Uniportal VATS dissection of subcarinal mediastinal lymph nodes (station 7) from the right side.

Background: Intrathoracic Lymphadenopathy (ITLN) in Human Immunodeficiency Virus (HIV) infected patients may have various etiologies and prognoses. Etiologies of ITLN can be distinguished based on the distribution of enlarged lymph nodes. Sometimes tuberculosis (TB) is the first sign of underlying HIV infection. Objective: We sought to determine ITLN distribution and associated pulmonary findings in TB/HIV co-infection using Computed Tomography (CT) scan. Methods: In this retrospective, observational, cross-sectional study, chest CT scans of 52 patients with TB/HIV co-infection were assessed for enlarged intrathoracic lymph nodes (>10 mm in short axis diameter), lymphadenopathy (LAP) distribution, calcification, conglomeration, the presence of hypodense center and associated pulmonary abnormalities. LAP distribution was compared in TB/HIV co-infection with isolated TB infection. Results: Mediastinal and/or hilar LAP were seen in 53.8% of TB/HIV co-infection patients. In all cases, LAP was multinational. The most frequent stations were right lower paratracheal and subcarinal stations. Lymph node conglomeration, hypodense center and calcification were noted in 25%, 21.4% and 3.5% of patients, respectively. LAP distribution was the same as that in patients with isolated TB infection except for the right hilar, right upper paratracheal and prevascular stations. All patients with mediastinal and/or hilar adenopathy had associated pulmonary abnormalities. Conclusion: All patients with TB/HIV co-infection and mediastinal and/or hilar adenopathy had associated pulmonary abnormalities. Superior mediastinal lymph nodes were less commonly affected in TB/HIV co-infection than isolated TB.

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Pathological Complete Response After Immune-Checkpoint Inhibitor Followed by Salvage Surgery for Clinical Stage IV Pulmonary Adenocarcinoma with Continuous Low Neutrophil-to-Lymphocyte Ratio: A Case Report

10.21203/rs.3.rs-127794/v1 ◽

2020 ◽

Author(s):

Mitsunori Higuchi ◽

Takahiro Kawamata ◽

Ikuro Oshibe ◽

Nobutoshi Soeta ◽

Takuro Saito ◽

...

Keyword(s):

T Cells ◽

Partial Response ◽

Lymph Nodes ◽

Pathological Complete Response ◽

Clinical Stage ◽

Lower Lobe ◽

Stage Iv ◽

Complete Response ◽

Mediastinal Lymph Nodes ◽

The Right

Abstract Background: Immune-checkpoint inhibitors (ICIs) play a crucial role in the treatment of advanced non-small cell lung cancer (NSCLC), however, most patients fail this treatment after a limited period. We here report a patient with a pathological complete response (CR) after treatment with ICI for stage IV pulmonary adenocarcinoma.Case presentation: A 73-year-old man was referred to our hospital because of hoarseness. A roentgenogram and chest CT scan revealed a huge (78-mm diameter) pulmonary tumor in the right upper lobe and a tumor with cavitation in the left lower lobe. A CT scan also showed enlarged upper mediastinal lymph nodes. Transbronchial lung biopsy (TBLB) of the tumors showed adenocarcinomas in both. The tumor in the right upper lobe was considered to be the primary with mediastinal lymph nodes metastasis and that in the left lower lobe a pulmonary metastasis. The disease was determined to be cT4N2M1a stage IVA after whole body evaluation . He was treated with first line chemotherapy comprising cisplatin, pemetrexed, and bevacizumab for six cycles, achieving a partial response. However, 6 months after initial treatment, the primary and metastatic tumors enlarged and he was treated with second line anti-PD-1 therapy for 7 months with a partial response. 18-fluorodeoxyglucose positron emission tomography (FDG-PET) revealed weak accumulation of FDG in the primary tumor only with no accumulation in the left pulmonary metastasis or mediastinal lymph nodes, despite the lymph nodes still being enlarged. He was diagnosed as having ycT1bN0M0 stage IA2 disease and underwent right upper lobectomy. Postoperative pathological findings revealed that cancer tissues had been replaced by scar tissue and that CD4 positive T cells, rather than CD8 positive T cells, were predominant. It was also noted that he had a lower neutrophil-to-lymphocyte ratio (NLR) during immunotherapy than before immunotherapy and after surgery. He was diagnosed to be ypT0N0M0 stage 0 (Ef.3). His postoperative course was uneventful and he remained well for twelve months after surgery with no further treatment.Conclusions: Neoadjuvant chemotherapy with ICIs for advanced NSCLC may be a promising modality, even for clinical stage IV disease, in the near future. Furthermore, NLR during immunotherapy may be a promising biomarker of ICIs treatment.

