Lymph Nodes
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2021 ◽  
Vol 8 (2) ◽  
pp. 014-018
Author(s):  
Omer Taha Ahmed Elmukashfi ◽  
Taha Ahmed Elmukashfi Elsheikh ◽  
Ahmed Mustafa Idris Mohamed ◽  
Wala Osman Eltieb Omer ◽  
Marwa Ahmed Ismail Elawal ◽  
...  

Cystic lymphangioma is a benign congenital malformation of the lymphatic vessels. At the National Center for Pediatric Surgery, Gezira State, Sudan; 2021; a female baby of 15 months old age presented complaining of abdominal distention of 10 days duration. Patient Looks unwell, not febrile, and not pale or jaundice; abdomen was distended with full flanks, there was a palpable mass in the epigastric region, no area of tenderness and no palpable organs. Abdomino-pelvic U/S showed very huge abdomino –pelvic cystic mass with multiple thick septa. CT abdomen showed huge abdomino-pelvic mass with multiple cysts that having variable sizes measuring up to 6*7 cm. An elective explorative laparotomy was done. Intra operative findings: Multiple cystic masses arise from the root of the small bowel mesentery matted together with multiple enlarged mesenteric lymph nodes involving segment of distal jejunum with multiple adhesions. Release of adhesion, resection of the masses along with 57 cm of the involving jejunum, anastomosis was done, and homeostasis was secured. Histopathology result showed dilated cystic spaces; lined by flat endothelial cells and multiple reactive lymph nodes, no evidence of malignancy. Features are in line with lymphangioma and associated mesenteric lymphadenitis. Discussion and Conclusion: Our case was 15 months old which is the age of presentation as mentioned internationally. Mesenteric cystic Lymphangiomas are more common among male unlike our case. Ultrasonography and CT abdomen were highly recommended to achieve early diagnosis and treatment of such cases.


2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Ricardo Donners ◽  
Raphael Shih Zhu Yiin ◽  
Matthew Blackledge ◽  
Dow-Mu Koh

Abstract Background Whole body DWI (WB-DWI) enables the identification of lymph nodes for disease evaluation. However, quantitative data of benign lymph nodes across the body are lacking to allow meaningful comparison of diseased states. We evaluated apparent diffusion coefficient (ADC) histogram parameters of all visible lymph nodes in healthy volunteers on WB-DWI and compared differences in nodal ADC values between anatomical regions. Methods WB-DWI was performed on a 1.5 T MR system in 20 healthy volunteers (7 female, 13 male, mean age 35 years). The b900 images were evaluated by two radiologists and all visible nodes from the neck to groin areas were segmented and individual nodal median ADC recorded. All segmented nodes in a patient were summated to generate the total nodal volume. Descriptors of the global ADC histogram, derived from individual node median ADCs, including mean, median, skewness and kurtosis were obtained for the global volume and each nodal region per patient. ADC values between nodal regions were compared using one-way ANOVA with Bonferroni post hoc tests and a p-value ≤0.05 was deemed statistically significant. Results One thousand sixty-seven lymph nodes were analyzed. The global mean and median ADC of all lymph nodes were 1.12 ± 0.27 (10− 3 mm2/s) and 1.09 (10− 3 mm2/s). The average median ADC skewness was 0.25 ± 0.02 and average median ADC kurtosis was 0.34 ± 0.04. The ADC values of intrathoracic, portal and retroperitoneal nodes were significantly higher (1.53 × 10− 3, 1.75 × 10− 3 and 1.58 × 10− 3 mm2/s respectively) than in other regions. Intrathoracic, portal and mesenteric nodes were relatively uncommon, accounting for only 3% of the total nodes segmented. Conclusions The global mean and median ADC of all lymph nodes were 1.12 ± 0.27 (10− 3 mm2/s) and 1.09 (10− 3 mm2/s). Intrathoracic, portal and retroperitoneal nodes display significantly higher ADCs. Normal intrathoracic, portal and mesenteric nodes are infrequently visualized on WB-DWI of healthy individuals. Trial registration Royal Marsden Hospital committee for clinical research registration number 09/H0801/86, 19.10.2009.


