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PubMed2005

Lymph node metastasis in ovarian cancer: difference between serous and non-serous primary tumors.

OBJECTIVE: To investigate the lymph node sites most susceptible to involvement relative to primary tumor histology in ovarian cancer. METHODS: The locations of metastatic lymph nodes were investigated in 208 patients with primary ovarian cancer who underwent systemic lymphadenectomy covering both the pelvic and para-aortic regions. RESULTS: Lymph node metastasis was present in 12.8% (20/156) of patients with stage I (pT1M0), 48.6% (18/37) with stage II (pT2M0), and 60% (9/15) with stage III (pT3M0) disease, thus in 22.6% (47/208) of all study patients. Isolated para-aortic nodal involvement was present in 23.3% (14/60) of patients with serous tumor and 4.1% (6/148) of those with non-serous tumor (P = 0.00002). In an analysis of 35 positive nodes from 25 patients with up to 3 positive nodes, 86.4% (19/22) of metastatic lymph nodes from patients with serous tumor were found in the para-aortic region, with 14 positive nodes located above the inferior mesenteric artery (IMA) and 5 below it, whereas metastasis to para-aortic lymph nodes accounted for 53.8% (7/13) of metastatic lymph nodes from patients with non-serous tumor (P = 0.0334). CONCLUSIONS: The locations of metastatic lymph nodes in ovarian cancer depend upon the histologic type of the primary cancer. In cases of serous tumor, the para-aortic region, particularly above the IMA, is the prime site for the earliest lymph node metastasis. However, the likelihood of pelvic node involvement is almost equal to that of para-aortic node involvement in cases of non-serous tumor.

Adenocarcinoma, Clear Cell↗

PubMed1989

[Analysis of regional lymph node T-lymphocyte subsets in patients with gastric cancer].

The proportion of T-lymphocyte subsets of the regional lymph node lymphocytes of 36 gastric cancer patients was analysed using single and two color flow cytometry technique. The antibodies against human T-lymphocyte were anti-CD3, CD4, CD8, CD4 X Leu8, CD4 X 4B4 and CD8 X CD11. The results were as follows. 1) Using single color analysis, the proportion of CD3+ and CD4+ cells in the metastatic lymph node was decreased and that of CD8+ cells was not changed compared with the non-metastatic lymph node. Therefore, the ratio of CD4 to CD8 was reduced. Using two color analysis, proportion of CD4+ Leu8- cells and CD4+ 4B4- cells was reduced. On the contrary, that of CD8+ CD11+ cells was increased in the metastatic lymph node compared with the non-metastatic lymph node. 2) The proportion of CD3+, CD4+ and CD4+ 4B4- cells was decreased in the non-metastatic lymph node of patients with lymph node metastasis compared with that of patients without lymph node metastasis. 3) The proportion of T-lymphocyte subsets was not changed in the metastatic lymph node, whether the volume including cancer cell is much or not. These results suggest that the metastatic lymph node was less defensive against lymph node metastasis in the gastric cancer.

Adult↗

PubMed2001

Periaortic lymph node involvement by metastatic angiosarcoma and benign sinus mesothelial cells.

Hyperplastic mesothelial cells involving lymph node sinuses have only been recently described. Most nodal mesothelial cells are thought to originate from mesothelial surfaces disrupted by serosal effusions. Dislodged mesothelial cells likely gain access to submesothelial lymphatics via mesothelial stomata and disseminate to draining lymph nodes. Unusual lymph node architectural patterns result when benign sinus mesothelial cells occur concurrently with a neoplastic nodal process. We describe a young man who developed diffuse metastases from a primary cardiac angiosarcoma. His periaortic lymph nodes contained metastatic angiosarcoma and hyperplastic mesothelial cells with a sinus distribution. The patient had a clinical history of progressive haemoperitoneum, exacerbated by thrombocytopaenia and disseminated intravascular coagulation. Massive haemoperitoneum of 5000 ml was confirmed at autopsy. This is the first report to suggest that multiple episodes of intraperitoneal haemorrhage and ascites may both act in the same manner to cause dislodgment and dissemination of mesothelial cells to draining lymph node sinuses.

Adult↗

PubMed1988

Effect of interferon-alpha-2a on the output of recirculating lymphocytes from single lymph nodes.

