scholarly journals Endometrial Cancer with Sarcoidosis in Regional Lymph Nodes: A Case Report

2015 ◽  
Vol 8 (3) ◽  
pp. 409-415 ◽  
Author(s):  
Satoshi Tamauchi ◽  
Yuji Shimomura ◽  
Hiromi Hayakawa

Sarcoidosis is a chronic, multisystemic disease commonly affecting the lungs and lymphatic system and is characterized by the formation of noncaseating granulomas. Although several reports are available on cases developing both sarcoidosis and cancer metachronously, cases of simultaneous diagnosis of these diseases have rarely been reported. A 67-year-old woman diagnosed with endometrial cancer had developed systemic lymph node swelling, including bilateral hilar, paraaortic, and a few pelvic lymph nodes, as observed on preoperative imaging. During surgery, frozen sections of a paraaortic lymph node were examined, revealing noncaseating granulomas compatible with sarcoidosis. Next, modified radical hysterectomy, bilateral salpingo-oophorectomy, and pelvic lymphadenectomy were performed. Postoperative pathological analysis revealed endometrioid adenocarcinoma of the uterus, and no metastasis but noncaseating granulomas were detected in the resected lymph nodes. Postoperatively, we identified cutaneous sarcoidosis and uveitis in the presence of a tuberculin-negative test. On the basis of these findings, we diagnosed the patients with endometrial cancer complicated by sarcoidosis. She underwent adjuvant chemotherapy, and at the 1-year follow-up, the lymph node swelling due to sarcoidosis was stable, and no recurrence of the cancer was observed. This turned out to be a case of early endometrial cancer mimicking advanced cancer by sarcoidosis. Histological confirmation and additional examination for sarcoidosis are necessary in cancer patients suspected of sarcoidosis.

2013 ◽  
Vol 2013 ◽  
pp. 1-2
Author(s):  
Angela Orcurto ◽  
Benoît Lhermitte ◽  
Alain Sermier ◽  
Dominik Berthold

Kidney lesions may be difficult to diagnose only by radiological exams, often requiring proof by tissue biopsy. Moreover, if enlarged regional lymph nodes are also present, the spectrum of differential diagnoses is even greater. The role of regional lymph node dissection in this setting is not clearly established. We show the case of a patient with a kidney mass associated with a conglomerate of para-aortic and iliac lymphadenopathies corresponding to an oncocytoma and a nodular lymphocyte predominant Hodgkin' lymphoma, respectively. Diagnosis of these two lesions was performed by morphology and immunohistochemistry. This case reflects how imaging can mislead to diagnosis and how histological confirmation helps decide treatment management.


2018 ◽  
Vol 3 (10) ◽  

Introduction: One of the mandatory components of radical treatment of patients with endometrial cancer is the impact on regional lymph nodes. Nowadays, pelvic lymphadenectomy remains not only therapeutic, but also a diagnostic method in case of predicting the effectiveness of treatment. However, it is important to point out that there are a lot of complications which can occur after dissection of lymph nodes. Lymphorrhea and lymphocele are among the most common postoperative complications of pelvic lymphadenectomy, with a reported incidence of 1% to 50%. Except for the occurrence of undesirable symptoms it can increase the time of drainage standing, which contributes to the delay of further stages of combined treatment. The aim of the study: The aim of the study was to evaluate the effectiveness of the intraoperative application of micro porous polysaccharide absorbable hemostat taking into account the functional outcomes to improve the long-term results of surgical treatment. Materials and methods: In order to solve the tasks, we analyzed the treatment of 12 patients with verified diagnosis of endometrial cancer. We divided the patients in 2 different groups. The first group included patients with polysaccharide absorbable hemostat application (6 patients). The second one (control group) included patients who were provided, according to traditional methods, without using polysaccharide application (6 patients). All patients underwent ultrasound examination on postoperative days 7, 14, 28. Groups were comparable in age, risk profile, and lymph node numbers. Postoperative drain loss and development of early and late lymphocyte were analyzed. Results: Group 1 showed a lower drainage volume and in this group there wasn’t any lymphocyte development. But the control group (group 2) showed 4 occasions of lymphocyte formation. Also two of them were symptomatic and were treated with percutaneous drainage (duration: 25 days in untreated patients versus 7 days in patients with absorbable hemostat using). Conclusion: In this preliminary investigation, the intraoperative application of micro porous polysaccharide absorbable hemostat on lymph node dissection areas significantly decreases total drain loss. In addition, it reduces frequency of lymphocyte formation, which contributes to the timely implementation of further stages of multidisciplinary approach in endometrial cancer’s treatment. A multicenter randomized clinical trial with a larger number of patients and longer follow-up is necessary toevaluate the overall outcomes of the combination of laparoscopic lymphadenectomy plus polysaccharide hemostat application.


