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At least 433 records · Page 24Linked to original sources
PubMed2002

Tumour thickness as a predictor of occult lymph node metastases in patients with stage I and II melanoma undergoing sentinel lymph node biopsy.

BACKGROUND: Sentinel lymph node biopsy (SLNB) is a minimally invasive procedure used accurately to stage nodal basins at risk of occult metastases. There are no data as yet to show a survival benefit from SLNB and its use remains controversial. If Breslow thickness of the tumour correlates well with positive SLNB, it could be used to select patients for SLNB. METHODS: A quantitative systematic review of published studies on SLNB in patients with melanoma available by September 2001 was performed. RESULTS: Twelve studies containing 4218 patients with stage I and II melanoma were identified; 17.8 (95 per cent confidence interval 16.7 to 19.0) per cent of patients had nodal micrometastases detected by SLNB. The incidence of micrometastasis in sentinel nodes correlated directly with Breslow tumour thickness; it was 1.0 per cent for lesions of less than or equal to 0.75 mm, 8.3 per cent for 0.76-1.50 mm, 22.7 per cent for 1.51-4.0 mm and 35.5 per cent for more than 4.0 mm. CONCLUSION: The Breslow thickness of primary melanoma predicts the presence of a sentinel node metastasis. The published data are not sufficient to demonstrate a correlation between other known prognostic indicators and a positive SLNB.

Humans↗
PubMedDate not supplied

Histopathologic examination of the sentinel lymph nodes.

Sentinel lymph nodes (SLNs) are the most likely site of regional metastasis. Their step sectioning and cytokeratin immunohistochemistry (IHC) result in the upstaging of breast cancer. The heterogeneity of histologic methods is partially responsible for differences in nodal upstaging of the disease in different reports. Intraoperative assessment might be done by both frozen sections and imprint cytology; both methods have advantages and disadvantages. Several guidelines relating to the histopathology of sentinel nodes, including the recent European Working Group for Breast Screening Pathology guidelines, are briefly summarized. These latter advocate multilevel assessment of grossly or intraoperatively negative sentinel nodes with levels separated by a maximum of 1 mm and allow IHC in their assessment, although this latter method is not mandatory. Both methods of intraoperative evaluation are allowable. There are also minimum requirements for the reports on sentinel node histology. For example, the reports should include the extent of nodal involvement, the method used for their identification, and preferably the method used for investigating the sentinel nodes, even if the results are negative. These guidelines are intended to form the basis for national guidelines in European countries.

Breast Neoplasms↗
PubMed1996

Type of lymph node involvement influences survival rates in T1N1M0 non-small cell lung carcinoma. Lymph node involvement by direct extension compared with lobar and hilar node metastases.

Stage II non-small cell lung cancer represents a group of patients with varying 5-year survival rates. Of 2,009 patients, we reviewed 58 patients with pT1N1M0 disease operated on from 1977 through 1994. The N1 status was refined into lymph node involvement by direct extension and/or involvement by metastases (lobar or hilar). The cumulative 5-year survival of all hospital survivors (n = 57) was 45.7%. The 5-year survival of patients with N1 direct extension was superior to survival of patients with N1 metastases (68.6% vs 31.2%; p = 0.0038). Survival of patients with N1 direct extension was better then survival of patients with N1 hilar metastases (p = 0.0006), but did not differ from survival of patients with lobar metastases. Survival was not related to histologic features, sex, and type of resection. Recurrence of malignancy occurred less in patients with N1 direct extension. In patients with N1 hilar nodes, the most common pattern was distant metastases. Survival differs according to the type of lymph node involvement: "direct extension" seems to be an early stage of the disease, while lymph node metastases represent a more advanced form.

Adult↗
PubMed2005

Th2-biased immune response in cervical lymph nodes: animal models of Graves' disease might administer autoantigen to body regions where lymphatics drain to cervical lymph nodes.

It is believed that cervical lymph nodes have an important impact on Th2-biased immune response to central nervous system (CNS)-derived antigens. Obstruction of these nodes prior to a CNS-infusion of antigen markedly lowers the level of serum antibody response to the antigen. Graves' disease is a Th2-biased autoimmunity in which autoantibodies against thyrotropin receptor stimulate thyroid hormone production. The reasons for the distinct Th2-biased immune response in this hyperthyroidism are not fully understood, whereas most of the other human organ-specific autoimmune diseases are believed to be Th1 mediated. It is suggested that the drainage of the thyroid lymphatics to cervical lymph nodes may play a role in the Th2-polarized immune response of Graves' disease. Thus, the generation of Graves' disease models by immunization may become more feasible if animals are administered the autoantigen to body regions whose lymph is drained to cervical lymph nodes.

