scholarly journals Parapharyngeal Lymph Node Metastasis From Papillary Thyroid Carcinoma

2021 ◽  
pp. 014556132110455
Author(s):  
Mohamed Masmoudi ◽  
Mehdi Hasnaoui ◽  
Manel Njima ◽  
Chaima Zitouni ◽  
Wadii Thabet ◽  
...  
Keyword(s):  
Computed Tomography ◽  
Lymph Node ◽  
Parapharyngeal Space ◽  
Treatment Options ◽  
Papillary Thyroid ◽  
Computed Tomography Scan ◽  
Serum Thyroglobulin ◽  
Node Metastasis ◽  
Cervical Approach ◽  
Tomography Scan

Metastatic parapharyngeal lymph nodes (LNs) from papillary thyroid carcinomas (PTC) are uncommon and can easily remain undetected. We describe a case that involves a 62-year-old woman treated for a PTC, who presented a rise in serum thyroglobulin (TG) levels. A computed tomography scan was performed, and revealed metastatic nodes in the left parapharyngeal space (PPS). A surgical resection of the nodes was performed with external cervical approach. A histological exam confirmed the diagnosis of a metastatic LN of a PTC. The aim of this report is to emphasize on the possibility of parapharyngeal metastatic nodes in PTC and to describe the diagnosis methods, treatment options, and impact on the prognosis.

A computed tomography-based radiomic nomogram for predicting lymph node metastasis in patients with early-stage papillary thyroid carcinoma

2021 ◽  
pp. 028418512110541
Author(s):  
Lisha Lai ◽  
Qianwen Guan ◽  
Yingying Liang ◽  
Junwei Chen ◽  
Yuting Liao ◽  
...  
Keyword(s):  
Computed Tomography ◽  
Lymph Node ◽  
Papillary Thyroid Carcinoma ◽  
Lymph Node Metastasis ◽  
Thyroid Carcinoma ◽  
Early Stage ◽  
Roc Curves ◽  
Maximum Diameter ◽  
Papillary Thyroid ◽  
Node Metastasis

Background Accurate assessment of lymph node metastasis (LNM) is important for the selection of the optimal therapeutic strategy in patients with papillary thyroid carcinoma (PTC). Purpose To develop and validate a radiomics nomogram based on computed tomography (CT) for predicting LNM in patients with early-stage PTC. Material and Methods A total of 92 patients with pathologically confirmed PTC were divided into a training cohort (n =  64) and validation cohort (n  =  28). Radiomic features of the tumor and peritumoral interstitium were extracted from contrast-enhanced CT images. The radiomic signature was constructed and the radiomic score (Rad-score) was calculated. Combined with the Rad-score and independent clinical factors, a radiomic nomogram was constructed and its performance was assessed by receiver operating characteristic (ROC) curves and calibration plots. The comparison of ROC curves was performed with DeLong's test Results A combined nomogram model of the thyroid tumor and peritumoral interstitium was constructed based on the Rad-score, tumor location, maximum diameter, and T stage, and it had areas under the ROC curve of 0.956 (95% confidence interval [CI] = 0.913–1.000) and 0.876 (95% CI = 0.741–1.000) in the training and validation cohorts, respectively. Decision curve analysis suggested that the combined nomogram model had better clinical usefulness than the other models. Conclusion A CT-based radiomics nomogram incorporating the radiomic signature and the selected clinical predictors can be a reliable approach to preoperatively predict the LNM status in patients with early-stage PTC, which is helpful for treatment decisions and prognosis.

Perilesional Lymph Node Swelling Might Be a Radiologic Clue for Appendiceal Schwannoma: A Case Report

2021 ◽  
Vol 17 ◽  
Author(s):  
Kunihito Suzuki ◽  
Kazuhiro Saito ◽  
Takafumi Yamada ◽  
Elly Arizono ◽  
Hidehiro Kumita ◽  
...  
Keyword(s):  
Computed Tomography ◽  
Case Report ◽  
Lymph Node ◽  
Lymph Nodes ◽  
Ileocecal Resection ◽  
Pelvic Cavity ◽  
Reactive Lymphoid Hyperplasia ◽  
Computed Tomography Scan ◽  
Lymph Node Swelling ◽  
Tomography Scan

Background: Gastrointestinal schwannoma is not a common type of tumor, and lesions originating from the appendix are extremely rare. Herein, we report a patient with appendiceal schwannoma characterized by lymph node swelling. Case report: A 67-year-old male patient who had diabetes complained of weight loss. A computed tomography scan revealed a mass in the right side of the pelvic cavity. Moreover, a contrast-enhanced computed tomography scan showed perilesional lymph node swelling measuring up to 28 mm. A low-intensity mass was observed on T1-weighted imaging, heterogeneous high-intensity mass on T2-weighted imaging, and restricted diffusion on diffusion-weighted imaging. There were no abnormal findings on colonoscopy. Based on a preoperative examination, a differential diagnosis of either appendiceal schwannoma, carcinoid, or gastrointestinal stromal tumor was considered. During surgery, a large appendiceal mass and multiple swollen perilesional lymph nodes were observed. Therefore, ileocecal resection and D3 lymph node dissection were performed. Pathological and immunohistochemical analyses confirmed the diagnosis of appendiceal schwannoma. There were numerous swollen lymph nodes in the mesenteric region. The lymph nodes revealed reactive lymphoid hyperplasia, with enlarged follicles of various sizes and shapes with an irregular distribution. Almost all lymphocytes, except those at the germinal centers, were small. Conclusion: Gastrointestinal schwannoma is characterized by lymph node swelling. Appendiceal schwannoma may have characteristics, including peritumoral lymph node swelling, similar to other types of gastrointestinal schwannoma such as that in the stomach. Thus, this characteristic can be a diagnostic clue for appendiceal schwannoma.

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