Intracholecystic Papillary-Tubular Neoplasms (ICPNs): A Pathology Report

Mapping Intimacies ◽

10.33844/cjm.2021.60512 ◽

2021 ◽

Keyword(s):

Colon Cancer ◽

Lymph Nodes ◽

Tumor Marker ◽

Laboratory Tests ◽

Hepatic Flexure ◽

Pathology Report ◽

Wound Surface ◽

Polypoid Mass ◽

High Cholesterol ◽

Biopsy Report

We presented a 60-year-old man who underwent a colonoscopy examination of a polypoid mass with a wound surface of 1.1 cm in hepatic flexure. An adenocarcinoma of intestinal type was diagnosed based on the biopsy report, and patient was referred to the hospital for colectomy. In colonoscopy and biopsy, the polypoid mass was completely removed, and despite different sections of the whole specimen in the colectomy specimen, any mass was not found, while only one out of three identified lymph nodes were involved. In laboratory tests, CBC had anemia: (Hb: 10.8 mg/ dl), elevated CEA tumor marker (range: 18 ng/ml), and lipid profile disorder together with high cholesterol (300 mg/dl), indicating colon cancer manifestation.

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Clinical analysis of metastatic characteristics of infrapyloric lymph nodes (No.206) and terminal ileum lymph nodes in patients with right colon cancer

World Journal of Surgical Oncology ◽

10.1186/s12957-021-02414-z ◽

2021 ◽

Vol 19 (1) ◽

Author(s):

Jiangrui Liu ◽

Yibin Su ◽

Xing Liu ◽

Jinfu Zhuang ◽

Yuanfeng Yang ◽

...

Keyword(s):

Colon Cancer ◽

Lymph Node ◽

Lymph Nodes ◽

Lymph Node Dissection ◽

Terminal Ileum ◽

Tumor Location ◽

Right Hemicolectomy ◽

Hepatic Flexure ◽

Node Dissection ◽

Right Colon Cancer

Abstract Background D3 or complete mesocolic excision (CME) surgery has become a common surgical procedure for the treatment of colon cancer metastasis. Clinical misuse and overuse of lymph node dissection bring unnecessary burdens to patients. A detailed guidance for lymph node dissection in patients with T3 and T4 stage right colon cancer at different locations is urgently needed. Methods A retrospective study was performed. Patients received D3 or CME surgery were divided into ileocecal group, ascending colon group, and hepatic flexure group according to the 9th edition of the Japanese Society for Cancer of the Colon and Rectum guidelines. The distributions of lymph node metastases were analyzed according to tumor infiltration depth (T stage) and tumor location. Results The incidence of metastases in the paracolic area (or station), intermediate area, and main (or central) area was 38.4% (139/362), 12.7% (46/362), and 9.7% (35/362), respectively. The proportion of patients having No.206 and terminal ileum lymph nodes metastases was 7.7% (14/181) and 3.7% (9/244), respectively. No.206 lymph node metastasis is related to tumor location (χ2 = 7.955, p = 0.019) and degree of differentiation (χ2 = 18.99, p = 0.000), and terminal ileum lymph node metastasis is related to tumor location (χ2 = 6.273, p = 0.043). Patients with T3/T4 hepatic flexure cancer received radical right hemicolectomy in addition to No.206 lymph node dissection. Conclusion Radical right hemicolectomy and No.206 group lymph node dissection are necessary for T3 and T4 stage colon cancer therapy.

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Regional Lymph Nodes Distribution Pattern in Central Area of Right-sided Colon Cancer: In-Vivo Detection and the Update on the Clinical Exploration.

10.21203/rs.3.rs-95107/v1 ◽

2020 ◽

Author(s):

Xiaochuang Feng ◽

Hongming Li ◽

Xinquan Lu ◽

Xiaojiang Yi ◽

Jin Wan ◽

...

Keyword(s):

Colon Cancer ◽

Lymph Nodes ◽

Distribution Pattern ◽

Lymphatic Vessels ◽

Central Area ◽

Radical Resection ◽

Pathology Report ◽

Target Area ◽

Regional Lymph Nodes

Abstract BackgroundDistribution of regional lymph nodes (LNs) is decisive for the lymphadenectomy boundary in radical resection of a right-sided colon cancer (RCC). Currently, the data of LNs in central area remains ambiguous and scarce. Herein we aim to provide a more detailed anatomical research on LNs surrounding the superior mesenteric vessels for RCC and investigated the metastasis rate.MethodsCarbon Nanoparticles (CNs) or Indocyanine Green (ICG) were used as dye and we laparoscopically observed the stained LNs distribution pattern and analyzed the harvested LNs combined with pathology report. Lastly, 137 RCC patients who received a “superior mesenteric artery (SMA)-oriented” hemicolectomy from September 2016 to September 2020 were included to calculate the probability of LNs metastasis in our target area.Results20 patients diagnosed as RCC (mean age 55.55 years, 13 male) were included. 13 patients underwent CNs injection and 7 patients consented to the ICG, while 4 cases suffered from imaging failure. The unequal number of the regional LNs located between SMV and SMA was detected in 17 cases (85%), posterior to SMV area in 6 cases (30%), and anterior to SMA in 11 cases (55%), respectively. The presence of LNs posterior to SMV was associated with the crossing pattern of ileocolic artery (²= 5.38, p= 0.020). The probability of LNs metastasis in the above areas (target areas) was 2.19% (3/137). No dyed LNs occurred when the SMA sheath was exposed. What’s more, the number of total harvested LNs in patients with dye injection was significant more than dye-free RCC patients (22.44±13.78 vs 43.20±22.70, p<0.01). ConclusionRight-hemi colon-draining lymphatic vessels anteriorly/posteriorly traversed the SMV and arrived at the surface of SMA near the middle colonic artery (MCA) level, which highlights the potential need of CME to place the internal border anterior to SMA and the removal of mesenteric tissue in our target area on lymphatic resection.

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