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Migration of Teflon after Vocal Cord Injection

Otolaryngology ◽

10.1177/019459988709600111 ◽

1987 ◽

Vol 96 (1) ◽

pp. 63-66 ◽

Cited By ~ 35

Author(s):

John C. Ellis ◽

Thomas V. Mccaffrey ◽

Lawrence W. Desanto ◽

Herbert V. Reiman

Keyword(s):

Cerebral Cortex ◽

Lymph Nodes ◽

Vocal Cord ◽

Vocal Fold ◽

Mediastinal Lymph Nodes ◽

Polarizing Microscopy ◽

Cervical Lymph Nodes ◽

Upper Cervical ◽

The Right

Each of eight mongrel dogs received a 0.5 ml injection of polytef paste into the right vocal fold. These dogs were killed at 1 week, 1 month, 3 months, and 6 months after injection, and a number of organs were examined. Polarizing microscopy was used to examine the upper cervical lymph nodes, lower cervical lymph nodes, mediastinal lymph nodes, abdominal lymph nodes, cerebral cortex, brainstem, lung, liver, spleen, and kidney to determine if migration of polytef had occurred. Examination of these organs revealed that there was consistent migration of polytef particles into the cervical lymph nodes, with the highest incidence occurring in upper cervical lymph nodes on the side of injection. There was no evidence of migration of polytef particles to distant sites. The study shows that polytef particles may migrate to cervical lymph nodes after injection into the larynx; however, there is no evidence of distant migration.

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Immunotherapy-Induced Sarcoid-Like Reaction: A Shrewd Imitator

Journal of Investigative Medicine High Impact Case Reports ◽

10.1177/23247096211009400 ◽

2021 ◽

Vol 9 ◽

pp. 232470962110094

Author(s):

Hassaan Yasin ◽

Vivek Yadala ◽

Noman Ahmed Jang Khan ◽

Vincent Graffeo ◽

Krista Denning ◽

...

Keyword(s):

Positron Emission Tomography ◽

Lymph Nodes ◽

Mediastinal Lymph Node ◽

Mek Inhibitor ◽

Needle Aspiration ◽

Neck Mass ◽

Emission Tomography ◽

Mediastinal Lymph Nodes ◽

Positron Emission ◽

The Right

A 40-year-old male with a right-sided neck mass was diagnosed with metastatic melanoma. A repeat positron-emission tomography after treatment with combination immunotherapy demonstrated increased hypermetabolic activity in the right supraclavicular, hilar, and mediastinal regions. Immunotherapy was discontinued and a BRAF/MEK inhibitor combination was started. Repeat imaging showed a decrease in size of the neck mass; however, hilar and mediastinal lymph nodes increased in size. A fine needle aspiration of mediastinal lymph nodes was consistent with a granulomatous process. A diagnosis of a sarcoid-like reaction (SLR) was made, and he was started on steroids. A follow-up positron emission tomography showed decreased hilar and mediastinal lymph node hypermetabolic activity. We, therefore, report this rare case of immunotherapy-induced SLR to the expanding literature on immunotherapy-related adverse effects and would like to highlight that SLR can occur in conjunction with disease progression making it challenging to distinguish between the two.

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Carcinoma of unknown origin manifested as adenocarcinoma in the hilar and mediastinal lymph nodes of the right lung.

