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A high number of tumor free axillary lymph nodes from patients with lymph node negative breast carcinoma is associated with poor outcome.

BACKGROUND: Lymph node metastasis is the oldest and most reliable prognostic indicator in breast carcinoma. In the absence of tumor metastasis, draining lymph nodes can undergo hyperplasia, resulting in increases in the number and size of detectable lymph nodes. The prognostic value of this process has never been established. Lymph node negative breast carcinoma provides a unique opportunity to study the downstream effects of increased lymphatic drainage and lymph node hyperplasia. METHODS: The authors studied 290 cases of lymph node negative breast carcinoma and provided patients with a median of 103 months of follow-up. The number of tumor free lymph nodes in ipsilateral axillary resections, as well as 10 traditional histopathologic markers, were analyzed for their prognostic value. RESULTS: The cohort was divided into quartiles according to the number of tumor negative lymph nodes. The 5-year survival for patients with 20 or more tumor free lymph nodes (top quartile) was 84.7%, compared with 96.3% for patients with fewer than 20 tumor free lymph nodes. The 5-year relative risk of dying of metastatic disease in the top quartile was 3.61 (95% confidence interval, 1.37-9.52, P = 0.01), independent of necrosis, tumor size, patient age, nuclear and histologic grade, lymphocytic infiltrate, and lymphovascular invasion. The absolute lymph node number was highly associated with the presence of necrosis in invasive tumor. CONCLUSIONS: The number of tumor free lymph nodes is a novel, independent predictor of aggressive disease in cases of lymph node negative breast carcinoma. This finding may be a biologic function of host-derived, and possibly tumor-derived, lymphangiogenic cytokines.

Adult↗

[Differential diagnosis of cervical lymph node enlargements: ultrasound and histomorphology of reactive lymph nodes].

The purpose of this study was to investigate the morphology of reactive lymph nodes of the neck in ultrasound and its histological implications. By revealing a characteristic sonomorphology of reactive lymph nodes we would like to contribute to the differential diagnosis of cervical lymph node enlargements. In 81 patients the morphology and the longitudinal/ transverse axis ratio (L/T ratio) of 257 reactively enlarged lymph nodes were examined. Besides 6 false-positive cases the L/T ratio turned out to be a reliable instrument in detecting reactive lymph nodes. Concerning the nodal texture, 89 lymph nodes (34.6%) appeared homogenously. Those lymph nodes which demonstrated a more complex nodal texture could be assigned to three sonomorphological groups: In 134 lymph nodes (52.1%) a centrally located echogenoic line ("central echogenoic line', CEL) was observed. Its maximal diameter was defined to be maximally up to one third of the lymph node width. In the histological examination this CEL could be identified as a widened hilus with an increased fibrosis. An echogenoic nodal area measuring between one third up to one half of the lymph node width demonstrated histologically a fatty replacement of the hilar tissue. This "echogenoic hilus reflex' occurred in 28 lymph nodes (10.9%). A nearly complete lipomatous atrophy of the lymph node parenchyma was found in 6 lymph nodes (2.4%) demonstrating a "central echogenicity' with just a small peripheral, less echogenoic border corresponding to the remaining parenchyma.

Adult↗

Prognostic significance of the number of lymph nodes examined in patients with lymph node-negative breast carcinoma.

BACKGROUND: A recent report suggested that the number of lymph nodes examined was a strong predictor of survival in patients with lymph node-negative breast carcinoma. Among women who had >or= 20 lymph nodes examined, the risk of dying from breast carcinoma within 5 years was increased nearly 4-fold compared with women who had fewer lymph nodes examined. Because these findings were based on a relatively small cohort of patients, corroborative studies with larger patient populations were needed. METHODS: The authors studied the relation between the number of lymph nodes examined and breast carcinoma survival among 911 women with lymph node-negative breast carcinoma with a median length of follow-up of 84 months. The association between other prognostic indicators and survival and the number of lymph nodes examined also was investigated. RESULTS: The number of lymph nodes examined was not found to be associated with either 5-year or long-term survival. The proportion of women dying from breast carcinoma was the same (8%) in both groups (those patients with >or= 20 lymph nodes examined vs. those in whom < 20 lymph nodes were examined) and the hazard ratio was 0.98 (95% confidence interval, 0.58-1.64). CONCLUSIONS: In this larger study population, the authors failed to confirm the findings of an earlier investigation in which having a larger number of lymph nodes examined was associated with poorer survival. This finding suggests that it is unlikely the number of lymph nodes examined is an important prognostic indicator in patients with lymph node-negative breast carcinoma.

