Postoperative recurrence with right cervical lymph node metastasis in hepatocellular carcinoma: a case report

Abstract Background Hepatocellular carcinoma (HCC) patients with metastases to the cervical lymph nodes are extremely rare, and its clinical course is characterized by rapidly progressive disease. Hence, there have been no reports of metastatic cervical lymph node recurrence indicated after a long postoperative surveillance period. Case presentation The patient was a 63-year-old male who underwent right hepatectomy for HCC of the right upper lobe. Three years after resection, metastatic lymph node recurrence was detected in the subdiaphragm, superior mediastinum, and right cervical lymph nodes. The patient underwent excisional biopsy of the cervical lymph node, followed by molecular-targeted therapy and radiation therapy. Lenvatinib reduced the size of all metastatic lymph nodes and the patient survived for a relatively long period of 43 months after the recurrence was detected. Conclusions After resection of HCC in the right upper lobe, there is the possibility of metastatic lymph node recurrence in unusual sites, including the cervical region, and lenvatinib may be effective in those recurrences.

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MRI-based radiomics as response predictor to radiochemotherapy for metastatic cervical lymph node in nasopharyngeal carcinoma

British Journal of Radiology ◽

10.1259/bjr.20201212 ◽

2021 ◽

pp. 20201212

Author(s):

Xu Hao ◽

Hao Xu ◽

Jieke Liu ◽

Ying Huang ◽

Peng Zhou ◽

...

Keyword(s):

Lymph Node ◽

Nasopharyngeal Carcinoma ◽

Lymph Nodes ◽

Treatment Response ◽

Cervical Lymph Node ◽

Validation Cohort ◽

Cervical Lymph Nodes ◽

Metastatic Lymph Nodes ◽

Metastatic Lymph ◽

Sensitivity Specificity

Objective: To establish and substantiate MRI-based radiomic models to predict the treatment response of metastatic cervical lymph node to radiochemotherapy in patients with nasopharyngeal carcinoma (NPC). Methods: A total of 145 consecutive patients with NPC were enrolled including 102 in primary cohort and 43 in validation cohort. Metastatic lymph nodes were diagnosed according to radiologic criteria and treatment response was evaluated according to the Response Evaluation Criteria in Solid Tumors. A total of 2704 radiomic features were extracted from contrast-enhanced T1-weighted imaging (CE-T1WI) and T2-weighted imaging (T2WI) for each patient, and were selected to construct radiomic signatures for CE-T1WI, T2WI, and combined CE-T1WI and T2WI, respectively. The area under curve (AUC) of receiver operating characteristic, sensitivity, specificity, and accuracy were used to estimate the performance of these radiomic models in predicting treatment response of metastatic lymph node. Results: No significant difference of AUC was found among radiomic signatures of CE-T1WI, T2WI, and combined CE-T1WI and T2WI in the primary and validation cohorts (all p > 0.05). For combined CE-T1WI and T2WI dataset, 12 features were selected to develop the radiomic signature. The AUC, sensitivity, specificity, and accuracy were 0.927 (0.878–0.975), 0.911 (0.804–0.970), 0.826 (0.686–0.922), and 0.872 (0.792–0.930) in primary cohort, and were 0.772 (0.624–0.920), 0.792 (0.578–0.929), 0.790 (0.544–0.939), and 0.791 (0.640–0.900) in validation cohort. Conclusion: MRI-based radiomic models were developed to predict the treatment response of metastatic cervical lymph nodes to radiochemotherapy in patients with NPC, which might facilitate individualized therapy for metastatic lymph nodes before treatment. Advances in knowledge: Predicting the response in patients with NPC before treatment may allow more individualizing therapeutic strategy and avoid unnecessary side-effects and costs. Radiomic features extracted from metastatic cervical lymph nodes showed promising application for predicting the treatment response in NPC.

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

Update Dental College Journal ◽

10.3329/updcj.v1i2.13978 ◽

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

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Cervical lymph node enlargement as the initial manifestation of rectal cancer

BMC Gastroenterology ◽

10.1186/s12876-021-01628-5 ◽

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.

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

The Journal of Laryngology & Otology ◽

10.1017/s0022215111000958 ◽

2011 ◽

Vol 125 (8) ◽

pp. 820-828 ◽

Cited By ~ 4

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.

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Nanoparticles can improve the positive rate of metastatic lymph node in thyroid cancer surgery

10.21203/rs.3.rs-23046/v1 ◽

2020 ◽

Author(s):

Xindi Su ◽

Fang Chai ◽

Benrui Lin ◽

Lu Qu ◽

Keyi Liu ◽

...

Keyword(s):

Thyroid Cancer ◽

Lymph Node ◽

Lymph Nodes ◽

Metastatic Lymph Node ◽

Cancer Surgery ◽

Control Group ◽

Blood Calcium ◽

Metastatic Lymph ◽

Positive Rate ◽

Experimental Group

Abstract Objective. To investigate the application of carbon nanoparticles in lymph node dissection and parathyroid gland protection during thyroid cancer surgery. Subjects and Methods. Retrospective analysis was performed on 282 cases of thyroid cancer surgery in our hospital from 2018 to 2019. All patients underwent total thyroidectomy and cervical central lymph node dissection. Nanocarbon was not used in the control group, but was used in the experimental group. The general situation of the patients, the number of postoperative lymph nodes and the number of metastasis were collected, and the differences between serum parathyroid hormone and blood calcium were compared before and on the 3rd and 30th day after surgery. Results. There was no difference in age, sex and TNM stage between the two groups (P > 0.05). The number of metastatic lymph nodes in the experimental group (9.80 ± 4.80) was different from that in the control group (6.95 ± 3.86) (P < 0.05), and the number of metastatic lymph nodes in the experimental group was different from that in the control group (χ2 = 14.968, P < 0.05). There was no difference in blood calcium and PTH between the two groups before and at 3 and 30 days after surgery (P > 0. 05). Conclusion. The application of carbon nanoparticles in thyroid cancer surgery can significantly increase the number of lymph nodes seized and the positive rate of metastatic lymph node removal, but the protection of parathyroid gland is not obvious.

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

10.36106/gjra/6302790 ◽

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

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Presurgical, ultrasound-guided anchor-wire marking of impalpable cervical lymph nodes

The Journal of Laryngology & Otology ◽

10.1258/0022215054516241 ◽

2005 ◽

Vol 119 (8) ◽

pp. 627-628 ◽

Cited By ~ 13

Author(s):

J A Bryant ◽

N J Siddiqi ◽

E J Loveday ◽

G H Irvine

Keyword(s):

Lymph Node ◽

High Risk ◽

Lymph Nodes ◽

Cervical Lymph Node ◽

Ultrasound Guidance ◽

Operating Time ◽

High Risk Patient ◽

Wire Localization ◽

Ultrasound Guided ◽

Cervical Lymph Nodes

This case illustrates the surgical use of wire localization, a well tried technique from a different field of surgery, in the removal of an ultrasound-detected, impalpable deep lower cervical lymph node in a high-risk patient. A localization needle with an echogenic tip was placed freehand under ultrasound guidance, immediately before surgery. The imaging and marking of the impalpable cervical lymph node resulted in a precise surgical dissection and a reduction in operating time whilst minimizing risks to the patient and staff.

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