• Title/Summary/Keyword: Neck node

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Unexpected Lymph Node Pathology in Neck Dissection for Head and Neck Cancer (두경부 종양환자에서 경부 림프절의 예기치 않은 병리적 소견)

  • Oh Kyung-Kyoon;Lee Guk-Haeng;Lim Sang-Moo;Shim Yoon-Sang
    • Korean Journal of Head & Neck Oncology
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    • v.10 no.1
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    • pp.3-6
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    • 1994
  • Neck dissection has become an integral part of the staging and management of head and neck tumors. This paper reports a series of head and neck patients who had pathological findings in their neck dissection specimens, which were unrelated to their primary tumors. In 7 cases, there was unexpected pathology in the cervical lymph nodes which was not related to the primary tumor. Four cases were squamous cell carcinomas and 3 were thyroid carcinomas. In 3 cases of squamous cell carcinomas, there were no evidence of metastatic squamous cell carcinoma in neck dissection specimen; however, the lymph nodes were found to be involved by metastatic papillary carcinoma in one larynx cancer, metastatic adenocarcinoma in the other larynx cancer, tuberculosis in one nasopharynx cancer. In three of neck dissection specimen of carcinoma(two thyroid carcinomas, one laryngeal carcinoma), dual nodal pathology was found: Each of these specimen contained carcinoma with tuberculosis of the lymph nodes in three cases. In one thyroid carcinoma, there was no evidence of metastasis; however, the lymph nodes were found to be involved by tuberculosis. Preoperative assessment did not reveal any findings to alert us to the possibility of a synchronous pathological process in the cervical nodes of this group of 7 patients. In particular, there was no evidence of active pulmonary tuberculosis in the 5 patients with active lymph node disease.

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NECK DISSECTION OF CLINICALLY NO NECK OF ORAL SQUAMOUS CELL CARCINOMA & PATHOLOGIC COMPARISON (구강편평세포암종에서 임상적 N0 경부의 경부 곽청술 후 병리학적인 비교)

  • Kang, Jin-Han;Ahn, Kang-Min;Lee, Sang-Woo;Myoung, Hoon;Lee, Jong-Ho;Kim, Myung-Jin
    • Journal of the Korean Association of Oral and Maxillofacial Surgeons
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    • v.33 no.6
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    • pp.591-596
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    • 2007
  • Neck node metastasis of oral cancer can be diagnosed by bimanual palpation, CT, MRI and neck sonography and the final diagnosis can be confirmed by pathologic evaluation of the neck nodes after elective neck dissection. When we meet clinically negative neck node(N0 neck) of oral squamous cell carcinoma, the treatment modality of the neck nodes with the primary lesions are so controversial. The usually used methods are various from close observation to elective radiation and elective neck dissection. The methods can be chosen by the primary size of the carcinoma, site of the lesions and the expected percentage of the occult metastasis to the neck. We reviewed the 86 patients from 1996 to 2006 who were diagnosed as oral squamous cell carcinoma, whose necks were diagnosed negative in radiographically and clinically. According to TNM stage, the patients were in the states of N0 and treated by surgery using mass excision and elective neck dissection. We compared the differences between the clinical diagnoses and pathologic reports and would discuss the needs for elective neck dissection.

A Case of Complete Remission after Palliative Chemotherapy and Salvage Radiotherapy for Lymph Node Recurrence in Advanced Gastric Cancer (근치적 절제술 후 림프절 재발이 발생한 진행성 위암에 대한 고식적 치료 1례)

  • Jong Seok Joo;Hyun Yong Jeong;Hee Seok Moon;Jae Kyu Sung;Sun Hyung Kang
    • Journal of Digestive Cancer Research
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    • v.3 no.2
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    • pp.108-112
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    • 2015
  • A 54-year-old male patient who was diagnosed with advanced gastric cancer underwent a distal gastrectomy, D2 lymph node dissection, and adjuvant chemoradiotherapy. After a year, in a follow-up PET-CT, lymph node metastases were observed in the neck and abdomen, and therefore, the patient underwent chemotherapy. After treatment, the follow-up PET-CT revealed a growth of the posterior neck lymph node. Thus, an excisional biopsy was performed, and the growth was diagnosed as metastatic adenocarcinoma. Therefore, the patient received chemotherapy with FOLFIRI. Another follow-up PET-CT after chemotherapy revealed a growth in the right inguinal lymph node, and the patient underwent salvage radiotherapy for this lesion. The PET-CT taken for the response evaluation showed no evidence of further metastasis of the lymph node. We hereby report a case of advanced gastric cancer with neck and inguinal lymph node recurrence showing complete remission after palliative chemotherapy and salvage radiotherapy.

