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Cervical Lymph Nodes (cervical + lymph_node)
Terms modified by Cervical Lymph Nodes Selected AbstractsComparative evaluation of intranasal and subcutaneous route of immunization for development of mucosal vaccine against experimental tuberculosisFEMS IMMUNOLOGY & MEDICAL MICROBIOLOGY, Issue 1 2005Pramod K. Giri Abstract Activation of mucosal immunity in the respiratory tract is crucial for protection against respiratory infections. Whether the intranasal route of vaccination imparts better protection against pulmonary tuberculosis than that of subcutaneous vaccination remains a debatable issue. In this study, we have investigated the effect of the routes of immunization on the induction of immunoprotection against experimental tuberculosis employing mycobacterial culture filtrate proteins complexed with dimethyldioctadecylammonium bromide. Vaccination via intranasal and subcutaneous routes triggered immune activation in the spleen and cervical lymph node, while the former route of vaccination lead to higher antigen-specific lymphocyte proliferation, interferon-,, interleukin-12 and interleukin-4 responses in cervical lymph node and induction of antigen-specific IgA responses at mucosal level of the respiratory tract. Mice vaccinated via the intranasal route were found to be better protected against experimental tuberculosis particularly in lung compared to subcutaneous-immunized mice. These results emphasize the importance of the intranasal route vaccination in tuberculosis. [source] Calcifying epithelial odontogenic (Pindborg) tumor with malignant transformation and metastatic spreadHEAD & NECK: JOURNAL FOR THE SCIENCES & SPECIALTIES OF THE HEAD AND NECK, Issue 8 2001Michael J. Veness MB Abstract Background Pindborg tumors (calcifying epithelial odontogenic tumors) are uncommon neoplasms of odontogenic origin most often located in the posterior mandible. First described in detail in 1955 by Pindborg, these tumors are considered benign but can be locally aggressive in nature, with recurrence rates of 10% to 15% reported. The malignant form of this tumor is exceedingly rare. Methods We describe the case of a 64-year-old woman initially treated for a painful infected left mandibular third molar. The patient underwent extraction of the tooth and excision of an associated soft tissue component. Subsequent histologic review identified a Pindborg tumor of the left posterior mandible. Results After initial excision, this tumor recurred twice, with the recurrences exhibiting a progression to a malignant Pindborg tumor (odontogenic carcinoma) with vascular invasion and spread to a cervical lymph node. Further treatment involved radical surgery and adjuvant radiotherapy. At last review 12 months after treatment, the patient was disease free. Conclusions This article describes only the second case of odontogenic carcinoma. The transformation from benign to malignant histologic findings has not previously been documented in this tumor. The salient clinical features of this case are presented along with supportive pathologic and radiologic evidence. © 2001 John Wiley & Sons, Inc. Head Neck 23: 692,696, 2001. [source] Extensive xanthelasma associated with anaplastic large cell lymphoma and hyperimmunoglobulin E syndromeINTERNATIONAL JOURNAL OF DERMATOLOGY, Issue 12 2003Mi-Woo Lee MD A 57-year-old woman presented with a 6-month history of an extensively spreading, yellowish patch on the periorbital areas and cheeks. A diagnosis of hyperimmunoglobulin E syndrome had been made at the age of 22 years on the basis of an eczematous eruption, recurrent furunculosis, and a persistently elevated immunoglobulin E (IgE) level. Her past medical history revealed that she had suffered from numerous recurrent bouts of chronic sinusitis, otitis media, oral candidiasis, orbital cellulitis, acne rosacea, and pneumonia caused by cytomegalovirus since her twenties. In addition, 1 year ago, anaplastic large cell lymphoma of the cervical lymph node (stage IIIb) developed, and she received six cycles of cyclophosphamide,doxorubicin,vincristine,prednisolone (CHOP) chemotherapy with partial remission. None of her family had any of these problems. Cutaneous examination showed extensive, symmetric, noninfiltrated macular areas of distinct yellow discoloration around the eyes and on both cheeks (Fig. 1). There were also erythematous papulonodular eruptions on the nose and both cheeks, which were thought to be acne rosacea. Laboratory findings were normal, except for an elevated IgE level (8157 IU/mL). Serum concentrations of IgG, IgA, and IgM were normal. Serum complement levels were normal, as evidenced by normal C3, C4, and CH50. Although she had a previous history of a decreased level (12%) of nitroblue tetrazolium (NBT) test (control, 53%), NBT test at our institute was normal. Neutrophil function tests, including neutrophil chemotaxis, neutrophil phagocytosis, neutrophil respiratory burst, and neutrophil microbial killing test, by flow cytometry, showed normal results. The serum lipid levels, including total cholesterol, triglyceride, low-density lipoprotein-cholesterol, and high-density lipoprotein-cholesterol, were normal. Serum lipoprotein electrophoresis was normal. A biopsy specimen revealed scattered foamy cells throughout the dermis. The larger clusters of foamy cells tended to group around the blood vessels of the dermis (Fig. 2). Figure 1. Extensively distributed, yellowish, flat xanthelasma on the face Figure 2. Clusters of foamy cells around the blood vessels of the dermis (hematoxylin and eosin, ×400) [source] Chronic lymphocytic leukemia presenting as cutaneous and bone involvementINTERNATIONAL JOURNAL OF DERMATOLOGY, Issue 1 2001Maria P. Stefanidou MD An 84-year-old man had a 3-year history of a progressive, painless, papulonodular eruption, that was particularly prominent on the face and extremities. Physical examination revealed firm, bluish-red nodules and plaques, located on the tip of the nose, the cheeks, ears, and distal digits. Skin lesions produced