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At least 271 records · Page 15Linked to original sources
PubMed1996

[An analysis of pelvic and para-aortic lymph node metastasis in ovarian carcinoma by systematic retroperitoneal lymph node dissection].

We performed a systematic retroperitoneal lymph node dissection (RPLND) on 137 patients with primary ovarian carcinoma, of whom 97 had undergone RPLND during the primary surgery before chemotherapy and 40 had undergone RPLND during the secondary cytoreductive surgery after preoperative chemotherapy. The tentative staging of the ovarian carcinoma used in this study was determined according to the FIGO criteria without considering the pathologic findings of retroperitoneal lymph nodes. Nodal metastasis was seen in 21.9% (30/137) of them. Thirteen had positive pelvic lymph nodes (PLN) but no positive para-aortic nodes (PAN). Eleven had both positive PLN and positive PAN. Six had positive PAN but no positive PLN. The PAN was the most frequent site of metastasis (17/137). Next were the common iliac, obturator, and lateral group of deep inguinal nodes. Solitary metastasis in the patients who had undergone RPLND during the primary surgery was seen in a PAN and a common iliac node. Among 24 patients with PLN metastasis, there was a significant (p < 0.05) difference in the number of positive PLN between the patients with PAN metastasis (5.27 +/- 3.00) and the patients without PAN metastasis (2.62 +/- 1.66). These results indicate that the PAN and common iliac nodes are the most important site of nodal metastasis in ovarian carcinoma. The metastasis to PLN such as obturator node and internal iliac node seems to occur independently of the PAN metastasis, and the PAN metastasis occurs not only through the direct route but also as a consequence of extension of PLN metastases. Systematic retroperitoneal lymph node exploration therefore seems to be necessary to clarify the lymph node status.

Aorta↗
PubMed1996

[Distribution of lymph nodes and lymph node metastases in esophageal carcinoma].

BACKGROUND: Lymph node metastases are an independent prognostic factor in esophageal cancer. Accurate pathologic work up depends on detailed knowledges of number and anatomic distribution of lymph nodes and metastases. Factors that may determinate metastatic spread are also important. METHODS: One hundred and fifty-six patients with esophageal cancer were included in this study. Number and localization of nodes and metastases were documented and correlated with localization, infiltration deepness and grade of malignancy of the tumor. The effectivity of the search for nodes and metastases was also studied. RESULTS: We found 3869 lymph nodes containing 338 metastases in the 156 specimens (median 25 and 2). 53.2% of the cases exhibited metastases and 15.4% contained only solitary metastasis. The minimal number of lymph nodes for excluding of metastasis was about six nodes. Most of the nodes were found at lower esophagus and on the oral stomach resection. Tumors of the middle and upper thoracal esophagus spread also frequently to the nodes along the lesser curvature of the stomach. Between infiltration deepness and grade of malignancy of the tumors a positive association was found. CONCLUSIONS: Lymph node metastases are a frequent pathological feature in esophageal cancer which depends on infiltration deepness and grade of malignancy of the tumor. This allows the estimation of metastatic spread. For staging a minimum of six nodes must be found in the specimen. In this context the frequent metastases along the lesser curvature of the stomach must be considered.

Adenocarcinoma↗
PubMed1997

[Strategy of lymph nodes dissection for the lower thoracic esophageal cancer without metastasis to the upper-mediastinal lymph nodes].

The incidence of metastasis to the lymph nodes in preoperative untreated patients with Ei, T2 or T3 esophageal cancer is 70.7% (41 of 58 cases) in our institute. Especially, a high incidence of metastasis to the abdominal lymph nodes has been noted. In contrast, metastasis to the cervical lymph nodes is not common. The majority of recurrence appear as a distant metastasis to the liver, lung or bone through the hematogenic route. However, recurrence in the peritoneum through the lymphatogenic route is not uncommon. Therefore, current strategy of lymph nodes dissection for esophageal carcinoma would be inadequate for the complete inhibition of recurrence, so that chemotherapy remains to be needed. Since the diagnostic procedure with ultrasonographic endoscopy and computerized tomography is highly accurate for the assessment of metastasis to the uppermediastinal lymph nodes, operative procedure suitable for each case should be determined on the basis of preoperative examination.

