Metastatic lymph node

IIIB Any tumor thickness with ulceration and one to three lymph nodes involved and micrometastases Or any tumor thickness without ulceration and one to three lymph nodes involved and macrometastases Or any tumor thickness ulceration with in transit metastases/satellite lesions without metastatic lymph nodes 46-59% 36-48%... 

MIC Any tumor thickness with ulceration with one lymph node involved and macrometastases Any tumor thickness with ulceration with two to three lymph nodes involved and macrometastases Any tumor thickness with four or more metastatic lymph nodes or in transit metastases/satellite lesions with metastatic lymph nodes 24-29% 15-24%... 

Formation of regional lymph node metastasis can be an important step in dissemination of cancer cells. In colorectal cancer, lymph node metastasis frequently occurs in patients (7, 8) and is an important factor in staging the disease. In particular, the metastatic lymph node ratio (LNR number of metastatic lymph nodes/number of examined lymph nodes) is predictive of overall survival (OS) and disease-free survival (DFS) in colorectal cancer patients (9, 10). Hence, an animal model of colorectal cancer with measurable lymphatic metastasis that allows for rapid evaluation of the effects of candidate treatment regimens on primary tumor growth and lymph node metastasis would be of great value. 

Schumacher P., Dineen S., Barnett C., Fleming J., Anthony T. (2007) The metastatic lymph node ratio predicts survival in colon cancer. Am J Surg 194, 827-832. 

A 28-year-old man, without a psychiatric history, developed a paranoid psychosis. He had been taking levamisole twice a week in an unspecified dose for 2 years for a stage 4 melanoma and metastatic lymph nodes in the axilla. Physical examination, a CT scan, an electroencephalogram, and standard laboratory tests were all normal. He was treated with perphenazine, with partial success, but after tapering of the dose his symptoms reappeared. It was thought likely that the psychosis had been caused by levamisole, which was discontinued. Three weeks later he had recovered completely. Levamisole was not reintroduced. 

U. Sharma, A. Mehta, V. Seenu, N.R. Jagannathan, Biochemical characterization of metastatic lymph nodes of breast cancer patients by in vitro IH magnetic resonance spectroscopy A pilot study, Magn. Reson. Imaging 22 (2004) 697. 

Vartanian JG, Pontes E, Agra IM, et al. Distribution of metastatic lymph nodes in oropharyngeal carcinoma and its implications for the elective treatment of the neck. Arch Otolaryngol Head Neck Surg. 2003 129(7) 729-732. 

De Baere, T., et al., Bacteremic infection with Pantoea ananatis, J Clin Microbiol, 42,4393, 2004. Vaneechoutte, M., et al.. Isolation of Moraxella cards from an ulcerated metastatic lymph node, J Clin... 

Potentially a so-called MRI-diffusion-PETgraphy described by Takahara et al. [45] may facilitate diagnosis of metastatic lymph node disease with the use of STIR-EPI-diffusion-sequences. The authors demonstrated pathological lymph nodes at high resolution and adequate fat suppression as a promising application in whole-body MRl. 

Fig. 2.5. Regional metastatic lymph node (/) involvement in patients with gastrointestinal cancer presenting as slight hypoechoic, soft and round lesion...

Fig. 15.4a,b. Rectal cancer with circumferential thickening of the wall, a Transverse sonogram of the pelvis shows circumferential thickening of the rectal wall. Note adjacent small metastatic lymph nodes (arrows), b Sagittal sonogram of the liver shows a well-defined hepatic mass representing metastasis (arrow)... 

Lymph node metastases are characterized hy the round-shaped swelling of lymph nodes (Fig. 16.10h). One must be careful in the differentiation from inflammatory swelling of lymph nodes caused by a benign gastric ulcer, which is more elliptical in shape than that of metastatic lymph nodes. 

Fig. 16.10. a Metastatic liver tumors are demonstrated, b Metastatic lymph nodes (In) around the superior mesenteric artery (sma) are demonstrated, c A seeding nodule (asterisks) seen in a patient with advanced gastric cancer... 

TABLE 3 Anticancer Effect of Bleomycin-Small Silica (BLM-SI) and Bleomycin Solution (BLM-SOL) on Transplanted Tumor and Metastatic Lymph Nodes... 

Reinhardt MJ, Ehritt-Braun C, Vogelgesang D, Ihling C, Hogerle S, Mix M, Moser E, Krause TM (2001) Metastatic lymph nodes in patients with cervical cancer detection with MR imaging and FDG PET. Radiology 218 776-782... 

There is no indication for administration of an unspecific Gd-based MR contrast agent with distribution in the extracellular space (e.g. Magnevist or Omniscan) for lymph node imaging. However, on Tlw images, an unspecific contrast agent can improve the differentiation of lymph nodes from vessels. If an IV contrast agent is administered for evaluation of the primary tumor, necrosis in metastatic lymph nodes may be seen better. 

Fig. 15.3a,b. Slightly enlarged metastatic lymph node in the area of the internal iliac artery (arrow). Axial images obtained with (a) T2w TSE sequence and (b) Tlw TSE sequence in a patient with advanced cervical cancer... 

The standard unspecific contrast agents used in MRI and CT lead to an increase in signal intensity or density of both reactively enlarged and metastatic lymph nodes following IV administration and do not improve the differentiation of reactive and metastatic nodes [7]. The visualization of central necrosis in a metastatic node is improved after contrast administration. 

Scholbach T, Scholbach J, Krombach GA, Gagel B, Maneschi P, Di Martino E (2005) New method of dynamic color Doppler signal quantification in metastatic lymph nodes compared to direct polarographic measurements of tissue oxygenation. Int J Cancer 114 957-996 Semenza GL (2000) Hypoxia, clonal selection, and the role of HIF-1 in tumor progression. Crit Rev Biochem Mol Biol 35 71-103... 

Lymphatic tumor spread. The main location of tumor spread in ovarian cancer is the ovarian vessels, the common iliac vessels, and the para-aortic lymph nodes. The threshold for diagnosing a metastatic lymph node is about 1 cm, with a sensitivity of about 40% and a specificity of about 90% (Tempany et al. 2000). 

N. Ohtsuka, T. Konno, Y. Miyauchi, and H. Maeda, Anticancer effects of arterial administration of the anticancer agent SMANCS with Lipidol on metastatic lymph nodes. Cancer, 59 (9), 1560-1565,1987. 

A comparison of protein profiles from cell lines, derived from a primary tumor and a metastatic lymph node, revealed four differentially expressed proteins in the latter two membrane-associated proteins (downregulated), annexin I and aimexin II, glycolytic protein enolase-a (upregulated), and a calumenin precursor (down-regulatedX The identification of the upregulated proteins was validated using digestion with endoproteinase lysine-C [101]. 

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