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[Contrast retention in retroperitoneal lymph nodes after lymphography; the effect of lymph node abnormalities, radiotherapy and contrast quantity].

The rate of contrast loss from retroperitoneal lymph nodes after lymphography was studied radiologically over a prolonged period in 302 patients. It varied remarkably, even in normal persons who were not receiving any treatment. Lymph nodes empty more quickly if only a small quantity of contrast has been used. Irradiation accelerates contrast transport, not only in the irradiated, but also in the neighbouring, group of nodes. This effect is dose dependent. There is evidence that pathological lymph nodes empty more quickly than normal ones.

Adult

[Regional neck lymph nodes and primary tumors. 2. The reactive neck lymph node lesion].

Topographic classification of lymphatic nodes with reactive changes and with metastasis makes evident, that the regional lymph nodes have not only changes, caused by inflammation but also by growth of tumor. Thus, the lymph nodes are accomodation of defense and in the second place as an accommodation of discharge. The regional lymph nodes respond independent of the extent of the primary tumor. The regional metastasis are nearly always localized in the center of lymph nodes with reactiv changes. Lymph nodes with follicular lymphatic hyperplasia are situated in the immediate environment of the metastasis. Lymph nodes with sinus-reaction are extended before the metastasis, in direction of lymph discharge. By super imposed projection of the results of histological evaluation of cervical glands with metastasis in the neck, one obtains to some extent an impression of the defense activity by the lymph nodes at the time of the operation.

Head and Neck Neoplasms

Lymph node involvement by direct extension in adenoid cystic carcinoma. Absence of classic embolic lymph node metastasis.

Thirty-four cases of adenoid cyctic carcinoma seen at the University of Virginia Hospital from 1946 to 1974 were reviewed, with special emphasis on lymph node involvement by tumor. Lymph node involvement was found in three cases of primary tumors of the submaxillary gland, and all of the affected lymph nodes were in the immediate vicinity of the primary tumor. Two lymph nodes were involved in two of the cases, and one node was involved in the third case. In all of these lymph nodes, adenoid cystic carcinoma was present in the soft tissue surrounding the node, and the tumor extended into the node. No metastatic tumors were observed in 46 lymph nodes removed incidentally at the time of local excision of the primary tumors in 10 additional cases or in 212 lymph nodes examined after unilateral radical neck dissections in six other cases. Five autopsies in this series showed no lymph node metastases. In this series of cases adenoid cystic carcinoma only invades lymph nodes in the immediate vicinity of the primary tumor. When lymph node involvement does occur, it does not result from embolic lymph node metastasis; rather, a direct invasion of the lymph node from tumor in the perinodal soft tissue occurs. Obviously, this small study does not completely exclude the possibility of embolic metastasis; however, if it does occur, it must be extremely rare.

Carcinoma, Adenoid Cystic

[Regional neck lymph nodes and primary tumors. 1. Neck lymph node metastases].

The metastasis are situated in the primary regional lymphnodes. Preoperative palpation of the neck gives unreliable results. The extent of the primary tumor has no correlation to the occurence of metastasis. When the tumor is localized in the supraglottic, transglottic or in the tongue base region the frequency of metastasis in lymph nodes is approximately equal; more than half of them have metastasis. When the tumor is localised in sinus piriformis or in the marginal region a still higher frequency of metastasis is found.

Head and Neck Neoplasms

[Glomus cell clusters of the lymph node].

Nine lymph nodes with so-called benign nevus cell nevi were studied by light microscopy. In three cases the lymph nodes were also examined by electron microscopy. The solitary or multiple cell clusters were 35-645 mu in diameter and were usually found in the lymph node capsule or cortex. They were more frequent in the older patients. There was no predisposition for either sex. Specific morphologic features allowing clear cytologic identification of the cells were not evidient. In particular, there was no indication that they represented nevus cells. However, they showed a great morphologic similarity to glomus cells. In addition, they were usually found near blood vessels. We assume that the cell clusters were hamartias related to glomangiomas. We call them glomus cell clusters.

