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At least 343 records · Page 19Linked to original sources
PubMed1995

Outpatient pelvic lymph node dissection.

PURPOSE: Staging pelvic lymph node dissection is an important part of the evaluation of most patients with prostatic carcinoma. While laparoscopic pelvic lymph node dissection provides an alternative to standard pelvic lymph node dissection, it has been associated with a significant learning curve, high major complication rate, frequent hospitalization and greater expense. We sought to modify the technique of pelvic lymph node dissection to allow its performance as an outpatient procedure. MATERIALS AND METHODS: Pelvic lymph node dissection was performed through bilateral 3 cm. incisions overlying the obturator fossa in 11 patients. RESULTS: Nodes sampled ranged from 5 to 26 per patient that differed insignificantly from those undergoing standard pelvic lymph node dissection. Four patients had lymph node metastases. Nine procedures were performed entirely on an outpatient basis. One complication (external vein injury) was repaired with a single suture after extending the incision to 6 cm. CONCLUSIONS: Outpatient pelvic lymph node dissection through small incisions provides an attractive alternative to standard or laparoscopic lymph node dissection. With further experience it may become the procedure of choice for staging prostatic carcinoma in patients with a high risk of pelvic lymph node metastases.

Aged↗
PubMed1979

Doppler ultrasound examination of pathologically enlarged lymph nodes.

Pathologically enlarged lymph nodes have been examined with a commercially available 10 MHz continuous-wave Doppler flowmeter. Many enlarged lymph nodes gave rise to significant Doppler-shift signals indicating increased blood flow. The signals have been spectrum analysed and the large diastolic flow components suggest that there is considerable arterio-venous shunting within lymph glands involved in leukemia, lymphoma and carcinoma. It also seems that the signals tend to diminish in response to treatment. The Doppler signals have been used in an imaging system to produce a vascular map of the region of the enlarged gland. It is suggested that these findings might be applicable to the detection of neoplastic tissues in less accessible sites.

Doppler Effect↗
PubMed1996

Inflammatory pseudotumor of pelvic lymph nodes.

Inflammatory pseudotumor of lymph nodes (IPT) is a rare, recently described benign cause of lymphadenopathy. The IPT is composed of a proliferation of spindle cells, small vessels and inflammatory cells without atypia and formed by high and poor cellular areas. This study reports a case of IPT. It was a 50-years-old man in whom the abdominal mass was an incidental finding during exploratory laparatomy. The mass was a lymphadenopathy measuring 12 x 10 x 5 cm in diameters. Histologic examination revealed IPT of the lymph nodes. The patient has remained asymptomatic for more than 10 months following surgery without any treatment. In conclusion, IPT of the lymph nodes is being recognized increasingly and should be considered in the differential diagnosis of lymphadenopathies. Inflammatory pseudotumor (IPT) of the lymph nodes resembling the IPT of other organs was recently described as a possible cause of lymphadenopathy. Histologically, the process showed a proliferation of spindle cells associated with a mixture of polymorphic inflammatory cells and small blood vessels involving the connective tissue framework (hilum, trabecula, capsule) of the lymph node. In this report, the case of a patient with IPT of pelvic lymph nodes is presented with the clinical and pathological features.

Cell Division↗
PubMed1981

The results of node resection for clinically enlarged lymph nodes in malignant melanoma.

Patients with malignant melanoma who require a block dissection for clinically enlarged lymph nodes have a relatively good prognosis if only one node is involved histologically and the primary is on the lower limb. Sixty per cent of these patients with single nodes show a 10 year disease-free survival rate, compared with 9% for those with multiple node involvement. The local recurrence rate at the resection site of hyperplastic nodes was 26% but fell to 10% when only a single node was involved. The disease-free interval and the survival time are a useful measure of the effectiveness of node resection.

Axilla↗
PubMed1997

[Is surgery useful in kidney cancer with lymph node invasion?].

SUMMARY: lymph node involvement in renal cell carcinoma is factor of very poor prognosis. In a series of 55 node-positive patients, 33 (60%) had simultaneous renal vein or vena cava invasion and 32 (58.2%) had metastases. Gross lymph node involvement was found in 39 patients (70.9%). Patients without venous invasion or metastasis may have a prolonged survival. In this group, those with microscopic nodal involvement can be cured, as the 10 and 15-year the actuarial survival rate is 54.5% Formal lymphadenectomy might have played a role in these results. Surgery can be performed when vein invasion is present without metastasis, but the prognosis is generally poor. Survival does not seem to be influenced by surgery when metastasis is present, regardless of the vein status.

