scholarly journals Disseminated lymph node tuberculosis after splenectomy: an unusual case report in an adolescent

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Moxin Cheng ◽  
Yu Chen
Keyword(s):  
Lymph Node ◽  
Lymph Nodes ◽  
Excisional Biopsy ◽  
Needle Aspiration ◽  
Nucleic Acid Amplification ◽  
Axillary Lymph Nodes ◽  
Tuberculous Lymphadenitis ◽  
Axillary Lymph ◽  
Increased Risk ◽  
Lymph Node Tuberculosis

Abstract Background Splenectomized patients are at an increased risk for overwhelming post-splenectomy infections typically with encapsulated bacteria. The clinical association between splenectomy and lymph-node tuberculosis is unclear. Case presentation We describe a rare case of disseminated tuberculous lymphadenitis in an 18-year-old woman with history of splenectomy because of hereditary sherocytosis. She was admitted with enlargement of bilateral-cervical and left-axillary lymph nodes and fever. A diagnosis of probable tuberculosis was made based on the findings of fine-needle aspiration. Histology showed granulomas and extensive caseous necrosis, with the site of puncture located at an enlarged lymph node on the right side. The diagnosis was confirmed via nucleic-acid amplification tests following excisional biopsy of the left axillary lymph node. Disseminated tuberculous lymphadenitis was localized in the bilateral neck, right lung hilum, left sub-axillary region, and mediastinum, as detected from contrast-enhanced computed tomography of the neck. Conclusions Mycobacterium tuberculosis infection should be considered in children and adolescents with extensive enlargement of lymph nodes after splenectomy.

scholarly journals DIAGNOSTIC VALUUE OF FINE NEEDLE ASPIRATION CYTOLOGY (FNAC) BIOPSY AND LYMPH NODES IN BREAST TUMOURS

2019 ◽  
Vol 3 (2) ◽  
Author(s):  
Surendra Kumar Dhruv
Keyword(s):  
Breast Cancer ◽  
Lymph Node ◽  
Lymph Nodes ◽  
Axillary Lymph Node ◽  
Needle Aspiration ◽  
Axillary Lymph Nodes ◽  
Axillary Lymph ◽  
Ultrasound Guided ◽  
Aspiration Cytology ◽  
Needle Aspiration Cytology

INTRODUCTION:  Breast cancer is the most common solid cancer in women and one of the leading causes of cancer deaths in the western countries. In India it is a leading cause for mortality and morbidity. Prognosis of invasive ductal carcinoma (IDC) of breast is determined by anatomic extent of the disease and can be assessed by tumor size, lymph node status and metastasis, also biologic markers such as histological grade, hormone receptor expression, HER2 overexpression, and/or amplification and genomic panels can be used. The presence of metastatic in axillary lymph nodes confirms the capacity of a cancer to metastasize. It represents the single most prognostically potent element of clinical stage in potentially curable cases. Axillary lymph node dissection and histological evaluation has a continuing place in the staging and management of patients with breast cancer. It has been shown that cytological grade correlates well with the axillary lymph nodal metastasis and also prognosis. Axillary lymph node evaluation in breast cancer is usually performed preoperatively by clinical examination, sonography, lymph node resection and by ultrasound-guided fine-needle aspiration cytology. MATERIAL AND METHODS: Patients with detected breast mass (palpable and non-palpable) and palpable axillary lymph node who were evaluated by FNAC. After sterile draping and sufficient disinfection, a 10-ml syringe was inserted into and withdrawn from the lymph node three times under aspiration while sonographically monitored. The procedure was performed by using 21-22 Gauge needle with 2–4 aspirations and it was repeated if the sample was inadequate. Ultrasound guided FNAC was performed for impalpable, and deeply located small lumps. RESULTS: A total of 156 patients were underwent for FNAC of the breast lump. Histological correlation of all the patients was done. The mean age of patients who underwent FNAC was 39.6 ± 9.42 years and all were female patients. The cytology reports were classified as benign, atypical, suspicious, malignancy, and unsatisfactory. In 59 (37.8%) cases benign lesions were observed of which the fibrocystic disease was the most common cytological diagnosis. 15 (9.6%) were atypical, 7(4.5%) were suspicious and in 72(46.2%) cases malignancy was diagnosed. In 3 (1.9%) cases sample was unsatisfactory. FNAC of the axillary lymph nodes was performed on 76 patients with palpable lymph nodes and histological correlation of axillary lymph node. In FNAC and histology correlation of axillary lymph node sensitivity was 81.94% (95% CI 71.11% to 90.02%) and specificity was 100% (95% CI39.76% to 100.00%) with positive predictive value of 100%. CONCLUSION: FNAC is a rapid, cost effective and safe procedure for management of breast lumps.