a leonine facies (Fig. 1), deformities of the fingers and toes, finger clubbing, and onyxis. An identical lesion was seen on a postoperational scar on the left cheek. The mucous membranes were spared. The patient had anterior and posterior cervical and bilateral axillary lymphadenopathy and splenomegaly. Figure 1. Leonine facies On admission, the peripheral blood count revealed 260,000/mm3 leukocytes (lymphocytes 97%, neutrophils 2%, and monocytes 1%), a hemoglobin level of 9.5 g/dL, and platelet count of 100,000/mm3. Hypogammaglobulinemia with reduction of immunoglobulin G (IgG) and IgM was found. Radiography of the fingers showed multiple osteolytic lesions of the phalanges and phalangette destruction of the left median finger (Fig. 2a,b). Computed tomography of the chest and abdomen revealed bilateral axillary, mediastinal, and para-aortic lymphadenopathy and spleen enlargement. Figure 2. X-Ray of the hands: (a) ,multiple osteolytic lesions of the phalanges and (b) ,partial destruction of the left median phalangette Skin biopsy specimens from the ear and finger lesions showed a massive nonepidermal leukemic infiltration in the papillary and reticular dermis, with a grenz zone consisting of small lymphocytes (Fig. 3). Figure 3. Skin biopsy (hematoxylin and eosin, ×,250). Massive leukemic infiltration consisting of small lymphocytes. Subepidermally, a grenz zone of connective tissue is noted Biopsy of the enlarged cervical lymph node showed a diffuse infiltration with lymphocytes. Tissue biopsy from a finger lytic lesion revealed infiltration of bone trabecular and fibrous tissue with a dense population of small- and medium-sized lymphocytes. Immunohistochemical study of cutaneous and bone lesions showed that the infiltrate in both biopsies consisted mainly of B lymphocytes (CD20+, CD45R+, CD45Ro,, OPD4,). Peripheral blood smear had a B-cell phenotype (CD19 98%, CD20 97%, CD23 99%, CD25 40%, CD5 90%, HLA-DR 100%). Bone marrow smear and immunophenotyping surface marker analysis found a diffuse pattern of B-lymphocytic infiltration. A diagnosis of B-cell chronic lymphocytic leukemia stage C (Binet staging system), with specific cutaneous and bone lesions, was established. The patient received chemotherapy with chlorambucil and methylprednisolone, which resulted in improvement of the hematologic profile. Two years later, the cutaneous lesions showed partial remission. [source] Cystic appearance of cervical lymph nodes is characteristic of metastatic papillary thyroid carcinomaJOURNAL OF CLINICAL ULTRASOUND, Issue 1 2003Ada Kessler MD Abstract Purpose The usefulness of high-resolution sonography in diagnosing cervical lymph node metastases from papillary thyroid carcinoma was investigated. The accuracy of a particular sign, cystic change within a node, in establishing the diagnosis was assessed. Methods The sonographic findings in 63 patients with enlarged cervical lymph nodes were retrospectively reviewed. The patients had undergone high-resolution gray-scale and color Doppler sonography followed by ultrasound-guided fine-needle aspiration (FNA) in all patients and surgical excision in 27 patients. Results Abnormal sonographic features were present in the lymph nodes of all 63 patients. In 14 (70%) of 20 patients with papillary thyroid carcinoma, sonography depicted cystic changes. This pattern was not found in any of the other 43 patients, in whom FNA revealed either metastasis from another malignancy (22 patients) or benign reactive lymphadenopathy (21 patients). Among the 63 patients, there were 43 true-negative, 14 true-positive, 6 false-negative, and no false-positive results in the diagnosis of metastatic papillary thyroid carcinoma using the presence or absence of an intranodal cystic area on sonography. These results yielded a 70% sensitivity, 100% specificity, 100% positive predictive value, 88% negative predictive value, and 90% overall accuracy for this criterion. Conclusions Cystic changes within a cervical lymph node are highly suggestive of metastatic papillary thyroid carcinoma. © 2002 Wiley Periodicals, Inc. J Clin Ultrasound 31:21,25, 2003 [source] KSHV/HHV8-associated primary cutaneous plasmablastic lymphoma in a patient with Castleman's disease and Kaposi's sarcomaJOURNAL OF CUTANEOUS PATHOLOGY, Issue 2006Wenhua Liu Three months following the diagnosis of KS affecting a left cervical lymph node and Castleman's disease with bone marrow involvement, he presented with a subcutaneous, tender lesion on his left arm. A skin biopsy demonstrated a superficial and deep, interstitial-nodular infiltrate of severely atypical lymphoid cells showing plasmacytoid features, numerous mitotic figures, and frequent individual apoptotic tumor cells. The morphologic features were those of plasmablastic lymphoma (PBL). Immunohistochemical study showed that the lymphoma cells strongly expressed CD45, CD30, and KSHV/HHV8 latency-associated nuclear antigen. KSHV/HHV8 was also detected in the biopsy sections of the patient's KS and Castleman's disease. Epstein,Barr virus in situ hybridization was diffusely positive. In situ hybridization demonstrated ,-light chain restriction. Although KSHV/HHV8 has been individually associated with KS, Castleman's disease, and PBL, this appears to be the first reported case in which all three entities were present simultaneously in one person, suggesting a critical role of KSHV/HHV8 as a common denominator in the pathogenesis of these diseases. [source] I-123-guided excision of metastatic papillary thyroid cancerJOURNAL OF SURGICAL ONCOLOGY, Issue 2 2007Saurabh Khandelwal MD Abstract The use of a gamma probe for intraoperative localization of a cervical lymph node, which contained recurrent metastatic papillary thyroid cancer, facilitated a radio-guided minimally invasive outpatient surgical procedure and resulted in complete excision of clinically occult disease. The technique raises the issue of whether nonpalpable regional node recurrences should be locally excised, removed in a formal modified neck dissection, or treated with therapeutic doses of I-131. J. Surg. Oncol. 