scholarly journals Hepatocellular carcinoma with regional lymphadenopathy caused by sarcoid-like reaction: a case report

2021 ◽  
Vol 7 (1) ◽  
Author(s):  
Tomoko Mizota ◽  
Masato Suzuoki ◽  
Saya Kaku ◽  
Kenichi Mizunuma ◽  
Kazuto Ohtaka ◽  
...  
Keyword(s):  
Hepatocellular Carcinoma ◽  
Lymph Node ◽  
Lymph Nodes ◽  
Granulomatous Inflammation ◽  
Giant Cells ◽  
Epithelioid Cell ◽  
Imaging Modalities ◽  
Hepatoduodenal Ligament ◽  
Regional Lymph Nodes ◽  
Multiple Imaging

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.

BIOPSY OF THE SIGNALING LYMPH NODES IN GASTRIC CANCER - CURRENT STATUS OF THE PROBLEM AND PROSPECTS

2018 ◽  
Vol 64 (3) ◽  
pp. 335-344
Author(s):  
Aleksey Karachun ◽  
Yuriy Pelipas ◽  
Oleg Tkachenko ◽  
D. Asadchaya
Keyword(s):  
Gastric Cancer ◽  
Lymph Node ◽  
Sentinel Lymph Node ◽  
Lymph Nodes ◽  
Stomach Cancer ◽  
Current Status ◽  
Regional Lymph Nodes ◽  
Systematic Analysis ◽  
Tumor Spread ◽  
Special Value

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.

scholarly journals Extended-field intensity-modulated radiotherapy and dosage boost for lymph node metastasis are beneficial for the prognosis of FIGO IIICr and IVA cervical cancer patients with positive regional lymph nodes

2020 ◽  
Author(s):  
Yuhua Zhao ◽  
Gong Li ◽  
Lei Gao
Keyword(s):  
Cervical Cancer ◽  
Lymph Node ◽  
Lymph Nodes ◽  
Intensity Modulated Radiotherapy ◽  
Figo Stage ◽  
Concurrent Chemotherapy ◽  
Regional Lymph Nodes ◽  
Free Survival ◽  
Node Metastasis ◽  
Extended Field

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.

scholarly journals Clinical, morphological, and molecular genetic predictors of metastatic lesions in the regional lymph nodes in breast cancer

2018 ◽  
Vol 5 (3) ◽  
pp. 8-16
Author(s):  
Yu. A. Dergunova ◽  
V. V. Podionov ◽  
V. K. Bozhenko ◽  
V. V. Kometova ◽  
M. V. Dardyk
Keyword(s):  
Breast Cancer ◽  
Lymph Node ◽  
Lymph Nodes ◽  
Molecular Genetic ◽  
Regional Lymph Nodes ◽  
Genetic Characteristics ◽  
Metastatic Lesions ◽  
Genetic Predictors ◽  
Node Metastases ◽  
High Degree

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.

scholarly journals Malignant pheochromocytoma in a pig

2011 ◽  
Vol 24 (1) ◽  
pp. 207-210 ◽  
Author(s):  
Jorge Martínez ◽  
Iván Galindo-Cardiel ◽  
Meritxell Díez-Padrisa ◽  
Emilio I. López-Sabater ◽  
Joaquim Segalés
Keyword(s):  
Lymph Node ◽  
Adrenal Gland ◽  
Lymph Nodes ◽  
Immunohistochemical Staining ◽  
Malignant Pheochromocytoma ◽  
Endocrine Tumors ◽  
Neurofilament Protein ◽  
Regional Lymph Nodes ◽  
The Masses ◽  
Current Report

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.

scholarly journals THE EFFECT OF ANTIGENIC STIMULATION ON INCORPORATION OF PHOSPHATE AND METHIONINE INTO PROTEINS OF ISOLATED LYMPH NODE CELLS

1959 ◽  
Vol 110 (2) ◽  
pp. 207-219 ◽  
Author(s):  
Milton Kern ◽  
Herman N. Eisen
Keyword(s):  
Lymph Node ◽  
Lymph Nodes ◽  
Protein Fraction ◽  
Antibody Formation ◽  
Antigenic Stimulation ◽  
Regional Lymph Nodes ◽  
Lymph Node Cells ◽  
Phosphate Incorporation ◽  
In Cells

Isolated lymph node cells incorporate inorganic orthophosphate into a protein fraction. The phosphorylated product is a phosphoprotein. The rate of phosphate incorporation into phosphoprotein was determined in cells isolated from regional lymph nodes at varying times after antigen injection. The rate was unaltered on the 3rd day, but was enhanced on the 4th day after injection. Parallel results were obtained with L-methionine incorporation into the same gross protein fraction. Possible relationships between antibody formation and the observed enhancement in phosphate incorporation into phosphoprotein are discussed.

Interstitial Mr Lymphography Using Gd-Carrying Liposomes

1997 ◽  
Vol 38 (412_suppl) ◽  
pp. 51-55
Author(s):  
B. Misselwitz ◽  
A. Sachse
Keyword(s):  
Lymph Node ◽  
Lymph Nodes ◽  
Contrast Agent ◽  
Low Dose ◽  
High Accumulation ◽  
Regional Lymph Nodes ◽  
The Third ◽  
Skin Fold ◽  
Mr Lymphography ◽  
Guinea Pig Model

