Kikuchi Disease in Korean Children: Clinical Features and Disease Courses.

Blood ◽  
2007 ◽  
Vol 110 (11) ◽  
pp. 2285-2285 ◽  
Author(s):  
Jun Eun Park ◽  
Hyun Joo Jung ◽  
Chul-Ho Kim ◽  
Jeong Hong ◽  
Jae Ho Han
Keyword(s):  
Lymph Node ◽  
Lymph Nodes ◽  
Medical Center ◽  
University Hospital ◽  
First Episode ◽  
Excision Biopsy ◽  
Cervical Lymph Nodes ◽  
Korean Children ◽  
Presenting Symptoms

Abstract OBJECTIVES: Kikuchi’s disease (KD) is a benign, self-limiting disorder of unknown origin with lymphadenopathy and fever, and prevalent in young Asian women. The initial presentations mimic malignancies or other serious infections, and the biopsy of lymph nodes affected is the only definite diagnostic tool of KD. We analyzed data from a series of pediatric cases collected at a single medical center and suggest proper guideline of management for patients with KD. METHODS: The medical records of children under 16 years of age, who underwent lymph node biopsies and received histiopathologic diagnosis of KD at Ajou University Hospital, South Korea from January 2000 to June 2007, were retrospectively reviewed. RESULTS: Twenty six pediatric patients with KD included 10 boys and 16 girls. In all cases except two, the cervical lymph nodes were involved. Twenty (76.9%) patients had fever as a presenting symptom, and 5 patients (19.2%) had various skin rash. Leukopenia was noted in 8 cases (30.8%), but there was no case of leukocytosis. The levels of ESR and LDH were slightly elevated, but CRP and liver enzymes were within normal range. No KD patients in this study developed any other autoimmune disorders during follow-up period. Eleven (55%) cases with fever improved immediately after excision biopsy of affected lymph nodes. Eight (30.8%) cases treated with steroid showed dramatic responses. Six patients (23.1%) had resolutions of symptoms simply with symptomatic treatments. The recurrence happened in 6 (23.1%) children within a few weeks from the first episode. CONCLUSIONS: Contrary to previous reports on Asian cases, KD in Korean children is not rare in young boys, and fever is more common presenting symptoms. It’s relationship with autoimmune diseases or infection of EBV is not clear. Symptoms such as fever improved in some cases only by the removal of affected lymph node for excision biopsy. In agreement with previous reports, patients treated with steroid recovered dramatically. Therefore, we suggest an earlier excision biopsy for patients suspicious with KD and an immediate treatment of cases with severe symptoms with steroid. The recurrence rate in this study was higher than that in previous studies, therefore, a spell of follow-up period after disappearance of symptoms is advisable for patients with original diagnosis of KD.

Bronchial-Associated Lymphoid Tissue (BALT) Lymphoma: Characteristics and Treatment Outcome of 19 Cases.

Blood ◽  
2004 ◽  
Vol 104 (11) ◽  
pp. 4564-4564
Author(s):  
Kathryn P. Beal ◽  
Carol Portlock ◽  
Joachim Yahalom
Keyword(s):  
Treatment Outcome ◽  
Lymph Node ◽  
Lymph Nodes ◽  
Lymphoid Tissue ◽  
B Cell Lymphoma ◽  
Mediastinal Lymph Nodes ◽  
Cervical Lymph Nodes ◽  
Balt Lymphoma ◽  
Disease Free

