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PubMed2000

Sentinel node biopsy as a practical alternative to axillary lymph node dissection in breast cancer patients: an approach to its validity.

BACKGROUND: Sentinel node biopsy (SNB) has been proposed as an alternative to axillary lymph-node dissection (ALND) in breast cancer. Before implementing SNB in our practice, we wished to test its validity by comparing it to the standard ALND, both in our hands and with other reported series. PATIENTS AND METHODS: One hundred thirty-two patients were included prospectively. SNB and immediate ALND were performed. For SNB, a technetium-colloid was used to produce preoperative lymphoscintigraphy and intraoperative gamma-probe search for the SN. Serial sectioning and immunostains were used on the SN. A comprehensive review of the literature was done in order to run a meta-analysis of diagnostic tests using a summary receiver operating characteristic curve (SROC) to calculate the pooled parameters of sensitivity and associated 95% confidence interval (95% CI), including our own data. RESULTS: Our technical success rate was 96%. Local sensitivity was 96%, with a 95% CI from 85%-99%. Seven patients were upstaged by the SNB. A literature search identified 18 studies published from 1996-1999. Estimates of sensitivity ranged from 83%-100%. The pooled data meta-analysis gave a global sensitivity of 91%, with a 95% CI from 89%-93%. The area under the global SROC curve was 0.9967. CONCLUSIONS: The minimally invasive SNB was shown to be a practical alternative to ALND. We propose to use local as well as global sensitivity and associated 95% CI to test the validity of SNB in the clinical setting. Due to limitations of ALND as the golden standard, SNB can in fact be considered a more accurate method for nodal staging.

Adult↗

PubMed1999

Comparison of laparoscopic sonography with surgical pathology in the evaluation of pelvic lymph nodes in women with cervical cancer.

OBJECTIVE: This study compared laparoscopic sonography with surgical pathology in the evaluation of pelvic lymph nodes in women with cervical cancer. SUBJECTS AND METHODS: Intraoperative laparoscopic sonography of pelvic lymph nodes was performed in 31 women with biopsy-proven cervical cancer. A lymph node that was rounded (longitudinal-transverse axis ratio of <2) or showed absence of central hilum was defined as positive for metastasis. For comparison, lymph nodes from each hemipelvis were grouped anatomically into paraaortic, common, internal, and external iliac chains during evaluation on laparoscopic sonography and on surgical pathologic examination. RESULTS: Pelvic dissection in 31 women yielded 630 lymph nodes. There were 54 metastatic nodes in 12 women. Laparoscopic sonography revealed 32 (59%) of all pathologically metastatic lymph nodes. Sensitivity on laparoscopic sonography when comparing groups by hemipelves was 93.3% and by anatomic lymph node chains was 76.2%. Metastatic nodes were most commonly located in the common iliac region and were characteristically rounded, hypoechoic, showed absence of central hilum, and occasionally showed central necrosis. Nine (28%) of 32 metastatic lymph nodes revealed by laparoscopic sonography measured 1 cm or less. Six benign nodes in four patients were also visualized with laparoscopic sonography. CONCLUSION: Laparoscopic sonography achieved a sensitivity exceeding 90% in the detection of metastatic lymph nodes in the hemipelves of women with cervical cancer. Laparoscopic sonography is a feasible and promising technique for the evaluation of pelvic lymph nodes in women with cervical cancer and merits further evaluation.

Adult↗

PubMed2006

Sentinel lymph node biopsy: A new perspective in head and neck mucosal melanoma?

