The Enlargement of Abdominal Lymph Nodes Is a Characteristic of Autoimmune Liver Disease

Background. The enlargement of lymph nodes is a common clinical sign in connective tissue disease (CTD) and viral hepatitis. In this research, we evaluated the incidence of enlarged lymph nodes in autoimmune liver diseases (AILD). Moreover, we identified the clinical significance of abdominal lymph node enlargement in AILD. Methods. The characteristics of abdominal lymph nodes, including their morphology and distribution, were assessed by ultrasonography and computed tomography in 125 patients with AILD, 54 with viral hepatitis, 135 with CTD, and 80 healthy controls. The pathological and laboratory results of 106 AILD patients were collected to analyze the association between lymphadenectasis and disease activity. Results. Enlargement of abdominal lymph nodes was found in 69.6% of patients with AILD, 63% of patients with viral hepatitis, 29.6% of patients with CTD, and 2% of healthy controls. Alkaline phosphatase (ALP), glutamate transpeptidase (GGT), and immunoglobulin M (IgM) levels were significantly increased in AILD patients with lymphadenectasis (LA) in contrast to patients without lymphadenectasis (NLA) (P<0.05). The pathological characteristics of inflammation, cholestasis, and focal necrosis were more common in the LA group than in the NLA group (P<0.05). As shown by multivariate logistic regression analysis, interface hepatitis (OR=3.651, P<0.05), cholestasis (OR=8.137, P<0.05), and focal necrosis (OR=5.212, P<0.05) were related to LA. Conclusions. The percentage of abdominal lymph node enlargement in AILD subjects was significantly higher than that in CTD subjects. Therefore, the enlargement of lymph nodes can represent a noninvasive indicator of histological and biochemical inflammation activity in AILD.

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Cervical lymph node enlargement as the initial manifestation of rectal cancer

BMC Gastroenterology ◽

10.1186/s12876-021-01628-5 ◽

2021 ◽

Vol 21 (1) ◽

Author(s):

Tong-Hui Xie ◽

Peng Su ◽

Jian-Guo Hong ◽

Hui Zhang

Keyword(s):

Colorectal Cancer ◽

Rectal Cancer ◽

Lymph Node ◽

Lymph Nodes ◽

Cervical Lymph Node ◽

Clinical Manifestations ◽

Initial Symptom ◽

Cervical Lymph Nodes ◽

Supraclavicular Lymph Nodes ◽

Lymph Node Enlargement

Abstract Background Colorectal cancer is a very common malignant tumor worldwide. The clinical manifestations of advanced colorectal cancer include the changes in bowel habits, hematochezia, diarrhea, local abdominal pain and other symptoms. However, the colorectal cancer with an initial symptom of cervical lymph node enlargement is extremely rare. In this article, we report a case of rectal cancer presenting with cervical lymph nodes enlargement as the initial symptom. Case presentation A 57-year-old woman was admitted to our hospital for cervical lymph node enlargement which was accidentally detected during physical examination. Computed tomography scan revealed multiple enlarged lymph nodes in the neck. Cervical ultrasound showed normal thyroid gland and multiple left supraclavicular lymph nodes enlargement. The patient underwent lymph nodes biopsy and pathologic results showed metastatic adenocarcinoma. The subsequent lower gastrointestinal endoscopy revealed a mucosal bulge lesion located at rectus and biopsy revealed adenocarcinoma. The patient underwent rectal cancer resection. She is alive with no evidence of recurrence or new tumors 2 years after surgery. Conclusions Cervical lymph node metastasis is a rare metastatic way in colorectal cancer. This is the first case of rectal cancer presenting with cervical lymph nodes metastases as the initial symptom. Surgical resection combined with postoperative chemotherapy improved long-term prognosis of the patient. This rare metastatic way of rectal cancer should be paid attention for clinicians.

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EUS Findings of Benign Mediastinal and Abdominal Lymph Node Enlargement Confirmed By EUS-FNA

Gastrointestinal Endoscopy ◽

10.1016/j.gie.2007.03.392 ◽

2007 ◽

Vol 65 (5) ◽

pp. AB200

Author(s):

Hae Jung Song ◽

Jin Oh Kim ◽

I.K. Sung Choi ◽

Young Doek Cho ◽

in Sup Joeng ◽

...

