OBJECTIVETo probe the relationship between lymphangiogenesis and cervical lymph node micrometastasis in oral squamous cell carcinoma.

METHODSThe microlymphatic vessel density was detected with enzyme histo-chemical method in 47 cases of oral squamous cell carcinoma and 10 cases of normal oral mucosa; 355 lymphnodes were detected with immunohistochemically using monoantibody AE3.

RESULTSThe mean MLVD was 14.04 +/- 6.92 in tumor group, or 5.48 +/- 2.62 in normal group. The difference was (P < 0.001). The percentage of tumor with expression CK was 48.9%. The mean MLVD was 16.94 +/- 5.43 in CK positive group, or 11.26 +/- 5.00 in CK negative group, There was difference significant (P < 0.001).

CONCLUSIONSLymphangiogenesis plays a key role in cervical lymph node micrometastasis of oral squamous cell carcinoma.

Carcinoma, Squamous Cell ; secondary ; surgery ; Humans ; Lymph Node Excision ; Lymph Nodes ; pathology ; Lymphangiogenesis ; Lymphatic Metastasis ; Mouth Neoplasms ; pathology ; surgery ; Neck

OBJECTIVEThe purpose of this study was to explore a feasible method to detect the micrometastases.

METHODSTotally 152 cases of negative cervical lymph nodes (CLNs) from 30 patients with squamous cell carcinoma in tongue were included in this study. The HE-stained slices of the CLN were reexamined by two experienced pathologists and, conformed that no carcinoma cells were found. Two slices were made from each paraffin specimen and, the slices were stained with the microwave immunohistochemical technique with monoclonal antibody CK (AE1/AE3) (DAKO Co. Denmark, 1:100).

RESULTSAmong these 152 cases 7 (4.6%) positive lymph nodes were found in 4(13.3%) patients, and CLN metastases were found in all the patients before the surgical treatment. Most of the micro-metastatic nodes appeared in the upper deep cervical area, except that one of them was found in the submandibular triangle.

CONCLUSIONThe results suggest that micrometastases frequently occurred in negative lymph nodes. The present method may be useful in detecting the micrometastases of lymph nodes and in evaluating clinical stages of patients with oral cancers.

Carcinoma, Squamous Cell ; secondary ; surgery ; Humans ; Immunohistochemistry ; Lymph Nodes ; pathology ; Lymphatic Metastasis ; Neck ; Neck Dissection ; Sensitivity and Specificity ; Tongue Neoplasms ; pathology ; surgery

OBJECTIVEWe analyzed the lymph node (MLNs) metastasis of thoracic esophageal squamous cell carcinoma (ESCC) to explore the patterns of lymphatic spread and the rational surgical procedure and extent of lymph node dissection for ESCC.

METHODSWe retrospectively evaluated 313 consecutive patients treated in our hospital between January 2010 and May 2014 who underwent minimally invasive esophagectomy (MIE) for ESCC. The information of lymph node status was obtained and the features of lymph node metastasis were analyzed.

RESULTSOf the 313 cases, 122 (39.0%) were found to have lymph node metastasis. In the 4461 dissected lymph nodes, metastasis was identified in 294 (6.6%) lymph nodes. The recurrent laryngeal nerve lymph nodes were the most frequent metastatic nodes with a metastasis rate of 25.2%, followed by the paracardiac and left gastric artery lymph nodes (18.2%). Chi-square test showed that the lymph node metastasis is associated with tumor invasion and tumor differentiation (P<0.001 for both). Metastases were more frequently found in the recurrent laryngeal nerve lymph nodes in patients with tumors in the upper third esophagus and with histologically poor differentiation (P<0.05 for both). The metastasis rate of para-cardiac and left gastric artery lymph nodes was associated with tumor in the lower third of esophagus, T stage and differentiation (all P<0.05). Logistic regression analysis showed that tumor differentiation and location are independent factors affecting the metastasis of recurrent laryngeal nerve lymph nodes (P<0.05 for all). T stage, tumor differentiation and location were independent factors associated with metastasis of para-cardiac and left gastric artery lymph nodes (P<0.05 for all).

