Incidental Small Lymphocytic Lymphoma/Chronic Lymphocytic Leukemia in Pelvic Lymph Nodes Excised at Radical Prostatectomy

2003 ◽  
Vol 127 (5) ◽  
pp. 567-572 ◽  
Author(s):  
Edward G. Weir ◽  
Jonathan I. Epstein
Keyword(s):  
Lymph Node ◽  
Radical Prostatectomy ◽  
Lymph Nodes ◽  
Diagnostic Accuracy ◽  
Hodgkin Lymphoma ◽  
Pelvic Lymph Node ◽  
Cell Phenotype ◽  
Small Lymphocytic Lymphoma ◽  
Pelvic Lymph Nodes ◽  
Non Hodgkin Lymphoma

Abstract Context.—Incidental non-Hodgkin lymphoma is often unrecognized at the time of radical prostatectomy in patients with prostate cancer because of nonspecific symptoms and an inconspicuous pathology. The early identification of lymphoma allows optimal long-term management and prevention of significant morbidity. Objective.—To show the subtlety of pathologic findings in cases of non-Hodgkin lymphoma in pelvic lymph nodes and the need for scrupulous attention to detail for diagnostic accuracy. Design.—Histologic and immunohistochemical profiles of 18 consecutive cases of small lymphocytic lymphoma (SLL) incidentally identified in pelvic lymph node dissections were reviewed and compared with 22 cases of benign pelvic lymph node dissections. Results.—Malignant nodes were grossly enlarged and averaged 3.2 cm in their greatest dimension. Histologically, 16 of the SLL cases were characterized by diffuse architectural effacement with obliterated sinuses and rare cortical follicles. Twelve of these cases showed evidence of pseudofollicles. Two cases showed an interfollicular growth pattern with occasional small pseudofollicles. In contrast, benign pelvic lymph nodes averaged 1.7 cm in their greatest dimension. Although most were architecturally distorted by fibrosis, all benign nodes were notable for patent sinuses. Immunohistochemistry was diagnostically helpful in several cases with equivocal morphology. All malignant cases had a B-cell phenotype with aberrant coexpression of T-cell–related antigens typical of SLL. Conclusion.—Incidental low-grade non-Hodgkin lymphoma identified at radical prostatectomy is often overlooked by both the urologist and the pathologist. Although malignant pelvic lymph node dissections frequently lack overt manifestations of lymphoma, attention to subtle morphologic features coupled with lymph node size and immunohistochemical findings should permit diagnostic accuracy.

DISTRIBUTION OF PELVIC LYMPH NODES IS NOT SYMMETRIC. RESULTS FROM AN EXTENDED PELVIC LYMPH NODE DISSECTION SERIES

2009 ◽  
Vol 181 (4S) ◽  
pp. 100-101 ◽  
Author(s):  
Firas Abdollah ◽  
Alberto Briganti ◽  
Andrea Gallina ◽  
Nazareno Suardi ◽  
Umberto Capitanio ◽  
...  
Keyword(s):  
Lymph Node ◽  
Lymph Nodes ◽  
Lymph Node Dissection ◽  
Pelvic Lymph Node Dissection ◽  
Pelvic Lymph Node ◽  
Node Dissection ◽  
Pelvic Lymph Nodes

scholarly journals Anatomic Extent of Pelvic Lymph Node Dissection: Impact on Long-term Cancer-specific Outcomes in Men With Positive Lymph Nodes at Time of Radical Prostatectomy

Urology ◽  
2013 ◽  
Vol 82 (3) ◽  
pp. 653-659 ◽  
Author(s):  
Trinity J. Bivalacqua ◽  
Phillip M. Pierorazio ◽  
Michael A. Gorin ◽  
Mohamad E. Allaf ◽  
H. Ballentine Carter ◽  
...  
Keyword(s):  
Lymph Node ◽  
Radical Prostatectomy ◽  
Lymph Nodes ◽  
Lymph Node Dissection ◽  
Pelvic Lymph Node Dissection ◽  
Pelvic Lymph Node ◽  
Node Dissection ◽  
Positive Lymph Nodes

Lymphography and Abdominal Computed Tomography in the Staging of Non-Hodgkin Lymphoma