Adult↗

Impact of separate versus en bloc pelvic lymph node dissection on the number of lymph nodes retrieved in cystectomy specimens.

PURPOSE: Pelvic lymphadenectomy during radical cystectomy yields a various number of lymph nodes depending on the extent of lymph node dissection and pathologist aggressiveness when searching the specimen. How the surgeon submits lymph nodes for pathological evaluation may also affect how many are retrieved. MATERIALS AND METHODS: Bilateral pelvic lymph node dissection and radical cystectomy for transitional cell carcinoma of the bladder was performed in 32 patients. The extent of lymph node dissection involved standard and extended lymphadenectomy in 20 and 12 cases, respectively. In patients who underwent standard dissection unilateral en bloc submission of the lymph nodes was done with the contralateral lymph node dissection sent as an individual discrete packet. In those who underwent extended dissection all lymph nodes from each side were submitted en bloc or as 6 packets. RESULTS: Standard lymphadenectomy en bloc specimens yielded a mean of 2.4 lymph nodes compared with 8.5 retrieved from individual lymph node specimens (p = 0.003). Extended lymphadenectomy en bloc specimens yielded a mean of 22.6 lymph nodes compared with 36.5 retrieved from the individually submitted packets (p = 0.02). CONCLUSIONS: Submitting pelvic lymph nodes as separate specimens optimizes pathological evaluation of the number of lymph nodes that may be involved with metastatic cancer. Such information is important for identifying patients who may benefit from adjuvant chemotherapy.

Cystectomy↗

Axillary lymph node ratio and total number of removed lymph nodes: predictors of survival in stage I and II breast cancer.

AIMS: Presence of axillary lymph node metastases is considered the most important prognostic factor for breast cancer survival. In a period of increasing popularity for the sentinel node procedure, clarity about the possible relation between axillary dissection and survival is essential. This study investigated whether the total number of removed lymph nodes and the ratio of invaded/removed lymph nodes (lymph node ratio (LNR) would prove to be independent prognostic factors for survival. METHODS: Data from 453 consecutive patients with stage I or II breast cancer were studied retrospectively. The total number of removed lymph nodes and the LNR were analysed for their prognostic value in comparison with known prognostic factors. RESULTS: Node-negative patients with < 14 lymph nodes removed had a 10 year survival of 79% compared with 89% in patients with > or = 14 lymph nodes removed (P=0.005). The 10 year survival for patients with an LNR > or = 0.2 was 52%, compared with 73% for patients with an LNR < 0.2 (P<0.0001). A Cox proportional hazards model showed that, for node-negative patients, only age and total number of removed lymph nodes were significant prognostic factors. For node-positive patients, age, total number of removed lymph nodes and the LNR were significant risk factors for survival outcome. The LNR was also significantly associated with the presence of distant metastases during follow-up (hazard ratio 3.56, range 1.63-7.77). CONCLUSIONS: In stage I and II breast cancer, a favourable prognosis was found for node-negative patients with > or = 14 removed lymph nodes. Before axillary lymph node dissection with its well-defined survival prognosis is replaced by less invasive staging methods, long-term survival using new staging techniques needs to be defined. For node-positive patients, the LNR proved to be an excellent predictor for survival outcome or development of metastatic disease. Selection of lymph node-positive patients based on the LNR may guide specific adjuvant treatment choices.

