• Title/Summary/Keyword: Cervical lymph node

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The Clinical Implication of Human Papilloma Virus, p53 and Proliferating Cell Nuclear Antigen Expression in Head and Neck Squamous Cell Carcinoma (두경부 편평세포암종에서 인유두종 바이러스와 p53과 Proliferating Cell Nuclear Antigen 발현의 임상적 의의)

  • 김종수;김민식;박경호;선동일;박동선;조승호
    • Korean Journal of Bronchoesophagology
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    • v.7 no.2
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    • pp.152-160
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    • 2001
  • The presence of HPV DNA and the expression of p53 protein and proliferating cell nuclear antigen(PCNA) in head and neck squamous cell carcinoma were determined to evaluate the relationship of these factors and their association with their pathologic stages and cervical lymph node metastasis. Among 65 patients the presence of HPV DNA was found in 12 cases(18.5%), p53 was found positive in 32 cases(49.2%) and expression of PCNA was observed in 24 cases(36.9%). The expression of PCNA was more frequent in the HPV positive cancers compared with the HPV negative ones(p =0.0018), and p53 revealed its higher rate of cooccurrence with the expression of PCNA(p =0.008), which might suggest that PCNA expression has a positive relationship with HPV and p53 mutation in head and neck cancer. There might be inverse relationship between HPV and p53 mutation(p =0.063), but 3 cases showed both HPV DNA positivity and p53 expression. HPV was detected at a higher rate in the early pathologic stages than in the advanced stages of cancer, and p53 expression was more frequently found in the advanced stages(p =0.044). These results suggests that HPV and p53 mutation might have different etiologic roles in the development of head and neck cancer, or cases with p53 mutation might have more aggressive behavior. PCNA expression showed no difference between early and late stages of cancer, and between cases with and without cervical lymph node metastasis.

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Is Surgical Staging Necessary for Patients with Low-risk Endometrial Cancer? A Retrospective Clinical Analysis

  • Kokcu, Arif;Kurtoglu, Emel;Celik, Handan;Kefeli, Mehmet;Tosun, Migraci;Onal, Mesut
    • Asian Pacific Journal of Cancer Prevention
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    • v.16 no.13
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    • pp.5331-5335
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    • 2015
  • Purpose: The aim of this study was to compare the tumor-free and overall survival rates between patients with low-risk endometrial cancer who underwent surgical staging and those who did not undergo surgical staging. Materials and Methods: Data, including demographic characteristics, grade of the tumor, myometrial invasion, cervical involvement, peritoneal washing, lymph node involvement, lymphovascular space invasion, postoperative complication, adjuvant treatment, cancer recurrence, and tumor-free and overall survival rates, for patients with low-risk endometrioid endometrial cancer who were treated surgically with and without pelvic and paraaortic lymph node dissection (LND) were analyzed retrospectively. The patients diagnosed with endometrioid endometrial cancer including the following criteria were considered low-risk: 1) a grade 1 (G1) or grade 2 (G2) endometrioid histology; 2) myometrial invasion of <50% upon magnetic resonance imaging (MRI); 3) no stromal glandular or stromal invasion upon MRI; and 4) no evidence of intra-abdominal metastasis. Then the patients at low-risk were divided into two groups; group 1 (n=117): patients treated surgically with pelvic and paraaortic LND and group 2 (n=170): patients treated surgically without pelvic and paraaortic LND. Results: There was no statistical significance when the groups were compared in terms of lymphovascular space invasion, cervical involvement, positive cytology, and recurrence, whereas the administration of an adjuvant therapy was higher in group 2 (p<0.005). The number of patients with positive pelvic nodes and the number of metastatic pelvic nodes were significantly higher in the group with positive LVI than in the group without LVI (p<0.005). No statistically significant differences were detected between the groups in terms of tumor-free survival (p=0.981) and overall survival (p=0.166). Conclusions: Total hysterectomy with bilateral salpingo-oophorectomy and stage-adapted postoperative adjuvant therapy without pelvic and/or paraaortic lymphadenectomy may be safe and efficient treatments for low-risk endometrial cancer.

Presence of Anemia and Poor Prognostic Factors in Patients with Endometrial Carcinoma

  • Wilairat, Wanitchar;Benjapibal, Mongkol
    • Asian Pacific Journal of Cancer Prevention
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    • v.13 no.7
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    • pp.3187-3190
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    • 2012
  • This study evaluated the relationship between pretreatment hemoglobin (Hb) and prognostic factors in Thai patients with endometrial cancer. Medical records of 228 patients who had undergone surgery between January 2005 and December 2007 were retrospectively reviewed. Associations between clinicopathological variables and pretreatment Hb levels were described using Pearson's chi square test or two-tailed Fisher's exact test. Survival analysis was performed with Kaplan-Meier estimates. Univariate and Cox-regression models were used to evaluate the prognostic impact of various factors, including Hb levels, in term of disease-free survival. The median duration of follow-up was 38.2 months. Eighty-nine patients (39%) had a preoperative Hb level of <12 g/dL, these having significantly higher rates of non-endometrioid histology, advanced FIGO stage, lymphovascular space invasion, cervical involvement, adnexal involvement, positive peritoneal cytology, and lymph node involvement than patients with Hb ${\geq}12$ g/dL. The 5-year disease-free and overall survival were significantly lower in patients with pretreatment Hb levels <12 g/dL compared with those with Hb ${\geq}12$ g/dL (79.3% vs. 89.2%, p=0.044 and 87.6% vs. 99.3%, p<0.001, respectively). In the multivariate analysis only histology, myometrial invasion, and lymphovascular invasion proved to be independent prognostic factors, whereas tumor grading, stage, cervical involvement, adnexal involvement, positive peritoneal cytology, lymph node involvement, and low Hb were not. In conclusion, presence of anemia before treatment may reflect poor prognostic factors in patients with endometrial cancer and low pretreatment hemoglobin level may have a prognostic impact on clinical outcome.

