scholarly journals Retroperitoneal ganglioneuroma with nodal involvement in an adult patient with human immunodeficiency virus: a case report and review of the literature

2021 ◽  
Vol 15 (1) ◽  
Author(s):  
Elliott Lebby ◽  
Daniel Kwan ◽  
Thanh-Lan Bui ◽  
Ryan O’Connell ◽  
Mani Seetharaman ◽  
...  

Abstract Background Ganglioneuromas are a benign tumor originating from neural crest cells. As one of the neuroblastic tumors, ganglioneuromas are most common in children, with a mean age at presentation of 7 years. Ganglioneuromas are typically singular in nature, but rarely can present with lymph node involvement and distant metastasis. We present a rare case of a retroperitoneal ganglioneuroma found in a human immunodeficiency virus positive adult, which was complicated by lymph node involvement. This case is notable not only in regard to the age of the patient, but also because of his human immunodeficiency virus positive status and the extension of tumor to lymph nodes. Case presentation A 27-year-old Latino male with history of human immunodeficiency virus presented with a 6-month history of left upper quadrant and epigastric abdominal pain with associated nausea and vomiting. The patient had a computed tomography scan showing a retroperitoneal mass encasing the aorta, celiac axis, and superior mesenteric artery. Core needle biopsy revealed ganglioneuroma. Owing to obstructive symptoms, resection of the mass along with partial gastric resection, partial pancreatic resection, and splenectomy was performed by a multidisciplinary group of surgeons. Pathology results revealed metastatic spread of ganglioneuroma to surrounding lymph nodes. Conclusions Ganglioneuromas are most common in children and very rarely occur in adults. However, it is still important to consider this entity in the differential for patients presenting with suspicious symptoms. While rare, it is essential to consider metastasis in this generally benign disease.

Author(s):  
Patrick Kavabushi ◽  
Immaculate Kambutse ◽  
Issa Ngabonziza ◽  
Carine Nyampinga ◽  
Fiacre B. Mugabe ◽  
...  

Introduction: Cryptoccocus neoformans is an encapsulated fungal pathogen which is contracted through inhalation of the infectious organisms which cause primarily pulmonary disease. The infection remains latent until the host becomes immunocompromised. The disease may disseminate to different sites; however most patients essentially present with brain and lung disease (meningitis and pneumonia, respectively). Cryptococcal lymphadenitis is therefore an uncommon occurrence of this infection. Objective: We describe the clinico-pathological features of an 18-year-old male with vertically transmitted HIV/AIDS infection who presented to our hospital with features of disseminated cryptococcal infection and notable lymph node involvement. Case Presentation: An 18-year-old secondary school adolescent boy presented to our hospital with a 3-week history of fever, headache, body weakness and marked loss of body weight. He had been recently diagnosed with HIV infection and initiated on antiretroviral therapy (ART). On examination, he was weak, dehydrated and had multiple enlarged lymph nodes and facial skin papules. Notably, laboratory investigations revealed positive India ink test on cerebrospinal fluid (CSF) microscopy examination and culture, positive PAS stain for yeasts on lymph node histopathology and markedly prominent chest lymph nodes on the chest X-ray. A diagnosis of disseminated Cryptococcosis with lymph node involvement was made. He improved on Amphotericin B and oral fluconazole and a repeat CSF culture two weeks later was negative for Cryptococcus neoformans. Conclusion: Cryptococcal lymphadenitis is a rare manifestation of Cryptococcal disease.


2020 ◽  
Author(s):  
Madiha Liaqat ◽  
Shahid Kamal ◽  
Florian Fischer ◽  
Nadeem Zia