Aged↗

Studies of the cells in the afferent and efferent lymph of lymph nodes draining the site of skin homografts.

Intermediate lymph (efferent from the prefemoral lymph node) was collected for 600 hr from both flanks of each of four sheep that had an autograft of skin on the left flank and a homograft of skin on the right flank. 8 days after the grafts had been applied considerable numbers of large basophilic cells, apparently identical with those that appear during immune responses to conventional antigens, appeared in the lymph draining from the homografts. No such cells appeared in the lymph draining from the autografts. At this time the homografts were already showing signs of rejection and were apparently dead well before the cellular response in the lymph reached a peak, about 350 hr (14-15 days) after the homografts had been applied. During the peak of the response up to 40% of the cells in the lymph were basophilic cells and in one experiment such cells were leaving the lymph node at a rate of 200 million per hr. Peripheral lymph (afferent to the popliteal lymph node) draining from the sites of homografts of skin was collected from five sheep. This lymph contained few white cells (<1000 per mm(3)) and showed only an insignificant lymphoid cell reaction. Although the percentage of macrophage-like cells was increased significantly there were few signs of a lymphoid cell reaction; the lymph also contained much amorphous debris. Experiments in which the basophilic cells from the efferent lymph were labeled in vitro with thymidine-(3)H and returned to the sheep by intravenous injections were carried out in six sheep. The presence of the labeled cells in the grafts, blood, and other tissue was detected by liquid scintillation counting of nucleic acid extracts of biopsy and postmortem material and by radioautography. 2-3 labeled cells out of every 1000 injected entered the homografts but hardly any entered the autografts. However, labeled basophilic cells that had originated in response to bacterial antigens entered the homografts with equal facility. It is thus hard to believe that the immunological specificity of a lymphoid cell endows it with a specific "homing" capability. Furthermore, in all the experiments the specific radioactivities of the nucleic acids extracted from the blood mononuclear cells were approximately of the same order as those of the nucleic acids extracted from the homografts. It was concluded that most of the mononuclear cells that infiltrate homografts represent a random selection from the mononuclear cell population of the blood.

Animals↗

Number and anatomical extent of lymph node metastases in gastric cancer: analysis using intra-lymph node injection of activated carbon particles (CH40).

BACKGROUND: The long-term survival of 200 patients with gastric cancer who underwent radical gastrectomy was analyzed with respect to the number and anatomical extent of lymph node metastasis. All of the patients received intra-lymph node injection of fine activated carbon particle solution (CH40) during surgery. METHODS: The average number of resected lymph nodes increased in line with the anatomical level of lymph node dissection; 32.5 per patient in D1, 42.3 in D2, 3 and 66.3 in D4. The percentage of blackened lymph nodes without metastasis (42.4%) was slightly higher than that of lymph nodes containing metastasis (37.2%), but the difference was not statistically significant. Of the 200 patients, 61 (30.5%) had microscopic evidence of metastatic lymph node involvement. Twenty-two patients had between one and three metastatic lymph nodes, 19 had between four and nine and 20 patients had more than nine. The 5-year survival rate was 93.1% in patients without lymph node metastasis, 71.9% in patients with 1-8 metastatic nodes, 36.1% in patients with 4-9 nodes and 19.2% in patients with > 9 nodes. RESULTS: The 5-year survival rate according to the anatomical extent of metastatic lymph nodes was 93.1% in n0, 63.1% in n1, 37.9% in n2, 27.8% in n3 and 0% in n4. The number of metastatic lymph nodes and also their anatomical extent were identified as independent prognostic factors for survival by multivariate analysis. CONCLUSION: The number and anatomical extent of metastatic lymph nodes have similar impacts on prognosis in gastric cancer.

Adult↗

[Disciplinarian of lymph node metastasis and effect of paraaortic lymph nodes dissection on clinical outcomes in advanced gastric carcinoma].