CONCLUSIONS(1) Metastases of thoracic esophageal carcinoma are often found in the recurrent laryngeal nerve lymph nodes, para-cardiac and left gastric artery lymph nodes. (2) Extensive lymph node dissection should be performed for ESCC with poor differentiation and deep tumor invasion.

Carcinoma, Squamous Cell ; secondary ; surgery ; Esophageal Neoplasms ; pathology ; surgery ; Esophagectomy ; Humans ; Lymph Node Excision ; Lymph Nodes ; pathology ; Lymphatic Metastasis ; Lymphatic Vessels ; Recurrent Laryngeal Nerve ; Retrospective Studies

OBJECTIVETo evaluate the missing diagnosis of neck metastases by routine detecting method (palpation combined with one pathological slide) in laryngeal carcinomas.

METHODSSixty-six specimens of neck dissections were collected and observed by routine method, transparent method, and continuous sliding method.

RESULTSTotally, 1153 lymph nodes were detected by palpation method and another 1204 lymph nodes were detected by transparent method. The lymph nodes detected by transparent method account for 51.1% of the total, and among them 10 metastases were found, which account for 15.6% (10/64) of metastatic lymph nodes. For those with no metastasis detected by routine method, 50 microm interval continuous sliding method was performed, and 14 tiny metastases were found, which account for 21.9% (14/64) of metastatic lymph nodes. Detecting by routine method, most lymph nodes (95%) were in tumor growth and tumor suffusion stage. The missing diagnosis rate of routine method was 37.5% (24/64).

CONCLUSIONSWhen routine method was used to detect lymph nodes in neck specimens, missing diagnosis should be considered to select best therapy. Through transparent method small lymph nodes could be found and it is a valuable method to observe pathological changes of small nodes. Continuous sliding method could find micrometastasis precisely, but the work burden is heavy and it is difficult to be widely used.

Carcinoma, Squamous Cell ; secondary ; surgery ; Diagnostic Errors ; Female ; Humans ; Laryngeal Neoplasms ; pathology ; surgery ; Lymph Nodes ; pathology ; Lymphatic Metastasis ; Male ; Neck Dissection ; Neoplasm Staging ; Specimen Handling ; methods

Primary squamous cell carcinoma of the thyroid is an extremely rare tumor with a highly aggressive clinical course. We report here on a patient with primary squamous cell carcinoma of the thyroid who remains alive more than 8 years after diagnosis. A 56-year-old man presented with a hoarse voice and a rapidly progressing mass on the right side of the thyroid gland. The patient underwent a total thyroidectomy without neck lymph node dissection. Histopathologic findings revealed primary squamous cell carcinoma combined with follicular carcinoma of the thyroid. The tumors metastasized to the cervical lymph nodes, thoracic spine and lung. He underwent 5000 rads of adjuvant radiotherapy to the neck. TSH suppressive therapy with L-thyroxine was administered alone rather than radioactive iodine therapy or chemotherapy. The patient's clinical course has been remarkable over the first 7 years; he has remained stable except for a transient paraplegia due to nerve compression. The patient underwent colectomy for the diagnosis of a colon cancer. Recent evaluation has revealed a new lesion in the lung; this was diagnosed as metastatic follicular carcinoma originating from the thyroid. High dose radioactive iodine therapy was administered, and he remains alive in stable condition.
Thyroidectomy ; Thyroid Neoplasms/*pathology/surgery ; Survival ; Spinal Neoplasms/secondary ; Radiotherapy, Adjuvant ; Neoplasm Metastasis ; Middle Aged ; Male ; Lung Neoplasms/secondary ; Humans ; Carcinoma, Squamous Cell/*pathology/surgery ; Adenocarcinoma, Follicular/*pathology/surgery

INTRODUCTIONPenile cancer is an uncommon disease affecting only about one in 100,000 men worldwide in a year. The diagnosis of the condition is frequently delayed, and the disease and its treatment frequently result in significant morbidity in patients.