The detection of metastasis in lymph nodes is greatly enhanced by the use of contrast media. Interstitial injection of lymphography contrast agents requires only injection of a low dose of the agent, and leads to high accumulation in regional lymph nodes with only minor side effects. We were able to show the suitability of liposome-encapsulated gadobutrol as an interstitially injectable lymphography contrast agent in an experimental animal model. For screening of possible lymphotrophic compounds a guinea pig model was used. Accumulation of the contrast agent in 3 successive lymph node groups was determined 4 h after subcutaneous injection of the contrast agent (about 0.1 ml of a 30 mmol Gd/1 solution resulting in a total dose of 10 μmol/kg) into the interdigital skin fold of a hind limb. The Gd concentration in the first lymph node group (popliteal) was 540 μmol/1 (16% dose/g tissue), in the second group (inguinal): 260 μmol/1 (8% dose/g tissue), and in the third group (iliacal): 910 μmol/1 (27% dose/g tissue). Moreover, this compound was completely eliminated and well tolerated.

scholarly journals Simultaneous Renal Oncocytoma and Lymphoma: Interest of Lymphadenectomy

2013 ◽  
Vol 2013 ◽  
pp. 1-2
Author(s):  
Angela Orcurto ◽  
Benoît Lhermitte ◽  
Alain Sermier ◽  
Dominik Berthold
Keyword(s):  
Lymph Node ◽  
Lymph Nodes ◽  
Regional Lymph Node ◽  
Renal Oncocytoma ◽  
Node Dissection ◽  
Regional Lymph Nodes ◽  
Regional Lymph Node Dissection ◽  
Histological Confirmation ◽  
Kidney Lesions

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.

PS02.022: INDOCYANINE GREEN: A USEFUL TOOL IN MINIMALLY INVASIVE ESOPHAGEAL CANCER SURGERY

2018 ◽  
Vol 31 (Supplement_1) ◽  
pp. 126-126
Author(s):  
Victor Turrado-Rodriguez ◽  
Dulce Nombre De Maria Momblan ◽  
Ainitze Ibarzabal ◽  
Alba Torroella ◽  
Rafael Gerardo Diaz Del Gobo ◽  
...  
Keyword(s):  
Esophageal Cancer ◽  
Lymph Node ◽  
Sentinel Lymph Node ◽  
Lymph Nodes ◽  
Indocyanine Green ◽  
Esophageal Surgery ◽  
Gastric Conduit ◽  
Early Esophageal Cancer ◽  
Regional Lymph Nodes ◽  
Vascular Assessment

Abstract Background Minimally invasive approach to esophageal cancer has been accepted as the standard of care in many centers. Nontheless, some technical difficulties are encountered during surgery. A proper vascularization of the gastric tube is mandatory to avoid the dreadful complication of a leak or of gastric conduit necrosis. On the other hand, there is controversy on the identification of sentinel lymph node in early esophageal cancer and on the extent of lymphadenectomy in locally advanced tumours. Indocyanine green (ICG) is a sterile, anionic, water-soluble but relatively hydrophobic, tricarbocyanine molecule, which is bound to plasma proteins when intravenously injected. It is extracted by the liver appearing in the bile around 8 minutes after injection. When injected outside the blood vessels, ICG reaches the nearest lymph node within 15 minutes and after 1 to 2 hours it binds to the regional lymph nodes. The usual dose of ICG is 0.1 - 0.5mg/mL/kg. ICG becomes fluorescent once excited with near-infrared (NIR) light at about 820 nm. The fluorescence released by ICG may be detected using specially developed cameras. Methods A systematic review of the literature of ICG in esophageal surgery was carried on February 2018 using the following terms: esophagus, indocyanine green, ICG, surgery, angiography, lymph node, and combinations of the above. Results The technique of ICG angiography for vascular assessment of the gastroepiploic arcade and gastric conduit is explained and the published results are review. The use of ICG for the evaluation of sentinel lymph node in early esophageal cancer and of lymph node mapping for regional lymph nodes is explained and current evidence is reviewed. Conclusion ICG use in esophageal surgery is still a novel and promising technique. It could help to reduce anastomotic leak by means of vascular assessment of the gastric conduit, locate lymph nodes out of the usual fields of lymphadenectomy and locate the sentinel lymph node in early esophageal cancer Disclosure All authors have declared no conflicts of interest.

Recurrences in the Soft Tissues of the Neck after Surgery or Radiotherapy plus Surgery on Regional Lymph Nodes in Patients Bearing Carcinomas of the Head and Neck

1983 ◽  
Vol 69 (3) ◽  
pp. 255-259 ◽  
Author(s):  
Sante Basso-Ricci ◽  
Roberto Molinari ◽  
Gian Franco Brambilla
Keyword(s):  
Lymph Node ◽  
Lymph Nodes ◽  
Lymph Node Dissection ◽  
Soft Tissues ◽  
Postoperative Radiotherapy ◽  
Cervical Region ◽  
Preoperative Radiation ◽  
Node Dissection ◽  
Regional Lymph Nodes ◽  
Node Metastases

A series of 45 recurrences in the soft tissues of the neck following lymph node dissection in 497 patients bearing carcinoma of the upper aerodigestive passages is reported. Only 22 cases that presented perilymph node metastases and/or in which there were reasons to indicate insufficient surgical radicality had been subjected to radiotherapy after surgical lymph node dissection; the other 23 cases had not been subjected to radiotherapy because the aforementioned premises had been lacking. All the recurrences therefore occurred in patients with clinically and histologically ascertained metastatic lymph nodes. The presence of perilymph node metastases and the judgement of surgical radicality was thus found insufficient criteria to plan future complementary postoperative radiotherapy. However, even in those cases in which postoperative radiotherapy was performed, there was a rather high incidence of recurrences, as high as 64.7% in patients with carcinoma of the tongue. Our data indicate the opportunity of a clinical trial with preoperative radiation therapy in patients with clinically evident lymph node metastases. Thirty-six of these recurrences were situated in the upper parts of the cervical region. The prognosis is very poor in such cases, so much so that only 2 of our series were disease free at 3 years after the treatment.

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