1987 ◽  
Vol 28 (3) ◽  
pp. 263-269 ◽  
Author(s):  
S. P. Strijk
Keyword(s):  
Computed Tomography ◽  
Lymph Node ◽  
Lymph Nodes ◽  
Ct Scan ◽  
Hodgkin Lymphoma ◽  
Lymph Node Involvement ◽  
Initial Examination ◽  
Additional Information ◽  
Non Hodgkin Lymphoma ◽  
Ct Lymphography

Ninety-one patients with non-Hodgkin lymphoma (NHL) were subjected to computed tomography (CT) and lymphography. Both examinations agreed in 74 patients (81%) with regard to the infradiaphragmatic lymph nodes. In patients undergoing CT prior to lymphography, the concordance amounted to 75 per cent. When lymphography was the initial examination, the concordance amounted to 86 per cent. Lymphography was abnormal in 30 per cent of the patients with a normal CT scan and in 93 per cent of those with an abnormal CT scan as the first examination. CT was abnormal in 4 per cent of patients with a normal lymphogram and in 84 per cent of those with an abnormal lymphogram as the first examination. CT did not detect mesenteric or retrocrural lymph node enlargement in the absence of retroperitoneal lymph node involvement. Eleven patients had extranodal manifestations of the disease (excluding liver and spleen), and 3 were detected primarily with CT. Lymphography is the most complete examination for the infradiaphragmatic lymph nodes for staging purposes. Although CT outlined the disease better, it changed the ***lymphographic diagnosis in only 2 per cent of the patients. Lymphography modified the CT stage in 15 per cent of the patients. When abdominal CT is performed first, in staging patients with NHL, lymphography will only yield additional information when CT is normal or equivocal.

scholarly journals Applied Anatomy of Pelvic Lymph Nodes and Its Clinical Significance for Prostate Cancer:A Single-Center Cadaveric Study

2019 ◽  
Author(s):  
Chen Jia-Jun ◽  
Zhu Zai-Sheng ◽  
Zhu Yi-Yi ◽  
Shi Hong-Qi
Keyword(s):  
Lymph Node ◽  
Radical Prostatectomy ◽  
Lymph Nodes ◽  
Lymph Node Dissection ◽  
Adult Male ◽  
Pelvic Lymph Node Dissection ◽  
Node Dissection ◽  
Lymph Node Count ◽  
Pelvic Lymph Nodes ◽  
Node Count

Abstract Background Pelvic lymph node dissection (PLND) is one of the most important steps in radical prostatectomy (RP). Not only can PLND provide accurate clinical staging to guide treatment after prostatectomy but PLND can also improve the prognosis of patients by eradicating micro-metastases. However, reports of the number of pelvic lymph nodes have generally come from incomplete dissection during surgery, there is no anatomic study that assesses the number and variability of lymph nodes. Our objective is to assess the utility of adopting the lymph node count as a metric of surgical quality for the extent of lymph node dissection during RP for prostate cancer by conducting a dissection study of pelvic lymph nodes in adult male cadavers. Methods All 30 adult male cadavers underwent pelvic lymph node dissection (PLND), and the lymph nodes in each of the 9 dissection zones were enumerated and analyzed. Results A total of 1267 lymph nodes were obtained. The number of lymph nodes obtained by local PLND was 4-22 (14.1±4.5), the number obtained by standard PLND was 16-35 (25.9±5.6), the number obtained by extended PLND was 17-44 (30.0±7.0), and the number obtained by super-extended PLDN was 24-60 (42.2±9.7). Conclusions There are substantial inter-individual differences in the number of lymph nodes in the pelvic cavity. These results have demonstrated the rationality and feasibility of adopting lymph node count as a surrogate for evaluating the utility of PLND in radical prostatectomy, but these results need to be further explored.

