Intraoperative lymphatic mapping and selective cervical lymphadenectomy for early-stage melanomas of the head and neck.

PURPOSE We developed intraoperative lymphatic mapping with selective lymphadenectomy (SLND) to identify micrometastatic spread of cutaneous melanoma to regional lymph nodes. This study was undertaken to assess the sensitivity and specificity of our technique in patients with clinical stage I (CS-I) melanoma of the head or neck. PATIENTS AND METHODS Seventy-two CS-I melanoma patients underwent intraoperative lymphatic mapping of primary cutaneous melanomas located on the head, neck, or upper chest/back draining to the neck. Key (sentinel) cervical lymph nodes in the regional lymphatic drainage basin were identified, selectively excised during SLND, and examined for microscopic evidence of tumor cells. If these sentinel nodes were tumor-negative, the surgery was concluded; if the sentinel nodes were tumor-positive, all nodes in the drainage basin were removed during en bloc lymphadenectomy (LND). RESULTS Intraoperative lymphatic mapping identified sentinel nodes in 90% of the regional drainage basins. Fifteen percent of these nodes were tumor-positive, indicating the need for LND. There were no false-negative sentinel nodes, and extended follow-up showed no local nodal recurrences in patients whose sentinel-node histology did not indicate the need for LND. CONCLUSION Intraoperative lymphatic mapping and SLND is a minimally invasive and highly accurate screening technique for determining which patients with CS-I head and neck melanomas have subclinical node metastases and therefore might benefit from cervical LND.

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Guidelines for safe and optimum neck dissection: a review article

International Surgery Journal ◽

10.18203/2349-2902.isj20210979 ◽

2021 ◽

Author(s):

Sheetal A. Murchite ◽

Thakut Gowtham ◽

Abhinandan Milind Kadiyal ◽

Vaishali Vinayak Gaikwad ◽

Ashutosh Tiwari

Keyword(s):

Lymph Nodes ◽

Head And Neck ◽

Neck Dissection ◽

Early Stage ◽

Neck Surgery ◽

Head And Neck Surgery ◽

Regional Lymph Nodes ◽

Cervical Lymph Nodes ◽

Early Stage Disease ◽

Regional Metastases

Head and neck cancer is the sixth most common cancer worldwide. The single most important factor affecting prognosis for squamous cell carcinoma is the status of the cervical lymph nodes. Metastasis to the regional lymph nodes reduces the 5-year survival rate by 50% compared with that of patients with early-stage disease. The American cancer society reports that 40% of patients with squamous carcinoma of the oral cavity and pharynx present with regional metastases to the cervical lymph nodes. This activity presents the steps for safe and optimum neck dissection. Objectives of the study were to identify the anatomical structures in neck dissection, review the complications of head and neck surgery and summarize the importance of care coordination and to improve outcomes for patients undergoing head and neck surgery.

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Clinical assessment of cervical node in head and neck malignancy: case series

International Journal of Otorhinolaryngology and Head and Neck Surgery ◽

10.18203/issn.2454-5929.ijohns20180043 ◽

2018 ◽

Vol 4 (2) ◽

pp. 387

Author(s):

Leena Rajam K. ◽

Vikram V. J. ◽

Anjan Kumar Selvaraj ◽

Saravana Babu P.

Keyword(s):