2007;96:173,175. © 2007 Wiley-Liss, Inc. [source] Transient Peripheral Immune Response and Central Nervous System Leaky Compartmentalization in a Viral Model for Multiple SclerosisBRAIN PATHOLOGY, Issue 5 2010María José Navarrete-Talloni Abstract Theiler's virus-induced demyelination represents an important animal model to study the chronic-progressive form of multiple sclerosis (MS). The aim of the present study was to identify specific genes and pathways in the deep cervical lymph node (cLN) and spleen of experimentally infected SJL-mice, using DNA microarrays. Analyses identified 387 genes in the deep cLN and only 6 genes in the spleen of infected animals. The lymph node presented 27.4% of genes with fold changes ±1.5 at 14 days post infection (dpi) and a reduced transcription at later time points. K- means clustering analyses resulted in five clusters. Accordingly, functional annotation revealed that the B-cell immune response pathway was the most up-regulated cluster at the early phase. Additionally, an increase of CD68- and lysozyme-positive cells in the deep cLN was observed by immunohistochemistry. Polioencephalitis was most intense at 14 dpi, and the spinal cord demyelinating leukomyelitis started at 42 dpi. In summary, early gene expression is indicative of virus-trigged immune responses in the central nervous system (CNS)-draining lymph node. The decreased gene transcription in the deep cLN during the chronic phase and the low number of spleen genes supports the hypothesis of a compartmentalized inflammation within the CNS, as described in progressive MS. [source] The incremental effect of positron emission tomography on diagnostic accuracy in the initial staging of esophageal carcinomaCANCER, Issue 1 2005Hiroyuki Kato M.D., Ph.D. Abstract BACKGROUND The purpose of the current study was to assess whether [18F]fluorodeoxyglucose positron emission tomography (FDG-PET) provides incremental value (e.g., additional information on lymph node involvement or the presence of distant metastases) compared with computed tomography (CT) in patients with esophageal carcinoma. METHODS The authors examined 149 consecutive patients with thoracic esophageal carcinoma. Eighty-one patients underwent radical esophagectomy without pretreatment, 17 received chemoradiotherapy followed by surgery, 3 underwent endoscopic mucosal resection, and the remaining 48 patients received definitive radiotherapy and chemotherapy. The diagnostic accuracy of FDG-PET and CT was evaluated at the time of diagnosis. RESULTS The primary tumor was visualized using FDG-PET in 119 (80%) of 149 patients. Regarding lymph node metastases, FDG-PET had 32% sensitivity, 99% specificity, and 93% accuracy for individual lymph node group evaluation and 55% sensitivity, 90% specificity, and 72% accuracy for lymph node staging evaluation. PET exhibited incremental value over CT with regard to lymph node status in 14 of 98 patients who received surgery: 6 patients with negative CT findings were eventually shown to have lymph node metastases (i.e., they had positive PET findings and a positive reference standard [RS]); 6 patients with positive CT findings were shown not to have lymph node metastases (i.e., they had negative PET findings and a negative RS); and 2 patients were shown to have cervical lymph node metastases in addition to mediastinal or abdominal lymph node metastases. Among the remaining patients, PET showed incremental value over CT with regard to distant organ metastases in six patients. The overall incremental value of PET compared with CT with regard to staging accuracy was 14% (20 of 149 patients). CONCLUSIONS FDG-PET provided incremental value over CT in the initial staging of esophageal carcinoma. At present, combined PET-CT may be the most effective method available for the preoperative staging of esophageal tumors. Cancer 2005. © 2004 American Cancer Society. [source] Papillary microcarcinoma of the thyroid,Prognostic significance of lymph node metastasis and multifocalityCANCER, Issue 1 2003Sin-Ming Chow M.B.B.S Abstract BACKGROUND It is known that patients with papillary microcarcinoma (PMC) of the thyroid gland have a very favorable prognosis. The rising incidence of PMC among papillary thyroid carcinoma (PTC) necessitates the identification of prognostic factors and the formulation of treatment protocols. METHODS The authors conducted a retrospective analysis of 203 patients with PMC who were diagnosed on or before 1999 and were treated at the Department of Clinical Oncology, Queen Elizabeth Hospital, Hong Kong. RESULTS The cause specific survival, locoregional (LR) failure free survival, and distant metastases failure free survival rates at 10 years were 100%, 92.1%, and 97.1%, respectively. Five patients had lung metastases; 2 patients died of their metastases 12.9 years and 14.8 years after diagnosis, and 3 patients achieved clinical remission after radioiodine (RAI) treatment. Twelve patients had LR recurrences. Patients with LR recurrence were highly salvageable with a combination of surgery, RAI treatment, and external radiotherapy; all but one (who refused treatment) were alive without disease at last follow-up. Multivariate analyses did not reveal any independent prognostic factor for survival. The risk of cervical lymph node (LN) recurrence increased 6.2-fold (P = 0.01) and 5.6-fold (P = 0.02) when LN metastases and multifocal disease were present at diagnosis. RAI ablation reduced the LN recurrence rate to 0.27 (P = 0.04). The presence of LN metastasis increased the rate of distant metastasis 11.2-fold (P = 0.03). Age was not a significant factor in predicting disease recurrence or survival. Subdivision by tumor sizes , 5 mm and > 5 mm did not affect the outcome, but no patient with tumors , 5 mm had mortality related to PMC. CONCLUSIONS Despite the overall excellent prognosis for patients with PMC, PMC was associated with a 1.0% disease-related mortality rate, a 5.0% LN recurrence rate, and a 2.5% distant metastasis rate. Therefore, the treatment of patients with PMC should be no