OBJECTIVE: To investigate the disciplinarian of lymph node metastasis and evaluate the effect of paraaortic lymph nodes dissection on the clinical outcomes in advanced gastric carcinoma. METHODS: One hundred and twenty-six patients who underwent D(3) (including D(3)(+)) radical resection (group D(3)) and 146 patients who underwent D(2) radical resection by the same surgical team (group D(2)) for advanced gastric cancer were enrolled in the present study. The dissected lymph nodes were grouped according to the definition of Japanese Research Society for the Study of Gastric Cancer (JRSGC) (Edition 13th). The lymph node metastasis was analyzed in group D(3). The clinicopathological characteristics and clinical outcomes were compared between the two groups. RESULTS: There were no differences in age, sex, tumor location, Borrman type, histological type and TNM stage between group D(2) and group D(3) (P > 0.05). The No16 lymph node metastatic rate was 3.8%, 22.3%, 46.8% and 32.1% in T(1), T(2), T(3), T(4) stage tumors respectively, 16.3% and 69.5% in the patients with negative and positive serosal invasion respectively; there were no differences in operative mortality (2/126 vs 2/146) and surgical complications (4/126 vs 6/146) between group D(2) and group D(3) (P > 0.05). The 5-year survival rate was 66.5% in group D(3) and 40.2% in group D(2) (P< 0.01). The 5-year survival rates of the patients with I, II, IIIa, IIIb and IV stage tumors who were No16 lymph nodes negative were 94.8%, 95.6%, 72.1%, 58.6%, 59% respectively in group D(3), and 42%, 36%, 27%, 35.6%, 16.3% respectively in group D(2). The 5-year survival rate of the patients with No16 (+) lymph nodes less than 3 was higher than that of the patients with No16(+) lymph nodes more than 3. CONCLUSIONS: No16a2 and No16b1 are the common locations of lymph node metastasis in advanced gastric cancer. The paraaortic lymph node metastasis closely is related with the depth of tumor invasion and serosal invasion. Paraaortic lymph nodes dissection (D(3) or D(3)(+) radical resection) improves the 5-year survival rate of the patients with No16 (-) and No16 (+) lymph nodes less than 3.

Female↗

Lymphocyte emigration from lymph nodes by blood in the pig and efferent lymph in the sheep.

Two types of experiment using local labeling of lymph nodes with FITC showed that lymphocytes emigrate from lymph nodes, predominantly in blood in the pig and in efferent lymph in the sheep. In the first type of experiment with the pig, few cells emigrated via the lymph, while the number of labelled cells in the blood increased progressively and the indices in mesenteric blood were always higher than in jugular blood in simultaneously-drawn samples. However, in the sheep, when efferent lymph flowed freely, very low numbers emerged in blood and continuing large numbers of lymphocytes emerged in efferent lymph. In the second type of experiment carried out wholely under anaesthetic on mesenteric lymph nodes in pigs and sheep, and on superficial inguinal lymph nodes in pigs, the lymph node was isolated, the lymph and venous drainage collected and only the arterial supply maintained. Large numbers of FITC+ lymphocytes emigrated via the vein in pigs with either node cannulation (i.e. up to 7% blood lymphocytes were labelled with an emigration rate of approximately 10(8) cells/hr) but in sheep, while lymph contained approximately 30-80% labelled cells and the emigration rate was also approximately 10(8) cells/hr, the mesenteric blood contained very few labelled cells (approximately 0.2%, giving a mean venous emigration rate of 2.7 X 10(6)/hr). Study of the type of lymphocytes emerging from labelled pig lymph nodes and spleen during the phase of major emigration showed that sIg+ B and E rosette-forming T cells, but almost no Null cells, are involved.

Animals↗

Kinetics of cytotoxic lymphocytes in efferent lymph from single lymph nodes following immunization with vaccinia virus.

