2.Assessment of lymph node metastasis in gastric cancer: status quo, recent advances and new perspectives.
Min TU ; Zhen-shu ZHU ; Lin-sen SHI ; Xi-qun JIANG ; Hao WANG ; Wen-xian GUAN
Chinese Journal of Gastrointestinal Surgery 2012;15(2):197-200
The precondition of accurate gastric cancer surgery is precise assessment of lymph node metastasis. To date, no imaging modality achieves both high sensitivity and high specificity in detecting lymph node metastasis in gastric cancer. Intraoperative sentinel node tracing and biopsy are the most popular method to identify the localization of tumor cell, but is limited to early gastric cancer. Nano-composite materials, designed for tumor imaging and tracing, show us a newly emerging domain for tumor detection in gastric cancer. The function of these nano-composite materials to detect lymph node metastasis in gastric cancer relies on the effective backflow of lymph system. However, the lymph vessels can be obstructed by tumor cells in advanced gastric cancer, which may restrain the application of these nanoparticles. Therefore, more methods to detect lymph node metastasis in gastric cancer should be explored. This review summarizes the characteristic of the targeted nanosphere. Based on the reported studies, a novel idea is conceived that targeted multifunctional nanosphere may be a potential method to achieve precise assessment of lymph node metastasis in gastric cancer.
Humans
;
Lymph Nodes
;
pathology
;
Lymphatic Metastasis
;
pathology
;
Stomach Neoplasms
;
pathology
4.The progression of the extent of lymph node dissection in radical resection of pancreatic head cancer.
Chinese Journal of Surgery 2023;61(3):251-255
Pancreatic cancer is a malignant tumor of digestive system with poor prognosis,and surgical resection is still the only hope for a radical cure. Although the current consensus and guidelines describe in detail the standard and extended range of lymph node dissection,the selection of specific range of lymph node dissection and its impact on prognosis are still controversial. Current studies have not only proposed some improved extent of lymph node dissection, such as total mesopancreas excision and Heidelberg triangle dissection, but also suggested different extent of lymph node dissection for ventral and dorsal pancreatic head cancer. In addition, the prognosis of pancreatic head cancer in uncinate process and non-uncinate process is different after para-aortic lymph node dissection, which is worthy of further study. Neoadjuvant therapy or conversion therapy provides more surgical opportunities for patients with pancreatic cancer. For these patients, Heidelberg triangle dissection has potential value in improving prognosis. This paper summarizes the exploration and latest progress of standard and extended lymph node dissection, lymph node dissection of specific site of pancreatic head cancer and the extent of lymph node dissection after neoadjuvant/transformation therapy in recent years.
Humans
;
Lymph Node Excision
;
Pancreatic Neoplasms/pathology*
;
Lymph Nodes/pathology*
;
Pancreas/pathology*
;
Prognosis
6.Diagnostic Use of Endoscopic Ultrasound-guided Trucut Biopsy in Various Diseases.
Jin Ho LEE ; Jung Hwan LEE ; Jung Hoon SONG ; Kyung Sun OK ; Won Cheol JANG ; Soo Hyung RYU ; You Sun KIM ; Jeong Seop MOON
Korean Journal of Gastrointestinal Endoscopy 2010;40(1):9-15
BACKGROUND/AIMS: Endoscopic ultrasound-guided trucut biopsy (EUS-TCB) is a relatively new method, which facilitates obtaining a core biopsy through the gut wall. We evaluated the diagnostic accuracy of EUS-TCB based on the types of lesions. METHODS: We retrospectively reviewed the database of 37 cases in 35 patients (mean age, 57.2+/-2.3 years; 23 men) with thoracic and abdominal masses who got EUS-TCB between January 2007 and June 2008. Final diagnoses were determined by malignant positive EUS specimens, surgical pathology, or the clinical course. RESULTS: Adequate samples were obtained by EUS-TCB in 78.4% (29/37) of the cases. The overall diagnostic accuracies of the EUS-TCB were 73.0%. The mean size of the masses was 3.7+/-2.6 cm. The diagnostic accuracies of EUS-TCB according to the lesions were as follows: lymph node, 85.7% (18/21); subepithelial lesion, 60.0% (6/10); and solid tumor, 50% (3/6). With respect to accuracy, lymph nodes were significantly superior to non-lymph node lesions (p=0.046). There was a minor bleeding controlled by hemoclipping (2.7%). CONCLUSIONS: EUS-TCB is a useful technique for the diagnosis of lymph nodes, subepithelial tumors, and solid tumors that were not able to be diagnosed by other methods. In addition, EUS-TCB is a safe and minimally invasive method.
