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At least 199 records · Page 11Linked to original sources
PubMed2001

[Efficacy of elective lymph node dissection in malignant melanoma of the extremities and trunk. An analysis in view of the sentinel lymph node biopsy].

Elective lymph node dissection (ELND) is increasingly displaced by the Sentinel-lymph node biopsy. In this view we analyzed the efficacy of ELND in the treatment of malignant melanoma of the extremities and the trunc. Between 1979 and 1998 we performed a lymph node dissection in 834 patients (336 male, 498 female; average age 52 years). The analysis of the prospectively collected data was based on those 650 patients in whom an ELND was performed for UICC-stage I (T2) to stage III melanoma. The 5-year survival rate was 75% for all 650 patients. It was 87% for patients suffering from stage I-disease (T2-n = 65), 86% for those with stage II-disease (n = 354) and 47% in case of stage III-disease (n = 231) respectively. In 7 of the 73 patients undergoing ELND for a T2-tumor, in 56 of the 424 patients suffering from T3-tumor and in 38 of the 153 patients with a T4-tumor clinically obvious lymph node metastases had been detected by ELND. Discerning our results, we could demonstrate that a few of our patients profited from ELND, namely the patients in those clinically obvious metastases could be detected and survival could be achieved, i.e. 29 of all 650 electively dissected patients (2 of 7 T2N1-patients, 18 of 56 T3N1-patients and 9 of 38 T4N1-patients). We regard this benefit as an argument not to abandon the histological evaluation of the regional lymph nodes. However, because of the limited efficacy of elective lymphadenectomy, ELND should be displaced by the less invasive Sentinel-lymph node biopsy.

Adolescent↗
PubMed1958

Studies on the transfer of lymph node cells. XII. The effect of anti-rabbit-leucocyte serum on the transfer of antigen-incubated lymph node cells.

In earlier studies it was shown that if rabbit lymph node cells were incubated with Shigella-trypsin filtrate and transferred to other, recipient, rabbits, agglutinins to Shigella appeared subsequently in the sera of the recipients. However, if leucocytes from the donor rabbits were injected into the recipients at a suitable interval prior to lymph node cell transfer, agglutinins to Shigella did not appear after cell transfer. In the present study, a number of experiments were done which bear on the immunologic character of this suppressive effect on the transferred cells, the "pre-injection effect." X-irradiation of the recipients before the injection of donor leucocytes led to a decrease in the extent of the pre-injection effect, i.e. to the appearance of higher agglutinin liters, in the recipient animals. It was found possible to transfer the pre-injection effect by cells of rabbit lymph nodes draining sites of injection of rabbit leucocytes. No such effect was obtained with heated aliquots of these cell suspensions or with lymph node cells from sheep-erythrocyte-injected donors. It was also possible to transfer the pre-injection effect passively by serum. Suppression of transferred lymph node cells was observed regularly after injection of serum pooled from groups of rabbits which had been injected with leucocytes pooled from the blood of 60 to 70 rabbits. The active material in anti-leucocyte serum could be precipitated in the globulin fraction of the serum and could be removed by absorption with rabbit lymph node cells. In the course of experiments on the passive transfer of the pre-injection effect by antisera of individual rabbits to leucocytes of individual donor rabbits, evidence was obtained of the existence in the sera of some normal rabbits of antibodies to some of the rabbit leucocyte antigens.

Animals↗
PubMed1966

Antibody formation by single cells from lymph nodes and efferent lymph of sheep.

The antibody-forming cells which appear in the popliteal lymph node and efferent lymph of the sheep following immunization with boiled Salmonella have been studied by light and electron microscopy. Cells were incubated in monolayers with target erythrocytes sensitized with bacterial lipopolysaccharide. Three types of interaction between a proportion of the lymph cells and the erythrocytes surrounding them have been shown to indicate antibody formation: plaque-formation, immuno-cyto-adherence, and localized agglutination. At the peak of the response, 4 days after antigenic stimulation approximately 1 cell in every 200 from lymph node suspensions produces detectable specific antibody, while up to 1 cell in 20 in the lymph is active. For light microscope examination, individual antibody-forming cells were smeared in serum and stained with Leishman's stain. For electron microscopy, a number of active cells were clumped with antiserum to form a specimen of convenient size, then sectioned. Most of the active cells from efferent lymph are large and basophilic, while a small proportion are blastlike. These cells contain abundant free ribosomes and very little endoplasmic reticulum. In the node only, an additional class of antibody-forming plasma cells is found which have considerable amounts of endoplasmic reticulum in their cytoplasm.