Abstract Background: Bronchial-associated lymphoid tissue (BALT) lymphoma, an indolent marginal zone lymphoma, is a rare clinical entity with only few published reports on its optimal management and treatment outcome. In the absence of a well established standard of care, different treatment options are available including surgery, radiation, chemotherapy, immunotherapy or merely observation. We analyzed a large cancer center’s experience with the management of BALT lymphoma patients during the last 12 years. Patients and Methods: Nineteen cases of BALT lymphoma were identified from a database of 175 cases of MALT lymphoma pathologically confirmed at our center. We retrospectively reviewed the clinical data and treatment results. Results: There were 12 (63%) men and 7 (37%) women with a median age of 68 years (range 37–81 years). Seven (37%) patients were asymptomatic at diagnosis and were diagnosed after radiologic studies ordered either for routine evaluation or for pre-operative clearance showed unexpected abnormalities. The 12 (63%) symptomatic patients had non-specific pulmonary complaints such as cough, shortness of breath, or dyspnea on exertion. One patient had B symptoms (significant unintentional weight loss). Twelve patients (63%) had unilateral lung involvement and 7 (37%) had bilateral involvement on chest CT. Twelve patients had FDG-PET scans at the time of diagnosis and all had FDG uptake in pathologically confirmed sites of disease with a median SUV of 3.2 (range 1.3–26). Five patients (26%) had radiographically enlarged hilar or mediastinal lymph nodes including 1 with pathologically confirmed transformation to diffuse large B-cell lymphoma in a mediastinal lymph node and 1 with progression to a supraclavicular lymph node. Fifteen patients (79%) had stage I or II disease limited to their thorax. One patient had previously treated MALT of the bilateral orbits, 1 patient was also found to have MALT involving her small bowel, 1 patient also had bone marrow involvement, and 1 patient had extensive disease involving not only lung parenchyma but also mediastinal lymph nodes, and bilateral axillary, supraclavicular, and cervical lymph nodes. Ten patients were treated with surgery alone (8 had wedge resections, 2 had lobectomies). Six received chemotherapy alone and 2 had rituximab alone. One received radiation (RT) alone. With a median follow-up of 28 months (range 11–146 months), no patients were lost to follow-up. At 5 years, overall survival was 91% and disease free survival was 42%. At latest follow-up all patients were alive with the exception of one patient who died of his disease (the patient who had extensive lung parenchymal disease and lymphadenopathy) and 8 patients (42%) were without evidence of any disease after RT(1), chemotherapy(2), or surgery(5). Conclusion: In one of the largest series of BALT lymphoma patients with complete follow-up, we document good response to local treatment and overall excellent prognosis. Of interest, BALT lymphoma lesions are PET-positive and thus are similar to lung cancer lesions. Limited lesions may be safely resected and patients remain disease-free, but even some patients with unresectable disease respond to chemotherapy and are rendered disease-free or stable.

Microwave Ablation for Papillary Thyroid Cancer With Cervical Lymph Node Metastasis

2020 ◽  
Author(s):  
Zhen-Long Zhao ◽  
Ying Wei ◽  
Xiao-Jing Cao ◽  
Li-Li Peng ◽  
Yan Li ◽  
...  
Keyword(s):  
Lymph Node ◽  
Lymph Node Metastasis ◽  
Lymph Nodes ◽  
Cervical Lymph Node ◽  
Microwave Ablation ◽  
Cervical Lymph Node Metastasis ◽  
Thyroid Function Tests ◽  
Cervical Lymph Nodes ◽  
Node Metastasis

Abstract Background: To evaluate the feasibility and safety of microwave ablation (MWA) for PTC with metastatic cervical lymph nodes who are ineligible for or refuse surgery. Materials and Methods: Twenty patients of unifocal PTC with metastatic cervical lymph nodes from three hospitals were enrolled in this study, and MWAs were performed. Contrast-enhanced ultrasound was used to evaluate the extent of ablation. The volume of the ablated area and thyroid hormones were measured. Results: PTC nodules in 9 patients completely disappeared at the end of follow-up. Compared with the volume before ablation, the mean volume reduction ratio of ablated lesions was 0.414 ± 0.700 (range: -1.92-0.95) at postoperative 6 months. The patients' thyroid function tests were normal at the end of follow-up. New lymph node metastasis was found in one patient during follow-up visits and she underwent a second MWA procedure. For the other patients, no new PTC nodule, local recurrence or cervical lymph node metastasis were suspected on ultrasound by the end of follow-up. No distant metastasis was encountered during the follow up. None of the patients developed hypocalcemia, permanent hoarseness or skin burns. Conclusions: MWA is a minimal invasive and safe method in treating PTC with cervical lymph node metastasis.