Keyword(s):

Lymph Node ◽

Abdominal Lymph Node ◽

Lymph Node Enlargement

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Evidence for persistent radiation-related injury to the immune system in patients with local breast cancer.

Journal of Clinical Oncology ◽

10.1200/jco.2020.38.15_suppl.e15189 ◽

2020 ◽

Vol 38 (15_suppl) ◽

pp. e15189-e15189

Author(s):

Janhavi Athale ◽

Kristen Broderick ◽

Xiaojun Wu ◽

Stuart A. Grossman

Keyword(s):

Breast Cancer ◽

Lymph Node ◽

Lymph Nodes ◽

Control Group ◽

Diep Flap ◽

Adult Women ◽

Node Density ◽

Abdominal Lymph Node ◽

Lymph Node Density ◽

Tumor Stages

e15189 Background: Clinical data in multiple tumors has demonstrated that the inadvertent radiation of circulating lymphocytes causes grade III-IV lymphopenia which is associated with worse outcomes in cancer patients and failure to respond to immunologic interventions. Murine data from our lab demonstrated that radiation to the brain results in striking changes in the anatomy and cellularity of distant unirradiated lymph nodes. This study was designed to understand the relationship between local radiation and the depletion of distant unirradiated lymph nodes in humans which has not been previously studied. Methods: Adult women with breast cancer who had undergone prior mastectomy with pathology, labs, and radiation data available at our institution were enrolled at the time of their deep inferior epigastric perforator artery (DIEP) flap reconstruction. During reconstruction, a single abdominal lymph node was extracted, and subsequently formalin fixed. The pre- and post-treatment lymph nodes of radiated and non-radiated patients were presented in a blinded manner to the hematopathologist. The pathologist described each lymph node and graded the lymph node density as (1) low, (2) low-normal, (3) normal, or (4) high. Results: Seven women have been enrolled (median age 50; range 31-55) with AJCC tumor stages from 1a – 3b (five are hormone positive, and two are triple negative). The reconstruction was completed on average 488.71 + 224.57 days after initial mastectomy. Three of the women received neoadjuvant chemotherapy, and five received adjuvant chemotherapy. Five of the seven women had received radiation (mean 50.9 + 5.6 Gy). The baseline median LN density score in all patients was 4 (range 1-4), with a post mean LN density of 1.2 + 0.4 in the radiation group compared to a mean score of 3 + 1.4 in the control group. Conclusions: Systemic lymphocyte counts remain relatively stable but lymph node density is markedly lower than baseline in 80% of patients who received chest wall irradiation consistent with data from animal model studies. It is important to note that this effect on the nodes is seen long after the radiation has been completed. [Table: see text]

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Relevance of Regional Lymph Node Invasion in Radical Hepatectomy and Lymphadenectomy for Alveolar Echinococcosis: A Retrospective Cohort Study

10.21203/rs.3.rs-67132/v1 ◽

2020 ◽

Author(s):

Xianwei Yang ◽

Tao Wang ◽

Shu Shen ◽

Wentao Wang

Keyword(s):

Lymph Node ◽

Lymph Nodes ◽

Alveolar Echinococcosis ◽

Regional Lymph Node ◽

Regional Lymph Nodes ◽

Node Number ◽

Lymph Node Enlargement ◽

Group A ◽

Group B ◽

Node Diameter

Abstract Background Hepatic Alveolar echinococcosis (AE) is also known as worm cancer, parasitic cancer, and it often invades the regional lymph nodes of the liver. The present study was to investigate the clinical value of radical hepatectomy and lymphadenectomy in AE patients. Methods Our study enrolled consecutive AE patients who underwent radical hepatectomy with removal the regional lymph nodes between January 2009 and April 2019. Patients with inflammatory lymph node enlargement was included in group A, and patients with AE lymph node invasion were included in group B. The clinical characteristics, survival and recurrence rates were compared.Results A total of 103 patients were enrolled group A, and 24 in group B. Preoperative computed tomography showed that the lymph node positivity rate in group B was 70.8% while that in group A was 43.7% (p=0.017). The lymph node diameter was 1.8±0.9 cm in group A vs 2.5±1.1 cm in group B (p=0.004), and the lymph node number (p=0.035) and lymph node location (p=0.001). A total of 10 patients (7.9%) had recurrent lesions, and 6 patients (4.7%) died (P>0.05). Conclusions lymph node diameter, number, and distance from the liver were important characteristics for describing lymph node invasion. There was no difference in the long-term efficacy of lymphadenectomy between patients with lymph node enlargement and those with invasion.

