Showing 10 results for Lymph Node
Jamali M, Irvanloo G, Farzan S,
Volume 59, Issue 1 (4-2001)
Abstract
Breast cancer is a major cause of mortality in women due to malignant diseases and is the most prevalent type of cancer in western countries. According to investigations which has been done in Iran so far, the prevalence of disease in our country is also very high, therefore complete attention to clinical and pathological findings of this disease would be extremely essential. In this study, the direct relationship between axillary lymph node involvement and the aggressiveness of invasive ductal carcinoma has been brought into consideration. This study is a case series of 90 patients which all of them have had radical mastectomy because of breast cancer and all their samples has been referred to the center of pathology of Imam hospital. Based on modified Bloom-Richardson grading, all the samples have been graded. The study of all lymph node samples related to above cases has also been conducted along with the main study. The most frequent ages of disease was 31 to 40 and left breast had most involvement. From all cases, 12.2% were in grade I with 27.2% lymph node involvement, 66.7% grade II with 73.4% lymph node involvement and 21.1% in grade III with 100% lymph node involvement (P=0.00008). Based on statistical analysis we concluded that the axillary lymph node involvement in breast cancer is strongly associated with the aggressiveness of invasive ductal carcinoma. This important point should not be neglected in planning for treatment of this kind of disease.
Omran Poor R, Hagh Shenas Sh, Giti M,
Volume 61, Issue 5 (8-2003)
Abstract
Knowledge of axillary lymph node Status is essential in treatment planning and in prognostic evaluation of breast cancer.
Materials and Methods: Preoperative high resolution Sonography of axilla, were performed on 100 patients with breast carcinoma (T1-T2) clinical, before axillary lymph node dissection and pathologic evaluation.
Results: The Sensitivity of ultra Sonography in detection of axillary metastasis was 78% with specificity of 79% and accuracy of 79% PPV was 85% and NPV was 70%.
Conclusion: Preoperative ultra sonography, alone, is not optimal for detect ion of axillary lymphnode metastasis.
Khlkhali K, Sadr Hosseini S M, Azizi M R, Dashti Khoidaki Gh A,
Volume 61, Issue 6 (9-2003)
Abstract
Kimura's disease (K.D) is an uncommon, benign, chronic inflammatory condition of unknown etiology and pathogenesis involving subcutaneous tissue presenting as a tumor like lesion with a predilection for the head and neck region. If parotid gland is affected clinically it is often confused with parotid tumor with lymph node metastasis. It is difficult to diagnosis before tissue biopsy and fine middle aspiration (FNA) has only limited value. There is no evidence of malignant transformation and occasional spontaneous resolution occurs. Various treatment modalities have been suggested in the management of this condition but none is proved best and recurrence is common. we describe a 33 - year- old man with KD who presented with left parotid mass.
Bannazadeh M, Mohajeri G R, Jamali M,
Volume 65, Issue 11 (2-2008)
Abstract
Background: It is well known that, at the time of the initial presentation of patients with non-small cell lung cancer, N-status is very important in accurate staging and avoiding inappropriate surgical procedures. Also, if mediastinal lymph node metastasis (N2) of non-small cell lung cancer (stage IIIA) is present, neoadjuvant (preoperative) chemora-diotherapy is indicated therefore a quick and accurate N-status determination is critical before thoracotomy. We compared the usefulness and accuracy of touch imprint and frozen section analysis for this purpose.
Methods: During 2006, fifty eight mediastinal lymph node specimens from 27 patients with lung cancer were excised. After touch imprint preparation, half of each lymph node was sent for frozen section and finally permanent histology.
Results: Frozen section and touch imprint had only one and two false negative results, respectively, but neither had false positive reports. The sensitivity, specificity and accuracy of the frozen section evaluation was 95.5%, 100% and 98.2%, respectively, and those of touch imprint were, 90.9%, 100% and 96.4%. The differences in the sensitivity, specificity and accuracy between the two methods were not significant (p>0.05).