2011 ◽  
Vol 122 (2) ◽  
pp. 251-254 ◽  
Author(s):  
F. Khoury-Collado ◽  
M.P. Murray ◽  
M.L. Hensley ◽  
Y. Sonoda ◽  
K.M. Alektiar ◽  
...  

2018 ◽  
Vol 64 (3) ◽  
pp. 335-344
Author(s):  
Aleksey Karachun ◽  
Yuriy Pelipas ◽  
Oleg Tkachenko ◽  
D. Asadchaya

The concept of biopsy of sentinel lymph node as the first lymph node in the pathway of lymphogenous tumor spread has been actively discussed over the past decades and has already taken its rightful place in breast and melanoma surgery. The goal of this method is to exclude vain lymphadenectomy in patients without solid tumor metastases in regional lymph nodes. In the era of minimally invasive and organ-saving operations interventions it seems obvious an idea to introduce a biopsy of sentinel lymph node in surgery of early gastric cancer. Meanwhile the complexity of lymphatic system of the stomach and the presence of so-called skip metastases are factors limiting the introduction of a biopsy of sentinel lymph node in stomach cancer. This article presents a systematic analysis of biopsy technology of signaling lymph node as well as its safety and oncological adequacy. Based on literature data it seems to us that the special value of biopsy of sentinel lymph nodes in the future will be in the selection of personalized surgical tactics for stomach cancer.


2021 ◽  
Vol 7 (1) ◽  
Author(s):  
Tomoko Mizota ◽  
Masato Suzuoki ◽  
Saya Kaku ◽  
Kenichi Mizunuma ◽  
Kazuto Ohtaka ◽  
...  

Abstract Background Sarcoid-like reaction (SLR) is a histological pattern of granulomatous inflammation that is clinically differentiated from sarcoidosis. Since SLR is known to occur in several neoplasias and occasionally causes lymphadenopathy and mimics metastatic malignancy, it needs to be considered whether lymphadenopathy is due to metastasis or SLR for the choice of cancer treatment. Few cases of hepatocellular carcinoma (HCC) with SLR have been reported. Here, a case of HCC with lymphadenopathy diagnosed as SLR without metastasis is presented. Case presentation A 69-year-old woman was admitted to our hospital because of upper abdominal pain. She tested positive for hepatitis C virus ribonucleic acid. Imaging modalities showed an 81 × 65-mm-sized tumor with multiple nodules in segment 3 and a 17 × 12-mm-sized tumor in segment 5 with a common HCC enhancement pattern. In addition, a lymph node in the hepatoduodenal ligament was enlarged at 13 mm in size, suggesting the metastasis of HCC. Hepatectomy of the lateral segment and segment 5 and lymph node dissection in the hepatoduodenal ligament were performed. Both tumors in segments 3 and 5 were pathologically diagnosed as HCC without vessel invasion. The tumors contained necrotic cells and epithelioid cell granulomas with multinucleated giant cells, which is typically observed in sarcoidosis. The dissected lymph nodes also contained epithelioid cell granulomas, as well as giant cells with asteroid bodies. There was no malignancy in the lymph nodes. The pathological findings suggested the coexistence of malignancy and sarcoidosis. However, since the patient did not show any typical findings of pulmonary or cardiac sarcoidosis, the case was diagnosed as HCC with SLR in the primary lesion and regional lymph nodes. Conclusions SLR needs to be considered in the differential diagnosis when a cancer patient develops lymphadenopathy. However, lymphadenopathy due to SLR is indistinguishable from that due to metastasis even when using multiple imaging modalities. Pathological examinations may be helpful for the diagnosis.