Role of Clinical Palpation in Evaluation of Cervical Lymph Node in Oral Squamous Cell Carcinoma

2013 ◽  
Vol 1 (2) ◽  
pp. 02-06
Author(s):  
SM Anwar Sadat ◽  
Sufia Nasrin Rita ◽  
Shoma Banik ◽  
Md Nazmul Hasan Khandker ◽  
Md Mahfuz Hossain ◽  
...  
Keyword(s):  
Squamous Cell Carcinoma ◽  
Lymph Node ◽  
Oral Squamous Cell Carcinoma ◽  
Lymph Nodes ◽  
Cell Carcinoma ◽  
Squamous Cell ◽  
Predictive Value ◽  
Cervical Lymph Node ◽  
Betel Quid ◽  
Cervical Lymph Nodes

A cross sectional study of 29 cases of oral squamous cell carcinoma with or without  cervical lymph node metastasis was done among Bangladeshi patients from January 2006 to December 2007. Majority of the study subjects (34.5%) belonged to the age group of 40-49 years. 58.6% of the study subjects were male, while remaining 41.4% of them were female. 51.7% of the lesions were located in the alveolar ridge where the other common sites were buccal mucosa (27.6%) and retro molar area (13.8%). Half of the study subjects (51.7%) were habituated to betel quid chewing followed by 37.9% and 10.3% were habituated to smoking and betel quid-smoking respectively. Grade I lesions was most prevalent (75.9%) in the study subjects.  Majority of cases presented with Stage IV lesions (55.2%). The sensitivity, specificity, positive predictive value, negative predictive value & accuracy of clinical palpation method for determining metastatic cervical lymph nodes were 93.33%, 64.29%, 73.68%, 90% and 79.3% respectively. Careful and repeated clinical palpation plays important role in evaluation of cervical lymph nodes though several modern techniques may help additionally in the management of oral cancer.DOI: http://dx.doi.org/10.3329/updcj.v1i2.13978 Update Dent. Coll. j. 2011: 1(2): 02-06

scholarly journals Cervical lymph node enlargement as the initial manifestation of rectal cancer

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.

scholarly journals Theragnostic Glycol Chitosan-Conjugated Gold Nanoparticles for Photoacoustic Imaging of Regional Lymph Nodes and Delivering Tumor Antigen to Lymph Nodes

Nanomaterials ◽  
2021 ◽  
Vol 11 (7) ◽  
pp. 1700
Author(s):  
In-Cheol Sun ◽  
SeongHoon Jo ◽  
Diego Dumani ◽  
Wan Su Yun ◽  
Hong Yeol Yoon ◽  
...  
Keyword(s):  
Gold Nanoparticles ◽  
Lymph Node ◽  
Lymph Nodes ◽  
Cancer Immunotherapy ◽  
Tumor Antigen ◽  
Tumor Antigens ◽  
Imaging System ◽  
Superior Performance ◽  
Glycol Chitosan ◽  
Cervical Lymph Nodes

Lymph node mapping is important in cancer immunotherapy because the morphology of lymph nodes is one of the crucial evaluation criteria of immune responses. We developed new theragnostic glycol-chitosan-coated gold nanoparticles (GC-AuNPs), which highlighted lymph nodes in ultrasound-guided photoacoustic (US/PA) imaging. Moreover, the ovalbumin epitope was conjugated GC-AuNPs (OVA-GC-AuNPs) for delivering tumor antigen to lymph node resident macrophage. In vitro studies proved the vigorous endocytosis activity of J774A.1 macrophage and consequent strong photoacoustic signals from them. The macrophages also presented a tumor antigen when OVA-GC-AuNPs were used for cellular uptake. After the lingual injection of GC-AuNPs into healthy mice, cervical lymph nodes were visible in a US/PA imaging system with high contrast. Three-dimensional analysis of lymph nodes revealed that the accumulation of GC-AuNPs in the lymph node increased as the post-injection time passed. Histological analysis showed GC-AuNPs or OVA-GC-AuNPs located in subcapsular and medullar sinuses where macrophages are abundant. Our new theragnostic GC-AuNPs present a superior performance in US/PA imaging of lymph nodes without targeting moieties or complex surface modification. Simultaneously, GC-AuNPs were able to deliver tumor antigens to cause macrophages to present the OVA epitope at targeted lymph nodes, which would be valuable for cancer immunotherapy.