Efferent lymphocytes collected from a cannulated lymphatic draining single lymph nodes were studied for their cytotoxic activity following the injection of live vaccinia virus subcutaneously into the drainage site of a lymph node. Injection of virus produced a 40-fold increase in the lymphoblast output 7 days following virus injection. Cytotoxic lymphocytes were detectable in lymph shortly after the appearance of lymphoblasts at 80 h and also reached a maximum during the 7th day. This was followed by a rapid decline of the cytotoxic cells although cytotoxic cells were detectable up to 2 weeks. The cytotoxic activity in lymph was found to be antigen specific, dependent on the effector/target cell ratio, and allogeneically restricted, indicating that it was most likely due to cytotoxic T lymphocytes (CTL). CTL precursors were found in large numbers in efferent lymph and appeared at approximately the same time as the mature CTL. Unlike CTL, the precursors became part of the recirculating lymphocyte pool and were detectable in efferent lymph for at least 2 months. Following a secondary challenge with vaccinia, lymphoblasts and CTL appeared at least 36 h earlier in the lymph. In summary, we have demonstrated that virus specific CTL are found in the efferent lymph collected from a single immunized lymph node in sheep. The kinetics of the CTL and CTL precursors indicate that these lymphocytes are one of the earliest antigen specific cells detectable in efferent lymph and suggests that these cells migrate rapidly from the lymph node into efferent lymph for dissemination throughout the host to sites of virus infection.

Animals↗

Extraction and analysis of carcinoembryonic antigen in lymph nodes: a new approach to the diagnosis of lymph node metastasis of colorectal cancer.

PURPOSE: To detect lymph node metastasis of colorectal cancer, we extracted protein from lymph nodes and determined the concentration of carcinoembryonic antigen. METHODS: In Experiment 1, a total of 237 lymph nodes from 23 colorectal cancer patients were examined histologically after immersion in 200 microl of saline for 2 hours. Concentrations of protein and carcinoembryonic antigen in each saline sample were determined by protein assay and immunoradiometric assay, respectively. Each value of carcinoembryonic antigen in the saline was divided by extracted protein, and the carcinoembryonic antigen levels in lymph nodes were represented as nanograms per milligram of protein. In Experiment 2, 63 lymph nodes from 8 colorectal cancer patients were cut into 2 pieces and immersed in 1 ml of saline for 15 minutes, and they were subjected to reverse transcriptase-polymerase chain reaction for carcinoembryonic antigen and histologic examination, respectively, after measurement of the carcinoembryonic antigen concentration in the extract. RESULTS: From 236 of 237 lymph nodes in Experiment 1, an average of 3,249.4 microg/ml protein was successfully extracted. Histologic examination revealed that 33 of 236 lymph nodes had colorectal cancer metastases, with a significantly higher concentration of carcinoembryonic antigen on average (655.5 ng/mg protein) than in the 203 lymph nodes without metastasis (18.2 ng/mg protein; P < 0.0001). In Experiment 2, 19 of 63 lymph nodes examined were positive for metastasis in both reverse transcriptase-polymerase chain reaction and histology and showed a significantly higher carcinoembryonic antigen concentration on average (1,003.9 ng/mg protein) than the 42 lymph nodes that demonstrated no metastasis by either method (18.0 ng/mg protein; P < 0.0001). The remaining two lymph nodes, which were positive by reverse transcriptase-polymerase chain reaction but negative by histology, showed high carcinoembryonic antigen concentrations of 514.7 and 61,970.5 ng/mg protein, respectively. CONCLUSION: This simple method of protein extraction and determination of carcinoembryonic antigen concentration in lymph nodes may provide an alternative tool for the diagnosis of colorectal cancer metastasis.

Carcinoembryonic Antigen↗

Patterns of age-dependent changes in the numbers of lymph follicles and germinal centres in somatic and mesenteric lymph nodes in growing C57Bl/6 mice.