Endosonography↗
PubMed1997

[Lymph flow and the development of the lymph nodes in human fetuses].

Since its anlage lymph node forms as a functional anastomosis between lymph and blood vessels. They make a complex with intimate anatomotopographic interrelations and their branches--an interconnected system, within which intervascular connective tissue transforms into lymphoid one. Interstitial canals networks may play a role of connecting "bridges" during lymphatic sinuses and blood microvessels unification with lymphoid tissue into a specific functional complex of counterflow system (arteries/veins--lymphatic vessels). On this basis histo- and morphogenesis of lymph node as a part of lymphatic bed occur. Lymph node uneven growth due to their depositing and resorptive function development allows to explain peculiarities of central lymph flow in human embryos.

Abdomen↗
PubMed1996

Benefits of D2 lymph node dissection for patients with gastric cancer and pN0 and pN1 lymph node metastases.

A retrospective immunohistological analysis of 100 patients with pT1-3 N0 and pT1-3 N1 gastric adenocarcinoma demonstrated a high frequency of micro-involvement in the removed lymph nodes. The presence of three or more tumour cells in more than 10 per cent of the lymph nodes was of significant prognostic value in the pN0 cases. Multivariate analysis identified micro-involvement as an independent prognostic factor. The results explain why patients benefit from lymphadenectomy even if the removed lymph nodes are not involved by tumour (pN0) in routine histological examination. The frequent occurrence of micro-involvement is a strong argument favouring routine D2 lymph node dissection in gastric cancer surgery in patients with lymph node metastasis.

Adult↗
PubMed1989

Metachronous seeding of lymph node metastases in rats bearing the MT-100-TC mammary carcinoma: the effect of elective lymph node dissection.

Following the introduction of cancer cells into the lymphatic system, metastases in 'down-stream' lymph nodes often appear in a sequential manner. This could be due to synchronous seeding of the in-line nodes with progressively diminishing numbers of tumorigenic cancer cells, or alternatively, by discrete, stepwise (metachronous) seeding of 'down-stream' nodes by 'up-stream' nodal metastases acting as 'generalizing' sites. Metachronous seeding to local lymph nodes is potentially curable by elective lymph node dissection; synchronous seeding is not. Synchronous versus metachronous seeding of lymph node metastases was investigated using the MT-100-TC mammary carcinoma injected into the hind foot-webs of rats. When the primary tumor was removed by amputation one week after injection, 1/15 animals survived; in contrast, removal of the draining popliteal lymph node in addition to the primary lesion, resulted in 8/19 long-term survivors. At this time, occult metastases detectable by bioassay but not by conventional histology, were present in all draining popliteal nodes and in 60 percent of lungs. The fact that some amputees were cured when the popliteal node was removed, indicated the metachronous nature of nodal metastases in this system. Further, recurrence of nodal and lung metastases in those amputees in which the popliteal node was left intact, identified the popliteal node as a 'generalizing' site. By the time popliteal node involvement was evident by conventional histology, micrometastases were present in 'down-stream' nodes, and accordingly, removal of the popliteal node and the primary lesion at this time was not curative.

Amputation, Surgical↗
PubMed1997

The impact of lymph node metastases on the survival of breast cancer patients with ten or more positive lymph nodes.

To investigate the impact of the number of involved lymph nodes on survival, we retrospectively reviewed the data for 37 patients with breast cancer and metastases of ten or more lymph nodes who underwent treatment between 1987 and 1995. Based on the number of positive lymph nodes, the patients were allocated to one of three groups. The 5-year disease-free and overall survival rates for all patients were both 53.0%. The 7 patients with 26 or more positive nodes had significantly poorer survival than either the 19 patients with 10-15 nodes, or the 11 with 16-25 nodes, although there were no differences in survival related to the extent of node involvement as defined using the Japanese staging system. Patients with 50%-75% frequency of metastasis, defined as the positive nodes/total resected nodes, had significantly better survival than those with < 50% or > 75% frequency. These results indicate that the number of involved lymph nodes is related to survival and that 25 positive nodes is a cutoff point in breast cancer patients with ten or more positive lymph nodes.

Adult↗
PubMed1988

Lymph esterases of the house mouse (Mus musculus)--I. Identification and possible origins of abdominal lymph esterases.