Assessment of cervical lymph node metastases using indirect computed tomography lymphography with iopamidol in a tongue VX2 carcinoma model

2011 ◽  
Vol 125 (8) ◽  
pp. 820-828 ◽  
Author(s):  
Y Shu ◽  
X Xu ◽  
Z Wang ◽  
W Dai ◽  
Y Zhang ◽  
...  
Keyword(s):  
Computed Tomography ◽  
Lymph Node ◽  
Lymph Nodes ◽  
Lymph Node Metastases ◽  
Cervical Lymph Node ◽  
Cervical Lymph Nodes ◽  
Cervical Lymph Node Metastases ◽  
Computed Tomography Images ◽  
Vx2 Carcinoma ◽  
Node Metastases

AbstractObjective:To investigate the performance of indirect computed tomography lymphography with iopamidol for detecting cervical lymph node metastases in a tongue VX2 carcinoma model.Materials and methods:A metastatic cervical lymph node model was created by implanting VX2 carcinoma suspension into the tongue submucosa of 21 rabbits. Computed tomography images were obtained 1, 3, 5, 10, 15 and 20 minutes after iopamidol injection, on days 11, 14, 21 (six rabbits each) and 28 (three rabbits) after carcinoma transplantation. Computed tomography lymphography was performed, and lymph node filling defects and enhancement characteristics evaluated.Results:Indirect computed tomography lymphography revealed bilateral enhancement of cervical lymph nodes in all animals, except for one animal imaged on day 28. There was significantly slower evacuation of contrast in metastatic than non-metastatic nodes. A total of 41 enhanced lymph nodes displayed an oval or round shape, or local filling defects. One lymph node with an oval shape was metastatic (one of 11, 9.1 per cent), while 21 nodes with filling defects were metastatic (21/30, 70 per cent). The sensitivity, specificity, accuracy, and positive and negative predictive values when using a filling defect diameter of 1.5 mm as a diagnostic criterion were 86.4, 78.9, 82.9, 82.6 and 83.3 per cent, respectively.Conclusion:When using indirect computed tomography lymphography to detect metastatic lymph nodes, filling defects and slow evacuation of contrast agent are important diagnostic features.

scholarly journals Intraoperative Ultrasound-guided Excision of Cervical Lymph Nodes for Recurrent Differentiated Thyroid Cancer

2013 ◽  
Vol 5 (2) ◽  
pp. 45-49
Author(s):  
Ian C Bennett ◽  
Magdalena Biggar ◽  
Clement Wong ◽  
Michael Law
Keyword(s):  
Thyroid Cancer ◽  
Thyroid Carcinoma ◽  
Lymph Nodes ◽  
Differentiated Thyroid Cancer ◽  
Intraoperative Ultrasound ◽  
Surgical Excision ◽  
Ultrasound Guided ◽  
Cervical Lymph Nodes ◽  
Intraoperative Localization