Lymph Node ◽

Prognostic Factor ◽

Lymph Nodes ◽

Head And Neck ◽

Primary Tumour ◽

False Negative ◽

Case Series ◽

Primary Malignancy ◽

Cervical Lymph Nodes ◽

Important Prognostic Factor

Background: Lymph node involvement is well established as an important prognostic factor for head and neck cancer, the spread of carcinoma of head and malignancy to the node levels is probably predictable according to the site of the primary. The appropriate staging of cervical lymph nodes is very important in the management of any head and neck primary carcinoma. Clinical palpation of cervical lymph nodes may yield false negative and false positive results. Methods: In a prospective study in patients of patients with primary malignancy from larynx, any sub site of pharynx (nasopharynx/oropharynx/hypopharynx) of histologically proven squamous cell carcinoma, the nodal status of primary tumour, the level of lymph node involved and the stage of presentation of the tumor and node were analysed clinically. Results: 61 cases included in our study, where males were 52 cases and females were 9 cases. The age incidence ranging from 35 years to 76 years noted. In the distribution of nodal secondary carcinoma of the nasopharynx was 100% nodal positive followed by hypopharynx, oropharynx, and larynx. 21% of patient presented in the N0 stage. The remaining 79% were node positive. In nodal secondary by size of primary most of the patients presented with T3 disease (52%) followed by T2 disease (26%), T1 disease (11%) and T4 disease (11%). Conclusions: In malignancy of larynx, pharynx, lymph node assessment clinically is an important prognostic factor to determine the staging of tumour. The clinical evaluation may also have false negative, so radiological evaluation will further give a detailed assessment of the nodes for better treatment outcomes to reduce the overall mortality.

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B-helper Neutrophils in Regional Lymph Nodes Correlate with Improved Prognosis in Patients with Head and Neck Cancer

Cancers ◽

10.3390/cancers13123092 ◽

2021 ◽

Vol 13 (12) ◽

pp. 3092

Author(s):

Ekaterina Pylaeva ◽

Irem Ozel ◽

Anthony Squire ◽

Ilona Spyra ◽

Charlotte Wallner ◽

...

Keyword(s):

Head And Neck Cancer ◽

Lymph Nodes ◽

B Cell ◽

Head And Neck ◽

Neck Cancer ◽

Patient Survival ◽

Helper Cell ◽

Cell Phenotype ◽

Regional Lymph Nodes ◽

Patient Prognosis

The role of neutrophils during cancer formation and elimination is diverse. Here, for the first time, we investigate neutrophil helper cells (NBH), their influence on B cell activity in the regional lymph nodes (RLN) of head-and-neck cancer patients and the effect of this neutrophil/B cell interaction on patient prognosis. Circulating and RLN neutrophils of patients with stage I–IV head-and-neck squamous cell carcinoma were investigated with flow cytometry and qPCR. In addition, neutrophil/B cell co-localization in RLNs was evaluated using immunohistochemistry. B cell proliferation was assessed and correlated with the distance to neutrophils. Patient survival was evaluated. Neutrophils with the helper cell phenotype were identified in the RLN of HNC patients. B cells in close proximity to such NBH showed significantly higher proliferation rates, together with elevated activation-induced cytidine deaminase (AID) expression. Notably, patient survival was significantly higher in individuals with high NBH frequencies in the B follicles of RLNs. Neutrophils in RLN can support T cell-independent activation of the adaptive immune system through B cell stimulation, capturing helper cell phenotype character. The presence of such helper neutrophils in the RLNs of HNC patients positively correlates with patient prognosis.

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Cervical Lymph Nodes and Unknown Primary Tumors of the Head and Neck

AJCC Cancer Staging Manual ◽

10.1007/978-3-319-40618-3_6 ◽

2016 ◽

pp. 67-78 ◽

Cited By ~ 5

Author(s):

Snehal G. Patel ◽

William M. Lydiatt ◽

John A. Ridge ◽

Christine M. Glastonbury ◽

Suresh K. Mukherji ◽

...

Keyword(s):

Lymph Nodes ◽

Head And Neck ◽

Unknown Primary ◽

Cervical Lymph Nodes ◽

Primary Tumors ◽

Unknown Primary Tumors

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US-guided core-needle biopsy versus US-guided fine-needle aspiration of suspicious cervical lymph nodes for staging workup of non-head and neck malignancies: A propensity score matching study

Journal of Surgical Oncology ◽

10.1002/jso.24747 ◽

2017 ◽

Vol 116 (7) ◽

pp. 870-876 ◽

Cited By ~ 2

Author(s):

Kyeong Hwa Ryu ◽

Jeong Hyun Lee ◽

Seung Won Jang ◽

Hwa Jung Kim ◽

Ji Ye Lee ◽

...