different from the treatment of patients with conventional PTC: i.e., complete surgery with consideration for RAI and/or external radiation therapy if poor prognostic factors are present. Cancer 2003;98:31,40. © 2003 American Cancer Society. DOI 10.1002/cncr.11442 [source] Fine-needle aspiration cytology of metastatic nasopharyngeal carcinomaDIAGNOSTIC CYTOPATHOLOGY, Issue 4 2005José M. Viguer M.D. Abstract Cytological features of nasopharyngeal carcinoma (NPC) were reviewed in an attempt to select cytological criteria that permit a specific recognition of metastases. For this purpose, 54 fine-needle aspiration (FNA) procedures from 43 patients with NPC were analyzed. Thirty-two (59.3%) procedures were performed before the histological diagnosis. In 25 (46.3%) procedures, smears showed many neoplastic single cells, clusters, and abundant lymphoid cells (mixed pattern). A dissociated (single cell) pattern consisting of individual neoplastic and lymphoid cells was seen in 18 (33.3%) cases. Finally, 11 (20.4%) cases showed cohesive epithelial clusters (cohesive pattern) without relevant cellular dissociation or lymphoid cells. Squamous-cell differentiation was seen in three of these cases. Most single neoplastic cells presented as large, pleomorphic naked nuclei. Other interesting findings were granulomas (n = 3), prominent eosinophilic infiltrates (n = 4), and suppurative changes (n = 5). In most smears with mixed and dissociated patterns, a nasopharyngeal origin could be suggested. On the contrary, those smears with a cohesive pattern were indistinguishable from other head and neck carcinomas. The presence (on cervical lymph nodes) of a dissociated or mixed (single cells and groups) architectural pattern of large, anaplastic cells and naked nuclei accompanied by an abundant lymphoid component is highly suggestive of undifferentiated NPC. Cytology offers a rapid diagnosis, establishes the necessity of a complete cavum examination, and helps in avoiding unnecessary and harmful biopsies. Diagn. Cytopathol. 2005;32:233,237. © 2005 Wiley-Liss, Inc. [source] Isolated granulocytic sarcoma involving the mediastinum and bilateral cervical lymph nodesEUROPEAN JOURNAL OF HAEMATOLOGY, Issue 6 2007Vassilios Vassiliou No abstract is available for this article. [source] Predictive index for carcinoma of thyroid nodules and its integration with fine-needle aspiration cytology,HEAD & NECK: JOURNAL FOR THE SCIENCES & SPECIALTIES OF THE HEAD AND NECK, Issue 7 2009Bekir Kuru MD Abstract Background The objective of this study was to select patients for resection of thyroid malignity among patients with thyroid nodules by integration of predictive indices with fine-needle aspiration cytology (FNAC). Methods Characteristics of 571 euthyroid patients with thyroid nodules who underwent surgery in our institution were prospectively recorded. Predictive factors for malignancy were identified and categorized as predictive indices that were integrated with FNAC to select patients for surgery. Results Eighty-three (14.5%) of the 571 patients had thyroid carcinoma. Size ,4 cm, age ,65, cervical lymph nodes, solid structure, hypoechogenicity, microcalcification, and elevated serum thyroglobulin levels were independent predictive factors associated with thyroid malignancy. Sensitivity, specificity, and accuracy of FNAC were 88%, 80%, and 81%, respectively, and were 100% for index 3. Conclusions Patients with malignant and suspicious FNAC findings and, among patients with follicular neoplasm and nondiagnostic FNAC findings, those with ,2 risk factors should undergo surgery. © 2009 Wiley Periodicals, Inc. Head Neck, 2009 [source] Marginal mandibular nerve injury during neck dissection and its impact on patient perception of appearanceHEAD & NECK: JOURNAL FOR THE SCIENCES & SPECIALTIES OF THE HEAD AND NECK, Issue 5 2009FRACDS(OMS), FRCS(OMFS), Martin D. Batstone MPhil(Surg) Abstract Background. Neck dissection to remove cervical lymph nodes is common practice in head and neck cancer management. The marginal mandibular nerve may be injured during neck dissection, particularly of level 1. The rate of injury to this nerve is underreported in the literature and its impact on patients is not well defined. Methods. An observational study was undertaken on patients who had undergone neck dissection over a 5-year period. The patients were examined for weakness and given a questionnaire related their perception of their appearance and their function. Results. Sixty-six patients were identified who had undergone 85 neck dissections. The rate of House Brackmann injury was 18% when analyzed by patient and 23% by neck. There were moderate correlations between observed injury and subjective responses to questions relating to ability to smile and weakness of the lower lip. Discussion. The rate of smile asymmetry following neck dissection is relatively high; however, severe injuries to the marginal mandibular nerve are uncommon. © 2009 Wiley Periodicals, Inc. Head Neck, 2009 [source] Cutaneous head and neck squamous cell carcinoma metastatic to parotid and cervical lymph nodesHEAD & NECK: JOURNAL FOR THE SCIENCES & SPECIALTIES OF THE HEAD AND NECK, Issue 7 2007FRANZCR, Michael J. Veness MMed (Clin Epi) Abstract Nonmelanoma skin cancers occur at an epidemic rate in Australia and are increasing in incidence worldwide. In most patients, local treatment is curative. However, a subset of patients will be diagnosed with a high-risk cutaneous squamous cell carcinoma (SCC) and are defined as patients at increased risk of developing metastases to regional lymph nodes. Patients with high-risk SCC may be identified based on primary lesion and patient factors. Most cutaneous SCC arises on the sun-exposed head and neck. The parotid and upper cervical nodes are common sites for the development of metastases arising from ear, anterior scalp, temple/forehead, or scalp SCC. The mortality and morbidity associated with high-risk cutaneous SCC is usually a consequence of uncontrolled metastatic nodal disease and, to a lesser extent, distant metastases. Patients