scholarly journals Reassessing the Value of Contrast-Enhanced Ultrasonography in Differential Diagnosis of Cervical Tuberculous Lymphadenitis and Lymph Node Metastasis of Papillary Thyroid Carcinoma

2021 ◽  
Vol 11 ◽  
Author(s):  
Xu Zhang ◽  
Lingling Wang ◽  
Na Feng ◽  
Tu Ni ◽  
Wei Tang
Keyword(s):  
Differential Diagnosis ◽  
Lymph Node ◽  
Lymph Node Metastasis ◽  
Lymph Nodes ◽  
Tuberculous Lymphadenitis ◽  
Papillary Thyroid ◽  
Node Metastasis ◽  
Contrast Enhanced ◽  
Significant Difference ◽  
Contrast Enhanced Ultrasonography

AimWe aimed to evaluate the ability of contrast-enhanced ultrasonography (CEUS) to perform differential diagnosis of cervical tuberculous lymphadenitis and lymph node metastasis from papillary thyroid cancer (PTC).MethodsWe analyzed 102 enlarged cervical lymph nodes as diagnosed by conventional ultrasound (US) and CEUS. The US and CEUS enhancement pattern and the time intensity curve (TIC) of the metastatic lymph nodes or tuberculous lymph nodes were compared following standard pathological protocols. The TIC included peak time (TTP), peak intensity (PI), and area under the gamma curve (AUC).ResultsPathological results demonstrated that 48 out of the 102 enlarged lymph nodes were lymph node metastasis from PTC, while 54 were tuberculous lymphadenitis. There was statistically significant differences in hyperechoic islands, pulse-like enhancement, and asynchronous enhancement between tuberculous lymphadenitis and lymph node metastasis (P < 0.05), but their diagnostic sensitivity and specificity were unsatisfactory. In addition, our data did not show statistically significant difference in enhancement direction, enlarged range on CEUS, and perfusion defect (P > 0.05). Similarly, quantitative parameters such as PI, TTP, and AUC did not yield significant differences between the groups.ConclusionTaken together, the present results demonstrate that CEUS can provide valuable information on lymph node blood flow, which can be used to identify tuberculous lymphadenitis and lymph node metastasis of PTC.

scholarly journals Impact of retrieved lymph nodes count on short-term complications in patients with gastric cancer: a retrospective study

2020 ◽  
Author(s):  
Feng Sun ◽  
Song Liu ◽  
Peng Song ◽  
Chen Zhang ◽  
Zhijian Liu ◽  
...  
Keyword(s):  
Gastric Cancer ◽  
Lymph Node ◽  
Postoperative Complications ◽  
Lymph Node Metastasis ◽  
Lymph Nodes ◽  
Operation Time ◽  
Short Term ◽  
Node Metastasis ◽  
Significant Difference ◽  
Univariate Analyses

Abstract Background: It is well established that retrieved lymph nodes (RLNs) count were positively correlated with better overall survival in gastric cancer (GC). But little is known about the relationship between RLNs count and short-term complications after radical surgery. Methods: A total of 1487 consecutive GC patients between January 2016 and December 2018 at Nanjing Drum Tower Hospital were retrospectively analyzed. Univariate analyses were performed to elucidate the association between RLNs count and postoperative complications. We further identified clinical factors that might affect the RLNs count.Results: Among all of the patients, postoperative complications occurred in 435 (29.3%) patients. The mean RLNs count was 25.1 and 864 (58.1%) patients were diagnosed with lymph node metastasis. Univariate analyses showed no significant difference between RLNs count and postoperative complications (both overall and stratified by CDC grade). We further explored that preoperative serum albumin, type of resection, operation time, tumor invasion, lymph node metastasis, and pTNM stage were associated with RLNs count. Conclusions: The current study demonstrated that RLNs count was not associated with postoperative short-term complications following gastrectomy of GC, which provided a rationale for the determination of a proper RLNs count of curative gastrectomy.

scholarly journals Impact of Retrieved Lymph Nodes Count on Short-Term Complications in Patients with Gastric Cancer

2020 ◽  
Author(s):  
Feng Sun ◽  
Song Liu ◽  
Peng Song ◽  
Chen Zhang ◽  
Zhijian Liu ◽  
...  
Keyword(s):  
Gastric Cancer ◽  
Lymph Node ◽  
Postoperative Complications ◽  
Lymph Node Metastasis ◽  
Lymph Nodes ◽  
Operation Time ◽  
Short Term ◽  
Node Metastasis ◽  
Significant Difference ◽  
Univariate Analyses