Low risk endometrial cancer: A study of pelvic lymph node metastasis

2003 ◽  
Vol 13 (1) ◽  
pp. 38-41 ◽  
Author(s):  
M. Watanabe ◽  
Y. Aoki ◽  
H. Kase ◽  
K. Fujita ◽  
K. Tanaka
Keyword(s):  
Endometrial Cancer ◽  
Lymph Node ◽  
Lymph Node Metastasis ◽  
Lymph Nodes ◽  
Pelvic Lymph Node ◽  
Tumor Diameter ◽  
Primary Therapy ◽  
Pelvic Lymph Nodes ◽  
Node Metastasis ◽  
Pelvic Lymph Node Metastasis

The aim of our study was to find preoperative or intraoperative pathologic indicators that would discriminate a subgroup of early corpus cancers that would not require lymphadenectomy. A retrospective review of the medical records of 107 patients with endometrioid adenocarcinoma, FIGO grade 1 or 2 tumor, myometrial invasion ≤50%, and no intraoperative evidence of macroscopic extrauterine spread was performed. Clinicopathologic risk factors were analyzed with Fisher ′s exact test with regards to pelvic lymph node metastasis. The median age of the patients was 54 years. Pelvic lymph node metastasis was observed in five of 107 patients (4.7%), where two patients with small tumors of 2 cm or less had positive pelvic lymph nodes. The presence of positive pelvic lymph nodes did not correlate with depth of invasion, histologic grade, cervical invasion, peritoneal cytology, menopausal status, preoperative serum CA125 level, or primary tumor diameter. Only lymphvascular space involvement (P < 0.0001) was significantly correlated to pelvic lymph node metastasis. We suggest that all patients with endometrial cancer who are taken to the operating room for primary therapy should be prepared to undergo extended surgical staging, except when clinical or operative factors increase patients' morbidity.

scholarly journals Unusual Case of Uterine Intravascular Leiomyomatosis with Lymphatic Spread to Pelvic Lymph Nodes

2021 ◽  
Vol 156 (Supplement_1) ◽  
pp. S74-S74
Author(s):  
H Siatecka ◽  
R Masand
Keyword(s):  
Smooth Muscle ◽  
Lymph Node ◽  
Lymph Nodes ◽  
Vena Cava ◽  
Rare Condition ◽  
Endometrial Stromal Sarcoma ◽  
Pelvic Lymph Node ◽  
Lymphatic Spread ◽  
Regional Lymph Nodes ◽  
Pelvic Lymph Nodes

Abstract Introduction/Objective Intravascular leiomyomatosis, also known as intravenous leiomyomatosis, is characterized by presence of smooth muscle within venous spaces in the myometrium, usually in conjunction with a leiomyoma. Although presence of tumor within lymphatics in addition to veins are alluded to in literature, exclusively lymphatic spread with lymph node metastases have not been previously reported. Methods/Case Report A 50-year-old woman presented with left flank pain. CT pelvis showed an enlarged uterus with multiple large leiomyomata as well as pelvic lymph node enlargement. Hysterectomy with bilateral salpingo- ophorectomy and pelvic lymph node dissection was performed. Gross examination revealed multifibroid uterus. Separately sent pelvic lymph nodes showed well-circumscribed, whorled lesions resembling leiomyoma. Microscopically, in addition to typical leiomyomata, a 11.5 cm intramural tumor with epithelioid cells, very rare mitoses and no necrosis was identified. Adjacent to this mass, several large endothelial lined spaces (positive for D240 and negative for CD31), consistent with lymphatics, showed intravascular extension of the same epithelioid tumor. All the pelvic lymph nodes were replaced by the tumor. Due to the unusual morphology and pattern of spread, immunohistochemical stains were performed to rule out an endometrial stromal sarcoma and lymphangioleiomyomatosis. The lesion was positive for desmin, caldesmon, and negative for CD10 and HMB45. Ki67 was extremely low (&lt;1%). Based on morphology and immunophenotype, the tumor was consistent with an epithelioid leiomyoma with highly unusual lymphatic spread through myometrial vessels to regional lymph nodes. Results (if a Case Study enter NA) NA Conclusion Intravascular leiomyomatosis is a rare condition with no reported progression to malignancy. Typically, benign smooth muscle is present in veins within the myometrium of a leiomyomatous uterus with progressive spread to the right heart via the inferior vena cava. We present the first report of a rare case of intravascular leiomyomatosis with spread exclusively via lymphatics to pelvic lymph nodes.

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