Sentinel lymph node biopsy in patients with head and neck mucosal melanomas has not been performed so far. Therefore, this method as a staging tool was tested in a pilot study. In two consecutive patients, a lymphoscintigraphy, elective neck dissection with radio-guided sentinel lymph node identification, and resection of the primary were performed. The histopathological status of the sentinel lymph node was compared with the lymphadenectomy specimen and with the clinical course. Patient no. 1, in whom both the sentinel lymph node and the lymphadenectomy specimen were found to be free of tumour, is well and with no evidence of disease, the follow-up interval being 19 months. Patient no. 2, with the sentinel lymph node and remaining lymphatic basin being positive and negative, respectively, developed hematogenous dissemination 3 months after the primary treatment, and he was started on palliative chemotherapy. In mucosal melanoma, the prognostic significance of clinical nodal status is controversial, resulting in the lack of an official, applicable TNM classification and also of therapeutic guidelines. The presence of microscopic metastatic focus in the sentinel lymph node was associated with an early hematogenous dissemination. Therefore, sentinel lymph node biopsy, which represents a potentially efficient staging tool, warrants further investigation.

Adult↗

PubMed2002

Immunological approach in the evaluation of regional lymph nodes of patients with squamous cell carcinoma of the head and neck.

In cancer, regional lymph node (LN) cells are one of the first components of the immune system to have contact with tumor cells or their products. Therefore, the phenotype and functional properties of hematopoietic cells present within the tumor-draining LN are important to understanding their role in the control of malignant cells. Based on the locoregional metastatic behavior of squamous cell carcinoma of the head and neck (SCCH&N) region, we analyzed tumor-draining lymph nodes from SCCH&N patients to obtain insights into regional tumor immunity. Using a three-color fluorescent labeling technique, surface antigen expression was visualized in mononuclear cells of lymph nodes that were obtained from head and neck cancer patients and compared to mononuclear cells of normal lymph nodes. Cell cycle analyses were performed using propidium iodide. Proliferation after phytohemagglutinin stimulation was measured by a sodium tetrazolium-based assay. LN histology was correlated with flow cytometric findings. Regional lymph nodes of head and neck cancer patients undergo morphologic and functional changes. Flow cytometry revealed a decrease in CD8(+) T cells and in some lymph nodes the presence of second or third populations of larger cells with distinct size and granularity that expressed both T (gammadelta/alphabeta) and different natural killer cell markers. Moreover, cell cycle analyses and proliferation assays showed a diminished response to mitogenic stimuli. These changes were found in both metastatic and hyperplastic lymph nodes from head and neck cancer patients; however, no alterations were found in control lymph nodes or peripheral blood mononuclear cells from noncancer patients. The immune alterations detected in lymphocytes present within the draining lymph nodes of head and neck cancer patients may improve our understanding of how tumor cells escape host immunosurveillance. However, this dysfunction in local draining lymph nodes may not be detected systemically.

Adult↗

PubMed2000

Cervical sentinel lymph node biopsy for melanomas of the head and neck and upper thorax.