with operable nodal disease have traditionally been recommended for surgery. The efficacy of adjuvant radiotherapy has previously been questioned based on weak evidence in the early literature. Recent evidence from larger studies has, however, strengthened the case for adjuvant radiotherapy as a means to improve locoregional control and survival. Despite this, many patients still experience relapse and die. Research aimed at improving outcome such as a randomized trial incorporating the addition of chemotherapy to adjuvant radiotherapy is currently in progress in Australia and New Zealand. Ongoing research also includes the development of a proposed new staging system and investigating the role of molecular factors such as the epidermal growth factor receptor. © 2007 Wiley Periodicals, Inc. Head Neck, 2007 [source] Retropharyngeal node metastasis from papillary thyroid carcinomaHEAD & NECK: JOURNAL FOR THE SCIENCES & SPECIALTIES OF THE HEAD AND NECK, Issue 5 2007Naoki Otsuki MD Abstract Background. Papillary thyroid carcinomas commonly metastasize to paratracheal and jugular lymph nodes. Metastasis to the retropharyngeal node is rare for this tumor. Methods. Five patients underwent surgical treatment for metastasis of thyroid papillary carcinoma to the retropharyngeal lymph nodes that presented as a parapharyngeal or retropharyngeal mass. All patients had a history of total or subtotal thyroidectomy as their initial treatment. Among them, 3 patients had undergone ipsilateral modified radical neck dissection at their initial treatment. The other 2 patients had a history of bilateral or ipsilateral modified neck dissection for their subsequent cervical lymph node metastases. Results. Metastatic retropharyngeal nodes were successfully resected via transcervical approach in all patients. Although aspiration and difficulty in swallowing were observed in 2 patients after surgical treatment for metastatic retropharyngeal nodes, these complications spontaneously resolved within a few months. Conclusions. This study suggests that neck dissection and/or metastatic cervical lymph nodes might alter the direction of lymphatic drainage to the retrograde fashion, resulting in the unusual metastasis to the retropharyngeal lymph nodes. Although the cases described here are rare, metastasis to the retropharyngeal node should be considered at the follow-up for thyroid papillary carcinoma. Because these metastases will be missed by routine ultrasonography of the neck, periodic CT scan or MRI is recommended for follow-up, especially for patients with a history of neck dissection. © 2006 Wiley Periodicals, Inc. Head Neck, 2007 [source] Importance of molecular analysis in detecting cervical lymph node metastasis in head and neck squamous cell carcinomaHEAD & NECK: JOURNAL FOR THE SCIENCES & SPECIALTIES OF THE HEAD AND NECK, Issue 9 2006Mohamed N. Elsheikh MD Abstract Background. Because of the impact of nodal status on treatment and survival in squamous cell carcinoma of the head and neck, accurate staging of cervical lymph nodes is critical. This article explores the value of molecular analyses in the detection of cervical lymph node metastasis. Methods. A review of the literature was carried out and combined with our own experience regarding the role of molecular analyses in detecting cervical lymph node metastasis. Results. Few studies have demonstrated the diagnostic and prognostic relevance of molecular analysis in detecting tumor cells in lymph nodes. Nodal staging was improved by the use of molecular techniques; when compared with histopathologic examination, however, the small sample size of these studies did not allow definitive conclusions. Conclusions. Molecular analysis is exquisitely sensitive in detecting very small cancer deposits within lymph nodes. It provides an oncologic basis that may be used to guide therapy and influence outcomes. It should be recommended for diagnostic use in controlled studies of patients without evidence of lymph node metastasis on routine hematoxylin,eosin,stained sections. The clinical significance of these types of metastases, however, must be determined with carefully designed and controlled prospective clinical trials. © 2006 Wiley Periodicals, Inc. Head Neck, 2006 [source] Nm23-H1 expression of metastatic tumors in the lymph nodes is a prognostic indicator of oral squamous cell carcinomaINTERNATIONAL JOURNAL OF CANCER, Issue 2 2008Yi-Fen Wang Abstract We recently reported that low Nm23-H1 expression of primary oral squamous cell carcinoma (OSCC) was correlated with the occurrence of lymphatic metastasis. However, little is known about whether Nm23-H1 level of metastatic tumors in the cervical lymph nodes is reduced in comparison with primary oral cancers and its significance for patients' prognosis. By immunohistochemistry, we analyzed the Nm23-H1 expression in 52 pairs of OSCC specimens from primary oral cancers and their metastatic lymph nodes. Western blot analysis further confirmed the immunohistochemical interpretation. To verify the effects of Nm23-H1 on cell migration and invasion, we established several stable clones derived from a human OSCC cell line (SAS) by knockdown and overexpression. Wound-healing closure, transwell migration and invasion assays were performed to determine cell motility, migratory and invasive activities. Western blot analysis was carried out to evaluate cyclin A expression of OSCC cells with the altered Nm23-H1 levels following knockdown and overexpression. By immunohistochemistry, Nm23-H1 expression of metastatic lymph nodes was significantly lower than that of their primary oral cancers, supporting a role of Nm23-H1 in metastasis suppression. Negative Nm23-H1 interpretation of OSCC specimens, in either primary oral cancers or metastatic lymph nodes, indicated a poor survival outcome of patients. On the basis of in vitro studies of Nm23-H1 knockdown and overexpression, we demonstrated an inverse correlation between Nm23-H1 expression and the invasiveness of OSCC cells. Moreover, we observed the concomitant reduction in Nm23-H1 