ABSTRACT As a result of sensitive thyroglobulin assays and widespread use of cervical ultrasound, endocrine surgeons are encountering patients with impalpable suspicious or frankly metastatic cervical lymph nodes in the follow-up phase after treatment for welldifferentiated thyroid cancer. The surgical excision of impalpable disease of recurrent or persistent thyroid cancer can represent a significant challenge which may require some means of intraoperative localization to ensure that affected nodes are removed. Surgeon-performed intraoperative ultrasound (IOUS) can be used for guiding excision of suspicious but impalpable cervical nodes. The IOUS-guided excision technique is described. The successful application of IOUS to localize and guide resection of impalpable nodal recurrences of papillary thyroid carcinoma in two patients is reported. The utilization of IOUS to guide resection of impalpable pathological nodes in the context of thyroid carcinoma is a safe and practical technique which avoids the need for additional localization procedures and unnecessary potential morbidity for the patient. How to cite this article Biggar M, Wong C, Law M, Bennett IC. Intraoperative Ultrasound-guided Excision of Cervical Lymph Nodes for Recurrent Differentiated Thyroid Cancer. World J Endoc Surg 2013;5(2):45-49.

scholarly journals Low value of whole-body dual-modality [18f]fluorodeoxyglucose positron emission tomography/computed tomography in primary staging of stage I–II nasopharyngeal carcinoma: a nest case-control study

2021 ◽  
Author(s):  
Bei-Bei Xiao ◽  
Qiu-Yan Chen ◽  
Xue-Song Sun ◽  
Ji-Bin Li ◽  
Dong-hua Luo ◽  
...  
Keyword(s):  
Overall Survival ◽  
Lymph Node ◽  
Lymph Nodes ◽  
Stage I ◽  
Relapse Free Survival ◽  
Retropharyngeal Lymph Node ◽  
Free Survival ◽  
Pet Ct ◽  
Pre Treatment

Abstract Objectives The value of using PET/CT for staging of stage I–II NPC remains unclear. Hence, we aimed to investigate the survival benefit of PET/CT for staging of early-stage NPC before radical therapy. Methods A total of 1003 patients with pathologically confirmed NPC of stages I–II were consecutively enrolled. Among them, 218 patients underwent both PET/CT and conventional workup ([CWU], head-and-neck MRI, chest radiograph, liver ultrasound, bone scintigraphy) before treatment. The remaining 785 patients only underwent CWU. The standard of truth (SOT) for lymph node metastasis was defined by the change of size according to follow-up MRI. The diagnostic efficacies were compared in 218 patients who underwent both PET/CT and CWU. After covariate adjustment using propensity scoring, a cohort of 872 patients (218 with and 654 without pre-treatment PET/CT) was included. The primary outcome was overall survival based on intention to treat. Results Retropharyngeal lymph nodes were metastatic based on follow-up MRI in 79 cases. PET/CT was significantly less sensitive than MRI in detecting retropharyngeal lymph node lesions (72.2% [62.3–82.1] vs. 91.1% [84.8–97.4], p = 0.004). Neck lymph nodes were metastatic in 89 cases and PET/CT was more sensitive than MRI (96.6% [92.8–100.0] vs. 76.4% [67.6–85.2], p < 0.001). In the survival analyses, there was no association between pre-treatment PET/CT use and improved overall survival, progression-free survival, local relapse-free survival, regional relapse-free survival, and distant metastasis-free survival. Conclusions This study showed PET/CT is of little value for staging of stage I–II NPC patients at initial imaging. Key Points • PET/CT was more sensitive than MRI in detecting neck lymph node lesions whereas it was significantly less sensitive than MRI in detecting retropharyngeal lymph node lesions. • No association existed between pre-treatment PET/CT use and improved survival in stage I–II NPC patients.