OBJECTIVE: To describe a clinical experience with sentinel lymph node biopsy (SLNB) of head and neck nodal basins for clinical stage I melanomas draining to these areas. DESIGN: Consecutive clinical case series with a mean follow-up of 10.7 months. SETTING: University tertiary care referral medical center. PATIENTS: Seventy patients with clinical stage I cutaneous melanoma who underwent SLNB of cervical and/or parotid lymph node basins. INTERVENTIONS: Patients underwent same-day preoperative technetium Tc 99m lymphoscintigraphy followed by SLNB using gamma probe and blue dye (66 patients) and blue dye alone (4 patients). Patients with histological evidence of tumor (here in after "positive") according to SLNB results underwent modified cervical completion lymph node dissection, including parotidectomy, as appropriate. Patients without histological evidence of tumor (hereinafter "negative") according to SLNB results were followed up clinically without undergoing completion lymph node dissection. MAIN OUTCOME MEASURES: The rates of SLNB success, SLNB positivity, completion lymph node dissection positivity, complications, and SLNB false-negative results were determined by clinical follow-up. RESULTS: Locations of melanomas in the 70 patients were the face (n = 20), neck (n = 14), ear (n = 9), scalp (n = 9), and upper thorax (n = 18). Locations of basins that underwent biopsy (n = 104) were in the cervical (n = 68), parotid (n = 19), and axillary (n = 17) regions. The mean Breslow thickness was 2.1 mm (range, 0.4-12.0 mm). Sentinel lymph node biopsy was successful in 103 basins (99%). The mean number of sentinel lymph nodes per basin was 2.5 (range, 1.0-8.0). Positive sentinel lymph nodes were found in 12 patients (17%) and 15 basins (14%). Sentinel lymph node biopsy results correlated with the American Joint Committee on Cancer tumor stage (P = .05) and a Breslow thickness of 1.23 mm or greater (P = .03). Additional tumor-containing nodes were noted in 5 (42%) of the 12 patients who underwent completion lymph node dissection, and these results correlated with the presence of multiple positive sentinel lymph nodes (P = .01). There were complications in 3 patients (4%) (seromas in 2 patients and temporary spinal accessory nerve paresis in 1 patient). One nodal recurrence in a basin that was negative according to SLNB results (SLNB with blue dye only) was noted (false-negative rate, 2%). The results of SLNB were accurate in 69 patients (99%). CONCLUSIONS: Sentinel lymph node biopsy using lymphoscintigraphy and blue dye to manage cutaneous melanomas draining to the head and neck nodal areas is reliable and safe. Sentinel lymph node biopsy results correlated with a Breslow thickness of 1.23 mm or greater and the American Joint Committee on Cancer tumor stage. Completion lymph node dissection is recommended after determining positive SLNB results.

Adolescent↗

PubMed1976

The migration of lymphocytes across specialized vascular endothelium. I. The entry of lymphocytes into the isolated mesenteric lymph-node of the rat.

The chain of lymph-nodes in the rat mesentery was isolated and the preparation was perfused via cannulae in the superior mesenteric vessels. The perfusate consisted of serum to which labelled lymphocytes had usually been added. The entry of radioactively labelled lymphocytes from the blood vessels into the lymph-nodes was studied by scintillation counting and autoradiography. It was observed that: (1) In the perfused node labelled lymphocytes localized in and around post-capillary venules in the paracortex as they do early after i.v. injection. (2) The number of lymphocytes which entered the node was directly proportional to the concentration in the perfusate over the range studied. The proportion of cells retained in the node varied considerably around a mean of 11% of lymphocytes reaching it. (3) The isolated lymph-node released few if any lymphocytes into the effluent (venous) perfusate. (4) Large lymphocytes migrated into isolated lymph-nodes slightly more readliy than did small lymphocytes. (5) Unlike intact cells isolated lymphocyte membranes did not adhere to specialized vascular endothelium.

Animals↗

PubMed2003

Effect of number of lymph nodes sampled on outcome in patients with stage I non-small-cell lung cancer.

PURPOSE: We postulate that surgical sampling and pathologic evaluation of lymph nodes of surgical specimens from patients with stage I non-small-cell lung cancer (NSCLC) can have an effect on the time to recurrence and survival of these patients. PATIENTS AND METHODS: We analyzed data on 442 patients with stage I NSCLC who were treated with surgical resection and some form of lymph node sampling. Associations between total lymph nodes sampled and disease-free survival (DFS) and overall survival (OS) were investigated. The effect of total lymph node stations sampled and the surgical techniques (random lymph node sampling, systematic sampling [SS], or complete mediastinal lymph node dissection [MLND]) on DFS and OS was also studied. Complete MLND and SS were defined as dissection or sampling of levels 4, 7, and 10 for right-sided lesions and levels 5 or 6 and 7 for left-sided lesions. RESULTS: Patients were divided into quartiles on the basis of total number of lymph nodes sampled. Improved DFS and OS were associated with greater number of lymph nodes sampled. SS and MLND were associated with improved survival compared with random lymph node sampling. The total number of lymph nodes sampled maintained strong significance in the multivariate analysis. CONCLUSION: These results indicate that examining a greater number of lymph nodes in patients with stage I NSCLC treated with resection increases the likelihood of proper staging and affects patient outcome. Such information is important not only for therapy and prognosis of individuals but also for identifying those who may benefit from adjuvant therapy.