Animals↗
PubMedDate not supplied

Intraoperative palpation for clinically suspicious axillary sentinel lymph nodes reduces the false-negative rate of sentinel lymph node biopsy in breast cancer.

Axillary sentinel lymph node biopsy (SLNB) is widely used to identify the first lymph node draining breast tumors. When the sentinel lymph node is free of metastasis, axillary dissection is avoided because the rest of the nodes are expected to be negative as well. A false-negative rate of 5% is considered acceptable. In the case of a false-negative SLNB, adjuvant local and systemic treatments might be suboptimal. We assessed the effect of intraoperative axillary palpation for clinically suspicious lymph nodes that are not otherwise detected by radioactive tracer or blue dye on the false-negative rate of SLNB in breast cancer patients. Our prospective database of patients having surgery for primary invasive breast cancer and who had a SLNB from 2000 to 2004 was reviewed. Only patients with clinically negative nodes preoperatively were included. The procedure included preoperative injection of radiotracer, with dye injection as backup, and intraoperative palpation of the axilla for suspicious lymph nodes that were not radioactive or blue. Of the 290 patients, 89 (30.7%) had sentinel node involvement by tumor. Seven patients had clinically suspicious nodes identified solely by palpation and not by tracer, in addition to sentinel lymph nodes detected by tracer. In five of the seven patients, the nodes harbored metastasis. In four of these five patients (4.5% of the 89 patients with axillary involvement), the palpable nodes were the only ones involved. A generous axillary incision and systematic palpation of the axilla reduces the false-negative rate and should be a part of the SLNB procedure.

Breast Neoplasms↗
PubMed1990

Contribution of lymph formation in the popliteal node to efferent lymph flow following stimulation of the sympathetic chain in the sheep.

Lymph flow and contraction frequency were measured in popliteal efferent lymphatics. Stimulation of the ipsilateral sympathetic chain resulted in an approximate threefold increase in lymph flow, while contraction frequency increased 28% (n = 6). Occlusion of the metatarsal afferent lymphatics with a pneumatic cuff reduced efferent flow from 18 to 4 microliters/min after 25 min (n = 5), indicating that approximately 80% of popliteal efferent lymph is derived from the foot. After occlusion of the afferent lymphatics, sympathetic stimulation failed to increase efferent lymph flow significantly, while efferent contraction frequency still showed a significant rise. It is concluded that lymph formation in the popliteal node does not contribute to the rise in efferent lymph flow following sympathetic stimulation.

Analysis of Variance↗
PubMed2002

Eighteen sensations after breast cancer surgery: a comparison of sentinel lymph node biopsy and axillary lymph node dissection.

PURPOSE/OBJECTIVES: To evaluate prevalence, severity, and level of distress of 18 sensations at 3-15 days (baseline), 3 months, and 6 months after breast cancer surgery; to compare sentinel lymph node biopsy (SLNB) to SLNB with immediate or delayed axillary lymph node dissection; to evaluate the Breast Sensation Assessment Scale(c) (BSAS(c)) for reliability and validity. DESIGN: Prospective, descriptive. SETTING: Evelyn H. Lauder Ambulatory Breast Center at Memorial Sloan-Kettering Cancer Center in New York City. SAMPLE: 283 women with breast cancer; 187 had SLNB, and 96 had SLNB and axillary lymph node dissection. METHODS: Patients completed the BSAS(c) at baseline, three months, and six months after surgery. MAIN RESEARCH VARIABLES: Prevalence, severity, and level of distress of sensations in patients who had breast cancer surgery. FINDINGS: Sensations were less prevalent, severe, and distressing following SLNB compared with axillary lymph node dissection at all three time points. Tenderness and soreness remained highly prevalent following SLNB at the three time points. Tenderness, soreness, tightness, and numbness were among the most severe and distressing symptoms in both groups. The BSAS(c) demonstrated good reliability and validity. CONCLUSIONS: Overall prevalence, severity, and level of distress were lower following SLNB compared with axillary lymph node dissection at baseline, three months, and six months after surgery. Certain sensations remained prevalent, severe, and distressing in both groups. The BSAS(c) is a reliable and valid instrument. IMPLICATIONS FOR NURSING: Nurses should be familiar with prevalent sensations patients experience after SLNB and axillary lymph node dissection so they can provide education and support.