Lymph Node Infarction

2003 ◽  
Vol 127 (1) ◽  
pp. 60-63 ◽  
Author(s):  
James A. Strauchen ◽  
Lorraine K. Miller
Keyword(s):  
Lymph Node ◽  
Lymph Nodes ◽  
Malignant Lymphoma ◽  
Immunohistochemical Study ◽  
Cell Lymphoma ◽  
Medical Center ◽  
Academic Medical Center ◽  
B Cell Lymphoma ◽  
Antigen Expression ◽  
Formalin Fixed Paraffin Embedded

Abstract Context.—The etiology of lymph node infarction may be difficult or impossible to determine by histologic examination. Lymph node infarction is followed by malignant lymphoma in some but not all patients. The role of immunohistochemistry in the evaluation of lymph node infarction is not well defined. Although it is widely believed that necrotic tissue is not suitable for immunohistochemical study, this view may be inaccurate. Objective.—To determine whether lymphoid antigens are preserved in infarcted lymph nodes and to determine the utility of immunohistochemical staining in the evaluation of lymph node infarction. Design.—Retrospective immunohistochemical study of infarcted lymph nodes using archival formalin-fixed, paraffin-embedded tissue. Setting.—Academic medical center. Patients.—Eleven adult patients with lymph node infarction retrieved from pathology files. Main Outcome Measures.—Results of immunohistochemistry, diagnosis of lymphoma. Results.—Preservation of lymphoid antigens was observed in 4 of 6 cases of lymph node infarction associated with malignant lymphoma, including 3 of 5 cases of diffuse large B-cell lymphoma and 1 case of peripheral T-cell lymphoma. Nonspecific staining was not encountered. In 1 case, in which an infarcted lymph node showed a benign pattern of lymphoid antigen expression, lymphoma has not developed after 5 years. Conclusion.—Lymphoid antigens are frequently preserved in cases of lymph node infarction, and immunohistochemical study of infarcted lymph nodes may provide clinically useful information.

scholarly journals Histomorphological Pattern of Cervical Lymphadenopathy

2013 ◽  
Vol 3 (1) ◽  
pp. 13-17 ◽  
Author(s):  
Md Atiqur Rahman ◽  
Md Mamun Ali Biswas ◽  
Syeda Tasfia Siddika ◽  
Abdul Mannan Sikder
Keyword(s):  
Lymph Node ◽  
Lymph Nodes ◽  
Hodgkin Lymphoma ◽  
Cervical Lymphadenopathy ◽  
Histological Evaluation ◽  
Cervical Lymph Nodes ◽  
Female Ratio ◽  
Study Results ◽  
Metastatic Neoplasm ◽  
Age And Sex

Background: Enlarged palpable cervical lymph nodes as a primary presenting sign are very common and may be due to inflammatory lesions and tumors. Correlation between clinical findings and laboratory data is essential in arriving at a diagnosis. In patients presenting with cervical lymphadenopathy, excision biopsy provides material to establish an early diagnosis. We designed this study in our population for histological evaluation of cervical lymph node biopsies that might be important in the management of these patients. Objective: Histopathological evaluation of different diseases involving the cervical lymph nodes in relation to age and sex of the study population. Materials and Methods: It was a cross sectional study conducted in the department of Pathology, Enam Medical College & Hospital, Savar, Dhaka during the period from January 2006 to December 2010. A total of 107 patients were evaluated for specific cause of cervical lymphadenopathy in relation to age and sex. Lymph node biopsies of all patients of both sexes and all age groups were included in the study. Results: Among the 107 subjects 58 (54.2%) were males and 49 (45.8%) were females with a male to female ratio of 1.2:1. The age of the patients ranged from 2 to 85 years with a mean age of 32.68 ± 18.01 years. Of the 107 lymph node biopsies, 34 cases (31.8%) were reactive lymphadenitis, 41 cases (38.3%) were tuberculosis, 2 cases (1.9%) were non-caseous granuloma, 6 cases (5.6%) were Hodgkin lymphoma, 8 cases (7.5%) were non-Hodgkin lymphoma, 12 cases (11.2%) were metastatic neoplasm and 4 cases (3.7%) were other specific lesions. Conclusion: The commonest cause of cervical lymphadenopathy was tuberculosis, followed by reactive lymphadenitis, lymphoma and metastatic neoplasm. DOI: http://dx.doi.org/10.3329/jemc.v3i1.13837 J Enam Med Col 2013; 3(1): 13-17

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