The output of recirculating lymphocytes from cannulated popliteal lymph nodes in sheep was measured after administration of human recombinant interferon (rIFN)-alpha-2a. Interferon (IFN) injection caused a dramatic decrease in lymphocyte output from lymph nodes. Following a single s.c. or i.d. injection of 2 x 10(7) U IFN into the drainage area of the popliteal lymph node, lymphocyte output fell to below 1% of the pre-treatment level and remained depressed for up to 35 hr. A substantial decrease in lymphocyte output from cannulated nodes also occurred after IFN was injected either i.v., into the skin of the opposite non-cannulated hind leg or into an afferent lymphatic vessel leading to the popliteal lymph node. After the period of depressed lymphocyte output, a seemingly compensatory surge of cell traffic occurred that lasted 2-3 days. During this phase there was a relative increase in the proportion of CD4+ T cells in lymph. Similar changes occurred after each treatment in animals given multiple doses of IFN. These effects are unlikely to be antigen-induced since there was no blast cell response in any treated animal. The analysis of blood and lymph plasma samples showed that the most severe depression of lymphocyte output was associated with high levels of IFN, while there was no apparent correlation between the reduction in lymphocyte traffic and concentrations of cortisol in plasma. These results suggest that IFN-alpha-2a is involved directly in the regulation of lymphocyte output from lymph nodes.

Animals↗

PubMed1998

Results of complete lymph node dissection in 83 melanoma patients with positive sentinel nodes.

BACKGROUND: The technique of sentinel lymph node (SLN) biopsy for melanoma provides accurate staging information because the histology of the SLN reflects the histology of the entire basin, particularly when the SLN is negative. METHODS: We combined two mapping techniques, one using vital blue dye and the other using radiolymphoscintigraphy with a hand-held gamma Neoprobe, to identify the SLN in 600 consecutive patients with stage I-II melanoma. The SLNs were examined using conventional histopathology and immunohistochemistry for S-100. RESULTS: Eighty-three (13.9%) patients had micrometastatic disease in the SLNs. Thirty percent of patients with primary melanomas greater than 4.0 mm in thickness had positive SLNs, followed by 48 of 267 (18%) of patients with tumors between 1.5 mm and 4 mm, and 12 of 169 (7%) of those with lesions between 1.0 mm and 1.5 mm. No patient with a tumor less than 0.76 mm in thickness had a positive SLN. Sixty-four of the 83 SLN-positive patients consented to undergo complete lymph node dissection (CLND), and five of 64 (7.8%) of the CLNDs were positive. All patients with positive CLNDs had tumor thicknesses greater than 3.0 mm. CONCLUSIONS: The rate of SLN-positive patients increases with increasing thickness of the melanoma. SLN-positive patients with primary lesions less than 1.5 mm in thickness may have disease confined to the SLN, thus rendering higher-level nodes free of disease, and may not require a CLND.

Adolescent↗

PubMed2001

[Treatment of lymph node metastasis from the viewpoint of surgical oncology].

We have investigated methods to predict lymph node metastasis in early gastric cancer. First, the efficacy of fluorescence in situ hybridization (FISH) using the dual-color method was evaluated as a potential marker of lymph node metastasis in 20 early gastric cancers. A significant increase in the fraction of cells with a decrease in p53 was observed in early gastric cancer compared with normal tissues. More importantly, a significant increase in the fraction of cells with p53 deletion was observed in patients with lymph node metastasis. The predictive accuracy was 45%. Second, the relationship between the degree of expression of biological markers and lymph node metastasis was examined. High expression of p27 and cyclin E had a strong correlation with lymph node metastasis. Moreover, all patients with combined high expression of p27, cyclin E, and matrix metalloproteinase-9 had lymph node metastasis. However, these represented only 21% of cases with lymph node metastasis. Difficulty in the clinical use of these biological markers to detect lymph node metastasis depends on the feedback mechanism of cell cycle regulators or heterogeneity of the lesion. These problems should be resolved in the near feature.

Cell Cycle Proteins↗

PubMed1986

Radiation synovectomy with 165Dy-FHMA: lymph node uptake and radiation dosimetry calculations.

The lymph node uptake of 165Dy was measured in 25 patients treated by radiation synovectomy via intra-articular injection of 165Dy-ferric hydroxide macroaggregates (FHMA). An average of 0.12% of the injected dose was found in the inguinal lymph nodes 19h post injection. This results in a lymph node of 16.6 rad (166 mGy), a dose significantly less than that reported following radiation synovectomy with other radiocolloids. Dosimetry calculations for the intra-articular injection of 165Dy-FHMA are provided in the appendix.