The timing of the first appearance of lymph follicles and germinal centres in various lymph nodes, and the ways in which numbers of these and IgM-synthesising cells increase within the nodes, were investigated in male and female C57Bl/6N mice aged from 4 d to 16 wk. The lymphoid organs examined were the Peyer's patches, spleen, somatic (submandibular, deep cervical, brachial, axillary, inguinal and popliteal) and visceral (mesenteric and lumbar) lymph nodes. Primary follicles appeared in most somatic lymph nodes 6 d after birth. The number of follicles per node then increased rather sharply in larger lymph nodes and slowly in smaller nodes, up to 28 d of age, reaching a level which varied according to the location of the node. Thereafter, the number of follicles in the somatic lymph nodes increased only slightly to moderately, reaching a peak or plateau at 8-12 wk. In the mesenteric (ileocaecal) nodes, primary follicles first appeared at 12 d, then increased linearly during the suckling period and after weaning to reach a plateau at 8 wk of age. Germinal centres appeared in the submandibular and mesenteric nodes at 28 d and their numbers increased consistently in the latter, while remaining low in the former. The impact of possible 'natural' exogenous antigen stimulation of the various lymph nodes was estimated from the presence of IgM-synthesising cells and germinal centres. Differences between the patterns of age-dependent changes in the numbers of lymph follicles observed in the somatic and mesenteric lymph nodes during their ontogeny are discussed in relation to differences in the magnitude of the exogenous antigen stimulatory effect. We also found that the variations in the numbers of lymph follicles produced in somatic lymph nodes at different locations during the first 28 d after birth reflected differences in the dimensions of the body regions drained by a particular somatic lymph node at this stage of development.

Aging↗

Benign lymph node hyperplasia and lymph node metastases in rabbits. Animal models for magnetic resonance lymphography.

OBJECTIVES: Experimental models of reactive lymph-node hyperplasia and lymph-node metastasis were developed for magnetic resonance imaging (MRI). METHODS: Reactive lymph-node hyperplasia was induced in 20 rabbits by injection of an egg-yolk emulsion intramuscularly in the hind limbs and subcutaneously in the flanks. In another 20 rabbits, lymph-node metastasis was induced by implantation of a squamous cell carcinoma (VX2 tumor) in one hind limb. Five rabbits remained untreated. Signal intensity and size of iliac medical and popliteal lymph nodes were investigated with T1-, T2-, and proton-density-weighted spin-echo sequences at 1.5 T. In addition, lymph-node activity and metastatic involvement were assessed histologically. RESULTS: Lymph nodes in untreated animals were small and difficult to visualize by MRI. After egg-yolk-induced reactive lymph-node hyperplasia, the enlarged nodes were well demonstrated by MRI. Implantation of VX2 tumors led to different degrees of lymph-node metastasis (micrometastasis, partial and complete metastatic permeation), depending on growth period and size of the primary tumor. In MR images, lymph nodes of untreated, stimulated, and tumor-bearing rabbits were not differentiable by signal intensity. CONCLUSION: Reactive lymph-node hyperplasia induced by interstitial egg-yolk injection and lymph-node metastasis secondary to implantation of VX2 tumors cannot be differentiated by standard MRI. Therefore, these models may serve for testing the efficacy of lymphographic techniques in MRI.

Animals↗

A histological and experimental study on the fate of an increased number of lymph follicles produced in the mouse popliteal lymph node by exogenous antigen stimulation.

Eight-week-old female C57B1/6 mice were injected with endotoxin LPS and/or other antigens into the left hind footpad, and then the number of lymph follicles in the draining popliteal lymph nodes was examined. In untreated mice each popliteal node contained 10-12 lymph follicles at both 8 and 15 weeks of age. Animals given 50 micrograms of LPS at 8 weeks of age showed an increase in the number of lymph follicles 3 weeks later, but this number returned to normal levels by 15 weeks after the LPS injection. After a 2-micrograms-LPS injection at 23 weeks of age, the number of lymph follicles in the draining lymph node was unchanged, but that in animals given the 2-micrograms-injection 15 weeks after the 50-micrograms-LPS injection was significantly increased. In animals receiving 2 Lf of diphtheria toxoid, instead of the 2-micrograms-LPS, at 15 weeks after a 50-micrograms-LPS injection, the number of lymph follicles per draining node was within the normal range. In one group of mice, the initial injection of 50-micrograms-LPS at 8 weeks of age was followed by injections every third week of several kinds of antigens which had been shown to be ineffective in inducing follicle formation. Here, the number of lymph follicles in the draining popliteal node was kept to significantly increased levels at 25 weeks of age. The present results suggest that, while most lymph follicles normally developing in the lymph node are maintained for a long time under normal conditions, many lymph follicles induced by antigenic challenge have a limited life span and undergo atrophy unless they are periodically activated by additional antigenic stimuli, and that atrophied follicles finally become unable to respond to antigenic stimulation. It is also suggested that antigenic materials which trigger the formation of lymph follicles in the primary challenge can evoke follicle formation more efficiently in the secondary challenge.

