Integrative hyperthermia treatments for different types of cancer
Clifford L. K. Pang, Kaiman Lee in Hyperthermia in Oncology, 2015
Breast mass is the most common manifestation of breast cancer. The symptom of nipple discharge mostly means benign change. But patients more than 50 years old with unilateral nipple discharge should be alerted to the possibility of breast cancer. Nipple retraction, nipple itching, scaling, erosion, ulceration, scab, and eczema-like changes are often clinical manifestations of mammary Paget’s disease. Some patients present breast skin and contour changes. For example, when the cancer invades the Cooper ligament of the skin a “dimple syndrome” can be formed, cancer cells blocking subcutaneous lymphatic capillaries can result in skin edema, and depressions at the hair follicles can form the “orange peel” syndrome. When the skin is widely invaded, many hard nodules or small cords are formed in the epidermis or even integrated into pieces. If lesions extend to the back and to contralateral chest wall, breathing can be restricted and corset cancer can be formed. Inflammatory breast cancer can present significantly enlarged breasts with skin congestion, redness, and swelling and with increased local skin temperature. In addition, advanced breast cancer can present skin ulceration and form cancerous ulcers. Some patients present with swollen lymph nodes: the ipsilateral axillary lymph nodes can undergo swelling. Advanced breast cancer can transfer to contralateral axillary lymph node metastasis and cause swelling; moreover, the ipsilateral and contralateral supraclavicular lymph nodes are palpable in some cases.
Naturally Occurring Alkaloids with Anti-HIV Activity
Namrita Lall in Medicinal Plants for Cosmetics, Health and Diseases, 2022
Immunodeficiency results in increased susceptibility to a wide range of infections, cancers and other diseases. The symptoms of HIV vary depending on the stage of infection. In the first few weeks after the initial infection, people may experience no symptoms or an influenza-like illness including fever, headache, rash or sore throat. However, they tend to be most infectious during this time. In severe cases, the people have symptoms including swollen lymph nodes, weight loss, fever, diarrhea and cough. In case of improper diagnosis and treatment, they could develop severe illnesses such as tuberculosis (TB), cryptococcal meningitis, severe bacterial infections and cancers such as lymphomas and Kaposi’s sarcoma. However, the most advanced stage of HIV infection is AIDS, which can take many years to develop if not treated, depending on the individual. AIDS is defined by the development of certain cancers, infections or other severe long-term clinical manifestations (WHO, 2020).
Cutaneous malignant melanoma: epidemiology, endocrine features and hormone replacement therapy
A. R. Genazzani in Hormone Replacement Therapy and Cancer, 2020
The Melanoma Staging Committee of the American Joint Committee on Cancer (AJCC) has recently proposed major revisions of melanoma staging criteria9 (Table 1). As for lymph node status, micrometastases are diagnosed after sentinel or elective lymphadenectomy and macrometastases are defined as clinically detectable metastases confirmed by lymphadenectomy or nodal metastasis with gross extracapsular extension. All melanoma patients who have clinically negative regional nodes and who may enter into adjuvant clinical trials should have pathological staging with sentinel lymphadenectomy. A multivariate analysis of prognostic factors has shown that tumor thickness and ulceration are the strongest independent variables in patients with localized melanoma10. The level of invasion is more predictive of clinical outcome than ulceration only in the subset of patients with thin (< 1 mm) melanoma. Increasing patient age, sex (males worse than women), and the anatomic site (trunk and head and neck worse than extremities) are other independent prognostic variables. Among patients with lymph node involvement the most important prognostic factors are the number of metastatic nodes and the tumor burden (microscopic versus macroscopic). Among metastatic patients the strongest prognostic variables are the site of metastasis (skin, subcutaneous or nodal metastases better than lung or other visceral sites) and serum lactate dehydrogenase levels.
