• Asian Pacific Journal of Cancer Prevention
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• v.15 no.1
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• pp.419-422
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• 2014

Background: Lymphadenopathy is a common presentation in both benign and malignant diseases which need to be diagnosed without delay. Fine needle aspiration cytology (FNAC) helps us diagnose a disease and follow its course, including the response to therapy. Aim: This study aimed to analyze the clinicopathological features of metastatic lymphadenopathy and the diagnostic utility of FNAC in our setting. Materials and Methods: This two-year prospective study included all the patients with metastatic lymphadenopathy, diagnosed with FNAC. Results: A total of 412 cases (male:female ratio, 1.3:1; age range, 3 to 90 years) were studied. Supraclavicular lymph nodes were involved most commonly (50.5%). The commonest metastatic tumor was squamous cell carcinoma in general (30.1%) and in males (37.6%), and infiltrating ductal carcinoma (25.3%) in females. Lung, with 64 (15.5%) cases followed by esophagus, 60 (14.6%) cases; breast, 49 (11.9%) cases; skin, 32 (7.8%) cases; and stomach, 25 (6.1%) cases were the most common primary sites of malignancy. In 69 patients, excision biopsy was performed. Histopathological findings correlated well with that of cytology in all these cases. Conclusions: FNAC is an important tool in the diagnostic work up of metastatic lymphadenopathy, which in the hands of an experienced and skilful cytopathologist can avoid the need for excision biopsy.

• Tuberculosis and Respiratory Diseases
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• v.38 no.1
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• pp.45-52
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• 1991

Clinical analysis was performed on 306 patients with cervical lymphadenopathy who were diagnosed histologically by fine needle aspiration biopsy cytology (FNABC) and/or excisional biopsy from Jan 1986 to Jan 1990 at Hanyang University hospital. The results obtained were as follows: 1) Of 306 patients with cervical lymphadenopathy, 216 (70.6%) were inflammatory lesions, and 90 (29.4%) malignant lesions. Tuberculous lymphadenitis of inflammatory lesions was most common (134 cass: 62%). Of malignant lesions, metastatic cancer was more frequent (75 cases: 83.3%). 2) The sex ratio were as follows: inflammatory lesion; M:F=1 : 1.8 (tuberculous lymphadenitis;M : F=1:2.3) malignant lesion; M : F=1.5 : 1 (metastatic cancer; M : F=2.6 : 1) 3) The peak age of inflammatory lymphadenopathy was 20-29 years old (38.9%), and that of malignant lesion 50-59 years old (46.7%). 4) In more than half of tuberculous lymphadenitis and metastatic cancer, the location of enlarged lymph nodes was one side of the neck and the number was more than one. 5) The common primary sites of metastatic cancer were lung and stomach. In 11 cases (14.7%), the primary site could not be found. 6) The sensitivity and the specificity of fine needle aspiration biopsy cytology (FNABC) was 0.83 & 1.0 in metastatic cancer respectively.

• Asian Pacific Journal of Cancer Prevention
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• v.13 no.8
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• pp.3621-3625
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• 2012

Lymphadenopathy is one of the commonest and significant manifestations of local as well as systemic ailments, especially malignancies. Fine needle aspiration cytology (FNAC) helps in diagnosing the disease itself, in general, but more importantly ruling out malignancy, in particular. Hence it saves much of the cost and use of resources incurred with excision biopsy of such lymph nodes. This prompted us to study the cytologic patterns of lymphadenopathy in our setting and the diagnostic utility of FNAC in the evaluation of lymphadenopathy. In this retrospective observational study, 1,579 patients (953 males and 626 females) with lymphadenopathy who were subjected to FNAC over a period of three years (January 2009 to December 2011) were studied. The cervical region was involved in most of the cases (76%) followed by the axillary region (17.5%). Metastatic malignancy (38.2%) was the commonest cause of lymphadenopathy followed by reactive lymphoid hyperplasia (36.9%), tuberculosis (9.1%) and lymphomas (8.6%). Squamous cell carcinoma (32.2%) followed by adenocarcinoma (21.9%) were the most frequent metastatic tumors. FNAC is a useful diagnostic tool in the management of patients presenting with lymphadenopathy and should be considered before more invasive and costly procedures are performed, particularly in developing countries.

