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At least 19 recordsLinked to original sources

Metastases to the regional lymph nodes, lymph node recurrence, and distant metastases in nonadvanced papillary thyroid carcinoma.

To investigate the biological characteristics of papillary thyroid carcinoma from the perspectives of lymph node metastasis, lymph node recurrence, and distant metastasis, 746 patients with nonadvanced papillary thyroid carcinoma were retrospectively studied. There were 76 men and 670 women with a mean age of 42.7 years. The rate of lymph node metastasis was significantly higher in young patients (aged less than 30 years). Lymph node recurrence was observed in 80 patients and distant metastasis in 13, being seen with significant frequency in the young and elderly (aged over 50 years) patients and in the men. The frequency of distant metastasis was significantly greater in the elderly patients and in those with lymph node recurrence. These findings indicate that the role of regional lymph nodes and the clinical meaning of lymph node recurrence differ between young and elderly patients.

Adult↗

[Incidence of nodal involvement of #12u nodes (lymph nodes around the upper lobe bronchus) in cases with right middle lobe, right lower lobe, and left lower lobe carcinoma].

#12u nodes are peribronchial lymph nodes around the upper lobe bronchus which should not be routinely dissected in cases with middle lobe carcinoma or lower lobe carcinoma. In this paper, #12u were examined histologically in 152 lung cancer cases. As a results, 14 of 152 (9.2%) had nodal diseases in #12 nodes. #12u nodes were involved in 3 of 30 N1 diseases (10%), and in 11 of 35 N2 diseases (31.4%). There was a case which had no nodal involvement except for #12u node. And in three cases, we found only one nodal metastasis except for #12u nodes. If we did not dissect #12u nodes, these cases will be relapse in near future. Thus, for curative operation, #12u nodes should be dissected as a standard operation.

Carcinoma, Non-Small-Cell Lung↗

[Intertracheobronchial lymph nodes: lymph inflow and outflow in lung segments from 200 adult subjects].

Topographic anatomy of the intertracheobronchial lymp nodes has been thoroughly studies and is now well known. Cinetic aspects of the lymphatic flux passing through these lymph nodes is not completely understood. Supleural lymphatics of lung segments were injected in 200 adults. Almost 300 segments were then injected among the different lobes. The intertracheobronchial lymph node group was interested by the afferencies of 3 segments out of 5. It was injected only once out of 5 from the upper lobes but in 90 to 100% of segmental injections of the lower lobes. Nine times out of ten, the middle lobe was drained by this group, the lingula less than on time out of fife. In almost one third of the cases, the injection was localized to this group and without further progression. This phenomenon was more frequent in the injections of the left lung. The other times the injection continued toward the latero tracheal ascendent chains : right paratracheal chain and esophageal-tracheal, left recurrent chain (left latero or paratracheal). In one third of the cases, only one of these chain was interested and in one time out of two, the right paratracheal chain was concerned. The other times, the injection continued in 2 chains, occasionally three. If these findings are analyzed in regard to the side injected, a contralateral lymphatic drainage is observed either from the left or from the right side. Finally, in less than 10% of the cases, there was a drainage of this group towards the thoracic duct in the mediastinum. Scarcely, it was observed a descendant drainage pathway to the abdomen.

Adult↗

Radiographic imaging of lymph nodes in lymph node dissection specimens.

A new method of identifying and locating lymph nodes in lymph node dissection specimens using a radiographic imaging technique is described. The specimen is immersed in 96% ethyl alcohol which possesses a radiographic density similar to fat tissue. Even small immersed lymph nodes contrast well with 96% ethyl alcohol. Thus, a radiograph of a nodal dissection specimen, immersed in 96% ethyl alcohol, does not show the interfering projection of variations in thickness of the specimen. Simultaneously, lymph nodes are clearly imaged. Using this procedure, we could visualize 97% of all lymph nodes present in the fat tissue of lymph node dissection specimens, which were dissected free from large radiodense structures like muscle and submandibular glands. Thus, a simple method was established for radiographic documentation of lymph nodes in lymph node dissection specimens.

Humans↗

[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↗

[Cytokinetics of lymph nodes in lymph nodes in lymphatic system diseases (author's transl)].

Untreated malignant lymphatic system diseases are characterized by a preponderance of cell new formation (proliferation) against the destruction of lymphatic cells. If the lymph nodes are enlarged during these diseases, then cell new formation occurs largely or mostly in these lymph nodes. The proliferating cells of the lymph node are bigger than small lyphocytes and have, in general, a mean diameter of the nucleus of 10 mu and more. In normal lymph nodes they belong morphologically to the big lymphocytes, immunoblasts and plasmoblasts. In pathological lymph nodes they have to be looked for among the bigger cells of the disease-specific cell population. Whereas in healthy lymph nodes and in chronic lymphatic leukemia only about 1% of lymph node cells was found to proliferate, they amount on the average to 5% in lymphomas of lymphogranulomatosis and mostly to 30--50% in the lympho-reticulosarcoma (lymphoblast and immunoblast sarcoma, corresponding to large-cell, poorly differentiated lymphomas). The proliferating cells often appear as foci in the lymphomas. The generation times of the proliferating cells both in normal and pathological lymph nodes are about 24 hrs. or slightly longer. In lymphatic proliferation, apart from plasma cells big and smallymphocytes are produced in the normal lymph node; in CLL, big and small lymphocytes, in lymphogranulomatosis, big and small lymphocytes and Hodgkin-cells, and in poorly differentiated lymphomas, the corresponding lymphoma cells are produced. The clinicist is at the beginning of drawing conclusions from prevalent kinetic disturbances.