METHODSWe herein describe seven cases of penile tumours: six cases of squamous cell carcinomas and one case of B-cell lymphoma that presented to our hospital's urology department between March 2011 and October 2012. We reviewed the literature to discuss the clinical presentation, natural history and current management of penile cancer.

RESULTSThe patients were followed up for 1-24 months. They were managed according to their disease stage and lymph node status. Four out of seven patients showed disease progression during the follow-up period.

CONCLUSIONThe accurate staging of inguinal nodes in cases of low-risk disease is important to prescribe appropriate surgery for the inguinal nodes. Aggressive management of inguinal and pelvic lymph nodes remains the cornerstone in the treatment of high-risk disease cases.

Aged ; Carcinoma, Squamous Cell ; diagnosis ; secondary ; surgery ; Humans ; Lymph Node Excision ; Lymphatic Metastasis ; Male ; Middle Aged ; Neoplasm Staging ; Penile Neoplasms ; diagnosis ; pathology ; surgery ; Urologic Surgical Procedures, Male ; methods

Basaloid squamous cell carcinoma is a rare and aggressive variant of squamous cell carcinoma, which mostly occurs in the upper aerodigestive tracts. Basaloid squamous cell carcinoma also typically arises in the anal canal, but is extremely rare in the lower gastrointestinal tract. A 70-year-old man presented with loose stool and intermittent hematochezia 2 months ago. Colonoscopy showed an ulceroinfiltrative mass on the rectosigmoid colon from 16 cm to 18 cm above the anal verge. Conventional colonoscope could not pass through the lesion but it was possible with pediatric colonoscope. Abdominal CT scan showed 1.6 cm sized wall thickening with circumferential luminal narrowing in the rectosigmoid colon and multiple ill-defined low density masses in both lobes of the liver. Therefore, colon cancer with liver metastasis was suspected. However, basaloid cells were noted on histologic examination, and they were weakly positive for synaptophysin on immunohistochemical study. After palliative lower anterior resection, histologic examination of the resected specimen revealed basaloid differentiation with keratin pearls, and tumor cells were positively stained with high molecular weighted cytokeratin (34BE12) and CK 5/6. Thus, the patient was finally diagnosed with basaloid squamous cell carcinoma of rectosigmoid colon with distant metastases.
Aged ; Carcinoma, Squamous Cell/*diagnosis/pathology/surgery ; Colonoscopy ; Colorectal Neoplasms/*diagnosis/pathology/surgery ; Humans ; Immunohistochemistry ; Keratins/metabolism ; Liver Neoplasms/radiography/secondary ; Lung Neoplasms/radionuclide imaging/secondary ; Male ; Positron-Emission Tomography ; Synaptophysin/metabolism ; Tomography, X-Ray Computed

OBJECTIVETo analyze the clinical feature and prognosis of primary branchial carcinoma.

METHODSThe main method of this study was reviewing the clinical feature, diagnosis, treatment methods and prognosis of 5 patients suffered from primary branchial carcinoma.

RESULTSAll of the tumors were excised extensively. All of the patients received radical neck dissection and post-operative radiotherapy. 3 patients had pathologic evident of metastasis in lymph nodes of cervical region. 2 patients died of local recurrence of tumor and metastasis to lung. 1 patient died after post-operative 2 years. 2 patients were still alive after 5 years' follow-up.

CONCLUSIONPrimary branchial carcinoma has the very similar clinical feature with branchial cyst. The diagnosis should be considered if painless mass and swollen lymph nodes were found in upper neck region of patients. Rapid frozen pathologic section should be made regularly to make the diagnosis clear. The treatment should include extensive excision of tumor and radical neck dissection to improve the cure rate and survival rate.