1. Abdominal lymph was obtained from Mus musculus by cannulation of the thoracic duct: lymph esterases were identified by polyacrylamide gel electrophoresis. Seven known esterases (ES-1, ES-2, ES-5, ES-27, SE-I, SE-II and SE-III) and a newly described activity (SE-IV) were demonstrated, all of which were also present in serum. 2. Electrophoretic staining intensities indicated that the lymph esterases were less concentrated than the corresponding activities in serum, with the single exception of ES-2. This finding was supported by quantitative immunoelectrophoresis of ES-1 and ES-2 (two allozymes each). 3. The jejunum appeared to be the origin of lymph ES-2 by a comparison of organ distribution of the allozymes ES-2B and ES-2D and by monitoring the re-appearance of ES-2 in several organs, serum and lymph after total inhibition in vivo by bis-p-nitrophenyl phosphate.

Abdomen↗
PubMed2005

The conduit system transports soluble antigens from the afferent lymph to resident dendritic cells in the T cell area of the lymph node.

Resident dendritic cells (DC) within the T cell area of the lymph node take up soluble antigens that enter via the afferent lymphatics before antigen carrying DC arrive from the periphery. The reticular network within the lymph node is a conduit system forming the infrastructure for the fast delivery of soluble substances from the afferent lymph to the lumen of high endothelial venules (HEVs). Using high-resolution light microscopy and 3D reconstruction, we show here that these conduits are unique basement membrane-like structures ensheathed by fibroblastic reticular cells with occasional resident DC embedded within this cell layer. Conduit-associated DC are capable of taking up and processing soluble antigens transported within the conduits, whereas immigrated mature DC occur remote from the reticular fibers. The conduit system is, therefore, not a closed compartment that shuttles substances through the lymph node but represents the morphological equivalent to the filtering function of the lymph node.

Animals↗
PubMed1984

Reconstruction of lymph follicles in the mouse popliteal lymph node after X-irradiation damage.

In order to suppress possible "de novo" formation of follicles in the node after irradiation, animals to be irradiated received surgical operations to block the afferent lymphatics to the popliteal node on one side, the corresponding node on the other side left intact. 600 R whole body X-irradiation severely destroyed lymph follicles in the nodes of both sides, but the number of follicles in the node on either side recovered toward normal by 3 weeks after irradiation, regardless of whether they contained germinal centers or not. In animals exposed to 1,000 R whole body X-irradiation and infused with bone marrow cells, no lymph follicles were observed in the nodes on day 9. If such treated animals were given 1.0 X 10(8) lymph node cells on day 5, lymph follicles were reconstructed in the nodes of both sides on day 9. In animals irradiated with 1,000 R to the lower half of the body, the number of follicles in the node on either side remained comparable to that of the unirradiated control node. The results favor the interpretation that although X-irradiation destroys the lymphoid elements of the follicles, the stromata of follicles persist and preserve the ability to collect small lymphocytes, and that lymph follicles are reconstructed at the sites of the stromata persisting from damaged follicles.

Animals↗
PubMedDate not supplied

Lymph node revealing solution: a new method for lymph node sampling: results in gastric adenocarcinoma.

Staging of gastric carcinoma depends on exact lymph node status. However, very small nodes are not easily found as they are obscured by the surrounding adipose tissue. The purpose of the present study was to demonstrate the usefulness of a Olymph node revealing solutionO (LNRS) in gastric cancer. The perigastric adipose tissue of ten OproblematicO cases of gastric carcinoma, in which <10 lymph nodes were found using the traditional method, was immersed in LNRS for 6-12 h. Subsequently, the lymph nodes stood out as white chalky nodules. They were excised and processed routinely. The traditional method yielded a total of 30 lymph nodes with a mean size of 6.69 +/- 3.43 mm. The LNRS revealed 89 additional nodes with a mean size of 3.03 +/- 3.43 mm, which was significantly smaller. The Node (N) stage was changed in four cases from Nx to N0, in one case from N1 to N2, and in one case from N0 to N2. LNRS seems to be the technique of choice for staging of patients with gastric adenocarcinoma in whom <10 lymph nodes were found with the traditional method and accurate staging was not possible.