Cell Division↗

The architecture of rat lymph nodes. II. Lymph node compartments.

Although lymph nodes are conventionally regarded as composed of superficial cortex, deep cortex, and medullary cords merge gradually into each other, the sinuses, the interstitium, and the germinal centres are separated by cellular borders that seem sufficiently complete to limit the rate of exchange of cells and molecules. Accordingly, the cellular composition shows distinct differences on either side of these borders. These compartments show further division into regions, the sinuses into superficial and deeply situated sinuses, the interstitium into superficial interstitium, follicles, paracortical nodules, and medullary interstitium, characterized by differences in densities of various cell types. Mechanisms behind the different distribution of cells within the different lymph node compartments and regions are discussed.

Animals↗

Computed tomography in early stages of testicular carcinoma. Size of normal retroperitoneal lymph nodes and lymph nodes in patients with metastases in stage II A. A SWENOTECA study: Swedish-Norwegian Testicular Cancer Project.

From the SWENOTECA Project, the CT findings in 156 patients treated by bilateral retroperitoneal lymphadenectomy were reviewed. Of these, 112 were in stage I (no metastases) and 44 in stage II A (metastases in normal-sized lymph nodes and in nodes with a maximum diameter in the transverse plane of less than or equal to 20 mm). The normal size of lymph nodes in young Scandinavian men was found to be less than 10 mm X 8 mm above the bifurcation, except in the area below the left renal vein to the left of the aortic midline where the normal size was found to be maximally 14 mm X 10 mm. The addition of a lymphangiographic contrast medium did not change the size of the lymph nodes significantly above the bifurcation, while changes of importance were noticed in the pelvic area. Normal size without contrast medium was found to be at the most 15 mm X 10 mm and after addition of contrast medium to the nodes 28 mm X 12 mm. The results of the CT findings in the stage II A group were not impressive but changed somewhat for the better using the new limits concerning size of retroperitoneal lymph nodes. The impact of using different limits is discussed and it is concluded that metastases in normal-sized or almost normal-sized lymph nodes will continue to be a diagnostic problem, at least when using CT.

Adult↗

A comparison of lymphocyte migration through intestinal lymph nodes, subcutaneous lymph nodes, and chronic inflammatory sites of sheep.

The migration of 51Cr- and 111In-labeled lymphocytes from blood to various lymph compartments was studied in sheep. When lymphocytes were isolated from lymph, radiolabeled, and returned intravenously to the same animal, nonrandom patterns of lymphocyte migration were observed, which depended on the source of the labeled cells. Lymphocytes isolated from intestinal (jejunum, ileum, or ileocecal junction) efferent lymph always produced greater specific activity in the efferent intestinal lymph than in the efferent lymph of subcutaneous (popliteal or prefemoral) lymph nodes. Conversely, lymphocytes isolated from the efferent lymph of subcutaneous lymph nodes produced greater specific activity in the efferent lymph of subcutaneous lymph nodes than in the intestinal efferent lymph. Unit gravity sedimentation of the free-floating lymphocytes in intestinal efferent lymph demonstrated that small, recirculating lymphocytes, but not lymphoblasts, were responsible for the radioactivity recovered in lymph. The most dramatic examples of nonrandom lymphocyte migration were seen when the migration of lymphocytes was compared between the intestinal efferent lymph and through sites of chronic inflammation.

Animals↗

Killer cell (K) activity in human normal lymph node, regional tumour lymph node and inflammatory lymph node.

Human normal lymph nodes, irrespective of their anatomical site of origin, have a low K cell activity, which may not be detected except with the appropriate target cell and at high lymphocyte to target cell ratios (100:1). This very low killer cell activity is also found in all the homolateral axillary nodes of patients with clinical stage I and II carcinoma of the breast and in the regional draining nodes of a variety of solid tumours, whether small and localized or large and with extensive spread. In all cases proximity to the tumour and obious hyperplastic changes in the nodes have no modifying effect. This pattern of minimal reactivity is similarly found with tonsillar lymphocytes and with nodes draining inflammatory foci. The Fc and C3 receptors on surface membranes are dectected with ease, and pretreatment of lymphocytes by incubation, washing and enzymatic treatment fail to alter their reactivity, thus excluding effector cell inhibition by immune complexes. The killer cell activity of lymphocytes from the blood of breast tumor patients is similar to the activity of lymphocytes from healthy controls.

Binding Sites↗

T and B lymphocyte populations in human normal lymph node, regional tumour lymph node and inflammatory lymph node.