Adult↗

PubMedDate not supplied

Sentinel lymph node mapping following neoadjuvant chemotherapy for breast cancer.

The purpose of this study was to evaluate the feasibility of sentinel lymph node mapping in patients undergoing neoadjuvant chemotherapy for breast carcinoma prior to lumpectomy or mastectomy and sentinel lymph node mapping followed by complete axillary dissection. A retrospective analysis of 14 patients from February 1998 to July 2000 with stage I to stage IIIB breast cancer diagnosed by core biopsy underwent neoadjuvant chemotherapy (doxorubicin/cyclophosphamide) prior to definitive surgery, including lumpectomy or mastectomy and sentinel lymph node mapping, followed by full axillary dissection. Thirteen of 14 patients had successful sentinel lymph node identification (93%), and all 14 underwent full axillary dissection. An average of 2.2 sentinel nodes and a median of 16 axillary lymph nodes (including sentinel nodes) were found per patient. Of the 13 patients in whom a sentinel lymph node was identified, 10 were positive for metastases (77%). Only 4 of the 10 had further axillary metastases (40%). Three patients had negative sentinel lymph nodes shown by hematoxylin and eosin and cytokeratin stainings and had no axillary metastases (0% false negative). The single patient in whom a sentinel lymph node could not be identified had stage IIIA disease with extensive lymphatic tumor emboli. Sentinel lymph node mapping is feasible in neoadjuvant chemotherapy breast cancer patients and can spare a significant number of patients the morbidity of full axillary dissection. Further study to evaluate sentinel lymph node mapping in this patient population is warranted.

Adult↗

PubMed2000

Genetic detection for micrometastasis in lymph node of biliary tract carcinoma.

The presence of regional lymph node metastasis is one of the most significant poor-prognosis factors in patients with biliary tract carcinoma. To establish a sensitive reverse transcription (RT)-PCR assay to detect micrometastases in lymph nodes of biliary tract carcinoma, we first investigated the optimal markers in biliary tract carcinoma. The expressions of the six candidates for a suitable RT-PCR marker [mammaglobin B, carcinoembryonic antigen (CEA), cytokeratin (CK) 20, prostate-specific antigen, and melanoma antigens (MAGE-1 and MAGE-3)] were evaluated in two bile duct cancer cell lines and human biliary tract carcinoma tissues. Of 32 carcinoma tissues, mammaglobin B, CEA, prostate-specific antigen, MAGE-1, MAGE-3, and CK 20 were expressed in 28 (88%), 26 (81%), 4 (13%), 5 (16%), 7 (22%), and 9 (28%), respectively. Mammaglobin B and CEA were considered to be good markers of the six candidates. We then examined 209 lymph nodes obtained from 15 patients with biliary tract carcinoma by RT-PCR assay using both mammaglobin B and CEA and compared the results with those of histological examination. All of 20 histologically positive lymph nodes for metastasis displayed the PCR product(s) of marker genes. Of 189 histologically negative nodes, 24 (13%) nodes expressed mammaglobin B and/or CEA mRNA, suggesting the presence of micrometastasis. Our findings suggest that mammaglobin B and CEA could be useful RT-PCR markers for the detection of lymph node micrometastases in biliary tract carcinomas. Our RT-PCR assay allows accurate clinical staging necessary for patient stratification with respect to adjuvant therapy after surgery.

Aged↗

PubMed1994

Patterns of lymph node metastasis in 3-field dissection for carcinoma in the thoracic esophagus.