Adenocarcinoma↗
PubMed1989

[Natural killer (NK) activity of peripheral blood and regional lymph nodes in patients with genitourinary malignant tumors. 2. NK activity and T-lymphocyte subsets in peripheral blood and regional lymph nodes].

We investigated natural killer (NK) activity and T-lymphocyte subsets in peripheral blood and regional lymph nodes in order to examine the host's defence mechanisms against cancer. The materials were obtained from 26 patients with genitourinary cancer and 9 patients with benign diseases, who were used as controls. NK activity was measured by ATP-chemiluminescence (ATP) assay, a new method which is well correlated to the 51Cr-release assay, and T-lymphocyte subsets were stained with anti-Leu-2, -3, -4, -7, and -11 monoclonal antibody. The NK activity of regional lymph nodes was lower than that of the peripheral blood in all 35 cases, and the percentage of Leu 7+ and Leu 11+ cells was in agreement with that of the NK activity detected by ATP assay. In the peripheral blood, the percentage of Leu 3+ cells was lower in high stage patients than it was in low stage patients and controls, but in the regional lymph nodes it was paradoxically higher. The NK activity of regional lymph nodes against autologous tumor cells was low in 8 patients with bladder cancer. It appears from this study that the regional lymph nodes have no function as immunological barriers for metastasis and we therefore conclude that they should be dissected during surgery.

Adult↗
PubMed1999

An experimental study of surgical treatment for lymphedema in rats: A modified Kinmonth procedure and autologous lymph node capsule-venous anastomosis with lymph node transfer.

This study was carried out in order to determine the effect of various surgical procedures on lymphedema in a rat model. In 26 adult male Sprague-Dawley rats, randomly divided into four groups, surgical lymphedema was created in the left hind limbs.: The control group had no drainage, Group 1 had a conventional Kinmonth operation, Group 2 had a modified Kinmonth operation using the greater omentum and Group 3 had autologous lymph node capsule-venous anastomosis with lymph node transfer. Circumference measurement was performed to calculate percent difference and circumferential reduction rate. In Groups 2 and 3, patent blue violet was injected to identify lymphatics. In all groups, hematoxylin-eosin (H-E) and 5'-nucleotidase stainning were done to evaluate lymphatics histopathologically. The percent difference and the circumferential reduction rate respectively showed the smallest and largest values in Group 2. A significant difference was found between the control group and Group 2 (p < 0.05). Lymphatic vessels were shown by patent blue violet injection in Groups 2 and 3. H-E and 5'-nucleotidase staining revealed patency of lymphatics. A modified Kinmonth procedure using the greater omentum was the most effective procedure for early lymphedema in a rat model and autologous lymph node capsule-venous anastomosis with lymph node transfer was effective for lymph draining in certain conditions, so it may assist in elucidating surgical treatment of lymphedema.

Anastomosis, Surgical↗
PubMed1999

[A case of multiple hepatocellular carcinoma complicated with N3 regional lymph node metastases preventing tumor progression by gradual introduction of lymph node excision and high-dose chemotherapy using percutaneous isolated hepatic perfusion].

We experienced a case of multiple hepatocellular carcinoma (HCC) complicated with N3 regional lymph node metastases. The gradual introduction of lymph node excision and high-dose chemotherapy using percutaneous isolated hepatic perfusion (PIHP) was effective in preventing progress of the tumor. The patient was a 63-year-old male who underwent a thorough medical examination because of elevated AFP at a local hospital. He was referred to our hospital. The preoperative laboratory results showed the elevation of AFP (729 ng/ml) and PIVKA-II (2,110 mAU/ml). CT scan of the liver revealed tumors in segment 4, 5 and 6, and lymph node metastases from the pancreas to the hepato-duodenal ligament. The enlarged lymph nodes were excised and the tumor in segment 5 was resected for pathological examination. Adriamycin was administered in doses of 100 mg/m2 and 80 mg/m2 using PIHP two and three months after the operation. According to the results of laboratory studies conducted 14 months after the operation, AFP was 12 ng/ml and PIVKA-II was within the normal range. CT scan of the liver showed the liquefaction degeneration of the remaining HCC. Although surgery is not generally indicated in a patient with multiple HCC complicated with N3 regional lymph node metastases, it should be considered in combination with PIHP in those with resectable extrahepatic lesion.