Utility of 18-fluorodeoxyglucose positron emission tomography in children with relapsed/refractory leukemia
Published in Pediatric Hematology and Oncology, 2018
Zühre Kaya, Ozgür Umit Akdemir, Ozlem Lütfiye Atay, Nalan Akyürek, Faruk Güçlü Pınarlı, İdil Yenicesu, Ülker Koçak
Of the 28 total patients, six (21%) were FDG-PET/CT negative, four (14%) were positive at only one location, eight (29%) were positive at two locations, and 10 (36%) were positive at three or more sites. In total, 72 extramedullary lesion sites were detected, including 48 in ALL patients and 24 in AML patients. The most commonly involved sites of extramedullary leukemia were lymph nodes (n = 30), spleen (n = 8), soft tissues (n = 6), bone (n = 6), liver (n = 5), and thymus (n = 4). Rarely involved sites were the kidney (n = 3), central nervous system (CNS) (n = 2), joints (n = 2), muscle (n = 2), testis (n = 1), lung (n = 1), pancreas (n = 1), and eye (n = 1). The involvement of the kidney, CNS, eye, testis, and lung was only detected in patients with ALL. The involvement of the pancreas was only detected in patients with AML. The most common lymph node sites affected were the cervical, supraclavicular, abdominal, and axillary lymph regions. On FDG-PET/CT, the involved lymph nodes were mildly to moderately FDG avid, with a median SUVmax of 4.5 (range, 1.5–10.5). For those with splenic involvement, the median spleen SUVmax was 3.6 (range, 2.3–5.0). Four patients showed pulmonary, joint, tonsil, and bone FDG uptake, and these findings were consistent with infectious etiologies as opposed to leukemia.
Mediastinal lymphadenopathy: a practical approach
Published in Expert Review of Respiratory Medicine, 2021
Hariharan Iyer, Abhishek Anand, PB Sryma, Kartik Gupta, Priyanka Naranje, Nishikant Damle, Saurabh Mittal, Neha Kawatra Madan, Anant Mohan, Vijay Hadda, Pawan Tiwari, Randeep Guleria, Karan Madan
The International Thymic Malignancy Interest group (ITMIG) classification divides the mediastinum into three compartments viz. prevascular, visceral, and paravertebral. The prevascular space has the same boundaries as the anterior part of inferior mediastinum, but it extends superiorly to the thoracic outlet level. It consists of the thymus, left brachiocephalic vein and lymph nodes. The visceral compartment is behind the anterior fibrous pericardium. It extends posteriorly till an imaginary plane passing from each thoracic vertebra at a point 1 cm behind the anterior border of the central body of the vertebra. It contains heart, ascending aorta, arch of the aorta and descending aorta, superior vena cava, pulmonary arteries, trachea, esophagus, thoracic duct and lymph nodes. Posterior to this imaginary vertical plane lies the paravertebral compartment. This compartment contains the thoracic spine and paravertebral soft tissue [6]. The intra-thoracic lymph nodes are distributed in all of these compartments (Figure 1A).
Drug delivery to the intestinal lymph by oral formulations
Published in Pharmaceutical Development and Technology, 2022
Takayuki Yoshida, Hiroyuki Kojima, Kazuhiro Sako, Hiromu Kondo
Lymph nodes are small, oval glands that contain T cells, B cells, and macrophages (Thomas and Schudel 2015). Certain lymphatic vessels connect to a lymph node and deliver lymph fluid to the nodes that filter pathogens, viruses, and bacteria through phagocytosis or via an immune response (Fanous et al. 2007). Lymphocytes circulate through the blood and lymphatic vessels where they are trapped in lymph nodes. T cells in the cortical zone are activated by dendritic cells in the nodes, and subsequently, T cells promote antibody production by B cells in the nodular cortex and medulla of the nodes (Thomas and Schudel 2015). Therefore, lymph nodes are crucial sites for mounting and maintaining immune responses and therefore serve as the main target sites for the delivery of vaccines or immunosuppressive drugs.