Lymph node metastasis is well-known as the most important prognostic indicator for esophageal carcinomas, and an accurate assessment of positive metastasis can only be made after total lymphadenectomy around the esophagus. However, prior to the development of 3-field lymph node dissection in Japan, no such operation existed for ascertaining the full positivity distribution. We report herein the results of a retrospective study conducted on 70 patients who underwent subtotal esophagectomy with 3-field dissection to discover the patterns of lymph node metastasis from carcinoma in the thoracic esophagus. Lymph node metastases tended to have an orderly spreading pattern in relation to the tumor location, even though the lymph node metastasis varied widely from the lower neck to the upper abdomen. The nodes along the right recurrent nerve and the paracardiac nodes were most frequently found to be positive for metastasis. In contrast, no metastasis was found in the internal jugular nodes, the pretracheal nodes, the common hepatic nodes, or the splenic nodes. Patients with carcinoma in the upper thoracic esophagus rarely had metastasis in the abdominal nodes, while those with carcinoma in the lower thoracic esophagus rarely had metastasis in the cervical nodes. Thus, surgical extirpation of the lymph nodes during 3-field dissection is effective not only to determine the correct tumor staging for the planning of adequate adjuvant therapies postoperatively, but also to produce a guideline for prospective lymphadenectomy for esophageal carcinomas.

Carcinoma, Squamous Cell↗

PubMed1987

[Extra-organic lymphatic vessels and regional lymph nodes of the kidneys in dogs].

An anatomical investigation of extraorganic lymphatic vessels and regional renal lymph nodes has been performed in 70 dogs. The regional lymph nodes in the right kidney are stated to be quantitatively constant, as well as cranial and caudal lateroaortal lymph nodes in the left kidney in regard to the middle left lateroaortal nodes, that get lymph from the left kidney parenchyma. One middle left lateroaortal lymph node is found in 47 animals examined, two lymph nodes--in 17 animals. In 6 cases a lymphatic vessel, that gets lymph from the renal parenchyma and independently runs into the cistern of the thoracic duct is found for the first time. The variant revealed is an exception from the rule known in lymphology: lymph in its way from periphery to the central collector runs, at least, through one lymph node.

Animals↗

PubMed1990

The potential of 2-deoxy-2[18F]fluoro-D-glucose (FDG) for the detection of tumor involvement in lymph nodes.

To assess the potential of FDG for PET imaging of nodal tumor metastases, we evaluated its uptake into normal lymph nodes, tumor-involved lymph nodes, and subcutaneous tumor xenografts in rodents. Normal lymph nodes in mice and rats accumulate FDG moderately, developing node/blood ratios of 1.3-11.9/1 at 2 hr following i.v. injection. By contrast, FDG given subcutaneously to healthy Sprague Dawley rats developed very high normal draining lymph node/blood ratios (272/1) versus 7.7/1 by i.v. injection. In nude mice, subcutaneous human ovarian cancer xenografts had 1.27-fold more uptake relative to blood than did normal popliteal lymph nodes. Subcutaneous tumor xenografts of rat breast cancer developed tumor/normal node uptake ratios of 4.91 +/- 0.43/1 and tumor/blood ratios of 6.6 +/- 0.9 at 2 hr postinjection. Mouse nodes involved with 38C13 murine B-cell lymphoma had mean node/blood ratios of 42.9 +/- 6.7/1 and tumored node/normal lymph node uptake of 6.3/1. Thus, FDG given intravenously but not subcutaneusly (due to high normal nodal uptake) has potential as an agent for the detection of metastatic tumors in regional lymph nodes using PET scanning.

Animals↗

PubMed1984

[Method of radical transabdominal tumor nephrectomy with facultative or systemic lymph node dissection and results in 381 patients].