Arthritis, Rheumatoid↗

PubMed2002

Sentinel lymph node biopsy in staging of differentiated thyroid cancer: a critical review.

Sentinel lymph node biopsy has recently been utilized to map tumor lymphatics in patients with differentiated thyroid carcinoma. Currently, controversy centers around the feasibility and future role of this technique in the management of differentiated thyroid cancer patients. A review of the current literature in which sentinel lymph node biopsy was performed on patients with a diagnosis of differentiated thyroid cancer was undertaken. Sentinel lymph node biopsy has been carried out on thyroid cancer patients utilizing a vital dye technique, a radiotracer technique, and a combination of both techniques. In the current literature the average rate of sentinel node identification is 91% (range 66-100%) and when identified, the sentinel node accurately predicts the disease status of the neck in most patients (range 80-100%). Limitations to carrying out the sentinel node biopsy on thyroid cancer patients include staining of parathyroid glands, identification of lymph nodes draining into the mediastinum, and the 'shine through' effect. Sentinel lymph node biopsy is technically feasible, but for a disease in which nodal metastases are of debatable prognostic value, the clinical utility of sentinel lymph node biopsy in the management of patients with differentiated thyroid cancer appears less than promising.

Humans↗

PubMed2000

Pathologic analysis of the sentinel lymph node.

The development of the sentinel lymph node concept has had a revolutionary effect on the way radical cancer surgery is viewed. The selective excision of the sentinel node alone has been proposed as an alternative to complete regional lymphadenectomy. This article addresses the sentinel lymph node hypothesis and the role of pathologic analysis, radiation safety, intraoperative and postoperative assessment, pathologic analysis in prognosis, and polymerase chain reaction-based studies.

Breast Neoplasms↗

PubMed1993

Detection of pericolonic lymph nodes in patients with colorectal cancer: an in vitro and in vivo study of the efficacy of endosonography.

OBJECTIVE: Rectal endosonography is useful for the preoperative detection of perirectal lymph nodes in patients with rectal carcinoma, but some lymph nodes may be overlooked. The aim of this study was to compare the number of lymph nodes detected at sonography with the actual number and the pathology of the nodes found on examination of surgical specimens. MATERIALS AND METHODS: Colorectal specimens from 20 patients who had undergone resection of the colon (six patients) or rectum (14 patients) for carcinoma were selected for study. Sonography with 7-MHz endoprobes was performed with the bowel opened and submerged in water. The location and size of all lymph nodes that could be visualized in the pericolonic fat were marked on a drawing of the specimen. Distinction between malignant and benign nodes was not attempted. After fixation, pericolonic lymph nodes were identified by careful palpation, and their location and size were noted on a similar line drawing of the specimen. This was performed "blindly" without knowledge of the sonographic findings. By comparing the sonographic localization and size of the nodes with the histologic findings, it was possible to determine which nodes had been identified and which had been overlooked on sonograms. Preoperative endosonography had also been performed in 10 patients with rectal carcinoma, and the number of lymph nodes detected with this examination was compared with the results of the in vitro sonographic and histopathologic examinations. RESULTS: Histologic examination detected 205 lymph nodes in the 20 specimens. Sixty-four (31%) of them were seen on in vitro sonograms (25% of the benign nodes and 56% of the malignant nodes). The overall detection rates were 16% for nodes less than 5 mm in diameter, 56% for nodes between 6 and 10 mm, and 82% for lymph nodes larger than 10 mm. Preoperative rectal endosonography generally showed fewer lymph nodes (average, 1.2 nodes) than what was subsequently found with in vitro sonography (average, 2.7 nodes). CONCLUSION: Our study suggests that only approximately half of the malignant nodes in patients with colorectal carcinoma are visualized with endosonography of the surgical specimen. Even fewer nodes are visualized on preoperative in vivo examinations. The inability to detect more than 56% of metastatic lymph nodes makes preoperative endosonographic assessment less valuable than hitherto believed. This should be considered if sonographically guided biopsy of lymph nodes is considered as part of preoperative staging.

Colon↗

PubMed2006

A national study on lymph node retrieval in resectional surgery for colorectal cancer.