Abstract Background: Involvement of lymph nodes has been an integral part of breast cancer prognosis and survival. This study aimed to explore factors influencing on the number of auxiliary lymph nodes in women diagnosed with primary breast cancer by choosing an efficient model to assess excess of zeros and over-dispersion presented in the study population. Methods: The study is based on a retrospective analysis of hospital records among 5,196 female breast cancer patients in Pakistan. Zero-inflated Poisson and zero-inflated negative binomial modeling techniques are used to assess the association between under-study factors and the number of involved lymph nodes in breast cancer patients. Results: The most common breast cancer was invasive ductal carcinoma (54.5%). Patients median age was 48 years, from which women aged 46 years and above are the majority of the study population (64.8%). Examination of tumors revealed that over 2,662 (51.2%) women were ER-positive, 2,652 (51.0%) PR-positive, and 2,754 (53.0%) were Her2.neu-positive. The mean tumor size was 3.06 cm and histological grade 1 (n=2021, 38.9%) was most common in this sample. The model performance was best in the zero-inflated negative binomial model. Findings indicate that most factors related to breast cancer have a significant impact on the number of involved lymph nodes. Age is not contributed to lymph node status. Women having a larger tumor size suffered from greater number of involved lymph nodes. Tumor grades 11 and 111 contributed to higher numbers of positive lymph node.Conclusions: Zero-inflated models have successfully demonstrated the advantage of fitting count nodal data when both “at-harm” (lymph node involvement) and “not-at-harm” (no lymph node involvement) groups are important in predicting disease on set and disease progression. Our analysis showed that ZINB is the best model for predicting and describing the number of involved nodes in primary breast cancer, when overdispersion arises due to a large number of patients with no lymph node involvement. This is important for accurate prediction both for therapy and prognosis of breast cancer patients.


2020 ◽  
Vol 7 (7) ◽  
pp. 2151
Author(s):  
Pratap Kumar Deb ◽  
Syed Abul Fazal

Background: In adenocarcinoma stomach, lymph node involvement is a significant predictor of survival, and a decisive factor in planning management. Size has always been an important criterion while considering the metastatic status of the node, in its radiological evaluation or otherwise. However, to what extent the size of a node can be considered as a reliable criterion for its metastatic potential remains a question.Methods: The present study is based on retrieving lymph nodes per operatively from patients of carcinoma stomach, measuring each node, evaluating its metastatic status and comparing the results to find a correlation between these two parameters.Results: The present study, examined a total of 187 nodes from 30 gastrectomy specimens. Among them, metastasis was found in 59 nodes (31.55%). Among these metastatic nodes, 34 (57.62%) were actually less than 5mm in size. Among the total sizes of all the lymph nodes examined, the mean±SD (standard deviation) of the metastasis positive nodes were found to be 6.42±3.86 mm, while that of the non-metastatic nodes were found to be 5.51±1.99 mm. However, it was also observed that larger nodes (>1 cm), tend to have a high chance of being malignant (62.5%).Conclusions: The above study shows though large nodes tend to be malignant, ignoring small nodes can lead to gross under staging or incomplete clearance while treating patients of adenocarcinoma stomach. Smaller nodes constitute a significant proportion of malignant nodes and must be evaluated. Size is not a reliable criterion of metastasis in lymph nodes of carcinoma stomach.


1995 ◽  
Vol 81 (6) ◽  
pp. 469-474 ◽  
Author(s):  
György Csanaky ◽  
Zoltán Szereday ◽  
Tamás Magyarlaki ◽  
Gábor Méhes ◽  
Tamás Herbert ◽  
...  

Aims and background Angiomyolipomas (AMLs) are benign hamartoid tumors which frequently occur in tuberous sclerosis (TS). They may be manifest at different organ sites such as kidneys, lymph nodes, liver and lung and may be associated with renal cell carcinoma (RCC). The nature of multiple organ involvement in AML (metastasis versus multicentric synchronous tumors), the malignant transformation and the relation of AML to RCC have not been sufficiently clarified. Study design Three cases of renal AMLs in patients with tuberous sclerosis associated with lymphangioleiomyomatosis of the paraaortic lymph nodes and/or with RCC are reported. The concise clinical history of the patients as well as the findings of histology, immunohistochemistry and quantitative DNA analysis are presented. Results The multicentric form of AML and coincidence of renal AML and RCC were observed in 2 patients. AML and RCC were found within the same focus in one of the cases. RCCs were either aneuploid or “near diploid”, whereas one of the multicentric AMLs showed a discordant DNA ploidy pattern, namely aneuploidy in the kidney and diploidy in the lymph nodes. Conclusions The presented cases (all of them underwent periaortic lymphadenectomy) suggest that lymph node involvement in renal AML may be more frequent than expected (1-2% of all AMLs) on the basis of the few reported cases. The discordant DNA ploidy (renal versus lymph node lesions) observed in one of the cases with multicentric AML implies synchronous tumor growth at different sites rather than metastatic disease. The intimate coexistance of RCC and AML (RCC revealed by immunohistochemistry within a larger mass of renal AML) may indicate that malignant transformation of an AML should only be accepted, if such a coincidence is unequivocally excluded.