The prognosis of 381 patients without metastases operated on renal cell carcinoma depends on the extent of the lymph node dissection. After facultative lymph node dissection (FLD) the uncorrected actuarial survival rates (SR) are 64 +/- 8% after 3 years and 50 +/- 9% after 5 years compared to 77 +/- 7% (3 years) and 60 +/- 11% (5 years) when systematic lymph node dissection (SLD) was performed. For stage I the better results in the SLD-group (80 +/- 10% 5 years SR for SLD; 67 +/- 13% 5 years SR for FLD) are partially to be explained as a staging-effect, whereas in stage II the difference (92 +/- 10% 5 years SR for SLD; 45 +/- 25% 5 years SR for FLD) is due to the higher radicality of the systematic dissection. In stage III (35 +/- 14% 5 years SR for SLD; 37 +/- 12% 5 years SR for FLD) the predominant influence of the tumor invasion in renal veins cannot be influenced by local extension of the operation. The incidence of lymph node metastases was 16% (n = 170) in the FLD and 23% (n = 211) in the SLD group. When only facultative dissection is done, 30% of lymph node metastases escape detection. Without any lymph node dissection the number of unrecognized lymphmetastases can be expected to be still higher. The controversies about the role of lymph node dissection in radical tumor nephrectomy are mainly caused by the lack of standardized criteria for operative and patho-histological staging procedures. Any conclusions drawn from comparing reports in the literature should be related to these modalities.

Aged↗

PubMedDate not supplied

Temporal stability of local lymph node assay responses to hexyl cinnamic aldehyde.

The local lymph node assay is an alternative method for the prospective identification of chemicals that have the potential to cause skin sensitization. Activity in the assay is measured as a function of proliferative responses by draining lymph node cells induced by topical exposure of mice to the test chemical. Positive responses are defined as those where a test chemical, at one or more application concentrations, is able to induce a stimulation index of 3 or greater compared with concurrent vehicle-treated control values. Although the method has been evaluated extensively, the stability over time of responses induced in the local lymph node assay has not previously been addressed formally. It was the purpose of the investigations described here to consider this issue and, to this end, responses provoked in the local lymph node assay by hexyl cinnamic aldehyde (HCA)--a skin sensitizing chemical of moderate potency--were assessed in five separate experiments conducted in a single laboratory over a 10-month period. In each case, HCA elicited a positive response. Although some significant inter-experimental variation was recorded, this was attributable entirely to the stimulation by HCA of slightly more vigorous responses in one of the five experiments. When the results of this experiment were excluded from the data set, significant variations were lost. Finally, for each experiment an EC3 value was derived, this being the estimated concentration of test chemical required to induce a stimulation index of 3. Similar EC3 values were derived in each experiment. These data demonstrate the relative stability over time of activity in the local lymph node assay.

Acrolein↗

PubMed2005

Laparoscopically assisted distal gastrectomy with standard radical lymph node dissection for gastric cancer.

BACKGROUND: Laparoscopically assisted distal gastrectomy (LADG) with limited lymph node dissection (D1+alpha) has been used to treat a subset of patients with early gastric cancer. Technical advances have expanded indications for LADG to more advanced gastric cancers. However, little data are available on the feasibility or advantages of LADG with standard radical D2 lymph node dissection for patients with gastric cancer. METHODS: This study reviewed the clinical features of 37 patients who underwent LADG with D2 lymph node dissection for preoperatively diagnosed gastric carcinoma, then compared the results with the features of 31 patients who underwent conventional open distal gastrectomy (ODG) with D2 lymph node dissection. RESULTS: The laparoscopic procedure was not converted to laparotomy in any patient. There was no operative mortality and no serious morbidity among the patients who underwent LADG with D2 lymph node dissection. As compared with the ODG group, the LADG group had less operative blood loss (p < 0.001), earlier recovery of bowel activity (p = 0.012), and a shorter duration of fever after surgery (p = 0.015), despite the longer operation time (p = 0.007). CONCLUSIONS: According to this study, LADG with D2 lymph node dissection is feasible and provides several advantages similar to those of limited lymph node dissection (D1+alpha). Depending on surgeons' technical proficiency, LADG can be used with standard radical lymph node dissection for patients with gastric cancers.

Carcinoma↗

PubMed1999

Differential diagnosis of cervical lymph nodes in head and neck cancer by ultrasonography.