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Mediastinal lymph node staging by EBUS-TBNA and CT: Characteristics of lymph node enlargement caused by anthracosis and other benign conditions

International Journal of Diagnostic Imaging ◽

10.5430/ijdi.v1n2p64 ◽

2014 ◽

Vol 1 (2) ◽

pp. 64

Author(s):

Johannes Kirchner ◽

Michael Broll ◽

Philipp Müller ◽

Esther Maria Kirchner ◽

Natalia Pomjanski ◽

...

Keyword(s):

Lymph Node ◽

Lymph Nodes ◽

Mediastinal Lymph Node ◽

Needle Aspiration ◽

Endobronchial Ultrasound ◽

Control Group ◽

Lymph Node Staging ◽

Ultrasound Guided ◽

Transbronchial Needle Aspiration ◽

Lymph Node Enlargement

Objectives: Aim of this comparative study was to assess the accuracy of computed tomography (CT) and endobronchial ultrasound guided transbronchial needle aspiration (EBUS-TBNA) for mediastinal lymph node staging in cases of lymph node enlargement due to anthracosis and other benign conditions. Methods: In a retrospective analysis we report on the MSCT findings of 39 patients (28 males, 11 females) with EBUS-TBNA confirmed diagnosis of 53 enlarged lymph nodes due to anthracosis. A control group comprised 20 consecutive patients with 27 enlarged lymph nodes (11 males, 9 females) due to chronic lymphadenopathy (n = 14) or sarcoidosis (n = 13). Results: No significant differences were observed between the two groups regarding size (mean short axis diameter 13.7mm vs. 14.5mm), shape (most often oval) or presence of lymph node confluence (32.1% vs. 33.3%), contrast enhancement (3.8% vs. 3.7%), and fatty involution (3.8% vs. 3.7%). In comparison with the control group anthracotic lymph nodes were significantly less often ill-defined in EBUS (5.7 vs. 25.9, p = 0.025) as well as in CT (1.9% vs. 18.5%, p = 0.01), but more often showed calcifications in CT (24.5% vs. 3.7%, p = 0.017). Lymph node colliquation was seen neither in anthracosis nor in other benign conditions. Conclusions: Mediastinal lymph node enlargement due to anthracosis, lymphadenopathy and sarcoidosis show some different findings in EBUS and CT but cannot definitely be differentiated. Advances in knowledge: Radiologists should be aware of mediastinal lymph node enlargement due to anthracosis.

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Mediastinal lymph node enlargement in idiopathic pulmonary fibrosis: relationships with disease progression and pulmonary function trends

BMC Pulmonary Medicine ◽

10.1186/s12890-020-01289-2 ◽

2020 ◽

Vol 20 (1) ◽

Author(s):

Giacomo Sgalla ◽

Anna Rita Larici ◽

Nicoletta Golfi ◽

Mariarosaria Calvello ◽

Alessandra Farchione ◽

...

Keyword(s):

Lymph Node ◽

Idiopathic Pulmonary Fibrosis ◽

Pulmonary Fibrosis ◽

Lymph Nodes ◽

Ct Scan ◽

Disease Progression ◽

Mediastinal Lymph Node ◽

Mediastinal Lymph Nodes ◽

Lymph Node Enlargement

Abstract Background and objectives Evidence of mediastinal Lymph Node Enlargement (LNE) on CT scan is a common finding in idiopathic pulmonary fibrosis (IPF). We sought to investigate whether the involvement of mediastinal lymph nodes is associated with accelerated disease progression, and explored the changes occurring in mediastinal lymph nodes during the radiological follow up of these patients. Methods This retrospective study included IPF patients referred to a single ILD centre in Italy. A consensus-based assessment of mediastinal LNE on chest CT scan was performed by two thoracic radiologists. Kaplan-Meier curves and multivariate Cox proportional hazards regression were used to assess hazard ratios for mortality and disease progression (defined as categorical FVC decline ≥10%). The annualized rates of change in functional parameters for each patient were calculated using mixed linear models. Results The study population consisted of 152 IPF patients, of whom 135 (89%) received antifibrotic treatment for IPF during the study follow up. Patients having evidence of 3 or more enlarged mediastinal lymph nodes on baseline CT scan showed increased rates of mortality (HR 5.03, 95% CI 1.86–13.62, p ≤ 0.001) and significant disease progression (HR 2.99, 95% CI 1.22–7.33, p = 0.17) as compared to patients without LNE, after adjusting for GAP stage. Among 62 patients with LNE who underwent a follow up CT scan of the chest and received antifibrotic treatment, 57 (92%) maintained evidence mediastinal LNE over time. Conclusions Diffuse mediastinal lymph node involvement predicts clinically meaningful functional deterioration in patients with IPF.