Anxiety↗
PubMed2000

[Lymph node metastasis and the extent of lymph node dissection for gastric cancer: report of 326 cases].

OBJECTIVE: To investigate the pattern of lymph node metastasis and the extent of lymph node dissection for gastric cancer. METHODS: 326 patients with gastric cancer admitted from 1990 to 1999 were analyzed retrospectively after D(2), D(3) or D(3) plus para-aortic lymphadenectomy (D(3) + PAL). RESULTS: The total incidence of lymph node metastasis was 69.9%; node involvement was 15.4% and 77.4% respectively for early gastric cancer and advanced gastric cancer. Depth of invasion, tumor size and histology affected lymph node metastasis significantly (P < 0.05). For T(1) patients, node involvement was mainly confined to N(1) and one patient had N(2) metastasis; 8.1% of T(2) patients and 28.7% of T(3), T(4) patients had N(3), M(1) lymph node metastasis. Among 107 patients who received D(3) + PAL, 16a2b1 lymph node metastasis was found in 15.0%. The patients who had 16a2b1 node involvement were all suffered from advanced gastric cancer and N(1)-N(2) node metastasis. In the patients with serosal invasion-positive tumors or tumors size over 5 cm, the incidence of 16a2b1 metastasis was high, and that of entire stomach cancer was up to 38.5%. The 3-year and 5-year survival rates for D(3) + PAL group were 60.7% and 50.0% respectively. After D(3) + PAL, the 1-and 2-year survival rate, of patients with 16a2b1 metastasis were 60.0%, 50.0% respectively. CONCLUSIONS: D(2) lymphadenectomy should be taken for patients with early gastric cancer and D(3) lymphadenectomy for those with relatively early' advanced gastric cancer. For advanced gastric cancer with suspect or confirmed N(1)-N(2) node metastasis, tumor size over 5 cm and/or serosa invasion, D(3) plus para-aortic lymphadenectomy appears to be a necessary surgical procedure.

Adult↗
PubMed1992

[A suspected case of perforation of a lymph node into the bronchus during the treatment of adult hilar lymph node tuberculosis].

A 27-year old patient was diagnosed as having post-primary hilar lymph node tuberculosis. First being admitted to the hospital with a high fever, a chest x-ray examination revealed a swelling of the left hilar lymph nodes and a sputum smear tested positive for acid-fast bacilli. Neither regular clinical examination or investigation had reported abnormality. The acid-fast bacilli was successfully treated through treatment using INH RFP SM. However, after two months, swelling was observed in the right para-tracheal lymph nodes, Further, a bronchoscopic examination revealed polyp-like tumors at the left upper and lower bifurcation. The swelling of the para-tracheal lymph nodes was considerably reduced and the tumors non-existent after five months. These lymph node reactions could have likely been a part of the so called early exacerbation. The polyp-like tumors were not found during the bronchoscopy performed during admission to the hospital. It is therefore suspected that the cause was perforation of the hilar lymph node into the bronchus.

Adult↗
PubMed2006

Safety and efficacy of modified radical lymph nodes dissection in patients with papillary thyroid cancer and clinically evident lymph nodes metastasis.