Animals↗
PubMed2002

Application of the popliteal lymph node assay in immunotoxicity testing: complementation of the direct popliteal lymph node assay with flow cytometric analyses.

The popliteal lymph node assay (PLNA) has been proposed to measure the immunosensitizing potential of chemicals. The direct PLNA detects an immunomodulating effect but does not give insight into the mode of action of the chemical under test. Modifications of this test have been proposed, but they are difficult to perform in routine toxicity testing and require many animals. In the present investigation the direct PLNA was extended with the flow cytometric determinations of: (a) lymphoblasts; (b) the phenotyping of lymphoid subpopulations; (c) the determination of expression of proliferation/activation markers CD25, CD69 and CD62L/CD44 and (d) the analysis of intracellular cytokines interferon gamma, interleukin 2 and interleukin 4. Streptozotocin, hydrazine, HgCl2 and trinitrobenzene sulfonic acid were used as model chemicals. The different mode of action of these substances was well documented by the techniques applied. As the proposed flow cytometric methods can easily be performed and do not require additional test animals this complementation of the direct PLNA seems a promising approach in immunotoxicity testing.

Allergens↗
PubMed1999

Detection of microscopic melanoma metastases in sentinel lymph nodes.

BACKGROUND: Sentinel lymph node biopsy following radioisotope labeling is a recently developed, minimally invasive surgical staging procedure used in the management of primary cutaneous malignant melanoma. If histologic analysis reveals melanoma metastasis in the sentinel lymph node, completion lymphadenectomy is performed and adjuvant therapy considered. The routine pathologic assessment of the sentinel lymph node consists of bisecting the lymph node along its long axis and histologic examination of one hematoxylin and eosin-stained section of each cut surface. METHODS: In this study, the authors reexamined 235 sentinel lymph nodes reported as negative for melanoma metastasis following routine histologic examination, from 94 patients with American Joint Committee on Cancer (AJCC) Stage I and II cutaneous melanoma. RESULTS: Deeper sections into the lymph node and immunohistochemical stains with antibodies to S-100, HMB-45, NK1C3, and MART-1 led to the identification of microscopic metastases in 11 sentinel lymph nodes from 11 patients and capsular nevi in 9 sentinel lymph nodes from 8 patients. CONCLUSIONS: Deeper serial sections and immunohistochemical stains detected microscopic metastases in approximately 12% of cases that would be reported as negative for metastasis by routine pathologic analysis. These techniques also allowed for the identification of capsular melanocytic nevi in the sentinel lymph nodes of 9% of patients. [See editorial on pages 551-2, this issue.]

Adult↗
PubMed1996

[Comparative tomography of the lymph nodes of the Peulh Peulh sheep and the Sahel goat. I: Lymph nodes of the cranial vascular net (head, neck and thoracic limb)].

Peulh Peulh sheep and Sahel's goat are the most present small Ruminants in the slaughterhouses of Dakar. Former studies have been undertaken in order to facilitate differential diagnosis between the two carcasses. Here, the authors deliver complete topography of lymph nodes of Peulh Peulh sheep and Sahel's goat, for easier meat inspection in abattoirs. This first study is devoted to lymph nodes of cranial part of lymphatic system in the two species.

Animals↗
PubMed1996

[Comparative tomography of the lymph nodes of the Peulh Peulh sheep and the Sahel goat. II. Lymph nodes of the caudal vascular net. (Pelvic limbs, pelvis, abdomen and thorax)].

Peulh Peulh sheep and Sahel's goat are the most present small Ruminants in the slaughterhouses of Dakar. Former studies have been undertaken in order to facilitate differential diagnosis between the two carcasses. Here, the authors deliver complete topography of lymph nodes of Peulh Peulh sheep and Sahel's goat, for easier meat inspection in abattoirs. This second study is devoted to lymph nodes of caudal part of lymphatic system in the two species, and to the use of their topography in meat inspection.

Animals↗
PubMed1982

The influence of lymph node metastasis and ulceration of primary melanoma on germinal centers within draining lymph nodes: a histomorphometric study.

Microscopic counts and histoelectronic measurement of germinal centers in regional lymph nodes of melanoma patients showed a significant progressive increase in average number, as well as area, of germinal centers with occurrence of (adjacent) metastasis and presence of primary-tumor ulceration. The findings confirm in a quantitative manner the stage-dependent effect of progressive liberation of tumor antigen [10] on lymph node centers of humoral immune response.