2020 ◽  
Author(s):  
Yuhua Zhao ◽  
Gong Li ◽  
Lei Gao

Abstract Background: This study aimed to evaluate the therapeutic efficacy of extended-field intensity-modulated radiotherapy (EF-IMRT) and dosage boost for positive lymph nodes, prognostic factors, treatment failure, and toxicity for Federation of Gynecology and Obstetrics (FIGO) stage IIICr and IVA cervical cancer patients with positive regional lymph nodes.Methods: We retrospectively evaluated 34 patients with stage IIICr and IVA who had received treatment in our institute between 2013 and 2016. Patients with stage IVA cervical cancer who had been enrolled in the analysis all had positive regional lymph nodes (pelvic or/and para-aortic). All 34 patients were treated with EF-IMRT and simultaneously integrated boost-IMRT (SIB-IMRT) for lymph node metastasis with concurrent chemotherapy and brachytherapy. Positive regional lymph nodes (short-axis diameter ≥5 mm in computed tomography [CT] or magnetic resonance imaging [MRI]) remaining after SIB-IMRT were then treated with sequential boost-IMRT (SeB-IMRT). The prognostic factors for overall survival (OS); disease-free survival (DFS); local control rate (LCR); regional control rate (RCR); distant metastasis-free survival (DMFS), including age, FIGO stage, pretreatment hemoglobin (HB) level, tumor size, para-aortic lymph node (PALN) metastasis, point A equivalent dose in 2-Gy fractions (EQD2 dose), concurrent chemotherapy, and adjuvant chemotherapy cycles, were analyzed.Results: Complete response (CR) was achieved in 31 (91.2%) patients with acceptable adverse effects. Notably, the three-year OS, DFS, LCR, RCR, DMFS for these patients were 73.5%, 70.6%, 88.1%, 87.9%, and 81.6%, respectively. In particular, the three-year OS, DFS, LCR, RCR, and DMFS of patients with positive PALNs was 41.7%, 33.3%, 65.6%, 72.2%, and 60.2%, respectively. The corresponding values in patients without positive PALNs were 90.9%, 90.9%, 100%, 95.5%, and 90.9%, respectively.Conclusions: Our study suggested that the EF-IMRT and nodal dosage boost decreased regional node failure and that patients with stage IIIC1r and IVA cervical cancer without PALN metastasis who received EF-IMRT and SIB-IMRT with or without SeB-IMRT had a significant survival advantage in terms of the DFS and OS.


2018 ◽  
Vol 5 (3) ◽  
pp. 8-16
Author(s):  
Yu. A. Dergunova ◽  
V. V. Podionov ◽  
V. K. Bozhenko ◽  
V. V. Kometova ◽  
M. V. Dardyk

Despite the sufficient amount of data accumulated in the literature, there are still no factors, on the basis of which it would be possible to estimate the regional lymph nodes status in breast cancer with a high degree of accuracy. The review presents literature data relating to the influence of clinicopathological, molecular-biological and genetic characteristics of primary tumor on lymph node metastases. Data of 66 foreign and Russian articles are included.


2014 ◽  
Vol 106 ◽  
pp. 5
Author(s):  
M. Yamaguchi ◽  
K. Ohnishi ◽  
Y. Komohara ◽  
F. Saito ◽  
C. Erdenebaatar ◽  
...  

2011 ◽  
Vol 24 (1) ◽  
pp. 207-210 ◽  
Author(s):  
Jorge Martínez ◽  
Iván Galindo-Cardiel ◽  
Meritxell Díez-Padrisa ◽  
Emilio I. López-Sabater ◽  
Joaquim Segalés

Endocrine tumors are rarely observed in pigs, and pheochromocytomas have been only punctually described. The current report describes a white and firm, 15-cm in diameter, neoplastic mass located in the adrenal gland with metastasis to regional lymph nodes in a 2.5-year-old sow. The masses had marked desmoplasia that supported a population of polygonal-to-spindle–shaped neoplastic cells arranged into cords and packets within a delicate fibrovascular stroma. Immunohistochemical staining of the tumor was positive for chromogranin and negative for neurofilament protein in adrenal and lymph node masses, which was characteristic of a malignant pheochromocytoma.


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