scholarly journals Dedicated Axillary MRI-Based Radiomics Analysis for the Prediction of Axillary Lymph Node Metastasis in Breast Cancer

Cancers ◽  
2021 ◽  
Vol 13 (4) ◽  
pp. 757
Author(s):  
Sanaz Samiei ◽  
Renée W. Y. Granzier ◽  
Abdalla Ibrahim ◽  
Sergey Primakov ◽  
Marc B. I. Lobbes ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Lymph Node ◽  
Lymph Node Metastasis ◽  
Lymph Nodes ◽  
Axillary Lymph Node ◽  
Axillary Lymph Node Metastasis ◽  
Axillary Lymph Nodes ◽  
Axillary Lymph ◽  
Mr Images ◽  
Node Metastasis

Radiomics features may contribute to increased diagnostic performance of MRI in the prediction of axillary lymph node metastasis. The objective of the study was to predict preoperative axillary lymph node metastasis in breast cancer using clinical models and radiomics models based on T2-weighted (T2W) dedicated axillary MRI features with node-by-node analysis. From August 2012 until October 2014, all women who had undergone dedicated axillary 3.0T T2W MRI, followed by axillary surgery, were retrospectively identified, and available clinical data were collected. All axillary lymph nodes were manually delineated on the T2W MR images, and quantitative radiomics features were extracted from the delineated regions. Data were partitioned patient-wise to train 100 models using different splits for the training and validation cohorts to account for multiple lymph nodes per patient and class imbalance. Features were selected in the training cohorts using recursive feature elimination with repeated 5-fold cross-validation, followed by the development of random forest models. The performance of the models was assessed using the area under the curve (AUC). A total of 75 women (median age, 61 years; interquartile range, 51–68 years) with 511 axillary lymph nodes were included. On final pathology, 36 (7%) of the lymph nodes had metastasis. A total of 105 original radiomics features were extracted from the T2W MR images. Each cohort split resulted in a different number of lymph nodes in the training cohorts and a different set of selected features. Performance of the 100 clinical and radiomics models showed a wide range of AUC values between 0.41–0.74 and 0.48–0.89 in the training cohorts, respectively, and between 0.30–0.98 and 0.37–0.99 in the validation cohorts, respectively. With these results, it was not possible to obtain a final prediction model. Clinical characteristics and dedicated axillary MRI-based radiomics with node-by-node analysis did not contribute to the prediction of axillary lymph node metastasis in breast cancer based on data where variations in acquisition and reconstruction parameters were not addressed.

scholarly journals The Findings of SPECT/CT Concerning Bypass Lymph Circulation in Lymphedema Following Breast Cancer Surgery

Healthcare ◽  
2021 ◽  
Vol 9 (4) ◽  
pp. 471
Author(s):  
Min Young Lee ◽  
Eunjung Kong ◽  
Dong Gyu Lee
Keyword(s):  
Breast Cancer ◽  
Lymph Node ◽  
Lymph Nodes ◽  
Lymphatic Drainage ◽  
Cancer Surgery ◽  
Breast Cancer Surgery ◽  
Axillary Lymph Nodes ◽  
Axillary Lymph ◽  
Node Dissection ◽  
Positive Group

