mediastinal lymph node
Recently Published Documents


TOTAL DOCUMENTS

1153
(FIVE YEARS 304)

H-INDEX

53
(FIVE YEARS 4)

2022 ◽  
Vol 270 ◽  
pp. 271-278
Author(s):  
Marcus Taylor ◽  
Matthew Evison ◽  
Bethan Clayton ◽  
Stuart W Grant ◽  
Glen P Martin ◽  
...  

2022 ◽  
Vol 22 (1) ◽  
Author(s):  
Bo Mi Gil ◽  
Myung Hee Chung ◽  
Ki-Nam Lee ◽  
Jung Im Jung ◽  
Won Jong Yoo ◽  
...  

Abstract Background To demonstrate and analyze the relatively common imaging findings in this rare primary pleural angiosarcoma (PPA). Case presentation Three cases of PPA, proven by video-assisted thoracic surgery biopsies are retrospectively reviewed. Patients were all male. Age ranges from 65 to 75 years old age (mean; 69). Major chief complaints were dyspnea and chest pain. One has a history of colon cancer, the other has a tuberculosis history and the other has no known history. Multidetector chest CT and PET CT were all done. Immunohistochemical studies were performed including CD31, CD34, or factor VIII-related antigen, vimentin, and cytokeratin. We also review the literatures on recently published PPA. All masses were from 1 to 10 cm. All three patients had multiple pleural based masses, which were ovoid in shape with relatively sharp margin in unilateral hemithorax. Multiple small circumscribed pleural masses are limited in the pleural space in two patients, whereas two, huge lobulated masses about up to 10 cm were present with pleural and extrapleural involvement in one patient. In two patients with pleural mass only, multiple pleural masses were only seen in parietal pleura in one patient and were in both visceral and parietal pleura in one patient. Pleural effusion were found in one side in one patient and in both sides in one patient. One angiosarcoma was arised from chronic tuberculotic pleurisy sequelae. All pleural masses are heterogenous with irregular internal low densities in all patients. Hematogenous metastases were found in liver, vertebra, rib in one patient, and were in lungs with mediastinal lymph node metastases in the other patient. Three patients survived for longer than 3months after diagnosis, but continued to deteriorate rapidly. Two patients underwent chemotherapy after surgical excision, and the other one with multiple metastases treated chemotherapy after CT-guided biopsy, but eventually all died. As a result of comparative analysis of a total of 13 patients’ images including 10 cases previously published, there was pleural effusion in all except 2 cases. Conclusions PPA were all necrotic without any vascularized enhancing nature, and manifested as unilateral circumscribed or localized pleural-based masses.


2022 ◽  
Vol 11 ◽  
Author(s):  
Yu Wang ◽  
Lin Yang ◽  
Jianyang Wang ◽  
Lin Gui ◽  
Wei Li ◽  
...  

Sarcomatoid carcinoma (SC) is a rare lung cancer subtype with poor prognosis and lack of effective treatment regimens. Studies concerning SC indicated common programmed death ligand-1 (PD-L1) overexpression and higher tumor mutational burden, leading to potential benefits from immunotherapy. The present case is the first report employing PD-L1 inhibitor durvalumab following definitive concurrent chemoradiotherapy (cCRT) in a patient with mediastinal lymph node metastatic SC, which was considered as a high probability of pulmonary origin but unclear primary lesion. After the 19-month follow-up, there was neither local recurrence nor distant metastasis. The patient was in a good condition, with the thoracic lesion controlled at Partial response-Response Evaluation Criteria in Solid Tumors (PR-RECIST). Except for grade 2 esophagitis, none of the other adverse events was observed. Our first attempt to adopt the consolidation immunotherapy after cCRT in unresectable locally advanced mediastinal SC exhibited improved local control, manageable safety, and potential survival benefits, representing a novel and promising therapeutic option for SC and encouraging further research exploration of this regimen in the future.


2022 ◽  
Vol 12 (1) ◽  
Author(s):  
Abdalla Sheikh ◽  
Jennie Jackson ◽  
Hanjoo Brian Shim ◽  
Clement Yau ◽  
Jung Hee Seo ◽  
...  

AbstractInterleukin-7 (IL-7) is a cytokine known for its importance in T cell development and survival. How IL-7 shapes CD8 T cell responses during an acute viral infection is less understood. We had previously shown that IL-7 signaling deficient mice have reduced accumulation of influenza-specific CD8 T cells following influenza infection. We sought to determine whether IL-7 affects early CD8 T cell expansion in the mediastinal lymph node and effector function in the lungs. Using IL-7Rα signaling deficient mice, we show that IL-7 is required for a normal sized mediastinal lymph node and the early clonal expansion of influenza-specific CD8 T cells therein. We show that IL-7 plays a cell-intrinsic role in the accumulation of NP366–374 and PA224–233-specific CD8 T cells in the lymph node. We also found that IL-7 shapes terminal differentiation, degranulation and cytokine production to a greater extent in PA224–233-specific than NP366–374-specific CD8 T cells. We further demonstrate that IL-7 is induced in the lung tissue by viral infection and we characterize multiple cellular sources that contribute to IL-7 production. Our findings on IL-7 and its effects on lower respiratory diseases will be important for expanding the utility of therapeutics that are currently available.