INTRODUCTION: Papillary cancer of the thyroid gland is well known as a lymphotropic type of cancer. In more than 50 percent of all cases it metastasizes first and mainly in regional lymph nodes. The extent of surgical intervention remains a subject of controversy and discussions. AIM: The aim of our retrospective study was to evaluate efficacy and safety of modified radical lymph node dissection (MRND) in patients with papillary thyroid cancer (PTC). PATIENTS AND METHODS: We performed a retrospective analysis of survival and quality of life of 19 patients who underwent surgery at the Department of General Surgery. All patients had papillary thyroid cancer and regional lymph nodes metastases. The results were compared to literature data on surgical interventions differing in extent and specifics. RESULTS: Our analysis and its parallel with literature data revealed better survival rates and quality of life in patients who had undergone total thyroidectomy (TT) with modified radical lymph nodes dissection in comparison with those ones who had undergone total thyroidectomy with berry picking (BP). CONCLUSIONS: Modified radical lymph nodes dissection is an effective and comparatively safe procedure for the treatment of patients with papillary thyroid cancer and regional lymph nodes metastases. If adequately performed it ensures better quality of life, longer survival and improves further control on distant metastases.

Adult↗
PubMed1972

Ultrastructural analysis of antibody synthesis in cells from lymph and lymph nodes.

A variety of cells containing antibody were found in lymph from sheep responding to secondary challenges with horseradish peroxidase. Antibody was present in blast cells in lymph within the perinuclear space, the endoplasmic reticulum, the Golgi apparatus and on polyribosomes. Some lymphocytes in lymph also contained antibody but in these cells it was located principally in the perinuclear space. No cells were found containing antibody distributed throughout their cytoplasm nor were any lymphocytes found with a Golgi apparatus positive for antibody. After the immune response in the lymph had died away, a population of cells containing antibody was still present in the regional lymph node. These were all plasma cells in which the antibody was present for the most part in a highly organized endoplasmic reticulum. Cells of this type were never found in the lymph. The cells containing the smallest amounts of antibody had a few discrete focal points in the perinuclear space and a few positive groups of ribosomes in their cytoplasm. The endoplasmic reticulum in some cells was filled completely with antibody, while in others positive segments were found adjacent to negative ones. The antibody in the cytoplasmic endoplasmic reticulum was in continuity with the antibody in the perinuclear space. The Golgi apparatus contained antibody in only a small proportion of the cells but when it was positive it was strongly so, suggesting that antibody was concentrated in this organelle. In some cells a positive reaction to horseradish peroxidase antibody appeared in the nucleus over the nucleoli. The significance of this finding is not known.

Animals↗
PubMed1984

The flow and composition of lymph from the caudal mediastinal lymph node of sheep.

By cannulating the efferent duct of the caudal mediastinal lymph node in sheep, lymph from the lower respiratory tract was collected under physiological conditions for several days. In 18 such preparations the flow rate varied from 4 to 12 ml/hr between individuals and the lymphocyte count between 4000 and 117,000/mm3. The protein content of the lymph plasma averaged nearly 60% of that of the blood, and this indication of the high permeability of the capillary bed of the lungs was confirmed by measuring the time taken for intravenous doses of 125I-albumin to equilibrate between the blood and mediastinal lymph plasma. The concentration of immunoglobulin A was higher in the mediastinal lymph than in blood serum, while the reverse was true of the concentrations of IgG1, IgG2, and IgM. This evidence for the local production of IgA by the intra thoracic lymphoid tissue was supported by the demonstration by immunoperoxidase techniques of IgA-containing plasma cells in sections cut from the caudal mediastinal nodes, and of IgA-containing immunoblasts in the lymph.

Animals↗
PubMed1978

[Studies on the lymph drainage of the eye 5. Quantitative registration of the lymph drainage from the subconjunctival space with a radioactive tracer (author's transl)].

In 7 rabbits the drainage from the subconjunctival space to the cervical lymph nodes was observed after subconjunctival injection of 99mTc-micro-colloid. Measurements of the activity distribution were made in vivo with an Anger type camera (pho-Gamma-IV Hp, Searle Nuclear Chicago) and in vitro after dissection with a sodium iodine crystal well counter (Clinimat-200, Picker). 6 hours after the injection into the subconjunctival space of the right eye an average of 53.7% of the applied activity had drained off. A significant accumulation of activity could constantly be registrated in the cervical lymph nodes. Its amount was generally up to 2.08% of the applied total activity per animal, with a large individual spreading. In detail, activity was found in all 7 cases in the right superficial cervical lymph node, in 5 cases moreover in the right mandibular lymph node, additionally in 2 animals in the right or left deep cervical lymph node respectively and in one animal as well in the right as in the left deep cervical lymph node. Besides, in all cases high activity was registered in the right retrobulbar and subconjunctival spaces just as in the right eye. A small activity in the right optic nerve could be pointed out in three of our seven cases.