Adult

Selective accumulation of cells with 'B' properties in stimulated lymph nodes.

Draining lymph nodes from mice which had been stimulated with bacterial adjuvants or the skin sensitizing agent, oxazolone, showed a marked increase in cell content, presumably due to lymphocyte immigration. A surprisingly large proportion of these cells exhibit properties of B lymphocytes: the presence of surface Ig, lack of Thy-1-like antigen and responsiveness to lopopolysaccharide (LPS). The relationship between the presence of surface markerand responses to class-specific mitogens, of cells from the stimulated nodes, was established by testing fractionated lymphocyte populations. Enriched T cells did not react to LPS, whereas removal of cells with Thy-1 antigen by specific antisera eliminated the reactions to T mitogens but had little or no effect on the LPS response. The data thus suggest that B cells, which make up a small portion of the circulating lymphocyte pool, are selectively accumulated in lymph nodes stimulated by different immunogens, including T-specific stimulants. This interpretation contradicts the generally accepted assumption, that stimulat lymph nodes trap mostly T lymphocytes.

Animals

Lymph node activating factor from mixed cultures of allogeneic lymphoid cells: effect on the lymph nodes of euthymic and athymic mice.

The action of "lymph node activating factor" (present in supernatants from 4hr cultures of allogeneic lymphocytes) on the lymph nodes of athymic nu/nu mice, nu/+ hybrids and euthymic BALB/c mice was studied. An increase in lymph node weight, cellularity and changes in lymph node morphology, i.e. an increase of the dense lymphatic tissue of the cortex and paracortex and appearance of follicles with light centers, were found in all mice. Lymphocyte activation evaluated by the presence of lymphocytes with RNA synthesizing nucleoli occurred only in nu/nu mice and nu/+ hybrids. Marked changes in lymph node morphology found in nu/nu homozygotes suggest relation of the lymph node activating factor to mediators acting directly on B cells.

Animals

[Antigen-specific lysis in vitro of lymph node cells of intact mice injected with RNA from viable lymph node cells of immunized animals].

Supernatant fluid obtained after centrifugation of the suspension of viable lymph node cells of immunized animals proved to induce in vivo in the lymph node cells of intact mice sensitivity to lysis with a specific antigen in vitro. This property was possessed after chromatography of the supernatant fluid on Sephadex G-200 by the 3rd fraction (MW about 30000 dalton). DNA-ase, trypsin or deproteinization failed to influence whereas RNA-ase inactivated this fraction in respect to the inducing properties.

Animals

Light and electron microscopic studies of postcapillary venules in developing human fetal lymph nodes.

Developing lymph nodes from 30 human fetuses with crownrump lengths (CRL) of 38 mm (8.7 wk) to 245 mm (26 wk) were studied by light and electron microscopy. Blood vessels that appear to be postcapillary venules (PCV) are present in nodes of 47 mm CRL and older fetuses. These venules first appear in nodes whehn the nodal population of lymphocytes is sparse. In these early nodes PCV are distributed randomly and consist of a low endothelium, underlying basal lamina and incomplete pericyte sheath. Early nodal PCV are distinguised from other nodal blood vessels by the presence of lymphocyte diapedesis and several luminal lymphocytes. In the late stages of nodal development PCV are the more common non-capillary blood vessel and appear in the parenchyma near the periphery of the node. Late nodal PCV are generally characterized by a cuboidal endothelium that is rich in Golgi apparatus, lysosomes and Weibel-Palade bodies. The lumen and wall of late nodal PCV contain lymphocytes. The relationship between the development of the parenchyma of fetal nodes and the appearance and activity of PCV, the passage of lymphocytes through the PCV wall and the fine structure of developing PCV are described. It is suggested that the lymphocytes that first appear in developing nodes, and the majority of the lymphocytes found in late nodes, migrate to the node via the blood vascular system and enter the nodal parenchyma by passing across PCV endothelium.

Abortion, Spontaneous

Development of IgE-forming cells in vitro from rat mesenteric lymph node cells.