Conclusion: Frozen section and touch imprint have similarly high accuracies for detecting mediastinal lymph node metastasis in lung cancer. However, since the touch imprint method is more rapid and simple, it maybe method of choice.
Omranipour R,
Volume 66, Issue 2 (5-2008)
Abstract
Background: Sentinel lymph node (SLN) biopsy has become the standard of care in malignant melanoma, it is commonly identified by intradermal injection of both radiocolloid tracer and Patent Blue Dye (PBD) around the tumor. This study aims to evaluate the efficacy of PBD in identifying inguinal SLN and also the accuracy of SLN mapping performed by peritumoral injection of PBD without combined radioisotope in malignant melanoma of lower extremity.
Methods: Thirty consecutive patients with primary melanoma of lower exteremity who were referred to Cancer Institute of Tehran University of Medical Science between March 2003 to March 2006 were enrolled in this study. All patients had a preoperative pathologic diagnosis of malignant melanoma, median breslow thickness (range 1-4 mm) and none had clinical or radiologic evidence of nodal involvement or distant metastases.
At surgery PBD was injected around the lesion or scar of excisionl biopsy. Subsequently with a 5cm groin incision SLN Biopsy and complete lymph node dissection was done and all lymph nodes were sent for histopathologic examination. SLN examined by both hematoxylin-eosin and immunohistochemical staining.
Results: SLN identification rate was 100%. No complication directly related to PBD injection was seen. Forty-eight sentinel lymph nodes and 195 non sentinel lymph nodes were harvested. Nineteen SLNS were found to be metastasic in 13 patients (47%). In these patients metastases were found in other inguinal lymph nodes.
In the remaining 17 patients, both the SLN itself and the other removed nodes were negative for the metastatic involvement.
Conclusions: Patent blue dye may be enough to identify superficial inguinal SLN in lower extremity melanoma.
Soheila Aminimoghaddam , Fatemeh Mahmoudzadeh , Andisheh Maghsoudnia , Fatemeh Ghaemmaghami ,
Volume 72, Issue 9 (12-2014)
Abstract
Background: Endometrial carcinoma is considered the most common gynecological cancer in the world. Pelvic and para-aortic lymphadenectomy is widely advised based on FIGO staging system. Intra-operative frozen sections analysis is used to identify pa-tients at high risk for pelvic and para-aortic nodal metastasis evading lymphadenec-tomy in low-risk patients. However there is still some controversy concerning the effi-ciency of IFS. The aim of this study was to determine the validity and precision of fro-zen section diagnosis and gross examination of uterine specimen compared to the final histological results in patients with endometrial cancer.
Methods: Patients diagnosed as endometrial cancer based on office biopsy using a Pipelle or D&C who underwent surgical staging were compared for frozen section anal-ysis and permanent diagnosis. Patients with the history of radiotherapy or other types of cancer or co existence malignancies were excluded.
Results: There was no relation between the tumor size and lymph node involvement and the results were not significant (P= 0.1). Frozen section analysis was significantly accurate and correct in predicting final histopathological results (P< 0.0001). It has been shown that in more than 90% of patients the diagnosis made by frozen section analysis was in accordance with final pathology with considerable sensitivity and spec-ificity. Gross examination was also precise in determining myometrial microscopic in-vasions (P< 0.0001).
Conclusion: Although the sample size of the studied population was small but our study results support the previous data and suggest that in early stages and low grade tumors, gross examination and frozen section diagnosis are conveniently predictive of lymph node metastasis. These data might be useful for prediction of tumor invasion using frozen section and gross examination in low grade tumors and early stages and for doing complete surgical staging and lymph node sampling. However the im-portance of surgical staging always must be considered in patients who need systemat-ic lymphadenectomy. In overall these data might help to come up with new guidelines for surgical risk assessment in endometrial cancer.