and cyclin A levels of metastatic tumors in both results of in vitro OSCC cells and ex vivo tumor specimens. © 2007 Wiley-Liss, Inc. [source] Mycobacterium tuberculosis infection of bilateral cervical lymph nodes after renal transplantationINTERNATIONAL JOURNAL OF UROLOGY, Issue 11 2001Kiyohito Ishikawa Abstract We report the case of a 52-year-old man who underwent a renal transplantation and subsequently developed extrapulmonary tuberculosis. The immunosuppressive agent was intravenously administered continuously together with antituberculosis drugs. The tuberculosis improved and renal function has been well preserved for more than 3 years post transplantation. [source] Cystic appearance of cervical lymph nodes is characteristic of metastatic papillary thyroid carcinomaJOURNAL OF CLINICAL ULTRASOUND, Issue 1 2003Ada Kessler MD Abstract Purpose The usefulness of high-resolution sonography in diagnosing cervical lymph node metastases from papillary thyroid carcinoma was investigated. The accuracy of a particular sign, cystic change within a node, in establishing the diagnosis was assessed. Methods The sonographic findings in 63 patients with enlarged cervical lymph nodes were retrospectively reviewed. The patients had undergone high-resolution gray-scale and color Doppler sonography followed by ultrasound-guided fine-needle aspiration (FNA) in all patients and surgical excision in 27 patients. Results Abnormal sonographic features were present in the lymph nodes of all 63 patients. In 14 (70%) of 20 patients with papillary thyroid carcinoma, sonography depicted cystic changes. This pattern was not found in any of the other 43 patients, in whom FNA revealed either metastasis from another malignancy (22 patients) or benign reactive lymphadenopathy (21 patients). Among the 63 patients, there were 43 true-negative, 14 true-positive, 6 false-negative, and no false-positive results in the diagnosis of metastatic papillary thyroid carcinoma using the presence or absence of an intranodal cystic area on sonography. These results yielded a 70% sensitivity, 100% specificity, 100% positive predictive value, 88% negative predictive value, and 90% overall accuracy for this criterion. Conclusions Cystic changes within a cervical lymph node are highly suggestive of metastatic papillary thyroid carcinoma. © 2002 Wiley Periodicals, Inc. J Clin Ultrasound 31:21,25, 2003 [source] Cutaneous Rosai-Dorfman DiseaseJOURNAL OF CUTANEOUS PATHOLOGY, Issue 1 2005L. Lin Rosai-Dorfman disease, or sinus histiocytosis with massive lymphadenopathy (SHML), is a rare benign disease of unknown etiology that involves the cervical lymph nodes. Histologic findings include emperiopolesis of lymphocytes and S-100 protein positivity. Extranodal involvement occurs in 30,40% of cases, often involving skin. However, cutaneous Rosai-Dorfman disease without lymph node involvement is uncommon. We describe a case of cutaneous Rosai-Dorfman disease and discuss its clinical and histopathologic findings. A 69-year-old Caucasian male presented with a two-year history of a slowly enlarging violaceous mass on the mid-upper abdomen. He had a history of renal cell carcinoma two-year ago and was asymptomatic without any systemic symptoms. Physical examination revealed a large, violaceous mass of mid-upper abdomen with several violaceous nodules surrounding the periphery. There was no palpable lymphadenopathy. Punch biopsy showed diffuse dermal infiltrates composed of central xanthomatous cells surrounded by lymphoplasmacytic cells. Focal germinal center was noted. Immunostaining revealed strong S-100 and CD68 reactivity of central xanthomatous cells and kappa and lambda polyclonal lymphoplasmacytic cells. Special stains for infectious disorder were negative. Cutaneous Rosai-Dorfman disease is a benign reactive process, often under-recognized due to lack of systemic symptoms and lymphadenopathy. A high index of diagnostic awareness is required for its recognition. [source] Expression of vascular endothelial growth factor-C correlates with the lymphatic microvessel density and the nodal status in oral squamous cell cancerJOURNAL OF ORAL PATHOLOGY & MEDICINE, Issue 8 2003Roland Sedivy Abstract Background:, The cause of preferential metastatic spreading to cervical lymph nodes in oral squamous cell cancer (SCC) is not quite clear. As the density of microvessels may influence the metastatic behaviour, we were interested in how the density of blood/lymphatic microvessels are related to primary SCC and the clinical course of the disease. Methods:, Lymphatic and blood microvessels of 28 patients with oral SCC were identified immunohistochemically by antibodies against podoplanin and CD34, respectively. Lymphatic microvessel density (LVD) and blood microvessel density (MVD), and the expression of VEGF-C were determined. These findings were compared with the long-term clinicopathological data of the patients. Results:, LVD and MVD were significantly higher than in control tissues. The amount of lymphatic microvessels correlated positively with the expression of VEGF-C, the tumour grade, the nodal status and with later appearing metastasis. The latter three parameters, however, did not influence the clinical course of the disease. Conclusions:, VEGF-C expression in oral SCC triggers lymphatic angiogenesis, which may result in a higher risk for cervical lymph node metastasis. The angiogenetic effect of VEGF-C may also favour the onset of late lymphatic and haematogenous metastases. [source] Detection of chimerism following vascularized bone allotransplantation by polymerase chain reaction using a Y-chromosome specific primerJOURNAL OF ORTHOPAEDIC RESEARCH, Issue 6 2003Keiichi Muramatsu Abstract Chimerism following allogeneic organ transplantation is a phenomenon known to occur and be associated with development of immunologic tolerance in allotransplantation. However, little is known about graft cell migration following vascularized bone allografting. In this study, chimerism was assessed following vascularized tibia transplantation from male DA or PVG donors