Author(s):  
Xiangjun Tang ◽  
Jing Zhu ◽  
Fangcheng Zhu ◽  
Hanjun Tu ◽  
Aiping Deng ◽  
...  

Primary pulmonary angiosarcoma (PPA) is a rare malignant vascular tumor, of which early diagnosis is challenging due to lack of specific clinical manifestations and a low level of suspicion. Here, we report a case of PPA presented with advanced brain metastasis. A 21-year-old patient with 1 week history of headache and mild cough was hospitalized for a head injury. Head MRI showed multiple intracranial lesions with brain edema. Chest CT displayed bilateral pulmonary infiltrates with mediastinal lymph node enlargement. After 2 months of anti-tuberculosis treatment, the patient was readmitted for persistent headache and cough with occasional hemosputum along with worsening pulmonary and intracranial lesions. Despite seizure prophylaxis and control of intracranial pressure and brain edema, his symptoms progressively aggravated, accompanied by cough with bloody sputum, frequent epileptic seizures, and hypotension. He eventually developed coma and died within 3 months of onset of symptoms. An autopsy confirmed PPA with brain metastasis.


2021 ◽  
Author(s):  
Shahab Rafieian ◽  
Reza Ershadi ◽  
Hossein Ebrahimpoor ◽  
Matin Vahedi

Abstract Background: Endobronchial ultrasound-guided transbronchial needle aspiration (EBUS-TBNA) technique provides a complementary assessment of the areas of mediastinal lymph node involvement, and allows sampling of suspected lymph nodes. But, the usefulness of EBUS-TBNA in assessing all areas of mediastinal lymph nodes is little known and it seems that such assess is dependent to various factors related to the patient's condition and especially the characteristics of local lymph nodes. We aimed to evaluate the utility of EBUS-TBNA in assessing mediastinal lymph nodes and the factors associated with this utility.Methods: This cross-sectional study was performed on 40 patients suspected to mediastinal lymphadenopathy scheduled for assessment by EBUS-TBNA and mediastinoscopy. The diagnostic yield of EBUS-TBNA to mediastinal lymph nodes was evaluated and non diagnostic cases evaluated by mediastinoscopy .Results: In evaluation with EBUS-TBNA, the diagnostic yield of EBUS in assess to mediastinal lymph nodes including 34 out of 40 cases was equal to 85%. The size of lymph node (lower than 10mm), the area of sample (left and right upper paratracheal), and the nature of the lymph node sample (benign type) were associated with lower diagnostic yield for EBUS-TBNA.Conclusion: The diagnostic yield of EBUS in assessing mediastinal lymph nodes for sampling and diagnosis is 85%. This benefit is expected in the case of lesions larger than 10 mm, lesions of a malignant nature, as well as lesions in the inferior paratracheal and subcarinal stations.


2021 ◽  
Author(s):  
Yuan-Liang Zheng ◽  
Ju Sheng ◽  
Ri-Sheng Huang ◽  
Jun Zhao

Abstract Background: lymph node metastasis is a poor prognostic factor for lung cancer; however, the risk of lymph node metastasis has not been clarified yet, so it is controversial to conduct systematic lymph node dissection for early lung cancer. Therefore, this study aimed to focus on analyzing the predictive factors for lymph node metastasis in patients with clinical stage IA3 lung adenocarcinoma.Methods: Our study group retrospectively analyzed all surgical patients admitted to our hospital from January 1, 2017 to June 2021, and these patients were considered having stage IA3 lung adenocarcinoma. A total of 334 patients underwent lobectomy combined with systematic lymph node dissection. Univariate and multivariate logistic regression analysis were adopted to predict the risk factors of lymph node metastasis.Results: Among the 334 patients eligible for this study, the overall mediastinal lymph node metastasis rate was 15.27%. There were 45 cases of N1 metastasis and 11 cases of N2 metastasis, 5 cases had both N1 and N2 metastasis at the same time. The patients were divided into three groups according to consolidation tumor ratio (CTR) values (<0.25, 0.25-0.5, >0.5). The lymph node metastasis rates in each CTR group were 1.8% (2/112), 11.7% (17/145) and 41.6% (32/77), respectively. The mediastinal lymph node metastasis rate in patients with carcinoembryonic antigen (CEA>5ng/ml) was 57.89% (22/38). The receiver operating characteristic curve (ROC) showed that the area under the curve (AUC) of CTR, pathological type and CEA were 0.790 [95% confidence interval (CI): 0.727 – 0.853,P<0.001]; 0.800(95% CI:0.735–0.865,P<0.001);0.682(95% CI: 0.591–0.773, P<0.001);respectively. Multivariate regression analysis showed that these listed factors were significantly correlated with lymph node metastasis of clinical stage IA3 lung adenocarcinoma: CEA [Odds Ratio (OR)=3.05, P=0.016], CTR 0.25 to 0.5 (OR=14.12, P<0.017), CTR>0.5 (OR=7.75, P=0.015), micropapillary adenocarcinoma (OR=15.704, P<0.001), and solid adenocarcinoma (OR=8.971, P=0.001).Conclusions: CEA (>5ng/ml), histologic subtype and CTR (>0.25) are important predictors of lymph node metastasis in clinical stage IA3 lung adenocarcinoma, systematic lymph node dissection should be the prior choice for patients with clinical stage IA3 incorporated with risk factors. The lymph node dissection method in stage IA3 should be alternative from those in stage IA1 and IA2.