Narges Zamani, Mohammadhossein Zamani Zamani, Mitra Modaresgilani Modaresgilani ,
Volume 73, Issue 8 (11-2015)
Abstract
Background: Endometrial carcinoma is considered the most common gynecological cancer in the world. Pelvic and para-aortic lymphadenectomy is widely advised based on FIGO staging system. The purpose of this study was to determine whether the biomarker human epididymis protein 4(HE4) correlates with depth of myometrial invasion, histologic grade and metastases in patients with endometrioid adenocarcinoma of the uterus. Methods: This was a cross-sectional study in women with biopsy-proven endometrioid adenocarcinoma in the gynecological ward of Vali-e-Asr Hospital from October 2012 to October 2014. The concentrations of HE4 and CA125 were assessed before surgery and all surgical specimens were reviewed by dedicated gynecologic pathologists. The results were compared with the final histopathology report. Results: A total of 80 patients were initially entered in this study. Twelve patients were excluded because they didn’t have tumor marker. Most of patients (76%) was in stage I disease. Levels of serum HE4 greater than 140 PM and CA125 greater than 35 kU/L observed in 12(17%) and 26(38.2%) of patients, respectively. Of the 52 patients with satge I, 14(26.9%) had CA125&ge35 KU/L, compared with 6(66.7%) of the 9 patients with stage II and 6(85.7%) of the 7 patients with stage III (P<0.002). A significant increase in serum CA125 level was noted in patients with grade III tumors, deep myometrial invasion, cervical stromal involvement and nodal metastasis (P<0.001, P<0.0001, P<0.006, P<0.002). Among the group of patients with early stage disease a significant increase in serum CA125 was noted in patients with deep myometrial invasion. Five out of 52 patients (9.6%) in stage I had HE4 level&ge140 PM, compared with 3 patients (33.3%) with stage II and 4 patients (57.1%) with stage III disease (P<0.003). A significant increase in serum HE4 level was noted in patients with grade III tumors, deep myometrial invasion, cervical stromal involvement and nodal metastasis (P<0.035, P<0.001, P<0.012, P<0.007). Conclusion: Human epididymis protein 4 (HE4) and CA125 may be a useful markers preoperatively in the clinical decision making for determining the need for lymph node dissection in women with endometrial cancer.
Fariba Behnamfar , Matina Jafari , Masoud Moslehi ,
Volume 75, Issue 8 (11-2017)
Abstract
Background: Endometrial cancer (EC) is the most prevalent genital related cancer of females. One of the controversial points about endometrial cancer surgery is preserving or dissection of sentinel lymph nodes (SLNs). Lymphatic mapping and sentinel nodes sample has been used widely for diverse solid tumors in order of finding metastasis in lymph nodes. The aim of current study was to evaluate diagnostic value of technetium-99 and methylene blue in diagnosis of sentinel lymph node involvement in low-risk endometrial cancer.
Methods: This cross-sectional study was conducted through 2016 on 14 patients with low-grade endometrial cancer referred to Al-Zahra and Shahid Beheshti Hospitals (affiliated to Isfahan University of Medical Sciences), Iran, in 2016-17. Eighteen and twenty-four hours before operation, patients underwent technetium-99 (Tc-99) injection to uterine cervix. Twenty-four hours prior to surgery, patients were referred to resident of gynecology and filled demographic checklist. In next day during operation, Tc-99 was detected by gamma probe. Methylene blue was injected in operation room and blue nodes were detected by naked eye. All patients underwent total hysterectomy, bilateral salpingo-oophorectomy and pelvic lymphadenectomy. Dissected lymph nodes were sent for frozen section and assessment of positive/negative metastasis. Then data were analyzed with SPSS software, version 20 (SPSS Inc., Chicago, IL, USA).
Results: Mean age of our patients was 60.64±9.18 years. Total number of 80 SLNs was dissected. 18.8% of nodes were detected using methylene blue, 12.5% using tecnethium-99 and 6.3% were in common with both methods. Number of two nodes was metastatic and was detected by blue dye and Tc-99. Sensitivity, negative predictive value and detection rate of Tc-99 alone, methylene blue alone and their combination was 100% and false negativity of all above was 100%.
Conclusion: Due to findings of our study, as sensitivity, detection rate, negative predictive value and false negativity of methods lonely and in combination were similar thus based on higher probability of blue dye adverse effects, use of Tc-99 lonely may be adequate.