PURPOSE: This study was designed to develop a mathematical model for predicting the number of lymph nodes harvested in bowel cancer resection specimens based on the current clinical practice in the United Kingdom. METHODS: Prospective clinical data were collected from 8,409 newly diagnosed bowel cancer patients presenting to 79 hospitals in Great Britain and Ireland during a variable 12-month period from 2000 to 2002. A two-level hierarchical regression model was used to identify predictors for lymph node harvest. The model was internally validated by comparing observed and model predicted lymph node harvest for patient subgroups. RESULTS: Inclusion criteria were satisfied by 5,164 patients. The average lymph node harvest was 11.7 nodes with significant between-center variability in lymph node harvest (range, 5.5-21.3 nodes). Increasing age, American Society of Anesthesiology grade, and preoperative radiotherapy were associated with a reduction of lymph node harvest (P < 0.001). Abdominoperineal resection of the rectum and transverse colectomy were the lowest yield procedures for lymph node harvest. Independent predictors of lymph node harvest were age, American Society of Anesthesiology grade, Dukes stage, operative urgency, type of resection, and preoperative radiotherapy. When tested, the model was found to accurately predict lymph node harvest for group statistics (comparison of observed and model predicted lymph node harvest F(1,5154) = 0.63; P = 0.427). CONCLUSIONS: The results of the study suggest that the minimum number of lymph nodes harvested in colorectal cancer surgery cannot be set at a fixed value. The lymph node harvest model provides a simple tool to the frontline clinician for comparing standards between multidisciplinary bowel cancer teams.

Age Factors↗

PubMedDate not supplied

Gastric cancer: extent of lymph node dissection and requirements for a correct staging.

AIMS AND BACKGROUND: Lymphatic spread is an important prognostic factor in gastric cancer. The TNM classification requires at least 15 lymph nodes to stage and identify three prognostic groups according to the number of metastatic lymph nodes: N1 (1-6), N2 (7-15), N3 (> 15). The aim of this study was to investigate which type of lymph node dissection allows an accurate staging. METHODS: From 1996 to 2001, we treated 140 gastric cancer patients, 27 with D1 and 113 with D2 dissection. We evaluated lymph node count, status and ratio between metastatic and total number of excised lymph nodes, keeping 20% as the cutoff value. RESULTS: The mean number of lymph nodes was 18 and 33 respectively for D1 and D2 (P < 0.001), 41% of patients in D1 and 5% in D2 had less than 15 lymph nodes (P < 0.001). 59% in D1 and 73% in D2 (P = 0.145) had lymph node metastases, but this incidence decreased to 36% (P = 0.045) and 16% (P < 0.001) respectively for D1 and D2 when less than 15 lymph nodes were available. Considering the ratio between metastatic and total number of lymph nodes, 45% of D1 versus 3% of D2 (P < 0.001) in the N1 group exceeded 20%. CONCLUSIONS: D2 lymph node dissection is better than D1 in providing at least 15 lymph nodes required for a correct staging. We confirm the risk of a downstage when less than 15 lymph nodes are available.

Adult↗

PubMed2000

Biosynthesis of glycosaminoglycans and proteoglycans by the lymph node.

Previous studies of hyaluronan uptake and catabolism by lymph nodes indicated that the nodes might also add some HA of low molecular weight to the unabsorbed fraction that passes through from afferent to efferent lymph vessels. The ability of lymph nodes to synthesise HA and proteoglycans was therefore examined (i) by perfusion of [(3)H] acetate through an afferent lymph vessel in vivo, and recovery of labeled products from the efferent lymph vessel and from the node after perfusion; and (ii) by tissue culture of lymph nodes with [(3)H] acetate. Perfusion of lymph nodes with [(3)H] acetate in situ yielded: (a), in outflowing lymph, small amounts of chondroitin/dermatan sulfate within the first hour which continued to be produced for up to 24 h; heparin in the second hour and HA in the third. In the nodes removed 17 to 19 h later, equal amounts of hyaluronan and chondroitin/dermatan sulfate and heparan sulfate proteoglycans were detected. In the tissue culture of lymph nodes: (1) HA, heparin and proteoglycans of heparan sulfate and chondroitin/dermatan sulfate were released into the medium but in the cell extract only heparan sulfate proteoglycan was detected; and (ii) molecular weight of the released hyaluronan ranged widely but was mostly less than 4-5x10(5)D; heparan sulfate proteoglycan was 2.8x10(4) to 9.4x10(5)D; heparin 7.9x10(4)D and chondroitin sulfate 1.3x10(4)D, suggesting that the chondrotin sulfate were released from their proteoglycans core by enzymic degradation. It is concluded that lymph nodes can release HA, heparin, heparan sulfate and chondroitin/dermatan sulfate proteoglycans into efferent lymph but the amount of hyaluronan is likely to be small without immune or other stimulation and its molecular weight is lower than in other tissues.