Adult↗
PubMed2006

Lymphoscintigraphy in penile cancer: limited value of sentinel node biopsy in patients with clinically suspicious lymph nodes.

The staging lymph node dissection in patients with penile carcinoma is accompanied with a high morbidity. As many patients are free of nodal metastases the lymphoscintigraphic sentinel node biopsy is supposed to minimize perioperative morbidity in these patients. In the current study the accuracy of the lymphoscintigraphic sentinel node biopsy was verified against the gold standard of radical inguinal dissection. In particular, patients with enlarged lymph nodes have also been included since one half of these patients is known to have histologically negative lymph nodes. Between 2000 and 2004 fifteen patients with penile carcinoma were elected to undergo bilateral groin dissection, thus 30 inguinal areas have been dissected. Nine patients have had clinically palpable nodes. All patients underwent lymphoscintigraphy after injection of Tc99-nanocolloid subcutaneously into the peritumoral area. Intraoperatively the sentinel nodes were identified with the aid of a gamma ray detection probe and excised. Afterwards a standard groin dissection was performed and the different lymph nodes were histopathologically assessed separately. In all patients lymph nodes with high radioactivity uptake were detected bilaterally. In 10 out of 30 inguinal areas histopathologically positive lymph nodes were present. In four of them the sentinel node was positive for tumor but in six dissection areas lymph node metastases were found despite a negative sentinel node. These patients had clinically palpable lymph nodes in their histologically positive inguinal regions. If no palpable nodes were present dynamic sentinel biopsy detected the positive nodes. The current study showed that dynamic sentinel node biopsy in patients with clinically suspicious lymph nodes is of low value for detection of lymphatic spread in penile cancer. Therefore the gold standard in these patients remains the radical groin dissection. However, dynamic sentinel node biospy is still a promising strategy to identify lymphatic spreading in clinically N0 patients and therefore to prevent unnecessary groin dissection.

Adult↗
PubMed2003

The prognostic significance of total lymph node number in patients with axillary lymph node-negative breast cancer.

AIM: In node-negative breast cancer patients, several factors for survival have been evaluated and currently, some of them are accepted for their prognostic and/or predictive values after validation in the separate data sets. The prognostic significance of increases in the number of pathologically detectable axillary lymph nodes in the node-negative patients could not been established clearly. To address this question, we have reviewed our patients' records. METHODS: A retrospective cohort study was conducted in pathologically node-negative patients who underwent modified radical mastectomy for stage I and II breast cancer. Survival and multivariate prognostic factor analyses were carried out to determine whether the number of tumour-free lymph nodes in complete axillary dissection material in addition to known factors was significant for the outcomes. RESULTS: Two hundred and seventy consecutive patients were eligible to enter the trial. The median observation time and the median number of tumour-free lymph nodes were 61 (from 30 to 120) months and 18 (from 10 to 44), respectively. The cohort was divided into the groups according to the number of nodes. The 5-year event-free and overall survivals were 92.5 and 98.3% for patients who had 18 lymph nodes or less, and 70 and 86.7% for those who had more than 18 negative nodes, respectively (P < 0.00001). Multivariate analysis for event-free survival demonstrated that the number of lymph nodes (Relative risk: 3.2 and 95% confidence interval: 1.7 to 5.9) in addition to the pathological tumour size and age was the most important independent prognosticator. In similar, multivariate analysis for overall survival showed that the number of lymph nodes together with the tumour size was the significant indicator (RR of cancer-specific dying in patients who had more than 18 nodes: 3.1 and 95% CI: 1.2 to 8.5). CONCLUSION: The increases in number of tumour-free lymph nodes are clinically important and this parameter should be taken into consideration in the breast cancer patients without metastatic lymph nodes.

Adult↗
PubMed2003

It is true that, when Langerhans cells migrate from the skin to the lymph node, they are transported via lymph vessels.

BACKGROUND: Generally, Langerhans cells deliver antigen information from the skin to the draining lymph nodes via lymph vessels. METHODS: By immunohistopathology, we investigated the delivery route of Langerhans cells in human skin using CD1a and S-100 protein antibodies. RESULTS: We noted CD1a- and S-100-positive Langerhans cells in the lymph vessels of the dermis. These were shaped like dendritic cells and presented with some lymphocytes, melanophages, melanin granules and lymph in the same vessels. CONCLUSION: These observations support the concept that Langerhans cells deliver antigen peptides to regional lymph nodes via afferent lymph vessels.

Antigens, CD1↗
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↗