Antineoplastic Agents↗
PubMed1999

Adjuvant small field pelvic radiation for patients with high risk, stage IB lymph node negative cervix carcinoma after radical hysterectomy and pelvic lymph node dissection. A pilot study.

BACKGROUND: After radical hysterectomy and pelvic lymph node dissection, an identifiable subgroup of patients with International Federation of Gynecology and Obstetrics Stage IB lymph node negative cervix carcinoma remains at high risk of pelvic recurrence. This study attempted to determine whether postoperative small field of pelvic radiation can improve the disease free survival (DFS) of this high risk group of patients without producing significant morbidity. METHODS: Between 1991 and 1995, after radical surgery, 25 patients with Stage IB lymph node negative cervix carcinoma were considered to be at high risk of pelvic recurrence on the basis of tumor dimension, depth of stromal invasion, and the presence of lymph-vascular space invasion. All had a score >/= 120 as determined by the Gynecologic Oncology Group (GOG) study. These patients received 50.4 gray of adjuvant radiation to a small central pelvic field and were followed prospectively. A Kaplan-Meier 5-year DFS curve was generated. A log rank analysis produced an estimated log rank P value (est P value) by comparing the 5-year DFS of the patients in the current study with the 5-year DFS of the corresponding high risk group of the GOG study (observation only). The morbidity of small field pelvic radiation was recorded. RESULTS: Among the 25 patients who received small field pelvic radiation, the mean GOG score was 166 (range, 120-263) and the mean follow-up was 32 months (range, 12-64 months). There was 1 recurrence (4%) recorded at 16 months. The log rank analysis demonstrated a significant improvement in the 5-year DFS for the group who received adjuvant small field pelvic radiation (est P value = 0.005) when compared with the DFS of the high risk GOG patients who were observed postoperatively. Four cases of minor morbidity were recorded: lymphedema (three cases) and mild rectal incontinence (one case). No major morbidity was reported. CONCLUSIONS: With low morbidity, adjuvant small field pelvic radiation appears to improve significantly the 5-year DFS of patients with high risk, lymph node negative Stage IB cervical carcinoma. However, this pilot study requires verification.

Adult↗
PubMed2000

[Breast cancer and lymph node metastasis: relation of lymph node dimensions and metastasis].

The Authors have examined 1159 lymph nodes obtained from 64 cases of breast carcinoma to value the presence of a correlation between the insurgence of metastases and lymph node dimensions. Metastases were more frequent in larger lymph nodes. Nevertheless, metastases were also present in small (< 5 mm) or very small (< 2 mm) lymph nodes. This indicates the importance to carefully examine small lymph nodes during gross examination and to obtain multiple sections from them.

Breast Neoplasms↗
PubMed1975

Iliac lymph nodes as a primary lymph center draining the testicles.

The visceral radioisotopic lymphography, as a new technic, reveals new possibilities to investigate the lymph system of the testicle. The testicular lymph center is regularly visualized at the level of the para-aortic lymph nodes. But in 16.9% of the patients, respectively in 10.8% of the examined testes, iliac lymph nodes are demonstrated as a primary lymph center, draining the testicle. A preoperative scintigraphic search can be made for every patient with testicular neoplasma in the intention to obtain a more correct determination of the stage, the prognosis and the proper treatment planning.

Humans↗
PubMed2006

[Papillary thyroid microcarcinoma presenting as cervical lymph node metastasis. Interest of tetrofosmin scintigraphy and lymph node thyroglobulin measurement].

PURPOSE OF THE STUDY: Thyroid microcarcinoma presenting as cervical lymph node metastasis is common and it is associated in most cases with the papillary variety. Diagnosis of lymph node metastases from a thyroid microcarcinoma is not always easy, because a thyroid nodule may not be palpable. MATERIAL AND METHOD: In this work, the authors report two cases of papillary microcarcinoma presenting as cervical lymph adenopathy. RESULTS: The diagnosis was made preoperatively by Tetrofosmin scintigraphy and thyroglobulin measurement in the lymph node. CONCLUSION: Tetrofosmine scintigraphy is a performing exam but with a poor specificity. Lymph node thyroglobulin is a simple exam which is very sensitive and specific.

Adult↗