1996 ◽  
Vol 63 (2) ◽  
pp. 188-191
Author(s):  
G. Severini ◽  
C. Morisi ◽  
M. Frigola ◽  
S. Arnone ◽  
S. Voce

One of biggest problems when assessing radical surgery of prostatic cancer is progression of the locally advanced disease when lymph nodes are positive. The following questions should be asked: 1) if there are patterns of lymph node involvement 2) if retroperitoneal lymphadenectomy is indispensable in pre-operative clinical removal 3) if the prognosis, in relation to lymph node invasion, worsens with the increase in number of positive lymph nodes or if the lesion becomes bilateral. The authors’ experience is reported.


1974 ◽  
Vol 60 (4) ◽  
pp. 317-323 ◽  
Author(s):  
Renato Musumeci ◽  
Carlo Uslenghi

Abdominal lymphography was performed in 30 patients, 12 males and 18 females, with sarcoidosis. The diagnosis of disease was in every case histological, after mediastinal biopsy in 16 cases and after biopsy of lymph nodes in various sites in 14 cases. Mediastino-pulmonary involvement of varying degree was present in 23 patients. Lymphography revealed involvement of the inguinoretroperitoneal lymph nodes in 18 cases, bilateral in 15 of them. Lymphographic diagnosis of sarcoidosis is fairly arduous because the pattern elicited is very similar to that of lymphomas. The pathological findings were graded into 4 groups. No correlation between lymphographic pattern and duration and extent of the disease was demonstrated. In 5 patients with pathological lymphography lymph node biopsy confirmed the diagnosis. The routine use of lymphography in patients with sarcoidosis is not to be racommended because the demonstration of extensive lymph node involvement does not affect the treatment in any way.


2006 ◽  
Vol 24 (18_suppl) ◽  
pp. 13575-13575 ◽  
Author(s):  
M. Hetnal ◽  
K. Malecki ◽  
S. Korzeniowski ◽  
T. Zemelka

13575 Background: The aim of this paper is an assessment of results of adjuvant chemoradiotherapy in patients with rectal cancer with respect to prognostic factors, causes of treatment failures and treatment tolerance. Methods: 178 pts with Dukes’ stage B or C rectal cancer received postoperative chemoradiotherapy between 1993 and 2002. Median age was 62; 110 patients were males, 68 were females. Median follow-up time was 45 months. Main endpoints of the analysis were locoregional recurrence-free survival (LRRFS), distant relapse free survival (DRFS), disease free survival (DFS) and overall survival (OS). Kaplan-Meier method was used to calculate survival rates. Univariate and multivariate analyses of prognostic factors were performed using log rank and Cox’s proportional hazard method. Results: The 5-year LRRFS was 73%, DRFS was 80%, DFS was 61% and OS was 65%. Lymph node involvement and method of resection (AR favoured) were the only independent prognostic factors for LRRFS. Lymph node involvement, in particular when four or more are involved, was independent prognostic factors for DFS. For DRFS are histological grade, lymph node involvement and extracapsular extension of the lymph node metastases. For OS, the independent prognostic factors were infiltration of the pararectal fatty tissue, lymph node involvement in particular when four or more are involved, total number of chemotherapy cycles (at least six favoured). The 5-year LRRFS was 73%, DRFS was 80%, DFS was 61% and OS was 65%. Radiation therapy was well tolerated in 45% of patients. Most common early reactions were diarrhoea, nausea/vomiting and leucopoenia. Conclusions: Involvement of lymph nodes and method of resection were the only independent prognostic factors for LRRFS. Prognostic factors for OS were infiltration of the pararectal fatty tissue, lymph node metastases, four or more involved lymph nodes, total number of chemotherapy cycles. No significant financial relationships to disclose.


Sign in / Sign up

Export Citation Format

Share Document