Keyword(s):

Propensity Score ◽

Lymph Nodes ◽

Head And Neck ◽

Fine Needle Aspiration ◽

Core Needle Biopsy ◽

Needle Biopsy ◽

Needle Aspiration ◽

Cervical Lymph Nodes ◽

Core Needle ◽

Fine Needle

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Diffusion weighted magnetic resonance imaging is a feasible method for characterizing regional lymph nodes in canine patients with head and neck disease

Veterinary Radiology & Ultrasound ◽

10.1111/vru.12694 ◽

2018 ◽

Vol 60 (2) ◽

pp. 176-183 ◽

Cited By ~ 5

Author(s):

Jessica A. Stahle ◽

Martha M. Larson ◽

John H. Rossmeisl ◽

Nick Dervisis ◽

Dana Neelis

Keyword(s):

Magnetic Resonance Imaging ◽

Magnetic Resonance ◽

Lymph Nodes ◽

Head And Neck ◽

Resonance Imaging ◽

Regional Lymph Nodes ◽

Feasible Method ◽

Diffusion Weighted ◽

Neck Disease ◽

Weighted Magnetic Resonance Imaging

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Mucosal Melanoma of the Head and Neck Pathologic Regional Lymph Nodes TNM Finding v7

10.32388/i0lkzm ◽

2020 ◽

Author(s):

Keyword(s):

Lymph Nodes ◽

Head And Neck ◽

Mucosal Melanoma ◽

Regional Lymph Nodes

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Manifestations of Tuberculosis in Ear, Nose, Throat, Head and Neck Region – A Retrospective Study

Bengal Journal of Otolaryngology and Head Neck Surgery ◽

10.47210/bjohns.2020.v28i2.332 ◽

2020 ◽

Vol 28 (2) ◽

pp. 144-150

Author(s):

Vandana P Thorawade ◽

S A Jaiswal ◽

Seema Ramlakhan Gupta

Keyword(s):

Retrospective Study ◽

Early Diagnosis ◽

Lymph Nodes ◽

Head And Neck ◽

Salivary Glands ◽

Neck Region ◽

Pulmonary Medicine ◽

Cervical Lymph Nodes ◽

Head And Neck Region ◽

Variable Nature

Introduction Tuberculosis can involve any organ or site. Otorhinolaryngologist may encounter tuberculosis affecting lymph nodes, ear, larynx, deep neck spaces, salivary glands etc. which can mimic other chronic granulomatous conditions or malignancy. To ensure early diagnosis, it is important to recognize its cardinal signs and symptoms and to be aware of potential pitfalls in diagnosis. This study was done to learn the clinical presentation of tuberculosis in ear, nose, throat and head and neck region, and to assess the effectiveness of various investigations and treatment done for the same. Materials and Methods A retrospective study done in our institution involving 120 patients suffering from tuberculosis in ear, nose, throat and head and neck region who attended pulmonary medicine or ENT OPD or ward between January 2008 to December 2017 that is, 10 years. Study period for data collection and analysis was 1 month. Results Total 120 patients-69 males and 51 females. Most common site was cervical lymph nodes(77.5% patients), followed by larynx(8.3%),middle ear(7.5%),deep neck spaces(2.5%) and salivary glands and nose(1.7% each). Histopathology was highly sensitive(99. 1%).All except one patient responded to first-line antitubercular drugs, the other patient was given treatment for MDR-TB to which he responded. Conclusion Tuberculosis can involve any site in the head and neck region, most common being cervical lymph nodes mainly presenting as neck swelling. Variable nature of manifestations of tuberculosis makes it essential to have high degree of suspicion for early diagnosis.

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Nasopharyngeal carcinoma with secondaries at the porta hepatis presenting as obstructive jaundice

The Journal of Laryngology & Otology ◽

10.1017/s0022215100111752 ◽

1990 ◽

Vol 104 (1) ◽

pp. 41-42 ◽

Cited By ~ 3

Author(s):

S. Elango ◽

C. R. Jayakumar

Keyword(s):

Head And Neck Cancer ◽

Nasopharyngeal Carcinoma ◽

Obstructive Jaundice ◽

Lymph Nodes ◽

Head And Neck ◽

Nasopharyngeal Cancer ◽

Distant Metastases ◽

Porta Hepatis ◽

Cervical Lymph Nodes ◽

The Common

AbstractRecent reports have dispelled the previously held concept that head and neck cancer rarely metastases beyond the cervical lymph nodes. Nasopharyngeal cancer has been reported to have a higher incidence of distant metastases compared to other head and neck cancers, the common sites being bone, lung and liver. A case of nasopharyngeal carcinoma presenting as obstructive jaundice because of secondaries at the porta hepatis is presented here.

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