• Journal of Chest Surgery
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• 제54권4호
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• pp.258-262
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• 2021

Mediastinal lymph node dissection is an important part of lung cancer surgery that provides accurate nodal staging and may improve survival outcomes. The minimally invasive approach, such as video-assisted thoracic surgery (VATS) lobectomy for patients with non-small cell lung cancer, has become a standard operation worldwide. VATS mediastinal lymph node dissection should be thorough and accurate to ensure the completeness of lung cancer surgery. Herein, the author describes techniques for VATS mediastinal lymph node dissection.

• Journal of Chest Surgery
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• 제22권4호
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• pp.705-708
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• 1989

Angiofollicular lymph node hyperplasia is a relatively rare benign lesion. It develops most often in the mediastinum, but also it found in other area of the body, usually where lymph nodes are normally found. There are histologically divided hyaline vascular type, plasma cell type and transitional type. The lesions were discovered most often on routine roentgenograms, and complete surgical excision is the treatment of choice. Recently, the authors experienced a case of angiofollicular lymph node hyperplasia, transitional type, located in the right hilar area. The lesion was removed and the patient is in good condition postoperatively. Now we report this case with review of previously reported literatures.

• Journal of Chest Surgery
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• 제20권3호
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• pp.582-587
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• 1987

Castleman`s disease, giant lymph node hyperplasia, is a rare benign disease. The lesion usually consists of a single node, unassociated with any abnormality of the adjacent lymph nodes or other organs. In the first accounts of giant lymph node hyperplasia of Castleman, the lesion was described as solitary and localized to the mediastinum, which is still the most frequent site of involvement. The disease occurs in all age groups and there is no particular sex preference. It is symptomless and is usually detected on chest films as an incidental finding. On a single involvement, it does not recur after excision, whether total or partial, and the main indication of operation is to rule out more serious tumors. Recently multicentric form appears to be a variant of classic giant lymph node hyperplasia and is associated with significant morbidity and mortality. Histologically, two distinct types have been reported; hyaline-vascular and plasma cell. The hyaline-vascular type of lesion is much more common than the plasma cell type. We report two cases of the hyaline-vascular type of Castleman`s disease.

• Archives of Plastic Surgery
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• 제42권4호
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• pp.478-483
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• 2015

Due to the fact that it reliably results in positive outcomes, lymph node flap transfer is becoming an increasingly popular surgical procedure for the prevention and treatment of lymphedema. This technique has been shown to stimulate lymphoangiogenesis and restore lymphatic function, as well as decreasing infection rates, minimizing pain, and preventing the recurrence of lymphedema. In this article, we investigate possible additional benefits of lymph node flap transfer, primarily the possibility that sentinel lymph nodes may be used to detect micrometastasis or in-transit metastasis and may function as an additional lymphatic station after the excision of advanced skin cancer.

• Journal of Chest Surgery
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• 제54권5호
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• pp.342-347
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• 2021

Thoracic surgeons need to be aware of several important points regarding intraoperative lymph node dissection during surgery for non-small cell lung cancer with ground-glass opacities. The first point relates to the need for lymph node dissection during sublobar resection. Since even patients undergoing sublobar resection may benefit from lymph node dissection, it should be selectively performed according to adequate indications, which require further study. Second, there seems to be no difference in postoperative morbidity between systematic sampling and systematic dissection, but the survival benefit from systematic dissection remains unclear. The results of randomized controlled trials on this topic are conflicting, and their evidence is jeopardized by a high risk of bias in terms of the study design. Therefore, further randomized controlled trials with a sound design should investigate this issue. Third, more favorable survival outcomes tend to be positively associated with the number of examined lymph nodes. Minimum requirements for the number of examined lymph nodes in non-small cell lung cancer should be defined in the future. Finally, lobe-specific lymph node dissection does not have a negative prognostic impact. It should not be routinely performed, but it can be recommended in selected patients with smaller, less invasive tumors. Results from an ongoing randomized controlled trial on this topic should be awaited.

• 대한방사성의약품학회지
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• 제1권1호
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• pp.62-73
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• 2015

We developed an evans blue-indocyanine green-$^{99m}Tc$-human serum albumin conjugate for sentinel lymph node mapping and we describe its unique potential usage for clinical implications. This conjugate has combined the strengths of visible blue dye, near-infrared fluorescence and radioisotope into one single conjugate without any additional weakness/disadvantage. All the components of evans blue-indocyanine green-$^{99m}Tc$-human serum albumin are safe and of low cost, and they have already been clinically used. This conjugate was stable in the serum, it showed a long retention time in the lymphatic system and the lymph nodes showed a much higher signal-to-noise ratio after the conjugate was injected intradermally into the paw of mice. Both the single-photon emission computed tomography and near-infrared fluorescent images of the mice were successfully obtained at the same time as the excised sentinel lymph nodes showed blue color. The visual color, near-infrared fluorescence and gamma ray from this agent could be complementary for each other in all the steps of sentinel lymph node sampling: exploring and planning sentinel lymph node before excision with visualization of the exact sentinel lymph node location during an operation. Therefore, the triple modal agent will possibly be very ideal for sentinel lymph node mapping because of the high signal-to-noise ratio for non-invasive imaging and its complementary multimodal nature, easy preparation and safety. It is promising for clinical applications and it may have great advantages over the traditional single modal methods.