Animals↗

Pelvic lymph node metastases in cervical cancer: comparison of lymphography, inspection, radiography, and histologic examination of lymph nodes.

Lymphangiography is commonly performed in the pretreatment evaluation of patients with cervical carcinoma, but its value is controversial. The purpose of this report is to determine the reliability of lymphography in the indication of metastatic pelvic lymph nodes by comparing data from preoperative lymphangiography, inspection of lymph nodes during laparotomy, radiography of surgically removed lymph nodes, and postoperative histologic report. Twenty-one patients (mean age 51.1 years, SD 14.5) with cervical cancer FIGO stages I b to II b were enrolled in this study. They all underwent Wertheim's radical hysterectomy with pelvic lymphadenectomy. With reference to histologic report this series included 8 squamous carcinomas (38%), 10 adenocarcinomas (48%) and 3 sarcomas (14%). Seven patients (33%) had a positive preoperative lymphangiography, in 9 patients (43%) lymph nodes were considered positive at the inspection during laparotomy, postoperative radiography of the lymph nodes was considered probably positive in 7 patients (33%) and positive in 2 patients (10%), histologic report was positive for lymphonodal metastases in 4 patients (19%). A total of 335 lymph nodes were studied, and with reference to the evaluated methods (lymphangiography, inspection, radiography, histology), 1 positive method was found in 40 lymph nodes (12%), 2 positive methods in 6 lymph nodes (2%), 3 or 4 positive methods in none of the lymph, nodes, and 4 negative methods in 289 lymph nodes (86%). Histologic report was positive in 4 lymph nodes (1%). Lymphangiography in the pretreatment evaluation in cases of cervical carcinoma is not reliable in indicating possible metastatic lymph nodes. It remains a useful exam fixation to be routinely performed.

Adult↗

Recombinant bovine interferon-alpha I 1 inhibits the migration of lymphocytes from lymph nodes but not into lymph nodes.

Recombinant bovine interferon-alpha I 1 (IFN-alpha) was tested for effects on lymphocyte migration into and out of the lymph nodes of sheep. Chronic lymph drainage methods were used to monitor the efferent lymph of single lymph nodes of unanaesthetized animals. When IFN-alpha was injected into the drainage area of the lymph node, infused directly via an afferent lymphatic, or injected intravenously, a marked decrease in cell output was observed. Nanogram quantities of IFN-alpha produced an effect that lasted several hours. To test whether this effect was specific for lymphocytes, we first stimulated a lymph node with Staphylococcus aureus so that large numbers of neutrophils and lymphocytes were present in efferent lymph. When IFN-alpha was then injected, the lymphocytes disappeared from efferent lymph but the neutrophils did not. Normal efferent lymph cells were labeled with radioisotopes and injected intravenously during the IFN-alpha induced effect. The entry of lymphocytes from the blood was significantly enhanced at a time coinciding with the suppressed cell exit in the efferent lymph. Recovery data indicated that the lymphocytes were retained temporarily in the lymph node but were not destroyed. Furthermore, the bovine IFN-alpha does not appear to be conspicuously antigenic in sheep. It is not yet certain whether IFN-alpha enhances the interactions of cells within the lymph node thereby potentiating immunologic reactions.

Animals↗