This study aimed to determine whether bypass circulation was present in lymphedema and its effect. This was a retrospective, cross-sectional study. Patients who underwent unilateral breast cancer surgery with axillary lymph node dissection were recruited and underwent single-photon emission tomography/computed tomography (SPECT/CT). SPECT/CT was performed to detect the three-dimensional locations of radio-activated lymph nodes. Patients with radioactivity in anatomical locations other than axillary lymph nodes were classified into a positive group. All patients received complete decongestive therapy (CDT). Exclusion criteria were as follows: History of bilateral breast cancer surgery, cervical lymph node dissection history, and upper extremity amputation. The difference in the upper extremity circumference (cm) was measured at four points: Mid-point of the upper arm, elbow, and 10 and 15 cm below the elbow. Twenty-nine patients were included in this study. Fifteen patients (51.7%) had bypass lymphatic systems on the affected side, six (20.7%) had a bypass lymphatic system with axillary lymph nodes on the unaffected side, and 11 (37.9%) showed new lymphatic drainage. The positive group showed significantly less swelling than the negative group at the mid-arm, elbow, and 15 cm below the elbow. Bypass lymphatic circulation had two patterns: Infraclavicular lymph nodes and supraclavicular and/or cervical lymph nodes. Changes in lymph drainage caused by surgery triggered the activation of the superficial lymphatic drainage system to relieve lymphedema. Superficial lymphatic drainage has a connection through the deltopectoral groove.

scholarly journals An AN OBSERVATIONAL STUDY OF SLN MAPPING IN PATIENTS OF LOCALLY ADVANCED BREAST CANCER FOLLOWING NCT

2020 ◽  
Vol 4 (2) ◽  
Author(s):  
Ankur Garg ◽  
Udbhav Kathpalia ◽  
Shweta Bansal ◽  
Manoj Andley ◽  
Sudipta Saha
Keyword(s):  
Lymph Node ◽  
Sentinel Lymph Node ◽  
Adjuvant Chemotherapy ◽  
Lymph Nodes ◽  
Locally Advanced ◽  
Lymph Node Biopsy ◽  
Axillary Lymph Nodes ◽  
Axillary Lymph ◽  
Node Biopsy ◽  
Neo Adjuvant Chemotherapy

Background : Locally advanced breast carcinoma (LABC) includes a wide range of clinical scenarios- advanced primary tumors (T4), advanced nodal disease and inflammatory carcinomas(1). Traditionally, treatment of LABC included a combination of Chemotherapy, Radiation and Surgery(2). However, there has been a shift to Neoadjuvant Chemotherapy in recent times.(3) Histological status and the number of axillary lymph nodes with metastasis is one of the most important prognostic factors and most powerful predictor of recurrence and survival in patients of breast carcinoma and remains so, even after neo-adjuvant chemotherapy. (3) Information derived from the sentinel lymph node is considered valuable, with less discomfort to the patient when compared with axillary dissection.(4) However, its role in detecting nodal metastasis after neo-adjuvant chemotherapy in LABC is still debatable and definitive studies to evaluate its role are still evolving. (5) Materials and Methods: Patients of LABC were evaluated using ultrasonography (USG) of axilla. Neo-adjuvant chemotherapy (NACT) was administered and patients were reassessed by USG of axilla. Thirty patients with node negative axillary status were subjected to Sentinel lymph node mapping using isosulfan blue followed by Modified Radical Mastectomy and Axillary Lymph Node Dissection. Histopathological evaluation of stained and unstained lymph nodes done and the data, thus obtained, was statistically analysed.   Results: Sentinel lymph node biopsy performed using Isosulfan Blue dye alone, after neo-adjuvant chemotherapy predicts the status of axillary lymph nodes with low accuracy.   Conclusions: Further studies would be required to establish the role of sentinel lymph node biopsy in patients with LABC after NACT.

scholarly journals DIAGNOSIS OF ROSAI-DORFMAN DISEASE BY FINE NEEDLE ASPIRATION CYTOLOGY- A STUDY OF ELEVEN CASES WITH EMPHASIS ON SITE