The Journal of the Japanese Association for Chest Surgery ◽

10.2995/jacsurg.10.166 ◽

1996 ◽

Vol 10 (2) ◽

pp. 166-170

Author(s):

Masaaki Kuroya ◽

Kenji Inui ◽

Tatsuo Fukuse ◽

Hiroyasu Yokomise ◽

Osamu Ike ◽

...

Keyword(s):

Lymph Nodes ◽

Unknown Origin ◽

Mediastinal Lymph Nodes ◽

The Right

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Castleman's Disease Masquerading as Sigmoid Colon Tumor and Hodgkin Lymphoma

Swiss Surgery ◽

10.1024/1023-9332.8.1.7 ◽

2002 ◽

Vol 8 (1) ◽

pp. 7-10 ◽

Cited By ~ 6

Author(s):

Altinli ◽

Pekmezci ◽

Balkan ◽

Somay ◽

M. Akif Buyukbese ◽

...

Keyword(s):

Lymph Nodes ◽

Hodgkin Lymphoma ◽

Sigmoid Colon ◽

Castleman’S Disease ◽

Malignant Potential ◽

Colon Tumor ◽

Rare Entity ◽

Castleman's Disease ◽

Mediastinal Lymph Nodes ◽

Histologic Types

Castleman's disease is a benign lymphoid neoplasm first reported as hyperplasia of mediastinal lymph nodes. Some authors referred to the lesions as isolated tumors, described as a variant of Hodgkin's disease with a possibility of a malignant potential and others proposed that the lymphoid masses were of a hamartomatous nature. Three histologic variants and two clinical types of the disease have been described. The disease may occur in almost any area in which lymph nodes are normally found. The most common locations are thorax (63%), abdomen (11%) and axilla (4%). We report two separate histologic types of Castleman's disease which were rare in the literature, mimicking sigmoid colon tumor and Hodgkin lymphoma. The diagnostic and therapeutic aspects of this rare entity is discussed.

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Sepsis-like illness with mediastinal involvement after EUS-FNP of mediastinal lymph nodes in a patient with sarcoidosis and a history of esophageal carcinoma

Ultraschall in der Medizin - European Journal of Ultrasound ◽

10.1055/s-0033-1354968 ◽

2013 ◽

Vol 34 (S 01) ◽

Author(s):

W Bohle ◽

WG Zoller

Keyword(s):

Lymph Nodes ◽

Esophageal Carcinoma ◽

Mediastinal Lymph Nodes ◽

History Of ◽

Mediastinal Involvement

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Prediction of lymph node metastase in NSCLC

Onkologische Welt ◽

10.1055/s-0038-1632899 ◽

2010 ◽

Vol 01 (05) ◽

pp. 219-226 ◽

Cited By ~ 1

Author(s):

F. Beyer ◽

B. Buerke ◽

J. Gerss ◽

K. Scheffe ◽

M. Puesken ◽

...

Keyword(s):

Lymph Nodes ◽

Fdg Pet ◽

Automatic Segmentation ◽

Correlation Coefficients ◽

Mediastinal Lymph Nodes ◽

Intra Class Correlation ◽

Axial Diameter ◽

Pet Ct ◽

Fdg Pet Ct

SummaryPurpose: To distinguish between benign and malignant mediastinal lymph nodes in patients with NSCLC by comparing 2D and semiautomated 3D measurements in FDG-PET-CT.Patients, material, methods: FDG-PET-CT was performed in 46 patients prior to therapy. 299 mediastinal lymph-nodes were evaluated independently by two radiologists, both manually and by semi-automatic segmentation software. Longest-axial-diameter (LAD), shortest-axial-diameter (SAD), maximal-3D-diameter, elongation and volume were obtained. FDG-PET-CT and clinical/FDG-PET-CT follow up examinations and/or histology served as the reference standard. Statistical analysis encompassed intra-class-correlation-coefficients and receiver-operator-characteristics-curves (ROC). Results: The standard of reference revealed involvement in 87 (29%) of 299 lymph nodes. Manually and semi-automatically measured 2D parameters (LAD and SAD) showed a good correlation with mean

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