2021 ◽  
Vol 100 (6) ◽  
pp. 178-181
Author(s):  
S.S. Nikitin ◽  
◽  
Yu.G. Pyattoev ◽  
N.B. Guseva ◽  
M.V. Leukhin ◽  
...  

The authors describe clinical observations of children with acute mesenteric adenitis with PCRconfirmed COVID-19 infection. Attention during ultrasound diagnostics is drawn to the condition of the lymph nodes – mesenteric adenitis in COVID-19 infection was manifested by a significant increase in the size of the nodes – more than 15 mm, a large number of nodes in the cut with a tendency to form a conglomerate, a more rounded shape, significantly increased blood flow, a reaction of the peritoneum in the form its thickening and the presence of free fluid in the abdominal cavity. Unusual for a «ordinary» respiratory viral or intestinal infection type of lymph nodes was the only sign that distinguishes the manifestations of mesenteric infection in COVID-19 infection.


2021 ◽  
Vol 44 (11) ◽  
pp. 795-804
Author(s):  
Kyong Hoon Kim ◽  
Aryeong Choi ◽  
Sang Hoon Kim ◽  
Heonju Song ◽  
Seohoon Jin ◽  
...  

Author(s):  
E. A. Gudilina ◽  
T. Yu. Danzanova ◽  
P. I. Lepedatu ◽  
G. T. Sinyukova

Purpose: Determination of informative value of a new method of ultrasound tomography, based on the properties of elasticity of soft tissues, in the differential diagnosis of metastatic lesions of the lymph nodes of the neck thyroid cancer.Material and methods: To assess the capabilities of shear wave ultrasound elastometry in the diagnosis of metastatic lesions of the lymph nodes in thyroid cancer, a study was carried out with 45 patients with suspected thyroid cancer. The work was performed by devices Acuson S2000 Siemens, Avius hi vision Hitachi using a linear sensor with a frequency of 5–12 MHz. For each object of the study, from 5 to 10 measurements of the shear wave velocity in m / s were made, depending on the size of the lymph nodes.Results: Reliable results were obtained in the group of altered lymph nodes (statistical significance p < 0.05). Interquartile intervals and the most common values of shear wave velocities do not overlap: in metastases — 2.20– 3.36 m/s, with hyperplasia of lymph nodes — 0.70–1.88 m/s, and medians show a significant difference in velocities: metastases — 3.00 m/s, hyperplastic lymph nodes 1.38 m/s.Conclusions: Shear wave elastography objectifies ultrasound studies, obtaining specific indicators of shear wave velocity in the areas of interest, and can be used as an additional diagnostic tool in the differential diagnosis of metastatic and hyperplastic lymph nodes.


Author(s):  
A. L. Dolbov ◽  
A. A. Stanjevskiy ◽  
D. N. Maistrenko ◽  
M. I. Shkolnik ◽  
А. Yu. Pakhomov ◽  
...  