We have determined the T and B lymphocyte subpopulations in normal human lymph nodes. The lymphocyte profile was the same irrespective of the anatomical distribution and was similar to that found in peripheral blood with identical T and B cell values but with a lower Fc and a higher C3-receptor-bearing lymphocyte subpopulation. This pattern showed a marked change in the regional nodes of patients with mammary carcinoma and nodes draining a variety of other solid tumours, with a fall in T and pronounced elevation of B, Fc and C3 cells but with a persistence of C3 predominance. The lymphocyte profile found in tonsils and nodes draining inflammatory foci was a similar but further exaggeration of the tumour node pattern, with reversal of T and B cell ratios. The T and B lymphocyte percentages in the peripheral blood of patients with clinically localized breast cancer are identical to those of the healthy controls. Different Fc/C3 subsets exist in peripheral blood and lymphoid structures and probably represent a differential functional heterogeneity. Proximity of tumour to the draining node modified this profile.

B-Lymphocytes↗

Cutaneous melanoma: therapeutic lymph node and elective lymph node dissections, lymphatic mapping, and sentinel lymph node biopsy.

Early clinical observation in cancer patients suggested that tumors spread in a methodical, stepwise fashion from the primary site, to the regional lymphatics, and only then to distant locations. Based on these observations, the regional lymphatics were believed to be mechanical barriers, at least temporarily preventing the widespread dissemination of tumor. Despite evidence now available disputing its validity, this barrier theory has guided the surgical management of the regional lymphatics in cancer patients for more than a century, influencing the use of such surgical modalities as therapeutic lymph node dissection, elective lymph node dissection, and most recently lymphatic mapping and sentinel lymph node biopsy. No published randomized controlled trial exists that demonstrates improved overall patient survival for cancer of any type, including melanoma, after surgical excision of regional lymphatics. This article will review the biology of lymphatics as it relates to regional tumor metastasis, and based on available information, offer practical recommendations for the clinical dermatologist and their patients who have cutaneous melanoma.

Animals↗

Phenotypic and functional characterization of lymphocytes derived from normal and HIV-1-infected human lymph nodes.

Lymph nodes are the major site of cell-to-cell transmission and replication of HIV-1. Trafficking of CD4+ T lymphocytes into lymph nodes provides a continual supply of susceptible target lymphocytes, and conversely, recruitment of CD8+ T lymphocytes may be critical for the host response that attempts to control HIV-1 replication. The present study was undertaken as no detailed assessment of lymphocyte subpopulations in HIV-1-infected lymph nodes has previously been reported. Peripheral blood and single-cell suspensions prepared from lymph nodes of patients with HIV-1 and control subjects were analysed using three-colour flow cytometry. Approximately 80% of the lymphocytes in control lymph nodes were CD3+ T lymphocytes, of which over 65% were CD4+. The majority of the CD4+ and CD8+ T lymphocytes obtained from both lymph nodes and blood of control subjects were immunologically naive (CD45RA+). By contrast, in HIV-1-infected patients there was a significant reduction in the proportion of CD4+ T lymphocytes and an expansion of the CD8+ T lymphocyte subset in both lymph nodes and peripheral blood. Furthermore, a high proportion of these T lymphocytes displayed a marker for immunological memory (CD45RO+). T lymphocytes derived from HIV-1-infected lymph nodes also showed altered expression of the adhesion molecules, L-selectin and very late antigen-4 (VLA-4), but not leucocyte function-associated antigen-1 (LFA-1). In an in vitro adhesion assay, lymphocytes from HIV-1-infected nodes were significantly more adhesive than control lymphocytes on fibronectin, as well as recombinant human intercellular adhesion molecule-1 (ICAM-1) and vascular cell adhesion molecule-1 (VCAM-1) substrates. This combination of altered lymphocyte subpopulations in the HIV-1-infected lymph nodes, as well as enhanced adhesion phenotype and function, suggests that T lymphocyte traffic to lymph nodes in HIV disease may be an important determinant of pathogenesis.

Adult↗

Usefulness of immunohistochemistry for recognizing metastatic colorectal adenocarcinoma in infarcted lymph nodes.

Lymph node infarction is a spontaneous coagulative necrosis of the affected lymph node and is frequently associated with concurrent and subsequent malignant lymphoma. However, this phenomenon appears to be rarely associated with metastatic carcinomas. Here, we report on the histopathologic and immunohistologic findings of three cases showing lymph node infarction in the regional lymph node associated with metastatic colorectal adenocarcinoma. Histologically, coagulative necrosis of metastatic carcinoma was surrounded by a thick rim of granuloma consisting of histiocytes with or without epithelioid features, foamy cells, and a small number of lymphocytes. The immunohistochemical study of the coagulative necrosis demonstrated that cytokeratins (AEI/AE3 and CAM5.2) and carcinoembryonic antigen (CEA) were well preserved in all three cases. However, compared with viable tumor tissues, only a few tumor cells were positive for epithelial membrane antigen. Using formalin-fixed and paraffin-embedded tissues, immunostaining for cytokeratins and CEA of the lymph node containing necrotic carcinoma may provide clinically valuable information.

Adenocarcinoma↗