2021 ◽  
pp. 030089162110646
Author(s):  
Ayse Engin ◽  
Akif Turna ◽  
Fehim Esen ◽  
Melek Agkoc ◽  
Duygu Ilke Cikman ◽  
...  

Introduction: Mediastinal lymph node (MLN) removal by video-assisted mediastinoscopic lymphadenectomy (VAMLA) for preoperative cancer staging was reported to be associated with increased survival. The aim of this study was to evaluate the immunologic effects of complete MLN removal by VAMLA on cytotoxic T lymphocyte (CTL) phenotype and function. Methods: Seventeen patients with non-small cell lung cancer (NSCLC) (stage cT1-4N0-3M0-1A) and 20 healthy participants were included in this study. Blood samples were collected before and 4 weeks after the procedure. Lymphocytes were isolated from the removed MLNs. CTL phenotypes and functions were evaluated by flow cytometry. Plasma levels of soluble programmed cell death protein 1 (sPD-1), soluble programmed cell death protein 1 ligand, and soluble CTL antigen 4 (sCTLA-4) were measured with enzyme-linked immunosorbent assay. Results: The ratio of the immunosenescent CTLs (CD3+CD8+CD28−) was increased in peripheral blood and MLNs of the patients with NSCLC compared to controls ( p = 0.037), and MLN removal did not change this ratio. PD-1 and CTL antigen 4 expressions were significantly reduced in peripheral blood CTLs after MLN removal by VAMLA ( p = 0.01 and p = 0.01, respectively). Granzyme A expression was significantly reduced in the peripheral blood CTLs of the patients compared to controls ( p = 0.006) and MLN removal by VAMLA significantly improved Granzyme A expression in CTLs ( p = 0.003). Plasma concentrations of sPD-1 and sCTLA-4 remained unchanged after VAMLA. Conclusion: CTLs in the MLNs and peripheral blood of the patients with NSCLC had an immunosenescent phenotype, increased immune checkpoint receptor expression, and impaired cytotoxicity. MLN removal by VAMLA improved these phenotypic and functional characteristics of CTLs. These changes may explain the potential contribution of VAMLA to improved survival.


2021 ◽  
Author(s):  
Yulin Wang ◽  
Jiaqi Li ◽  
Xue Zhang ◽  
Man Liu ◽  
Longtao Ji ◽  
...  

Abstract Background: This study aims to comprehensively discover novel autoantibodies (TAAbs) against tumor-associated antigens (TAAs) and establish diagnostic models for assisting in the diagnosis of lung cancer (LC) and discrimination of pulmonary nodules (PN).Methods: HuProt human microarray was used to discover the candidate TAAs and Enzyme-linked immunosorbent assay (ELISA) was performed to detect the level of TAAbs in 634 participants of two independent validation cohorts. Logistic regression analysis was used to construct models. Receiver operating characteristic curve (ROC) analysis was utilized to assess the diagnostic value of models.Results: Eleven TAAs were discovered by means of protein microarray and data analysis. The level of ten TAAbs (anti-SARS, anti-ZPR1, anti-FAM131A, anti-GGA3, anti-PRKCZ, anti-HDAC1, anti-GOLPH3, anti-NSG1, anti-CD84 and anti-EEA1) was higher in LC patients than that in NC of validation cohort 1 (P<0.05). The model 1 comprising 4 TAAbs (anti-ZPR1, anti-PRKCZ, anti-NSG1 and anti-CD84) and CEA reached an AUC of 0.813 (95%CI: 0.762-0.864) for diagnosing LC from normal individuals. 5 of 10 TAAbs (anti-SARS, anti-GOLPH3, anti-NSG1, anti-CD84 and anti-EEA1) existed a significant difference between malignant pulmonary nodules (MPN) and benign pulmonary nodules (BPN) patients in validation cohort 2 (P<0.05). Model 2 consisting of anti-EEA1, traditional biomarkers (CEA, CYFRA211 and CA125) and 3 CT characteristics (vascular notch sign, lobulation sign, mediastinal lymph node enlargement) could distinguish MPN from BPN patients with an AUC of 0.845 (sensitivity: 58.3%, specificity: 96.6%).Conclusions: High-throughput protein microarray is an efficient approach to discovering novel TAAbs which could increase the accuracy of lung cancer diagnosis in the clinic.


Sign in / Sign up

Export Citation Format

Share Document