to female PVG rat recipients using a semi-quantitative polymerase chain reaction for the Y-chromosome. FK-506 (Tacrolimus) was administered after transplantation for immunosuppression. All immunosuppresssed PVG rat recipients of PVG bone grafts showed a high level of chimerism (1%) in the thymus, spleen, liver and cervical lymph nodes at 18 weeks post-transplant. Donor cells were also detected in the contralateral tibia and humerus. In non-immunosuppressed PVG rat recipients of DA bone grafts, donor cells were detected in the spleen in three of five rats within 2 weeks post-transplant. In these animals the bone grafts were severely rejected. In immunosuppressed PVG rat recipients of DA bone grafts, two of five, four of eight and eight of 10 rats showed low level chimerism (0.1%) in peripheral blood at 1, 12, and 18 weeks post-transplant. Six rats showed a high level of chimerism in the spleen and thymus. Histological studies revealed no rejection findings through 18 weeks post-transplant. Our results indicate that chimerism, or the presence of graft cells in host tissue, may occur in the face of acute rejection and be demonstrable following vascularized isograft and allograft living bone transplantation when chronic immunosuppression is maintained. Graft vascular patency during the short-term likely allows cellular migration, even in the face of acute rejection. Long-term survival and proliferation of graft marrow elements in host tissue may be possible with adequate immunosuppression. © 2003 Orthopaedic Research Society. Published by Elsevier Science Ltd. All rights reserved. [source] Targeting the allergen to oral dendritic cells with mucoadhesive chitosan particles enhances tolerance inductionALLERGY, Issue 7 2009N. Saint-Lu Background:, Sublingual immunotherapy (SLIT) efficacy could be improved by formulations facilitating allergen contact with the oral mucosa and uptake by antigen-presenting cells (APCs). Methods:, Two types of chitosan microparticles, differing in size and surface charge, were tested in vitro for their capacity to improve antigen uptake and presentation by murine bone marrow-derived dendritic cells (BMDCs) or purified oral APCs. T-cell priming in cervical lymph nodes (LNs) was assessed by intravenous transfer of carboxyfluorescein diacetate succinimidyl ester-labelled ovalbumin (OVA)-specific CD4+ T cells and flow cytometry analysis. Ovalbumin-sensitized BALB/c mice were treated sublingually with soluble or chitosan-formulated OVA twice a week for 2 months. Airway hyperresponsiveness (AHR), lung inflammation and T-cell responses in cervical and mediastinal LNs were assessed by whole-body plethysmography, lung histology and Cytometric Bead Array technology, respectively. Results:, Only a mucoadhesive (i.e. highly positively charged) and microparticulate form of chitosan enhances OVA uptake, processing and presentation by murine BMDCs and oral APCs. Targeting OVA to dendritic cells with this formulation increases specific T-cell proliferation and IFN-,/IL-10 secretion in vitro, as well as T-cell priming in cervical LNs in vivo. Sublingual administration of such chitosan-formulated OVA particles enhances tolerance induction in mice with established asthma, with a dramatic reduction of both AHR, lung inflammation, eosinophil numbers in bronchoalveolar lavages, as well as antigen-specific Th2 responses in mediastinal LNs. Conclusions:, Mucoadhesive chitosan microparticles represent a valid formulation for sublingual allergy vaccines. [source] Oral immunization with Porphyromonas gingivalis outer membrane protein and CpG oligodeoxynucleotides elicits T helper 1 and 2 cytokines for enhanced protective immunityMOLECULAR ORAL MICROBIOLOGY, Issue 3 2010C. Liu Summary The aim of this study was to evaluate the efficacy of an oral vaccine containing the 40-kDa outer membrane protein of Porphyromonas gingivalis (40K-OMP) and synthetic oligodeoxynucleotides containing unmethylated CpG dinucleotides (CpG ODN) to control oral infection by P. gingivalis. Oral immunization with 40K-OMP plus CpG ODN induced significant 40K-OMP-specific serum immunoglobulin G (IgG), IgA, and saliva IgA antibody responses. The 40K-OMP-specific CD4+ T cells induced by oral 40K-OMP plus CpG ODN produced both T helper type 1 (Th1; interferon-,) and Th2 (interleukin-4) cytokines. Furthermore, increased frequencies of CD11c+ B220+ dendritic cells (DCs) and CD11c+ CD11b+ DCs with upregulated expression of CD80, CD86, CD40, and major histocompatibility complex class II molecules were noted in spleen, Peyer's patches, and cervical lymph nodes. Immunized mice were then infected orally with P. gingivalis to determine whether the immune responses induced by oral 40K-OMP plus CpG ODN were capable of suppressing the bone resorption caused by P. gingivalis infection. Mice given 40K-OMP plus CpG ODN showed significantly reduced bone loss associated with oral infection by P. gingivalis. Oral administration of 40K-OMP together with CpG ODN induces Th1-type and Th2-type cells, which provide help for protective immunity against P. gingivalis infection. This may be an important tool for the prevention of chronic periodontitis. [source] Dynamics of Mast Cells in Lymph Node Following Antigenic StimulationANATOMIA, HISTOLOGIA, EMBRYOLOGIA, Issue 1 2004D. O. Dabak Summary Dynamics of mast cells in rat cervical lymph nodes were examined using conventional histological techniques after injection of Salmonella paratyphi B-H antigen. There was no significant change in the number of mast cells at sixth hour and on the first day of stimulation compared with the controls. The number of mast cells was increased in all lymph node compartments on the second day of stimulation, which continued in the following 3 days. On the eighth day of stimulation, although the mast cell number decreased in the subcapsular area, it was still high in the paracortical area and medullary sinuses of the lymph nodes. On the second day of stimulation, the mast cell number was apparently increased in the subcapsular area than those of the other compartments. In