Adult ; Branchioma ; diagnosis ; secondary ; surgery ; Carcinoma, Squamous Cell ; diagnosis ; secondary ; surgery ; Diagnosis, Differential ; Female ; Follow-Up Studies ; Head and Neck Neoplasms ; diagnosis ; pathology ; surgery ; Humans ; Lymphatic Metastasis ; Male ; Middle Aged ; Neck Dissection ; Prognosis ; Retrospective Studies ; Survival Rate

Oral squamous cell carcinoma (OSCC) has a high incidence of cervical micrometastases and sometimes metastasizes contralaterally because of the rich lymphatic intercommunications relative to submucosal plexus of oral cavity that freely communicate across the midline, and it can facilitate the spread of neoplastic cells to any area of the neck consequently. Clinical and histopathologic factors continue to provide predictive information to contralateral neck metastases (CLNM) in OSCC, which determine prophylactic and adjuvant treatments for an individual patient. This review describes the predictive value of clinical-histopathologic factors, which relate to primary tumor and cervical lymph nodes, and surgical dissection and adjuvant treatments. In addition, the indications for elective contralateral neck dissection and adjuvant radiotherapy (aRT) and strategies for follow-up are offered, which is strongly focused by clinicians to prevent later CLNM and poor prognosis subsequently.
Carcinoma, Squamous Cell ; pathology ; radiotherapy ; secondary ; surgery ; Humans ; Lymph Nodes ; pathology ; Lymphatic Metastasis ; Mouth Floor ; pathology ; Mouth Neoplasms ; pathology ; radiotherapy ; surgery ; Neck ; pathology ; Neck Dissection ; Neoplasm Invasiveness ; Neoplasm Recurrence, Local ; Neoplasm Staging ; Radiotherapy, Adjuvant

OBJECTIVETo evaluate the surgical therapeutic strategy for non-small cell lung cancer (NSCLC) with (N2) mediastinal lymph node metastasis.

METHODSThe clinical data of 325 patients with N2 NSCLC treated surgically between 1961 and 1995 were analysed.

RESULTSThe over-all 5-year survival rate was 19.6%. Survival was higher in patients with radical resection than with palliative resection, with squamous-cell carcinoma than with adenocarcinoma, with sleeve lobectomy and pneumonectomy than with regular lobectomy, with 1 to 3 mediastinal metastatic lymph nodes than those over 4, and with adjuvant therapy (chiefly postoperative radiotherapy) than without. All these differences were statistically significant (P < 0.05). There was no 5-year survivor in patients with T3 or T4 tumor, nor in those with distant metastasis.

CONCLUSIONIt is suggested that surgery is the best choice for N2 NSCLC patients with T1 or T2 tumor, with non-adenocarcinoma, and with metastatic mediastinal lymph nodes less than 4 in number. Surgery is probably not a good choice in those with T3 tumor varieties. At operation, radical resection of the tumor and systematic removal of all hilar and mediastinal lymph nodes are essential for disease staging and survival improvement. Adjuvant therapy may improve long-term survival and is especially indicated in patients with residual tumor and/or metastatic mediastinal lymph nodes over 3 in number.

Adenocarcinoma ; drug therapy ; radiotherapy ; secondary ; surgery ; Adult ; Aged ; Carcinoma, Non-Small-Cell Lung ; drug therapy ; radiotherapy ; secondary ; surgery ; Carcinoma, Squamous Cell ; drug therapy ; radiotherapy ; secondary ; surgery ; Chemotherapy, Adjuvant ; Female ; Follow-Up Studies ; Humans ; Lung Neoplasms ; drug therapy ; pathology ; radiotherapy ; surgery ; Lymph Node Excision ; Lymph Nodes ; pathology ; Lymphatic Metastasis ; Male ; Mediastinum ; Middle Aged ; Neoplasm Staging ; Pneumonectomy ; methods ; Radiotherapy, Adjuvant ; Survival Rate