Relevance: Prostate cancer is one of the most frequently diagnosed malignant neoplasms of the genitourinary system in men in the world. Recently, there has been an active introduction into clinical practice of positron emission tomography technology combined with computed tomography (PET/CT) with 68Ga‑PSMA‑617 based on prostate‑specific membrane antigen (PSMA), the capabilities of which significantly increase the effectiveness of the diagnosis of prostate cancer at various clinical stages compared with routine methods used in the staging of prostate cancer.Purpose: To compare the diagnostic effectiveness of PET/CT with 68Ga‑PSMA‑617 with traditional methods of radiation imaging (computed tomography, magnetic resonance imaging and bone scan) in the staging of prostate cancer and to clarify the impact of this technology on the choice of surgical treatment.Material and methods: PET/CT with 68Ga‑PSMA was performed in our center in order to stage the verified prostate cancer in 109 patients aged 48 to 80 years (median 64.5). The selection criteria were: a PSA level of more than 5 ng/ml, the presence of a newly identified, histologically verified prostate cancer, lack of treatment, suspicion of metastatic lesion of the lymph nodes of the pelvis and skeleton. Patients were divided into groups by prostate‑specific antigen level, Gleason score, and d’Amico.Results: In the analysis of PET/CT results and MRI/CT comparison and Bone scan, 56 (51.4 %) of 109 patients showed a change in the TNM stage. A change in the data on the local spread of the tumor with an increase in the stage according to criterion T due to the detection of pathological accumulation of RFP in seminal vesicles was detected in 21 (37.5 %) of 56 patients. Additionally, according to PET/CT data, 13 (23.2 %) of 56 patients were found to have lesions of regional lymph nodes (N). Metastatic lesions of distant lymph nodes (M1a) and bones (M1b), not visualized during routine radiation examination, were observed in 32 (57.1 %) and 36 (64.3 %) of 56 patients, respectively.Conclusions: The use of PET/CT 68Ga‑PSMA‑617 in patients with newly diagnosed prostate cancer at the staging stage allows us to obtain valuable additional information about the local, regional and long‑term prevalence of the pathological process, and in some cases — to change the stage of the disease by TNM (usually by increasing it), which has a significant impact on the tactics of therapeutic measures and the choice of the optimal method of therapy for prostate cancer.


Author(s):  
A. S. Krylov ◽  
B. Ya. Narkevich ◽  
A. D. Ryzhkov ◽  
M. E. Bilik ◽  
S. M. Kaspshik ◽  
...  

Purpose: To develop a method for evaluation of the radiation dose of an embryo/fetus during lymphoscintigraphy (sentinel lymph node mapping) in pregnant patients with breast cancer.Material and methods: Two pregnant women (aged 43 and 30) with breast cancer stage IIA (T2N0M0), during the second trimester of pregnancy. We used a lymphotropic colloidal radiopharmaceutical labeled with 99mTc. To evaluate the radiation dose of an embryo, each patient had 6 individual dosimeters, which were placed around the abdomen using an elastic bandage at equal distances around the abdomen. Additionally, we placed the 7th dosimeter, it was placed near the injection site (under the mammary gland). After installing individual dosimeters, radiocolloid was injected into the affected mammary gland at four points (periareolar). The administered activity of radiopharmaceutical was 32.5 MBq, and 51.5 MBq. Lymphoscintigraphy was performed 1 hour after injection. First patient underwent sector resection of the left breast with SLN biopsy. The second patient underwent right mastectomy with SLN biopsy and breast reconstruction surgery using a tissue expander.Results: Based on the results of the study, the dose rate was calculated, on the basis of which the fetal radiation doses were calculated in both patients. Comparison of the mathematical data of both patients shows that, the calculated and experimental values of radiation exposure to the fetus during the radionuclide study of sentinel lymph nodes practically coincide. The obtained data shows that during pregnancy (280 days) the embryo/fetus will accumulate a natural radiation background dose of 1960 μSv, which is 2 times higher than the dose from the radionuclide study of sentinel lymph nodes. Thus these results verify the safety of SLN biopsy technology in pregnancy.Conclusion: 1. Radionuclide diagnostic studies of pregnant women determine radiation doses to the embryo/fetus that do not cause any radiation-induced effects in the prenatal period, and the probability of the occurrence of stochastic radiation-induced effects is several times lower than the incidence of endogenous cancers. 2. Radionuclide examination of sentinel lymph nodes appears to be safe for the fetus when conducted in pregnant women diagnosed with breast cancer. 3. In Russian Federation this method is used for the first time in pregnant women with diagnosed breast cancer. This technology has not been previously described in Russian literature.


Breast Care ◽  
2021 ◽  
Author(s):  
Michael Braun ◽  
Antonia Kriegmair ◽  
Nina Szeterlak ◽  
Anne Andrulat ◽  
Simone Schrodi ◽  
...  