Abstract Background: It is well established that retrieved lymph nodes (RLNs) count were positively correlated with better overall survival in gastric cancer (GC). But little is known about the relationship between RLNs count and short-term complications after radical surgery. Methods: A total of 1487 consecutive GC patients between January 2016 and December 2018 at Nanjing Drum Tower Hospital were retrospectively analyzed. Univariate analyses were performed to elucidate the association between RLNs count and postoperative complications. We further identified clinical factors that might affect the RLNs count.Results: Among all of the patients, postoperative complications occurred in 435 (29.3%) patients. The mean RLNs count was 25.1 and 864 (58.1%) patients were diagnosed with lymph node metastasis. Univariate analyses showed no significant difference between RLNs count and postoperative complications (both overall and stratified by CDC grade). We further explored that preoperative serum albumin, type of resection, operation time, tumor invasion, lymph node metastasis, and pTNM stage were associated with RLNs count. Conclusions: The current study demonstrated that RLNs count was not associated with postoperative short-term complications following gastrectomy of GC, which provided a rationale for the determination of a proper RLNs count of curative gastrectomy.

Clinical Usefulness of Telomerase Assay for the Detection of Lymph Node Metastasis in Patients With Oral Malignancy

2000 ◽  
Vol 124 (3) ◽  
pp. 398-400
Author(s):  
Tomoki Sumida ◽  
Hiroyuki Hamakawa ◽  
Hiroaki Kayahara ◽  
Hirofumi Zen ◽  
Kenichi Sogawa ◽  
...  
Keyword(s):  
Lymph Node ◽  
Lymph Node Metastasis ◽  
Oral Cancer ◽  
Lymph Nodes ◽  
Cancer Cell Line ◽  
Telomerase Activity ◽  
Cervical Lymph Nodes ◽  
Node Metastasis ◽  
Significant Difference ◽  
Oral Malignancy

Abstract Objective.—Telomerase is considered a diagnostic marker of malignancy. We investigated the usefulness of telomerase assay for the detection of lymph node micrometastasis. Methods.—Sixteen cervical lymph nodes with metastasis of oral cancer and 20 benign lymph nodes were studied. The oral cancer cell line was used to estimate the sensitivity for telomerase assay. Telomerase activity was measured by semiquantitative telomeric repeat amplification protocol. Results.—There was a significant difference between malignant and benign lymph nodes. The telomerase activity of 50 mg of lymph nodes with 103 or more cancer cells differed from that of control lymph nodes. Lymph nodes with 102 or fewer tumor cells expressed similar levels as benign lymph nodes. Conclusions.—In addition to routine histologic examination, telomerase assay is considered a useful tool for the detection of lymph node metastasis in patients with oral malignancy.

scholarly journals Pattern of regional metastasis in papillary thyroid cancer: our experience of 86 cases

2019 ◽  
Vol 7 (9) ◽  
pp. 3362
Author(s):  
Rajjyoti Das ◽  
Jagannath D. Sharma ◽  
Amal Ch Kataki ◽  
Chandi R. Kalita ◽  
Nizara Baishya
Keyword(s):  
Thyroid Cancer ◽  
Lymph Node ◽  
Lymph Node Metastasis ◽  
Lymph Nodes ◽  
Neck Dissection ◽  
Papillary Thyroid Cancer ◽  
Nodal Metastasis ◽  
Papillary Thyroid ◽  
Node Metastasis ◽  
Regional Metastasis

Background: Papillary thyroid cancer (PTC) have a high propensity for regional metastasis which ranges from 30- 80%. The objective of the study is to assess the pattern of lymph node metastasis and to plan the extent of neck dissection accordingly. Though central neck dissection (CND) is routinely done in PTC but the indication of extent of  neck dissection is still controversial.Methods: The medical records of   86 patients with PTC  who underwent total thyroidectomy (TT) and neck dissection at Dr. B. Borooah Cancer Institute(BBCI) from January 2010 to  December 2014 were retrospectively reviewed.Results: Out of 86 patients 22 were males and 64 were females. The median age of presentation was 40.0 years. 43 out of 86 patients (50%) had cervical lymph node metastasis. Ipsilateral nodal metastasis was found in 37 patients (43.0%) and contralateral metastasis was found in only 6 patients (7.0%).Tumors with size more than 3cm had ipsilateral nodal metastasis in 21(56.7%) patients which is statistically significant (p 0.03).A strong association was found between level VI and the ipsilateral group of lymph nodes involving level II,III,IV and V.Conclusions: Majority of patients present with multiple level nodal metastasis, with the central compartment commonly involved. In view of the high incidence of metastatic lymph nodes in levels II, III, IV and level VI ,our study  supports the recommendation  for posterolateral  and anterior  neck dissection in patients with clinically positive neck  nodes and tumor with aggressive criteria.

