. 653-659 ◽  
Author(s):  
Trinity J. Bivalacqua ◽  
Phillip M. Pierorazio ◽  
Michael A. Gorin ◽  
Mohamad E. Allaf ◽  
H. Ballentine Carter ◽  
...  
Keyword(s):  
Lymph Node ◽  
Radical Prostatectomy ◽  
Lymph Nodes ◽  
Lymph Node Dissection ◽  
Pelvic Lymph Node Dissection ◽  
Pelvic Lymph Node ◽  
Node Dissection ◽  
Positive Lymph Nodes

scholarly journals A Perplexing Case of Abdominal Pain That Led to the Diagnosis of Zollinger-Ellison Syndrome

2017 ◽  
Vol 2017 ◽  
pp. 1-4 ◽  
Author(s):  
Adrienne Lenhart ◽  
Mona Hassan ◽  
Alireza Meighani ◽  
Omar Sadiq ◽  
Yousuf Siddiqui
Keyword(s):  
Abdominal Pain ◽  
Somatostatin Receptor ◽  
Duodenal Bulb ◽  
Gastrin Level ◽  
Multiple Modalities ◽  
Clinical Disorder ◽  
Delay In Diagnosis ◽  
Zollinger Ellison Syndrome ◽  
Receptor Scintigraphy ◽  
Gi Symptoms

Zollinger-Ellison syndrome (ZES) is a rare clinical disorder, characterized by hypersecretion of gastric acid and multiple ulcers distal to the duodenal bulb. This occurs via the release of gastrin by neuroendocrine tumors known as gastrinomas. Patients with ZES present with nonspecific GI symptoms, which often leads to a delay in diagnosis. Our patient is a 55-year-old female with chronic abdominal pain, nausea, and diarrhea. She underwent EGD, EUS, MRCP, CT scans, and cholecystectomy, which did not reveal the cause of her symptoms. Repeat EGD showed a cratered ulcer in the second portion of the duodenum, suspicious for ZES. Serum gastrin was initially only moderately elevated while on PPI therapy, but chromogranin A was also elevated. Repeat gastrin level after stopping PPI therapy was 1639 pg/mL. Somatostatin receptor scintigraphy was obtained, which showed two small lesions in the gastrinoma triangle. She subsequently underwent a Whipple pancreaticoduodenectomy and pathology was positive for four microscopic foci of a neuroendocrine tumor. She reported improvement in her symptoms after surgery. This case highlights the need for increased awareness of ZES in patients with unexplained GI complaints and emphasizes the use of multiple modalities in the diagnosis of ZES.

scholarly journals Fine needle aspiration: a simple and handy tool to diagnose malignant lymphadenopathy

2017 ◽  
Vol 5 (9) ◽  
pp. 3949
Author(s):  
Sravani P. ◽  
Neeraja M. ◽  
Bhavani C.
Keyword(s):  
Lymph Node ◽  
Lymph Nodes ◽  
Fine Needle Aspiration ◽  
Needle Aspiration ◽  
Fine Needle ◽  
Radiological Data ◽  
Common Diagnosis ◽  
Malignant Lesions ◽  
Primary Lymph Node ◽  
Needle Aspiration Cytology

Background: Fine needle aspiration cytology (FNAC) of the lymph node is a simple useful screening test to diagnose suspected and unsuspected secondary and primary lymph node malignancy. The aim of the present study is to know the role of FNAC in the diagnosis of clinically suspected and unsuspected lymph node malignancies. Study design: prospective cohort study.Methods: Study material comprise of ‘76’ lymph nodes aspirates reported as malignant on cytology, out of total 445 cases of lymph node aspiration in two years period i.e. from October 2014 to September 2016.These 76 smears were studied and tabulated according to their cytomorphology and the lymph node group affected was noted. The clinical and radiological data were also noted.Results: Males were found more affected than females. cervical lymph node is the commonest group involved. Metastasis from squamous cell carcinoma was the most common diagnosis made on cytology.Conclusions: FNAC is found simple and very useful tool for diagnosing malignant lesions of lymph nodes especially in case of metastasis.

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