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

  • Park Chan-Hum;Kim Hee-Dong;Park Jun-Young;Jo Hyeong-Ju;Jun Jin-Hyoung;Park Youn-Kyu;Rho Young-Soo
    • Korean Journal of Head & Neck Oncology
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    • v.15 no.2
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    • pp.217-221
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    • 1999
  • Background and Objectives: Subacute necrotizing lymphadenitis or Kikuchi's disease has now become recognized in many parts of the world as a well-defined clinicopathologic entity. It typically affects cervical lymph nodes of young women, and subsides spontaneously within a few months without recurrences. The purpose of this study is to report the clinicopathologic finding, radiologic finding and many laboratory tests to elaborate the criteria that are useful in distinguishing this entity from inflammatory disease, granulomatous disease, lymphoma, malignant disease. Material and Methods: Authors evaluated 22 patients, who were diagnosed as subacute necrotizing lymphadenitis on excisional biopsy or fine needle aspiration cytology with retrospective chart review. Results: The patient population consisted of 21 women and 1 men. The mean age was 25 years old(range 17 to 42 years). All patient had palpable neck mass and associated fever, headache, weight loss, otalgia, diarrhea, night sweating. and associated disorder is dermatitis, hepatitis B, SLE, Hashimoto's thyroiditis, albinism et al. The multiple bilateral involvement of cervical lymph node was 20 cases(91%) and multiple unilateral 18 cases(82%), multiple bilateral 2 cases(9%). Solitary involvement was 2 cases(9%), mean size of involved lymph node was 2.0cm. In laboratory tests, leukopenia 17 cases(72%), elevated ESR 12 cases(54%), elevated GOT, GPT 3 cases(13%). In CT finding, lymph nodes enhanced in homogeneous fashion, and there was no evidence of central necrosis. Conclusion: Subacute necrotizing lymphadenitis, Kikuchi's disease may be easily confused clinically, pathologically, radiologically with malignant lymphoma, inflammatory disease, granulomatous disease. We should consider open biopsy of lymph node in the patient which had unilateral multiple cervical lymph node and in laboratory tests, were leukopenia, elevated ESR, especially in young women. otherwise, result of fine needle aspiration biopsy is nonspecific, excisional biopsy is recommended in order to differentiate other disease.

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Analysis of Risk Factors Related to the Recurrence of well Differentiated Thyroid Carcinoma (고분화성 갑상선 암종의 재발과 관련된 위험인자 분석)

  • Lee, Sang-Joon;Chung, Phil-Sang;Kim, Young-Saeng;Yun, Kyung-Sub
    • Korean Journal of Head & Neck Oncology
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    • v.23 no.2
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    • pp.138-141
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    • 2007
  • Objectives : Well differentiated thyroid carcinoma(WDTC) has relatively good prognosis. But recurrence is associated with increased morbidity and mortality, and always results in reoperation. So it is important to evaluate the risk factors relative to the recurrence. The aim of this study is to evaluate the risk factors of recurrence. Materials and Method : Two hundred seventeen patients who had undergone thyroidectomy and proved as WDTC from January 1999 to December 2004 was included in the study. We reviewed patient-related and tumorrelated factors respectively and analyzed the correlation with tumor recurrence. Results : Fourteen patients from two hundreds seventeen had recurred. Recurrence rate was 6.5%, and average interval of recurrence was 28 month. Male, age over 45, multiple mass, and advanced TMN stage patient group show higher recurrence rate, but no statistical significance. However, the recurrence rate of lymph node metastasis, tumor size>1.5cm, and extracapsular invasion group were statistically high. Conclusion : Lymph node metastasis, tumor size and extracapsular invasion are significant risk factors related to the recurrence of WDTC.

A Case of Co-Existence of Diffuse Large B cell Lymphoma in Parotid Gland and Follicular Lymphoma in Upper Neck (동측의 이하선과 상경부에 공존하여 발생한 미만성 거대 B세포 및 여포성 림프종 1예)

  • Hong, Seok Jung;Kim, Eun Ju;Kim, Seung Woo
    • Korean Journal of Head & Neck Oncology
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    • v.34 no.1
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    • pp.49-53
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    • 2018
  • Primary non-Hodgkin's lymphoma (NHL) rarely involves the parotid gland and its incidence is only 1.7% to 3.1% of all salivary gland neoplasms. The mucosa associated lymphoid tissue (MALT) is the most common subtype of NHL, followed by follicular lymphoma (FL) and diffuse large B cell lymphoma (DLBCL). However, two distinct types of lymphomas occurring synchronously in the parotid gland and cervical lymph node have not been reported earlier. A 72-year-old man with rubbery-hard and fixed mass on the left parotid area came to our clinic. We performed the left total parotidectomy with ipsilateral excision of lymph node (level II), and he was finally diagnosed as DLBCL in parotid gland and FL in upper neck. It is presumed that the DLBCL appeared to be a transformation from FL. We report the unique and rare disease entity with brief literature review.

A Clinical Study of the Elective Neck Dissection (예방적 경부청소술의 임상적 의의에 관한 연구)

  • Kim Myun-Joo;Lee Kwang-Sun;Choi Jong-Ouck
    • Korean Journal of Head & Neck Oncology
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    • v.7 no.1
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    • pp.10-16
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    • 1991
  • Elective neck dissection (END), provide proper information on nodal status and stage which are significant prognosticator in head and neck cancers with clinically $N_{(0)}$ neck. But there are many controversies for the extents, methods of surgery, moreover, whether normal lymph nodes, local defencer, have to be removed or not. The authors performed 47 END in 39 patients of head and neck squamous cell carcinoma from 1984 to 1989 and a retrospective study of the cases was conducted. Eighteen percent of nodal metastasis and five percent of extracapsular spread were found in END specimens. We concluded that END provide significant information for the management and evaluation of prognosis in head and neck cancer.

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