OBJECTIVE: Determination of whether an enlarged cervical lymph node is metastatic or not is clinically important in head and neck oncology. Differential diagnosis of the lymph node, however, is still a diagnostic problem. The purpose of this study is to clarify the ultrasonographic findings of the metastatic lymph nodes of head and neck squamous cell carcinoma and to establish the criteria. METHODS: We investigated 36 metastatic lymph nodes in head and neck squamous cell carcinoma and 24 non-metastatic nodes in benign disease with a 10-MHz transducer. We examined the size, shape, and internal echo (echo level, punctate bright echogenic spots, hilus echogenic line, cystic pattern) of these nodes. Based on this investigation, we evaluated 70 lymph nodes from 25 other patients by ultrasonography. RESULTS: The short axis diameter and shape of metastatic nodes were larger and rounder than those of non-metastatic ones. Of the metastatic nodes, 69% showed hypoechoic and 31% isoechoic levels, and 78% exhibited punctate bright echogenic spots. Of the non-metastatic nodes, 92% showed hypoechoic and 8% isoechoic levels, and none of them showed the spots. The hilus echogenic line was not present in any metastatic node, but it was seen in 58% of non-metastatic ones. Of the metastatic nodes, 19% exhibited a cystic pattern; none of the non-metastatic nodes showed the pattern. According to our criteria based on these results, the accuracy rate was 98.6% (69/70). The sensitivity and specificity were 97.2% (35/36) and 100% (34/34), respectively. The false positive rate and the false negative rate were 0% (0/70) and 1.4% (1/70), respectively. CONCLUSION: Internal echo findings and shape of lymph nodes can be an important diagnostic tool, and our ultrasonographical criteria of the lymph nodes are very useful for the differential diagnosis of the cervical lymph nodes.

Biopsy↗

PubMed2004

Axillary lymph node recurrence of papillary thyroid microcarcinoma: report of a case.

We report a case of axillary lymph node recurrence of thyroid papillary microcarcinoma (PMC) in a 51-year-old woman who had undergone thyroidectomy with lymph node dissection 5 years earlier. We performed residual thyroid resection with cervical and bilateral axillary lymph node dissection, and pathological examination revealed well-differentiated papillary carcinoma, with partial poor differentiation. Postoperative radioiodine therapy was ineffective, and the patient died of systemic dissemination of the recurrence 8 months after her second operation. The positive cell rates of proliferating cell nuclear antigen and Ki-67 were clearly higher in the recurrent lymph nodes than in the primary thyroid tumor, suggesting increased cell proliferation in the recurrent lymph nodes. Thyroid papillary carcinoma rarely recurs in the axillary lymph nodes, but its possibility must be kept in mind, especially in patients with remarkable cervical lymph node metastasis and those who undergo extensive lymph node dissection.

Axilla↗

PubMed1979

Immunological characterization of mononuclear cells in peripheral blood and regional lymph nodes of breast cancer patients.

Mononuclear cells from peripheral blood and draining lymph nodes of 40 patients with invasive locoregional breast cancer were examined for immunological cell surface markers (E, EAhuman, EAox, EAC, SIg pos.). Concomitantly, blood lymphocytes from 36 healthy women and axillary and mesenteric lymph-nodes from patients without malignant diseases were tested as controls. In peripheral blood of tumor patients E rosette-forming cells were slightly diminished as compared to the control group, whereas EAox and EAC rosette-forming cells were increased. These differences may be age-dependent rather than tumor-related. In the draining lymph nodes of breast cancer patients as well as in the control lymph nodes, the percentages of EAC rosette-forming cells and SIg positive lymphocytes were significantly increased compared to peripheral blood, whereas E and EAhuman rosette values remained unchanged. Percentages of EAox rosettes on the other hand were strongly diminished in the draining lymph nodes, suggesting that the EAhuman and EAox rosetting techniques detect 2 types of Fc-receptor bearing cells. No significant differences were found between the cell surface marker analysis of tumor-free and metastatic lymph nodes of breast cancer patients and the control lymph nodes.

Adult↗