Shahrbanoo Keihanian , Nafiseh Koochaki , Majid Pouya , Maryam Zakerihamidi ,
Volume 77, Issue 8 (11-2019)
Abstract
Background: Breast cancer is the most commonly diagnosed and the leading cause of cancer death among females worldwide. The rate of breast cancer incidence among Iranian women is 17% of all cancers, it has been ranked first in Iran. This study aimed to investigate the factors affecting axillary lymph node involvement in female patients with breast cancer.
Methods: A cross-sectional study was conducted on 167 patients with breast cancer diagnosed between March 2012 and March 2015 at Shahid Beheshti of Babol, Shahid Rajaei of Tonekabon and Imam Sajad of Ramsar hospitals. A researcher-made questionnaire was used to collect information on the patients and pathology report of tumor and lymph nodes was completed.
Results: The rate of axillary lymph node involvement was observed in 117 patients (70.1%). Mean age was 49.64±11.62 years in the patients with breast cancer. The highest frequency of lymph node involvement was observed in the 40-49 age group (24%). The average size of tumor was 3.39 cm and the majority of patients had a tumor 2-5 cm (T2) but the most involvement was related to T3 (>5cm). The most common type of cancer and grading were invasive ductal carcinoma (93.4%) and tumor grade 2 (52.1%), respectively. Most lymph node involvement was observed in invasive ductal carcinoma and 85.1% of patients had tumor degree 3. 22.2% of patients with vessels involvement had axillary lymph node involvement. 63% of patients’ tumors had receptors of estrogen and progesterone. A statistically significant association was observed between axillary lymph node involvement and tumor size (P=0.031), tumor type (P=0.007), tumor grade (P=0.011), estrogen receptor (P=0.008) and progesterone receptor (P=0.038).
Conclusion: There was a statistically significant association between axillary lymph node involvement and tumor size, type and grade, estrogen and progesterone receptor status, but there was no statistically significant association between axillary lymph node involvement and age and estrogen as well as progesterone receptor status.
Azim Motamedfar , Mohammad Momen Gharibvand, Mohammadghasem Hanafi , Fatemeh Neghab,
Volume 81, Issue 5 (8-2023)
Abstract
Background: The aim of the present study is to determine the accuracy of ultrasound imaging in the diagnosis of metastatic lymph nodes compared to postoperative pathology samples of patients with papillary thyroid cancer.
Methods: This study was carried out using a descriptive and analytical epidemiological method on 103 known patients with papillary thyroid cancer who referred to Imam and Golestan hospitals in Ahvaz for neck ultrasound from September 2021 to August 2022. A total of 103 patients (including 94 women (91.3%) and 9 men (8.7%)) with papillary thyroid cancer with an average age of (39.8±11.9) were included in the study. The average tumor size in these patients was estimated to be (16.8±10mm). The ultrasound results of these patients before surgery were compared with the pathology results of these patients after surgery.
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Results: According to the obtained results, metastatic involvement of cervical lymph nodes was diagnosed in 36.6% of patients (38 people). Of these, 30.7% of patients (32 people) were real positive. The results of ultrasound before surgery were shown as false positive in 9.5% of patients (6 people). Lymphatic metastasis was not seen in 58.4% of patients (60 people) before surgery, which was consistent with the pathology result after surgery (true negative). The positive predictive value of examining metastatic lymph nodes by ultrasound was estimated at 84.2% and the negative predictive value at 92.3%. The diagnostic accuracy of ultrasound was 89%, the sensitivity rate was 86%, and the specificity rate was 90% with the area under the curve AUC=0.884 and P<0.001. Ultrasound accuracy is not affected by tumor size, Hashimoto's thyroiditis and metastasis location (P<0.05). In patients with Hashimoto's thyroiditis, the tumor size increases significantly more than 10 mm.
Conclusion: Ultrasound alone has an acceptable diagnostic accuracy in detecting metastatic lymph nodes caused by papillary thyroid cancer. However, the incidence of false negative error increases as the tumor size decreases.
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