Expression of Ki67 in Papillary Thyroid Microcarcinoma and its Clinical Significance

  • Zhou, Yuan;Jiang, Hong-Gang;Lu, Ning;Lu, Bo-Hao;Chen, Zhi-Heng
    • Asian Pacific Journal of Cancer Prevention
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    • v.16 no.4
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    • pp.1605-1608
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    • 2015
  • Purpose: To investigate the expression of Ki67 protein in papillary thyroid microcarcinoma(PTMC), and to analyze its clinical significance. Materials and Methods: Ki67 protein expression was evaluated in the tissues of 108 human PTMC and 50 other benign papillary hyperplasia of thyroid specimens using immunohistochemistry. Results: The expression intensity of Ki67 in PTMC and benign papillary hyperplasia of thyroid specimens were $1.45{\pm}1.83%$ and $0.46{\pm}0.46%$.The positive expression rates were 46.3% and 14%. There were significant differences between these two groups (p<0.01). There was no significant variation of the expression intensity and positive expression rates of Ki67 in PTMC with gender, age, position of the tumor and the level of TSH pre-operation (p>0.05), but these parameters varied with tumor size, invasion by membrane and cervical lymph node metastasis (p<0.05 or p<0.01). Conclusions: The expression of Ki67 in PTMC was related to tumor size, invasion by membrane and cervical lymph node metastasis, and could be the important indicator for judging clinical progress and estimating prognosis.

Failure patterns of cervical lymph nodes in metastases of unknown origin according to target volume

  • Kim, Dong-Yun;Heo, Dae Seog;Keam, Bhumsuk;Ock, Chan Young;Ahn, Soon Hyun;Kim, Ji-hoon;Jung, Kyeong Cheon;Kim, Jin Ho;Wu, Hong-Gyun
    • Radiation Oncology Journal
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    • v.38 no.1
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    • pp.18-25
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    • 2020
  • Purpose: This study was aim to evaluate the patterns of failure according to radiotherapy (RT) target volume for cervical lymph nodes in metastases of unknown primary origin in head and neck region (HNMUO). Materials and Methods: Sixty-two patients with HNMUO between 1998 and 2016 were retrospectively reviewed. We analyzed the clinical outcomes and primary site failure depending on the radiation target volume. The target volume was classified according to whether the potential head and neck mucosal sites were included and whether the neck node was treated involved side only or bilaterally. Results: Potential mucosal site RT (mucosal RT) was done to 23 patients and 39 patients did not receive mucosal RT. Mucosal RT showed no significant effect on overall survival (OS) and locoregional recurrence (LRR). The location of primary site failure encountered during follow-up period was found to be unpredictable and 75% of patients with recurrence received successful salvage therapies. No significant differences in OS and LRR were found between patients treated to unilateral (n = 35) and bilateral neck irradiation (n = 21). Treatment of both necks resulted in significantly higher mucositis. Conclusions: We found no advantages in OS and LRR of patients with HNMUO when mucosal sites and bilateral neck node were included in the radiation target volume.

Brachiocephalic Venous Aneurysm Mimicking Metastatic Cervical Lymphadenopathy in a Patient with Gastric Cancer: A Case Report (위암 환자에서 경부 전이성 림프절로 오인될 수 있는 팔머리정맥류: 증례 보고)

  • Min Jung Ryu;Jae-Kwang Lim;Hoseok Lee
    • Journal of the Korean Society of Radiology
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    • v.81 no.4
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    • pp.933-938
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    • 2020
  • Brachiocephalic venous aneurysm (BVA) development is an extremely rare, particularly as a primary vascular disorder. BVAs may be misinterpreted as lymphadenopathies owing to the variable degrees of enhancement seen in imaging studies, especially among patients with underlying malignancy. We report a BVA that mimicked lymph node metastasis on CT in a 60-year-old female who had undergone subtotal gastrectomy for stomach cancer. After follow-up chest CT with different bolus times and Doppler ultrasonography, a venous aneurysm originating from the brachiocephalic vein was diagnosed. We emphasize that, to make an accurate diagnosis, physicians should be aware of the potential diagnostic pitfalls and have a high index of suspicion for BVA when encountering certain lesions in the cervical area.