• Journal of Medicine and Life Science
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• v.20 no.2
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• pp.73-82
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• 2023

Multiple studies have reported on unilateral axillary adenopathy following coronavirus disease 2019 (COVID-19) vaccination, which is currently recognized as a common finding. Here, we present a series of eight adult patients with reactive axillary lymphadenopathy following COVID-19 vaccination, in whom the follow-up ultrasonography (US) showed resolution of a previously noted unilateral axillary adenopathy. From March 2021 to March 2022, 2,599 consecutive women underwent breast US in Jeju National University Hospital. We identified 10 patients with unilateral axillary lymphadenopathy following COVID-19 vaccination detected on the breast US. The 10 patients were recommended for follow-up US. Two patients were lost to follow-up, whereas the remaining eight patients underwent follow-up US, in whom resolution of the unilateral axillary lymphadenopathy was noted. Radiologists should be aware of evolving guidelines for evaluating and managing axillary lymphadenopathy to avoid false positive biopsies. Recent studies on lymphadenopathy following COVID-19 vaccination show that a prolonged duration until resolution is often observed. Therefore, a follow-up US examination at least 12 weeks after vaccination may be reasonable. Furthermore, management guidelines should include a risk-stratified approach considering both vaccination timing and the patient's overall risk of metastatic disease.

• Journal of the Korean Society of Radiology
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• v.82 no.2
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• pp.423-428
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• 2021

Progressive transformation of germinal centers (PTGC) is a rarely diagnosed, benign disease of the lymph nodes that commonly manifests as chronic lymphadenopathy. PTGC may be characterized by single or multiple non-tender lymph nodes, and it commonly involves the cervical, axillary, and inguinal areas. Although PTGC is identified with concurrent lymphoma in some patients, it is not considered as a premalignant entity. Histopathologic diagnosis of PTGC is rarely made, and imaging findings have been reported in very few studies. We present a case of PTGC that occurred at the contralateral axillary lymph nodes and mimicked metastatic lymphadenopathy after breast cancer surgery. We also discuss its imaging findings.

• Journal of Chest Surgery
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• v.48 no.4
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• pp.294-297
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• 2015

Epithelioid hemangioendothelioma (EHE) is a relatively rare and moderately aggressive type of vascular tumor. We describe a case of EHE that presented in a 24-year-old woman as a palpable nodule in the left cervical area. Radiological examinations and fine-needle aspiration cytology led to a preliminary diagnosis of metastatic lymphadenopathy with an unknown primary site. However, during surgery, we determined that the nodule was an intra-vascular tumor arising from the left internal jugular vein. The histopathological examination revealed cords of epithelioid endothelial cells distributed in a hyaline stroma, compatible with a diagnosis of EHE.

• The Korean Journal of Cytopathology
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• v.8 no.1
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• pp.11-19
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• 1997

Clinical lymphadenopathies are subjected to fine needle aspiration cytology(FNAC) for diagnosing not only benign lesions but also malignant ones, as the first diagnostic procedure. While the diagnostic reliability in metastatic carcinoma is high, it is difficult to differentiate malignant lymphoma from reactive conditions. We evaluated the diagnostic reliability of FNAC in lymphadenopathy, and discuss the diagnostic limitation and its place in clinical practice in this study, Over 8 years from January 1988, FNAC of 1,216 lymphadenopathies were analyzed and among them 170 cases were compared with histopathology. The results are as follows. 1. Of ail the cases, 890 cases(73.2%) were diagnosed cytologically as benign, 312 cases(25.7%) as malignant, and 14 cases(1.1%) as unsatisfactory material. Reactive hyperplasia was diagnosed in 585 cases(65.7%) of the benign lesions, and among the malignant diseases, metastatic carcinoma was diagnosed in 248 cases(79.5%), and malignant lymphoma in 62 cases(19.9%). 2. The overall diagnostic accuracy was 89.2%, and no false positive case and 9 false negative results were observed among 170 cases which were proven by histopathology. Six cases of sampling error of false negative diagnoses included 3 of metastatic carcinomas and 3 of malignant lymphomas. The causes were difference between aspiration and biopsy site, poor fixation, or scanty cellularity with bloody smear. All 3 cases of misinterpretation error were malignant lympliomas, one of mixed type on biopsy which was diagnosed as reactive hyperplasia cytologically. In summary, FNAC technique is thought to be useful in the initial diagnosis of lymphadenopathies as well as in the follow-up of patients with known malignancy. Although the results of malignant lymphoma was less accurate than other malignant lesions, the application of strict cytologic criteria or lymphoid marker studies of aspiration material will reduce the false negative rate.