Animals↗
PubMed1978

[Phospholipid composition of lymphocytes from normal and leukemic blood, lymph, lymph nodes and spleen of cattle].

The phospholipid composition and cholesterol content of lymphocytes from bovine blood, lymph, lymph-nodes and spleen were studied. The cholesterol/phospholipid molar ratio in the normal lymphocytes of blood and spleen was found to be about two times higher than that in the normal lymphocytes from lymph and lymph-nodes. On lymphocytic leukemia the cholesterol/phospholipid molar ratio of the blood lymphocytes decreased sharply, whereas that in lymph and lymph-nodes lymphocytes was unaffected.

Animals↗
PubMed1999

Secondary lymph node involvement from primary cutaneous large B-cell lymphoma of the leg: sentinel lymph nodectomy as a new strategy for staging circumscribed cutaneous lymphomas.

BACKGROUND: Primary cutaneous large B-cell lymphoma of the leg (LBCLL) is a recently defined type of non-Hodgkin's lymphoma. It forms a separate category in the new classification of primary cutaneous lymphomas elaborated by the European Organization for Research and Treatment of Cancer. It is associated with a less favorable prognosis than the most frequently occurring types of primary cutaneous B-cell lymphoma. METHODS: The authors present four patients with the typical clinicopathologic constellation of LBCLL. Three of them died during the years 1993-1996. The authors reviewed their courses. The fourth patient was staged by sentinel lymph nodectomy (SLNE), i.e., the selective surgical removal and histologic examination of the first draining lymph node associated with the cutaneous tumor. RESULTS: The courses of the three previous patients were characterized by secondary involvement of regional lymph nodes followed by systemic dissemination of the lymphoma in a third step. Although the conventional staging of the fourth patient had been negative for any extracutaneous lymphoma manifestation, the SLNE revealed initial regional lymph node involvement, which had decisive implications for the choice of therapy. CONCLUSIONS: SLNE may gain a prominent role in the staging of circumscribed cutaneous lymphomas, in addition to its already established position in melanoma management. Further positive effects of SLNE are 1) better distinction of primary cutaneous lymphomas with secondary lymph node involvement from primary lymph node lymphomas with skin manifestation, and 2) better insight into the biology of different primary cutaneous lymphoma types.

Aged↗
PubMed2000

Morbidity following sentinel lymph node biopsy versus axillary lymph node dissection for patients with breast carcinoma.

BACKGROUND: Axillary lymph node dissection for staging the axilla in breast carcinoma patients is associated with considerable morbidity, such as edema of the arm, pain, sensory disturbances, impairment of arm mobility, and shoulder stiffness. Sentinel lymph node biopsy electively removes the first lymph node, which gets the drainage from the tumor and should therefore be associated with nearly zero morbidity. METHODS: Postoperative morbidity (increase in arm circumference, subjective lymphedema, pain, numbness, effect on arm strength and mobility, and stiffness) of the operated arm was prospectively compared in 35 breast carcinoma patients after axillary lymph node dissection (ALND) of Level I and II and 35 patients following sentinel lymph node (SN) biopsy. RESULTS: Patient characteristics were comparable between the two groups. Postoperative follow-up was 15.4 months (range, 4-28 months) in the SN group and 17.0 months (range, 4-28 months) in the ALND group. Following axillary dissection, patients showed a significant increase in upper and forearm circumference of the operated arm compared with the SN patients, as well as a significantly higher rate of subjective lymphedema, pain, numbness, and motion restriction. No difference between the two groups was found regarding arm stiffness or arm strength, nor did the type of surgery affect daily living. CONCLUSIONS: SN biopsy is associated with negligible morbidity compared with complete axillary lymph node dissection.

Activities of Daily Living↗
PubMedDate not supplied

Type-oriented therapy for gastric cancer effective for lymph node metastasis: management of lymph node metastasis using activated carbon particles adsorbing an anticancer agent.