Multicentric Primary Tumor of the Esophagus (다발성 원발성 식도종양 1례 보)

  • Lee, Jae-Won;Gang, Jeong-Ho;Ji, Haeng-Ok
    • Journal of Chest Surgery
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    • v.20 no.2
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    • pp.348-352
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    • 1987
  • A 51 year-old male was admitted with the chief complaints of swallowing difficulty and pain on neck and upper chest for 2 months prior to admission: He was taken biopsy under esophagoscopy, and the result was squamous cell carcinoma. Preoperatively we studied the esophagogram and chest CT. On these, we found the main appreciable mass at midesophagus easily. But, we missed the upper cervical unexpected mass. So we performed the esophagectomy and lymph node dissection from upper clavicle level to the esophagogastric junction by thoracic approach as wide as possible, and cervical esophagostomy and feeding gastrostomy also. At that evening we reviewed the studied films in detail, and we found another mass lesion at C4-C6 level of cervical esophagus. We performed the 2nd operation e.g. cervical esophagectomy on next morning without hesitation. Between these two masses, there was almostly normally looking skip area grossly. The squamous cell carcinoma of the esophagus could be multicentric in character and may have skip area. But, we heard little reports until now. The two masses could be different in origin or be same probably by submucosal spreading. Anyway, it was an alarming case to the surgeon not to neglect the another possible lesions in squamous cell type. Postoperative course was uneventful, he took G-tube feeding with no problems on 7th postoperative day. Now he took the postoperative irradiation at out patient department.

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Clinical Characteristics of Subacute Necrotizing Lymphadenitis in Pediatrics (소아에서의 아급성 괴사성 림프절염의 임상적 고찰)

  • Kim, Hee-Kyu
    • Korean Journal of Bronchoesophagology
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    • v.6 no.1
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    • pp.21-28
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    • 2000
  • Background:Subacute necrotizing lymphadenitis or Kikuchi's disease is unknown ethiology and self-limiting process. This disease predominantly affects young women age but rarely affects pediatrics, and usually manifests as lymphadenopathy and fever. Even though this disease is self-limited, benign process, many cases are misidentified as malignant lymphoma. The purpose of this study is to report the clinicopathologic finding, radiological finding and many labolatory test and to compare with characteristics of adult patients in this disease. Meterial and Methods:We reviewed 27 pediarics patients with subacute necrotizing lymphadenitis by excision biopsy or fineneedle aspiration cytology.Result:The most common symptomes were palpation of cervical lymh node(88.9%) and fever(66.7%). The common site of the involvement was cervical lymph node. The multiple involvement was 93% and bilateral involvement was 59%. Leukopenia(52%) and elevated erythrocyte sedimentation rates(93%) appeared in abnormal laboratory data. Microscopically, the characteristic finding was the wide area of florid nuclear dusts engulfed by histiocytes and well-circumscrbed area with eosinophilic fibrinoid material. There was a striking degree ofkaryorrhexis and an absence of granulocyte with paucity of plasma cell. All patients recovered with the conservative treatment and there was no specific complication and recurrence. Conclusion : We reviewed pediatric patients with this disease. Characteristics of this disease inpediatric patients were similar to adult patients.

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Ectopic Thymus Presenting as a Submandibular Neck Mass (경부 종물로 발현된 이소성 흉선 1예)

  • Hwang Won-Hyo;Park Jung-Je;Jeon Sea-Yuong;Kim Jin-Pyeong
    • Korean Journal of Head & Neck Oncology
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    • v.20 no.1
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    • pp.52-54
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    • 2004
  • Ectopic cervical thymic tissue is rarely reported in medical literature, but it should be included in the differential diagnosis of neck masses, especially in children. It occurs in the line of descent of the thymus from the angle of the mandible to the superior mediastinum. A preoperative diagnosis is seldom considered and is often misdiagnosed as a possible tumor or a lymph node. We present a case of a 2-month-old infant with an asymptomatic enlarging right neck mass. Patient underwent complete excision of the mass.

A Case of Aseptic Meningitis and Unilateral Vestibulopathy Associated with Histiocytic Necrotizing Lymphadenitis(Kikuchi's disease) (조직구괴사림프절염(Kikuchi병)과 동반된 무균뇌수막염과 한쪽 전정신경병증)

  • Kim, Kyung Jib;Do, Jin Kuk;Lee, Dong Kuck
    • Annals of Clinical Neurophysiology
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    • v.9 no.2
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    • pp.93-96
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    • 2007
  • A 34-year-old man presented with a severe headache, fever, and cervical lymphadenopathy followed by generalized tonic-clonic seizure. Evaluations showed splenomegaly, elevated liver enzymes, and 380 white blood $cells/mm^3$ in the cerebrospinal fluid. Two weeks after admission, he developed sudden vertigo. Examination revealed spontaneous horizontal-torsional nystagmus to the right and bithermal caloric tests documented left canal paresis. A cervical lymph node biopsy disclosed subacute necrotizing lymphadenitis. We report a case of aseptic meningitis and unilateral vestibulopathy associated with histiocytic necrotizing lymphadenitis (Kikuchi's disease).

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