Introduction The aim of the present study was to analyze the performance of Oncotype DX® multigene assay (ODX) in patients with 0-3 lymph nodes in a high volume community hospital. Methods Patients with non-metastatic HR+/HER2- EBC and 0-3 positive lymph nodes, who underwent primary surgery at the Red Cross Hospital Munich, Germany and consecutively had ODX testing were included in this retrospective study. The distribution of clinico-pathologic characteristics, recurrence score (RS) risk and use of systemic therapy were compared among patients without positive lymph nodes (N0) and patients with micrometastases or 1 to 3 positive lymph nodes (N1). Disease free survival (DFS) and overall survival (OS) were estimated. Results From 2012 to2017 ODX was consecutively performed in 575 (16.4%) of 3492 women with HR+/ HER- EBC, of which 553 were eligible for this analysis (N0: 60.8%; N1: 39.2%). Among the patients included, 441 (79.7%) had a RS of 0 to 25 and 112 (20.3%) had a RS of 26 or higher. In patients with RS 0 to 25 the rate of chemotherapy use was low, independent from nodal status (N0: 17.1% and N1: 19.1%) and 5y-DFS was 90.5% and 91.7% for N0 and N1 patients, respectively. There was no significant difference in DFS (90.5% vs. 93.3%; p= 0.101) or OS (97.2% vs. 96.0%; p= 0.737) for patients with a RS 0 to 25 when treated with chemo-endocrine therapy or endocrine therapy alone, independent from nodal status. Conclusions The results of the study confirm the observations from randomized studies on the use of the ODX in a real world population in terms of risk distribution and patient outcome. Adjuvant chemotherapy could be safely omitted in patients with HR+/HER2- breast cancer with 0-3 positive lymph nodes and RS<25.


Author(s):  
Manjit Sarma ◽  
Subramanyam Padma ◽  
Parvathy Pavithran ◽  
Vijay Harish Somasundaram ◽  
Palanisamy Shanmuga Sundaram

Abstract Background To determine locations, relative frequencies, imaging features, and pattern of distribution of extrahepatic metastasis from hepatocellular carcinoma (HCC) on 2-deoxy-2-[fluorine-18]fluoro-D-glucose (18F-FDG) PET CT. Methods FDG PET CT scans of 224 consecutive patients of HCC acquired between 2010 and 2018 were reviewed. Fifty-six patients detected with extrahepatic metastasis on FDG PET CT were retrospectively analyzed. Findings were correlated with prior/follow-up imaging studies, clinical findings, FNAC, or biopsy findings whenever available. Descriptive analysis of location, relative frequencies, imaging features, and pattern of distribution of extrahepatic metastasis was done. Results Commonest were metastatic pulmonary nodules (55.3% patients), most of them being well-defined solid lesions (53.5%) with bilateral involvement in 44.6% patients and lower lobes of lungs along with other lobes being more frequently involved (41.0% patients). While in 7.14% patients lung nodules were FDG avid, 23.2% patients had both FDG avid and non-avid pulmonary nodules. Second most common were regional metastatic lymph nodes in 44.65% of patients seen at aortocaval (25%), paraaortic (23.21%), portocaval (21.4%), and left gastric nodal (17.8% of patients) stations. Twenty-five percent of patients had FDG avid lymph nodes and 5.36% patients had both FDG avid and FDG non-avid lymph nodes. Distant metastatic lymph nodes were third most common in 39.2% of patients seen at paratracheal (2.5%), juxtaphrenic (8.9%), and mesenteric lymphnodal (7.1%) stations. Twenty-five percent of patients had FDG avid lymph nodes while 5.36% patients had both FDG avid and FDG non-avid lymph nodes. Skeletal involvement was seen in 32.1% of patients. Commonest sites are vertebrae (16.7%), pelvis (14.2%), and ribs (10.7% patients). Six out of 7 patients had unilateral adrenal gland involvement. Bilateral adrenal gland involvement was seen in 1 patient. FDG non-avid peritoneal/omental metastases was seen in 2 patients. Brain, spleen, and muscle metastatic lesions were seen in 1 patient each out of 56 patients (1.79%). Conclusions Lungs, regional and distant lymph nodes and skeleton are the most frequently involved sites of extrahepatic metastatic hepatocellular carcinoma. Adrenal glands, muscles, brain and peritoneum are also involved but to a lesser extent.


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