Mesenteric lymph node cells from normal rats and rats infected with Nippostrongylus brasiliensis (Nb) were cultured with pokeweed mitogen (PWM) or Nb antigen, and the development of IgM-, IgG2a-, or IgE-containing cells was assessed by immunofluorescence. Normal lymph node cells stimulated with PWM developed into both IgM- and IgE-containing cells, whereas similar stimulation of cells from Nb-infected rats resulted in the development of IgM-, IgG2a-, and IgE-containing cells. The in vitro plasma cell response to PWM was dependent on the presence of T lymphocytes. Lymph node cells from Nb-infected rats responsed to Nb antigen and developed into plasma cells of IgM, IgG, and IgE classes. The response was antigen specific and required antigen-primed T cells. Depletion of IgE-bearing cells or IgM-bearing cells before stimulation with either PWM or Nb antigen diminished the level of IgE forming cell development, suggesting that IgE-IgM double bearing cells are precursors of IgE-forming cells. The distribution of the three isotypes among the If-forming cells that developed in response to PWM was influenced by the source of both B and T cells. When B cells from Nb-infected rats were employed as a source of precursors, T cells from infected animals were more effective than normal T cells for the development of IgE-forming cells, whereas the latter cells were more effective for the development of IgG2a-forming cells than T cells from infected animals.

Animals

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

The appearance of non-specific antibody-forming cells in the efferent lymph draining antigen-stimulated single lymph nodes.

Immunization of single lymph nodes with various antigens led to the appearance of cells in the efferent lymph that secreted antibody specific for the antigen which induced their formation and for a number of unrelated, non-crossreacting antigens. Immunization of single lymph nodes with mitogens led to the appearance of cells secreting antibodies specific for an even greater number of antigens, including one (TNP) that in all probability is not present in the animals' natural environment. When the node was primed with one antigen, a subsequent challenge with an unrelated antigen 12 weeks later led to the appearance of greater numbers of cells containing and secreting antibody against the previously experienced antigen, than was the case in unprimed lymph nodes. These findings indicate that the immune response to antigen provokes the maturation of lymphocytes of specificities unrelated to that of the injected immunogen. Such a mechanism may be important in maintaining immunological memory. Mitogens may directly activate lymphocytes into maturation and expression as antibody-secreting cells, whereas antigens appear to act indirectly.

Animals

Lymph-node biopsy during simple mastectomy.

The distribution of pectoral (external mammary) nodes identified during the operation and removed with the axillary tail of the breast was studied in 45 patients treated by simple (total) mastectomy. Up to 13 nodes may lie within the axillary tail, and these are continuous with the pectoral nodes. Lymph-nodes were identified in 90 percent of patients treated by simple (total) mastectomy without dissection of the axilla.

Axilla

Elevated levels of immunoglobulin E in the acute febrile mucocutaneous lymph node syndrome.

Mucocutaneous lymph node syndrome (MCLS) is a newly recognized disease characterized by fever persisting for more than 5 days, an erythematous skin eruption, conjunctival congestion, dry red fissured lips, reddened tongue, palms, and soles, nonpurulent lymphadenopathy, and sometines diarrhea, arthralgia, and aseptic meningitis. Additional features may include carditis, pericarditis, aneurysmal dilation and thrombosis of coronary arteries, and sudden death. There is a striking similarity of fatal cases to infantile polyarteritis nodosa, a disease recently reported to be associated with elevated levels of serium IgE. Indeed, it is likely that MCLS represents a disease which can progress to polyarteritis nodosa in infants and young children. The paired acute and convalescent serum IgE levels of 20 subjects with acute nonfatal MCLS were studied along with 20 near-age unaffected controls from the same communities in Japan. The results indicate that most if not all subjects with MCLS in the study had an elevation of total serum IgE during the acute phase of the disease (geometric mean 157 IU/ml compared with the control value of 38 IU/ml, P = 0.005). The level appeared to reach a peak 1-2 weeks after onset and declined over the ensuing 1-2 months.

Acute Disease