Biopsy
;
Hemorrhage
;
Humans
;
Lymph Nodes
;
Pathology, Surgical
;
Retrospective Studies
7.Interpretation of Posterior Wall of Bronchus Intermedius and Subcarinal Region in Lateral Chest Radiographs.
Dong Wook SUNG ; Joo Hyeong OH ; Yup YOON
Journal of the Korean Radiological Society 1996;35(2):205-212
A lateral chest radiograph is frequently useful and sometimes decisive in detecting chest pathology. Certainparts, such as the posterior wall of the bronchus intermedius (PWBI) and subcarinal regions, can be evaluated onlyon lateral chest radiograph. The authors present and emphasize the findings of PWBI and subcarinal abnormalities. Abnormal PWBI, more than 3 mm thick, is seen in cases of minor degree of oblique position, pulmonary edema, inflammation, neoplasm and enlarged lymph nodes. It can also be seen in patients with subcarinal mass. The findings of subcarinal mass on lateral view are ill-defined increased opacity, fullness of the inferior hilarregion, doughnut sign, extra-density and thickening of the PWBI. Detection of changes in the PWBI and subcarinalregion may be the only diagnostic evidence of hilar and subcarinal disease and helps in its early detection priorto computed tomography.
Bronchi*
;
Humans
;
Lymph Nodes
;
Pathology
;
Radiography, Thoracic*
;
Thorax*
8.Renal Angiomyolipoma Partially Containing Epithelioid Component.
Han Min KIM ; Joon Myoung PARK ; Seung Wan YANG ; Young Ho IN ; Min Gyun KIM ; Won Jae YANG ; Luck Hee SUNG ; Jae Yong CHUNG ; Hyun Jung KIM ; Soo Hyun KIM
Korean Journal of Urology 2007;48(6):655-658
Epithelioid renal angiomyolipoma is a recently recognized pathologic variant of angiomyolipoma, which represents a more malignant course than a classical renal angiomyolipoma. We report a case of histologically proven renal angiomyolipoma. The patient presented with the symptoms and signs of spontaneous rupture of the kidney. On surgical exploration, the ruptured kidney with upper pole kidney mass was resected. The enlarged regional lymph nodes were also removed, which showed the same pathology.
Angiomyolipoma*
;
Epithelioid Cells
;
Humans
;
Kidney
;
Lymph Nodes
;
Pathology
;
Rupture, Spontaneous
9.Is Lymph Node Size a Reliable Factor for Estimating Lymph Node Metastasis in Early Gastric Cancer?.
Journal of Gastric Cancer 2018;18(1):20-29
PURPOSE: Pre-operative lymph node (LN) size is a valuable parameter for determining treatment strategy for gastric cancer. However, a correlation between LN size and metastasis has not been established. MATERIALS AND METHODS: Thirty-six LN-positive (LNP) and matched 36 LN-negative (LNN) patients were included, and pathology slides of the LNs of these patients were reviewed. All the LNs were measured along the long-axis (LA) and short-axis (SA), manually. RESULTS: Average retrieved LNs were 37.3±19.8 and 40.5±11.6 in the LNN and LNP groups, respectively. In total 2,800 LNs, including 136 metastatic LNs (MLNs) and 2,664 non-metastatic LNs (nMLNs), were evaluated. Mean length was significantly more in MLNs along both, the LA and SA (MLN_LA vs. nMLN_LA: 4.97±3.84 vs. 3.37±2.40 mm, MLN_SA vs. nMLN_SA: 3.86±3.19 vs. 2.43±1.59 mm; P<0.001). However, 92.6% (126/136) and 95.6% (130/136) of MLNs were <10 mm along the LA and SA, respectively. In addition, only 22.2% of the LNP group exhibited an MLN as the largest LN. CONCLUSIONS: Pre-operative multi-detector computed tomography has limited ability in estimating the presence of metastasis in LNs because most MLNs are less than 10 mm, and only a small proportion of the LNP group exhibits an MLN as the largest MLN.
Diagnosis
;
Humans
;
Lymph Nodes*
;
Neoplasm Metastasis*
;
Pathology
;
Stomach Neoplasms*