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Mediastinal lymph node enlargement in idiopathic pulmonary fibrosis: relationships with disease progression and pulmonary function trends.

10.21203/rs.3.rs-46826/v2 ◽

2020 ◽

Author(s):

Giacomo Sgalla ◽

Anna Rita Larici ◽

Nicoletta Golfi ◽

Mariarosaria Calvello ◽

Alessandra Farchione ◽

...

Keyword(s):

Lymph Node ◽

Idiopathic Pulmonary Fibrosis ◽

Pulmonary Fibrosis ◽

Lymph Nodes ◽

Ct Scan ◽

Disease Progression ◽

Mediastinal Lymph Node ◽

Mediastinal Lymph Nodes ◽

Lymph Node Enlargement

Abstract Background and objectivesEvidence of mediastinal Lymph Node Enlargement (LNE) on CT scan is a common finding in idiopathic pulmonary fibrosis (IPF). We sought to investigate whether the involvement of mediastinal lymph nodes is associated with accelerated disease progression, and explored the changes occurring in mediastinal lymph nodes during the radiological follow up of these patients.MethodsThis retrospective study included IPF patients referred to a single ILD centre in Italy. A consensus-based assessment of mediastinal LNE on chest CT scan was performed by two thoracic radiologists. Kaplan-Meier curves and multivariate Cox proportional hazards regression were used to assess hazard ratios for mortality and disease progression (defined as categorical FVC decline ≥10%). The annualized rates of change in functional parameters for each patient were calculated using mixed linear models.Results152 IPF patients were included in the analysis, of whom 135 (89%) received antifibrotic treatment for IPF during the study follow up. Patients having evidence of 3 or more enlarged mediastinal lymph nodes on baseline CT scan showed increased rates of mortality (HR 5.03, 95% CI 1.86-13.62, p≤0.001) and significant disease progression (HR 2.99, 95% CI 1.22-7.33, p=0.17) as compared to patients without LNE, after adjusting for GAP stage. Among 62 patients with LNE who underwent a follow up CT scan of the chest and received antifibrotic treatment, 57 (92%) maintained evidence mediastinal LNE over time.ConclusionsDiffuse mediastinal lymph node involvement predicts clinically meaningful functional deterioration in patients with IPF.

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Studies of lymph nodes from patients with classical hemophilia

Blood ◽

10.1182/blood.v64.4.768.bloodjournal644768 ◽

1984 ◽

Vol 64 (4) ◽

pp. 768-773

Author(s):

WA Andes ◽

RD deShazo ◽

RJ Reed ◽

JC Harkin ◽

NN Wang

Keyword(s):

Lymph Node ◽

Lymph Nodes ◽

Factor Viii ◽

Peripheral Blood ◽

Marker Chromosome ◽

Suppressor Cell ◽

Electron Microscopic ◽

Follicular Hyperplasia ◽

Asymptomatic Patients ◽

Lymph Node Enlargement

Within the last 18 months, we have noted the development of unexplained lymph node enlargement in otherwise asymptomatic patients with hemophilia. Because such changes are poorly understood and, in some patient groups, may be related to the acquired immunodeficiency syndrome (AIDS), we studied the enlarged lymph nodes in four patients with severe factor VIII deficiency and abnormally low peripheral blood helper-inducer/suppressor cell (OKT4/OKT8) ratios. Surgically excised lymph nodes were studied for histopathologic, electron microscopic, and chromosomal changes. Cell suspensions from these and normal nodes were also studied using monoclonal antibodies. Excised lymph nodes showed follicular hyperplasia. Electron microscopy revealed no viral particles or vesicular rosettes. Chromosomal aberrations included an acrocentric marker chromosome in one patient and monosomy 21 in another. T lymphocyte ratios (OKT4/OKT8) in lymph node suspensions were lower than those in nodes from normal controls (1.2 v 6.1) and reflected the lymphocyte ratio in peripheral blood. Mature B cell percentages were increased in the lymph nodes from patients with hemophilia (38% v 27% in controls). Patients treated with factor VIII concentrates and male homosexuals have similarities in persistent lymph node enlargement, histologic features of follicular hyperplasia, and changes in lymph node and circulating lymphocyte subpopulations.