the following days of stimulation, the highest number of mast cells was seen in the medullary sinuses. The highest paracortical mast cell number was determined on the third day of stimulation and some mast cells were observed near the high endothelial venules (HEVs). The changes of mast cell number among the lymph node compartments after antigenic stimulation support the hypothesis that the migration of mast cells occurred. This migration pattern indicates that mast cells enter the lymph node via afferent lymphatics and migrate to the lymph node compartments following antigenic stimulation. [source] Managing suspicious cervical lymph nodes after thyroidectomy: the utility of hook-wire needle localizationANZ JOURNAL OF SURGERY, Issue 4 2010BMedSc, PGDipSurgAnat, Warren Matthew Rozen MB BS No abstract is available for this article. [source] Pure versus follicular variant of papillary thyroid carcinomaCANCER, Issue 5 2003Clinical features, prognostic factors, survival, treatment Abstract BACKGROUND The follicular variant of papillary thyroid carcinoma (FVPTC) is a common subtype of papillary thyroid carcinoma. Few studies have compared the clinical behavior and treatment outcome of patients with FVPTC with the outcome of patients with pure papillary carcinoma (PTC). A retrospective study was performed to identify the influence of FVPTC compared with PTC on therapeutic variables, prognostic variables, and survival. METHODS A clinicopathologic analysis of 243 patients with papillary carcinoma was performed. One hundred forty-three tumors were PTC, and 100 tumors were FVPTC. The following variables were evaluated: age at diagnosis, tumor size, stage of tumor, treatment, capsular invasion, and survival. RESULTS The median follow-up was 11.5 years. The median age was 43 years in the PTC group and 44 years in the FVPTC group. The median tumor size, disease stage, and type of initial surgery and iodine 131 ablation were similar. More patients had capsular invasion by the tumor and less metastases to cervical lymph nodes in the FVPTC group. The actuarial survival of patients age < 40 years was higher compared with the survival of patients age > 50 years in both groups. The 21-year overall actuarial survival was 82% in patients with PTC and 86% in patients with FVPTC (P value not significant). CONCLUSIONS The pathologic and clinical behaviors of PTC and FVPTC were comparable. Prognostic factors, treatment, and survival also were similar. Patients in both groups must be treated identically. Cancer 2003;97:1181,5. © 2003 American Cancer Society. DOI 10.1002/cncr.11175 [source] Non-invasive imaging of mouse hepatitis coronavirus infection reveals determinants of viral replication and spread in vivoCELLULAR MICROBIOLOGY, Issue 5 2009Matthijs Raaben Summary Bioluminescence imaging (BLI) is a powerful new method to study virus dissemination in the live animal. Here we used this method to monitor the spatial and temporal progression of mouse hepatitis coronavirus (MHV) infection in mice using luciferase-expressing viruses. Upon intranasal inoculation, virus replication could initially be observed in the nasal cavity and the cervical lymph nodes, after which the infection spread to the brain and frequently to the eyes. The kinetics of virus spread to and clearance from the brain appeared to depend on the inoculation dose. After intraperitoneal inoculation, virus replication was predominantly observed in the liver and occasionally in the intestines, but interestingly also in the tail and paws. BLI thus elucidated new anatomic locations of virus replication. Furthermore, MHV dissemination was shown to be critically depended on the viral spike protein, but also on the mouse strain used. Widespread dissemination was observed in mice lacking a functional type I interferon response. The importance of the type I interferon system in limiting viral spread was also demonstrated by the administration of type I interferons to mice. Our results provide new insights in coronavirus pathogenesis and demonstrate the potential of BLI to study coronavirus,host interactions in vivo. [source] 3462: Epithelial tumours of the lacrimal glandACTA OPHTHALMOLOGICA, Issue 2010SE COUPLAND Purpose To provide an overview of benign and malignant epithelial neoplasms arising in the lacrimal gland. Methods In the normal orbit, the lacrimal gland is clinically impalpable and is situated in the lacrimal fossa posterior to the superotemporal orbital rim. The gland is not truly encapsulated and is divided into the deep orbital and the superficial palpebral lobes by the levator aponeurosis. The retrospective study of 265 epithelial tumours of the lac¬rimal gland conducted by the Armed Forces Institute of Pa¬thology (AFIP) improved our understanding of the histologic classification and clinical behavior of epithelial tumours of the lacrimal gland. The historic works of Forrest (1954) and Zimmerman (1962) alleviated confu¬sion by applying to epithelial tumours of the lacrimal gland the histopathologic classification of salivary gland tumours. Epithelial tumours originating from the lacrimal gland should be staged according to the 7th Edition of the Tumor Node Metastasis (TNM) system, which is a modification of the World Health Organization (WHO) classification of salivary gland tumours. Results The most common benign epithelial tumour of the lacrimal gland is the pleomorphic adenoma. The most common lacrimal gland carcinomas include adenoid cystic carcinoma, "carcinoma ex pleomorphic adenoma", primary adenocarcinoma & mucoepidermoid carcinoma. The regional lymph nodes include: preauricular, submandibular and cervical lymph nodes. The lung is the most common metastatic site, followed by bone and remote viscera. Conclusion Subtyping & grading of lacrimal gland epithelial tumours requires the latest WHO/AFIP classifications. Staging of these tumours should follow the 7th TNM system. Collection of datapoints is essential to identify biomarkers, which includes only nuclear N23 and MIB-1 at present. [source] | ||||||||||||||||||||||||||||||||||