• International journal of thyroidology
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• 제11권2호
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• pp.117-122
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• 2018

Metastases to regional cervical lymph nodes occur frequently in patients with thyroid cancer. The appropriate management of regional lymph node is important to achieve good disease control and to classify risk stratification for adjuvant radioactive iodine. However, there are some occasions that neck dissection is difficult and embarrassing in thyroid cancer. Especially, extensive or unusual nodal metastases bring challenges and makes neck dissection more difficult. Carotid artery management is one of the most difficult procedure in neck dissection. The management of patients who have persistent or recurrent cervical metastasis involving the carotid artery has been controversial and treatment dilemma to the surgeon. Metastasis of well differentiated thyroid cancer to the retropharyngeal lymph nodes is rare but occasionally encountered. The complete surgical excision is usually recommended for retropharyngeal lymph node metastasis of well differentiated thyroid cancer. An extensive mediastinal dissection in advanced differentiated thyroid carcinoma is occasionally required. This paper will review recent reports of management of advanced nodal metastasis of thyroid cancer and share the author's personal experience.

• Archives of Plastic Surgery
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• 제36권4호
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• pp.485-488
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• 2009

Purpose: Malignant melanoma of the lower extremity is well known to metastasize to the lymph nodes of the groin. However, in rare cases, the initial site of the nodal disease can be the popliteal fossa. As of yet, there has not been any report on cases with popliteal lymph node metastasis in Koreans. In the following report, authors would like to present two cases of popliteal node metastasis. Methods: A 60 - year - old male patient presented with nodular mass at his left sole. He had popliteal node metastasis detected on preoperative positron emission tomography(PET). Another 67 - year - old man presented with pigmented lesion at his right heel. He also had popliteal node metastasis detected on the MRI. They underwent wide excision of the primary lesion with popliteal node dissection. Results: In the first case, $2.5{\times}2.5cm$ sized metastatic melanoma in popliteal node was pathologically confirmed. There were no postoperative complications, and to date(18 months after the surgery), the patient is alive with no evidence of disease. In the second case, multiple(4) metastatic melanoma in popliteal nodes was confirmed. The patient is alive, but has had interferon therapy for liver metastasis. Conclusion: By increasing the use of lymphoscintigraphy or PET as a preoperative diagnostic work - up for metastasis, even popliteal node metastasis undetectable in a physical exam becomes detectable. When metastatic lymph node is found, node dissection is the standard of care. Therefore, it is essential that we know the anatomy and surgical technique for popliteal lymph node dissection.

• 대한기관식도과학회지
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• 제6권2호
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• pp.181-184
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• 2000

Catsleman's disease is a type of angiofolliculr lymph node hyperplasia and its etiology is not known yet. It usually presents with the mediastinal mass but rarely with the parotid mass. There are only five cases previously reported in the literatures. It has two pathologic types, which are hyaline vascular type and plasma cell type. Plasma cell type is frequently associated with systemic menifestations. Diagnosis is based on the histopatholgic findings. Treatment is surgical excision. A case of Catsleman's disease involving the parotid lymph node is presented and literatures are reviewed.

• 대한두경부종양학회지
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• 제31권2호
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• pp.86-90
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• 2015

Cystic lymph node metastasis of head and neck squamous cell carcinoma(HNSCC) which presumed to be mainly originated from oropharynx including Waldeyer's ring may present as a benign cystic mass on lateral neck such as branchial cleft cyst. Branchial cleft cyst is one of the most common lateral neck cystic mass which may result in regional infection or lymph adenopathy. Many of previously reported literatures showed the incidence of cystic lymph node metastasis from oropharynx including Waldeyer's ring. Preoperative imaging studies and fine needle aspiration cytology cannot provide the accurate results until excision of cystic mass for the diagnostic or therapeutic purpose. Recently, we experienced the rare case of cystic lymph node metastasis from ipsilateral tonsil, which mimicked infected 2nd branchial cleft cyst. Thus, we reported our experience with presentation of case and review of literatures.