Acetates↗

PubMed1998

Establishment of lymph node metastatic model for human gastric cancer in nude mice and analysis of factors associated with metastasis.

The actual mechanisms responsible for lymph node metastasis in gastric cancer are still unclear. To investigate the mechanisms of lymph node metastasis in gastric cancer, we established a lymph node metastatic model for human scirrhous gastric carcinoma. Lymph node metastasis had frequently developed after orthotopic implantation of OCUM-2M LN derived from a scirrhous gastric cancer cell line, OCUM-2M, which had low capacity for lymph node metastasis. We elucidated the different characteristics including binding ability, migratory capacity and immunoresponses induced by the cell surface molecules of these two cell lines. The binding ability to Matrigel and migratory capacity of OCUM-2M LN cells were significantly greater than those of OCUM-2M cells. On flow cytometric analysis, both OCUM-2M and OCUM-2M LN cells strongly expressed HLA-I (99.5 and 97.1%) and LFA-3 (76.6 and 99.2%) in level of expression between the two cell lines, but neither cell line expressed HLA-II (0.0 and 0.0%), B7-1 (0.0 and 0.0%) or B7-2 (0.4 and 0.3%). ICAM-1 expression in OCUM-2M LN cells was weaker (0.7%) than that in OCUM-2M cells (36.8%). Strong adhesiveness and cytotoxicity of mononuclear lymphocytes for OCUM-2M cells were observed in adhesion and cytotoxic assays, both of which were significantly decreased by the addition of anti-ICAM-1 antibodies. On the other hand, the adhesiveness and cytotoxicity of OCUM-2M LN cells were significantly less than those of OCUM-2M cells, and were not affected by the addition of anti-ICAM-1 antibodies. These findings suggest that decreased ICAM-1 expression in a new gastric cancer cell line with a high rate of lymph node metastasis may in turn decrease immune responses mediated through LFA-1-dependent effector cell adhesion, and that this escape from the immunosurveillance system may be one of the factors inducing lymph node metastasis. In conclusion, we established a gastric cancer cell line, OCUM-2M LN, with a high rate of lymph node metastasis. An in vivo lymph node-metastatic model with this cell line should be useful for analysing the mechanism and therapeutic approach of lymph node metastasis.

Adenocarcinoma, Scirrhous↗

PubMed1999

Tuberculosis versus lymphomas in the abdominal lymph nodes: evaluation with contrast-enhanced CT.

OBJECTIVE: Tuberculosis in the abdominal lymph nodes may be difficult to distinguish from lymphomas. This study evaluated specific CT imaging criteria for differentiating these entities. MATERIALS AND METHODS: We retrospectively reviewed the anatomic distribution and CT enhancement patterns of disease in 69 patients, 26 (38%) with tuberculosis and 43 (62%) with untreated lymphomas involving abdominal lymph nodes. Of the patients with tuberculosis, five (19%) had disseminated disease and 21 (81%) had nondisseminated disease. Of the patients with lymphomas, 16 (37%) had Hodgkin's disease and 27 (63%) had non-Hodgkin's lymphoma. RESULTS: Disseminated and nondisseminated tuberculosis involved predominantly lesser omental, mesenteric, anterior pararenal, and upper paraaortic lymph nodes. Lower paraaortic lymph nodes were involved more often in Hodgkin's disease (15 patients [94%]), non-Hodgkin's lymphoma (24 patients [89%]), and disseminated tuberculosis (five patients [100%]) than in nondisseminated tuberculosis (one patient [5%]). Mesenteric lymph nodes were involved more often in disseminated tuberculosis (four patients [80%]) and nondisseminated tuberculosis (11 patients [52%]) than in Hodgkin's disease (one patient [6%]) (p < .01). Anatomic distribution was not different between disseminated tuberculosis and non-Hodgkin's lymphoma. Tuberculous lymphadenopathy commonly showed peripheral enhancement, frequently with a multilocular appearance, whereas lymphomatous adenopathy characteristically showed homogeneous attenuation (14 patients [87.5%] with Hodgkin's disease and 19 patients [70%] with non-Hodgkin's lymphoma [p < .01]). CONCLUSION: Our findings indicate that the anatomic distribution and specific enhancement patterns of lymphadenopathy seen on contrast-enhanced CT can be useful in differentiating between tuberculosis and untreated lymphomas of the abdominal lymph nodes.