scholarly journals Risk factors of the suprasternal lymph node metastasis in papillary thyroid carcinoma with clinical lateral cervical lymph node metastasis

2020 ◽  
Author(s):  
Hyun-Keun Kwon ◽  
Yong-Il Cheon ◽  
Sung-Chan Shin ◽  
Eui-Suk Sung ◽  
Jin-Choon Lee ◽  
...  
Keyword(s):  
Risk Factors ◽  
Lymph Node ◽  
Lymph Node Metastasis ◽  
Lymph Nodes ◽  
Cervical Lymph Node ◽  
Cervical Lymph Node Metastasis ◽  
Nodal Metastasis ◽  
Papillary Thyroid ◽  
Inferior Pole ◽  
Node Metastasis

Abstract Background: Metastatic lymph nodes are occasionally found in the suprasternal lymph nodes in patients with papillary thyroid cancer (PTC), but there are few studies on these lymph nodes. Therefore, we investigated the frequency and risk factors of suprasternal lymph node metastasis in PTC patients with lateral cervical lymph node metastasis.Methods: A total of 85 patients with cN1b PTC underwent total thyroidectomy with elective lateral neck dissection including the suprasternal lymph nodes. We analyzed the correlation between suprasternal lymph node metastasis and sex, age, tumor characteristics, and cervical lymph node metastasis status.Results: Eleven patients (12.9%) had pathological suprasternal lymph node metastasis. Suprasternal lymph node metastasis was associated with tumors located in the inferior pole and level IV lymph node metastasis.Conclusion: In cN1b PTC patients, especially those with inferior pole tumors and level IV nodal metastasis, the suprasternal lymph node should be routinely dissected.

scholarly journals Nomograms Combining Ultrasonic Features With Clinical and Pathological Features for Estimation of Delphian Lymph Node Metastasis Risk in Papillary Thyroid Carcinoma

2021 ◽  
Vol 11 ◽  
Author(s):  
Qi Qi ◽  
Pan Xu ◽  
Cheng Zhang ◽  
Suping Guo ◽  
Xingzhi Huang ◽  
...  
Keyword(s):  
Risk Factors ◽  
Lymph Node ◽  
Lymph Node Metastasis ◽  
Lymph Nodes ◽  
Clinical Pathology ◽  
Diagnostic Model ◽  
Pathological Features ◽  
Node Metastasis ◽  
Significant Difference ◽  
Independent Risk Factors

BackgroundThis work explores the clinical significance of Delphian lymph nodes (DLN) in thyroid papillary carcinoma (PTC). At the same time, a nomogram is constructed based on clinical, pathological, and ultrasonic (US) features to evaluate the possibility of DLN metastasis (DLNM) in PTC patients. This is the first study to predict DLNM using US characteristics.MethodsA total of 485 patients, surgically diagnosed with PTC between February 2017 and June 2021, all of whom underwent thyroidectomy, were included in the study. Using the clinical, pathological, and US information of patients, the related factors of DLNM were retrospectively analyzed. The risk factors associated with DLNM were identified through univariate and multivariate analyses. According to clinical + pathology, clinical + US, and clinical + US + pathology, the predictive nomogram for DLNM was established and validated.ResultsOf the 485 patients with DLN, 98 (20.2%) exhibited DLNM. The DLNM positive group had higher positive rates of central lymph node metastasis (CLNM), lateral lymph node metastasis (LLNM), and T3b–T4b thyroid tumors than the negative rates. The number of CLNM and LLNM lymph nodes in the DLNM+ group was higher as compared to that in the DLNM- group. Multivariate analysis demonstrated that the common independent risk factors of the three prediction models were male, bilaterality, and located in the isthmus. Age ≥45 years, located in the lower pole, and nodural goiter were protective factors. In addition, the independent risk factors were classified as follows: (I) P-extrathyroidal extension (ETE) and CLNM based on clinical + pathological characteristics; (II) US-ETE and US-CLNM based on clinical + US characteristics; and (III) US-ETE and CLNM based on clinical +US + pathological features. Better diagnostic efficacy was reported with clinical + pathology + US diagnostic model than that of clinical + pathology diagnostic model (AUC 0.872 vs. 0.821, p = 0.039). However, there was no significant difference between clinical + pathology + US diagnostic model and clinical + US diagnostic model (AUC 0.872 vs. 0.821, p = 0.724).ConclusionsThis study found that DLNM may be a sign that PTC is more invasive and has extensive lymph node metastasis. By exploring the clinical, pathology, and US characteristics of PTC progression to DLNM, three prediction nomograms, established according to different combinations of features, can be used in different situations to evaluate the transfer risk of DLN.

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