2020 ◽  
pp. 1-3
Author(s):  
Rinsha Surendranath ◽  
M Rajani
Keyword(s):  
Lymph Node ◽  
Lymph Nodes ◽  
Cervical Lymph Node ◽  
Age Distribution ◽  
Needle Aspiration ◽  
Cervical Region ◽  
Axillary Lymph ◽  
Diagnostic Significance ◽  
Massive Lymphadenopathy ◽  
Rosai Dorfman Disease

Rosai Dorfman Disease also called as Sinus Histiocytosis with Massive Lymphadenopathy is a benign proliferative disorder of histiocytes which typically affects lymph nodes of cervical region ,however extranodal sites are also being reported by many authors[1].FNAC is the investigation of choice as is it less invasive and more reliable.Aims :To study the various sites of involvement and diagnostic significance of FNAC along with the pattern of site and age distribution .We studied a series of 11 cases for a period of one year.Materials and methods: Eleven cases studied in the department of Pathology Govt. Siddhartha Medical College,Vijayawada.Material collected from Govt. General Hospital,Vijayawada.Results:The present study showed two extranodal,one axillary lymph node,one inguinal lymph node and seven cervical lymph node involment.Conclusion:Rosai- dorfman disease main clinical manifestion is cervical lymph node enlargement ,but other lymph nodes and extranodal site can also be involved.Most common age of presentation was between 20-40years

Simultaneous Immunohistochemical Detection of Tumor Cells in Lymph Nodes and Bone Marrow Aspirates in Breast Cancer and Its Correlation With Other Prognostic Factors

2001 ◽  
Vol 19 (4) ◽  
pp. 960-971 ◽  
Author(s):  
Bernd Gerber ◽  
Annette Krause ◽  
Heiner Müller ◽  
Dagmar Richter ◽  
Toralf Reimer ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Bone Marrow ◽  
Prognostic Factors ◽  
Lymph Node ◽  
Lymph Nodes ◽  
Cancer Patients ◽  
Tumor Cells ◽  
Axillary Lymph Nodes ◽  
Axillary Lymph ◽  
Breast Cancer Patients

PURPOSE: We studied the prognostic and predictive value of immunohistochemically detected occult tumor cells (OTCs) in lymph nodes and bone marrow aspirates obtained from node-negative breast cancer patients. All were classified as distant metastases-free using conventional staging methods. PATIENTS AND METHODS: A total of 484 patients with pT1-2N0M0 breast cancer and 70 with pT1-2N1M0 breast cancer and a single affected lymph node participated in our trial. Ipsilateral axillary lymph nodes and intraoperatively aspirated bone marrow were examined. All samples were examined for OTCs using monoclonal antibodies to cytokeratins 8, 18, 19. Immunohistological findings were correlated with other prognostic factors. The mean follow-up was 54 ± 24 months. RESULTS: OTCs were detected in 180 (37.2%) of 484 pT1-2N0M0 patients: in the bone marrow of 126 patients (26.0%), in the lymph nodes of 31 patients (6.4%), and in bone marrow and lymph nodes of 23 (4.8%) patients. Of the 70 patients with pT1-2N1MO breast cancer and a single involved lymph node, OTCs were identified in the bone marrow of 26 (37.1%). The ability to detect tumor cells increased with the following tumor features: larger size, poor differentiation, and higher proliferation. Tumors of patients with OTCs more frequently demonstrated lymph node invasion, blood vessel invasion, higher urokinase-type plasminogen activator levels, and increased PAI-1 concentrations. Patients with detected OTCs showed reduced disease-free survival (DFS) and overall survival (OAS) rates that were comparable to those observed in patients who had one positive lymph node. Multivariate analysis of prognostic factors revealed that OTCs, histological grading, and tumor size are significant predictors of DFS; OTCs and grading of OAS. CONCLUSION: OTCs detected by simultaneous immunohistochemical analysis of axillary lymph nodes and bone marrow demonstrate independent metastatic pathways. Although OTCs were significantly more frequent in patients with other unfavorable prognostic factors, they were confirmed as an independent prognostic factor for pT1-2N0M0, R0 breast cancer patients.

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