Actuarial Analysis↗
PubMed1999

In vitro B-mode ultrasonographic criteria for diagnosing axillary lymph node metastasis of breast cancer.

Axillary lymph node status is an important factor for staging and treatment planning in breast cancer. Our study was performed in vitro on a node-by-node basis to evaluate the ability of B-mode ultrasonographic images to distinguish metastatic from nonmetastatic nodes. Immediately prior to histologic examination, individual dissected axillary nodes were scanned in a water bath using a 10 MHz B-mode ultrasonographic transducer. Four B-mode features (size, circularity, border demarcation, and internal echo) were evaluated for their ability to distinguish metastatic from nonmetastatic lymph nodes. Lymph node metastasis was indicated by (1) a large size (i.e., a length of the longest axis of 10 mm or greater); (2) a circular shape (i.e., the ratio of the shortest axis to the longest axis between 0.5 and 1.0); (3) a sharply demarcated border compared with surrounding fatty tissue; and (4) a hypoechoic internal echo, with obliteration of the fatty hilum. The sensitivity and specificity were compared for all combinations of features. We examined 84 histologically characterized axillary nodes from 27 breast cancer patients, including 64 nonmetastatic and 20 metastatic nodes. Of the criteria cited, circular shape was the best single feature for distinguishing metastatic from nonmetastatic nodes (sensitivity, 65%; specificity, 73%). The best combination of sensitivity (85%) and specificity (73%) was obtained using the criterion that a lymph node contained cancer when at least three positive features were present. The present in vitro study demonstrated that the sensitivity and specificity of B-mode ultrasonography for diagnosing lymph node metastasis were lower than 90%. Therefore, B-mode ultrasonography may not be an optimal noninvasive screening method for diagnosing axillary lymph node metastasis in breast cancer patients, particularly under in vivo clinical conditions.

Adult↗
PubMed1982

Plasmacytoma arising in giant lymph node hyperplasia.

Giant lymph node hyperplasia (GLNH) is generally thought to represent a benign process. A patient with GLNH of the chest wall had part of the lymph node replaced by large nodules of infiltrating plasma cells, and a serum paraprotein of the IgG lambda type. A peroxidase-antiperoxidase immunocytochemical technic showed that the plasma cells within areas of typical appearing GLNH were polyclonal, whereas those making up the nodular infiltrates were monoclonal. The observation of a plasmacytoma arising in this lesion demonstrates the neoplastic potential of GLNH.

Humans↗
PubMed1976

Mucocutaneous lymph node syndrome.

Mucocutaneous lymph node syndrome represents a series of clinical findings that has been observed primarily in Japanese children. The disease now appears to be migrating to this country. It involves the cervical lymph nodes, the skin, and mucus membranes. Although the course is usually benign and self-limiting, a number of deaths have resulted from coronary artery disease.

Acute Disease↗
PubMed1990

[Decision-making for lymph node excision in surgery of thyroid cancer. Extemporaneous examination of the external supraclavicular lymph nodes].

UNLABELLED: Modified neck dissection (MND) is not recommended for surgery of thyroid carcinoma (TC) in the absence of grossly involved nodes, except for medullary thyroid carcinoma, and clinical node recurrence in uncommon at follow-up (3% for us). But several authors report metastatic cancer in non-palpable nodes up to 70% on MND specimens. The fear of overlooking occult metastatic nodes prompted us to sample even normal appearing nodes and to rely on frozen sections (FS) to make a decision whether or not a MND should be done. PATIENTS AND METHODS: 130 among 300 consecutive patients operated for TC were submitted to supraclavicular node sampling with FS. All pathological varieties were covered. In 170 cases, sampling was not done purposely (lack of intraoperative diagnosis of carcinoma: 75) or for other reasons (absence of obvious nodes: 77; unavailable pathologist: 14; miscellaneous: 4). All specimens were reviewed by paraffin sections (PS). RESULTS: Among the 130 patients; 25 had gross metastatic node involvement, confirmed by FS+ and PS+; 1 had grossly equivocal nodes with FS- and PS+; 104 had grossly normal nodes. In 101 (97%) this was confirmed by FS- and PS-. In 3 (3%) FS was +, leading to MND, and PS confirmed metastatic involvement in 2. All 32 specimens of routine node sampling done in 1988 have been reviewed by serial cross sections, one each millimeter (331 sections). One only disclosed one occult metastatic invasion. CONCLUSION: No more than 3% of the grossly normal supraclavicular nodes are metastatic at the time of surgery.(ABSTRACT TRUNCATED AT 250 WORDS)

Carcinoma↗
PubMed2000

Regional lymph node dissections in malignant melanoma.