• Tuberculosis and Respiratory Diseases
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• v.43 no.4
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• pp.651-656
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• 1996

We have experienced a case of sarcoidosis appearing asymmetrical diffuse interstitial lung lesions with multiple lymphadenopathy. This patient was a 57 year-old female who had been in good health until 2 months ago. At that time she noted the onset of an exertional dyspnea and weakness. Pulmonary function tests showed moderate obstructive pattern with mild decreased DLco. In the chest CT, multiple lymphadenopathy with small nodular lesions are scattered, and the impression was a metastatic lymph nodes with lymphangitic carcinomatosis. In bronchofiberscopy, we noted luminal narrowing by extrinsic compression in the right middle and lower lobe bronchi. And microscopic examination of by bronchofiberscopic biopsy showed chronic inflammation. Thus we performed subcarinal and tight supraclaviclar lymph nodes aspiration biopsy cytology, and that revealed class 0 and class 1, respectively. Finally, we performed an excisional biopsy for the right scalene lymph node, which revealed the specimen as a noncaseating granuloma. The angiotensin convecting enzyme level was overt two folds compared to normal value. And the patient had negative PPD skin test and hyperglobulinemia. After 18 weeks treatment with prednisone, the signs and symptoms which the patient clad suffered from, disappeared.

• Korean Journal of Bronchoesophagology
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• v.8 no.1
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• pp.50-56
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• 2002

Advanced or recurrent thyroid cancer, and metastatic paratracheal lymph nodes may directly invade the trachea and lead to tracheal stenosis. In these cases the stenosis is not circumferential and it would be possible to reconstruct the trachea after partial resection of the stenotic trachea. We experienced five cases of tracheal reconstruction after partial resection of the tracheal wall in four Patients of advanced thyroid cancer, and in one Patient of malignant paratracheal lymphadenopathy.

• Korean Journal of Radiology
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• v.24 no.7
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• pp.668-680
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• 2023

Objective: To compare multiparametric magnetic resonance imaging (MRI) features of intraductal carcinoma of the prostate (IDC-P) with those of prostatic acinar adenocarcinoma (PAC) and develop prediction models to distinguish IDC-P from PAC and IDC-P with a high proportion (IDC ≥ 10%, hpIDC-P) from IDC-P with a low proportion (IDC < 10%, lpIDC-P) and PAC. Materials and Methods: One hundred and six patients with hpIDC-P, 105 with lpIDC-P and 168 with PAC, who underwent pretreatment multiparametric MRI between January 2015 and December 2020 were included in this study. Imaging parameters, including invasiveness and metastasis, were evaluated and compared between the PAC and IDC-P groups as well as between the hpIDC-P and lpIDC-P subgroups. Nomograms for distinguishing IDC-P from PAC, and hpIDC-P from lpIDC-P and PAC, were made using multivariable logistic regression analysis. The discrimination performance of the models was assessed using the receiver operating characteristic area under the curve (ROC-AUC) in the sample, where the models were derived from without an independent validation sample. Results: The tumor diameter was larger and invasive and metastatic features were more common in the IDC-P than in the PAC group (P < 0.001). The distribution of extraprostatic extension (EPE) and pelvic lymphadenopathy was even greater, and the apparent diffusion coefficient (ADC) ratio was lower in the hpIDC-P than in the lpIDC-P group (P < 0.05). The ROC-AUCs of the stepwise models based solely on imaging features for distinguishing IDC-P from PAC and hpIDC-P from lpIDC-P and PAC were 0.797 (95% confidence interval, 0.750-0.843) and 0.777 (0.727-0.827), respectively. Conclusion: IDC-P was more likely to be larger, more invasive, and more metastatic, with obviously restricted diffusion. EPE, pelvic lymphadenopathy, and a lower ADC ratio were more likely to occur in hpIDC-P, and were also the most useful variables in both nomograms for predicting IDC-P and hpIDC-P.