Abdomen↗

PubMed2005

Immunohistochemical detection of incipient melanoma micrometastases. Relationship with sentinel lymph node involvement.

It is acknowledged that tumour thickness, ulceration and lymph node invasion are the most important prognostic factors for cutaneous melanomas. Other histopathological features may also be informative. The aim of this study was to ascertain whether immunohistochemical methods can improve the detection of satellite micrometastases in primary melanoma patients. In addition, the predictive value of cutaneous satellite micrometastases for sentinel lymph node involvement was evaluated. A total of 265 primary cutaneous melanomas and 68 of the respective sentinel nodes were studied using a panel of seven antibodies directed against melanocyte-related antigens. In 12.4% of the 265 cases, small satellite micrometastases were detected by immunohistochemistry. Sentinel lymph node metastases were found in 14% of the 68 cases. Invasion of the sentinel lymph node correlated with the presence of cutaneous satellite micrometastases. It is concluded that the presence of cutaneous satellite micrometastases may be an indication for the performance of sentinel lymph node biopsy, and this finding calls for a closer follow-up of these patients.

Adult↗

PubMed2004

[Benign epithelial cells and Tamm-Horsfall protein in lymph nodes from nephrectomy specimens with nephroblastoma: a diagnostic pitfall].

When a lymph node metastasis is discovered during the pathology examination of surgical specimens with nephroblastoma, the tumour is classified as stage III, according to the classification of the International Society of Paediatric Oncology (SIOP 2001), and post-operative intensive treatment of the patient includes irradiation and chemotherapy. Benign epithelial cells in perinephric lymph nodes in cases of renal tumours in childhood may be confused with metastases. They are often associated with an accumulation of Tamm-Horsfall protein in lymph node sinuses. This case illustrates latero-aortic lymph node complexes of benign epithelial cells and Tamm-Horsfall protein in a 16-month-old girl with surgical resection of a nephroblastoma after pre-operative chemotherapy. The nephroblastoma was predominantly epithelial and was classified as SIOP stage I. There were accumulations of Tamm-Horsfall protein in lymph node sinuses, in lymphatic vessels, in the kidney outside the tumour, and in the renal sinus. This association of epithelial cells with deposits of Tamm-Horsfall protein and their resemblance to cells of the distal convoluted tubules favour a diagnosis of benignity. A definitive diagnosis is supported by the small size of the cells, their bland nuclei, and morphological features differing from those of tumour cells, but deposits of Tamm-Horsfall protein may be associated with true lymph node metastases.

Blood Group Antigens↗

PubMed2006

Comparison of B-mode and Doppler ultrasonographic findings with histologic features of benign and malignant superficial lymph nodes in dogs.

OBJECTIVE: To compare and correlate B-mode and color Doppler ultrasonographic characteristics with histopathologic findings of benign and malignant superficial lymph nodes in dogs. STUDY POPULATION: 50 superficial lymph nodes that were normal, abnormally large on physical examination, or represented regional lymph nodes draining an area of suspected primary malignancy in 30 dogs. PROCEDURES: Before excision, lymph nodes were evaluated via B-mode and color Doppler ultrasonography to assess size, echogenicity, presence of a hilus, acoustic transmission, and vascular flow. Formalin-fixed, paraffin-embedded tissue sections of excised lymph nodes were stained with H&E and examined for the presence and extent of necrosis, fibrosis, fat, metastases, and tissue heterogeneity. To assess vascularity, the number and distribution of vessels stained by the Verhoeff van Gieson technique were recorded. RESULTS: In superficial lymph nodes, a varied echogenicity corresponded to tissue heterogeneity. The ultrasonographic detection of a hilus was associated with the presence of fibrous tissue, fat, or both in the hilar region. Acoustic enhancement corresponded to presence of areas of intranodal necrosis. There was significant correlation between both the distribution and the number of vessels detected via ultrasonography and that detected by histopathology. The amount of flow estimated via ultrasonography was typically higher than that estimated via histologic examination. CONCLUSIONS AND CLINICAL RELEVANCE: Results indicated that histopathologic changes in canine lymph nodes have associated ultrasonographic changes and suggest that lymph node ultrasonography has an important role in the evaluation of lymph nodes in dogs in general and in dogs with neoplastic disease in particular.

Animals↗