Activated carbon particles are taken selectively up by lymphatics when injected into the tissues and visualize regional lymph nodes colored black. Furthermore, carbon particles adsorb a large amount of the anticancer agent mitomycin C (MMC) on their surface and release the drug reversibly. Using these properties of activated carbon particles, we have applied it for lymph node dissection and chemotherapy of lymph node metastasis. After injection of carbon particles, regional lymph nodes of the stomach were found to be black; blackened lymph nodes extending widely from perigastric to para-aortic nodes were identified from other structures. Four hundred and twenty-four patients with gastric cancer were treated with this method for lymph node metastasis during 1984-1988. Involved nodes were generally colored in high incidence, about 70% of involved ones except for highly positive nodes, which was the same as noninvolved nodes. In highly positive nodes, the colored incidence was decreased to about 48%. The cumulative 5-year survival rate of the patients treated with this series was 74.6%, which was significantly higher than the figures without this method.

Carbon↗
PubMed2005

Detection of lymph node micrometastases and isolated tumor cells in sentinel and nonsentinel lymph nodes of colon cancer patients.

About 20% to 30% of colon cancer patients classified as node negative by routine hematoxylin-eosin (H&E) staining are found to have micrometastases (MM) or isolated tumor cells (ITC) in sentinel lymph nodes (SLNs) if analyzed by step sections and immunohistochemistry (IHC). Whether SLNs are in this respect representative for all lymph nodes was addressed in this study. SLNs were identified using the intraoperative blue dye detection technique. If all lymph nodes (SLNs and non-SLNs) of a patient were negative by routine H&E staining, they were step-sectioned and analyzed by IHC using pancytokeratin antibodies. We identified at least one SLN in 47 of the 55 patients (85%) and examined a median of 26 lymph nodes per patient (range 10-59). By routine H&E staining, 14 of the 47 patients showed lymph node metastases (30%); the remaining 33 were classified as node-negative. In this group (33 patients), 1011 lymph nodes were analyzed by step sections and IHC: 14 of 70 SLNs. (20%) but only 37 of 941 non-SLNs (4%) had MM/ITC (p < 0.001). Furthermore, 13 of the 33 H&E-negative patients were found to have MM/ITC (39%). In 11 of the 13 patients, MM/ITC were identified in both SLNs and non-SLNs in 1 patient in the SLN only, and in 1 patient in a non-SLN only (sensitivity for the identification of MM/ITC: 92%; negative predictive value: 95%). The SLN biopsy is a valid tool to detect, as well as exclude, the presence of MM/ITC in colon cancer patients. Our results may be of prognostic relevance and influence patient stratification for adjuvant therapy trials.

Aged↗
PubMed2006

Impact of the number and extent of positive lymph nodes in 200 patients with thoracic esophageal squamous cell carcinoma after three-field lymph node dissection.

BACKGROUND: Subtotal esophagectomy with three-field lymph node dissection (3FLD) has been reported to improve survival in patients with thoracic esophageal squamous cell carcinoma (SCC). The purpose of this study was to evaluate the prognostic impact of the extent and number of positive lymph nodes for long-term survival of patients who underwent 3FLD. METHODS: From January 1983 to December 2002, a total of 200 patients with thoracic esophageal SCC underwent 3FLD without any neoadjuvant therapy. The prognostic impact of the extent and number of positive lymph nodes was evaluated by both univariate and multivariate analysis. RESULTS: The extent of positive nodes associated with a 5-year survival were as follows: none, 69%; one-field, 50%; two-field, 29%; and three-field, 11%. The number of positive nodes associated with 5-year survival were as follows: single node, 65%; two-nodes, 51%; and more than three-nodes, 20%. Among patients with cervical lymphatic spreading, patients with upper tumors showed significantly better survival than patients with lower tumors (P=0.036). Multivariate analysis indicated that number of positive nodes and the abdominal node status were independent prognostic factors among lymph node status. CONCLUSIONS: Together, number and extent of positive lymph nodes can be considered an independent predictor of a high risk of recurrence. Although cervical lymphatic spreading was risk factor for worse survival, patients with upper tumors may have survival benefit after cervical lymph node dissection.

Abdomen↗