Considerable controversy surrounds the application of regional lymphadenectomy in the treatment of cutaneous melanoma in patients with clinically negative nodes; however, therapeutic lymph node dissection for clinically positive nodes has shown clear benefits. Opponents of elective lymph node dissection (ELND) for clinically negative nodes believe that because 80% of patients with clinical Stage I disease have histologically negative nodes at the time of resection of the primary tumor, prophylactic excision of the regional nodes is unnecessary. Some clinicians have failed to demonstrate a survival advantage for ELND. With the recent introduction of sentinel lymph node dissection, it may be possible to select patients who are likely to benefit from ELND. The authors recommend ELND based on the identification of metastatic cells within the sentinel lymph node in all patients with primary melanomas with a thickness of at least 1.0 mm.

Elective Surgical Procedures↗
PubMed1997

Cords, channels, corridors and conduits: critical architectural elements facilitating cell interactions in the lymph node cortex.

The lymph node cortex is a critical site for encounter between recirculating T cells and their specific antigens. Due to its extreme plasticity, little is understood of the underlying functional unit of the lymph node cortex, the paracortical cord. The idealized paracortical cord (approximately 100 microns by 1000 microns) stretches from a medullary cord to the base of a B-cell follicle. In cross-section, a cord can be visualized as a set of nested cylinders consisting of spaces bounded by cells. The spaces are: i) the lumen of the high endothelial venule (HEV), ii) perivenular channels-narrow potential spaces (0.1 micron) tightly encircling the HEV, iii) corridors-broad spaces (10-15 microns) constituting the majority of the parenchyma, and iv) the cortical sinus. In addition to these spaces for cell traffic, the conduit (fifth space) is a special delivery system for the transit of soluble factors to the HEV and emigrating lymphocytes. The cellular barriers between these spaces are high endothelium, fibroblastic reticular cells, or sinus-lining cells. This review describes the spaces of the paracortical cord and their cellular boundaries, outlines the movement of cells and fluids through these spaces, and discusses how this anatomy affects the efficiency of surveillance by T cells.

Animals↗
PubMed1992

The enveloping of intercellular collagenous fibrils by reticular cell processes in postnatal development of rat lymph nodes.

In the lymph nodes of adult rats reticular fibers are known to be covered by the processes of reticular cells. This study aims to visualize the sequence of the envelopment of reticular fibers by reticular cells during development. Rat popliteal lymph nodes of one to twenty-three days after birth were examined by electron microscopy. At the earliest stages, collagenous protofibrils were found in the intercellular space between studded mesenchymal cells. The protofibrils clustered around the plasma membrane of immature reticular cells and then became arranged into microfibrils of 30-40 nm in diameter. Bundles of the fibrils which might be called reticular fibers were surrounded by processes of more than one reticular cell. Then the reticular fiber came to be enclosed by the cytoplasmic process of a single reticular cell. Finally at 16-23 days after birth, the reticular fiber was completely ensheathed by the thick cytoplasmic process of a single reticular cell closed with a junctional complex. Throughout these periods, basal lamina-like materials existed between the reticular fiber and cytoplasmic process. Clumps of fibrils were rarely in contact with leukocytes, including lymphocytes. Immature elastic fibers appeared among collagenous fibrils of the reticular fiber when the fiber came to be enclosed by processes of some reticular cells. It was shown that the enclosure of the reticular fiber by the reticular cell did not result from physical pressure due to the increase of the number of lymphocytes, but the reticular cell actively enclosed the reticular fiber.(ABSTRACT TRUNCATED AT 250 WORDS)

Animals↗
PubMed1991

[The characteristics of the bronchopulmonary lymph nodes situated along the pathway of lymph flow from human lungs at different periods of postnatal ontogeny].

Histological slices of the bronchopulmonary lymph nodes have been stained after van Gieson, azur-II eosin, hematoxylin-eosin, silver nitrate impregnation after Foot. Certain peculiarities of their structure have been revealed. For intersegmental lymph nodes a narrow lumen of the marginal sinus (13.2 +/- 1.3 mcm), small amount of lymphoid noduli in the cortex (10.8 +/- 1.0 per section) are specific. Lobular and portal lymph nodes have a wider lumen of the marginal sinus (15.9 +/- 1.6 mcm) and greater amount of the lymphoid noduli in the cortex (17.5 +/- 1.6 per section), the latter situating in two or three rows.

Aging↗