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Orchidectomy and the immune response I. Effect of orchidectomy on lymphoid tissues of mice

Proceedings of the Royal Society of London Series B Biological Sciences ◽

10.1098/rspb.1974.0027 ◽

1974 ◽

Vol 185 (1081) ◽

pp. 425-436 ◽

Cited By ~ 18

Keyword(s):

Lymph Node ◽

Lymph Nodes ◽

Lymphoid Tissues ◽

Spleen Size ◽

Thymic Involution ◽

Peripheral Lymph Node ◽

Peripheral Lymph ◽

Lymph Node Enlargement ◽

Spleen Mass ◽

Lymph Node Mass

The effects of pre- and postpuberal orchidectomy on the lymphoid tissues of mice have been studied. Prepuberal orchidectomy delayed the normal rate of thymic involution and caused relative hypertrophy of the thymus which was maximal 1 month after surgery. There was also enlargement of the peripheral lymph nodes to reach a sustained maximum by 6 weeks and also an increase of spleen size. Histological examination of the enlarged thymus showed widening of the cortex and medulla with increased cell density. The enlarged peripheral lymph nodes showed widening of the paracortical area which is thymus dependent. Synchronous thymectomy and orchidectomy prevented the lymph node enlargement that follows orchidectomy alone, but it did not affect the increase of spleen size until 3 months after surgery. After postpuberal orchidectomy thymic size increased to a maximum at 1 month and the increase of peripheral lymph node mass and spleen mass was less than the changes following prepuberal surgery ; only 3 months after operation was the lymph node mass of orchidectomized mice significantly greater than controls and changes in spleen mass were only apparent after correction for changes in body mass.

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The chemokine receptor CCR7 and α4 integrin are important for migration of chronic lymphocytic leukemia cells into lymph nodes

Blood ◽

10.1182/blood.v99.8.2977 ◽

2002 ◽

Vol 99 (8) ◽

pp. 2977-2984 ◽

Cited By ~ 127

Author(s):

Kathleen J. Till ◽

Ke Lin ◽

Mirko Zuzel ◽

John C. Cawley

Keyword(s):

Lymph Node ◽

Chronic Lymphocytic Leukemia ◽

Lymph Nodes ◽

Lymph Node Involvement ◽

Lymphocytic Leukemia ◽

Lymphocyte Migration ◽

High Endothelial Venules ◽

Lymph Node Enlargement ◽

Node Involvement

Abstract Malignant lymphocyte migration into lymph nodes is an important aspect of chronic lymphocytic leukemia (CLL), yet little is known about the processes involved. Here we demonstrate that CLL cells migrate across vascular endothelium in response to at least 3 chemokines, namely, CCL21, CCL19, and CXCL12. Moreover, transendothelial cell migration (TEM) in response to CCL21 and CCL19 was significantly higher for the malignant B cells of patients who had clinical lymph node involvement as compared with those of patients lacking such organomegaly. Furthermore, the expression of CCR7, the receptor for both CCL21 and CCL19, correlated with clinical lymphadenopathy, and blocking of CCR7 inhibited CLL cell TEM. By using immunohistochemistry we demonstrated that CCL21 and CCL19, but not CXCL12, are located in high endothelial venules and are, therefore, in an appropriate location to induce TEM. Regarding the adhesion receptors involved in TEM, α4 (most likely in association with β1) and αLβ2 were shown to be important in CLL cell TEM in vitro, but only the level of α4 expression correlated with the presence of clinical lymphadenopathy. The present studies are the first to shed light on the factors determining CLL cell entry into nodes and define the phenotype of circulating malignant cells likely to determine the pattern of lymph node enlargement in the disease.

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