Histologic study on the metastatic process in the experimental model of lymph node metastasis

Ohtake, Katsuya; Shingaki, Susumu; Nakajima, Tamio

doi:10.1016/0030-4220(93)90173-2

“…In US, normal LN is represented as oval-shaped structure composed of an outer hypoechoic cortex and an inner hyperechoic medulla [24]. The process of LN metastasis is represented as tumor cells initially seen as clusters in afferent lymphatic vessels, and which, in the peripheral sinuses, gradually spread to the medulla, replace the entire LN, and extend into adjacent extranodal tissues [25]. Therefore, in early-stage breast carcinoma, tumor deposits essentially restricted within the LN cortex represent either as microscopic nodules with little to no desmoplastic response or as a thin layer of tumor cells directly beneath the LN capsule or within the subcapsular sinuses, whereas in patients with advanced nodal disease, complete nodal replacement and true extracapsular extension are more frequently present [13].…”

Section: Discussionmentioning

confidence: 99%

Clinical axillary nodal staging in breast cancer using preoperative ultrasonography

Ahn¹,

Chae²,

Song³

et al. 2013

Korean J Clin Oncol

0

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Purpose: Among preoperative imaging modalities for axillary nodal staging in patients with breast cancer, Ultrasonography has been shown in many studies to have superior diagnostic accuracy. However, most of them are focused in ultrasonographic criteria toward abnormal nodes. We attempted to compare the differences in ultrasonographic findings according to the nodal stages. Methods: We divided consecutive 140 invasive breast cancer patients with axillary node metastases operated without neo-adjuvant therapy at our institution between January 2004 and June 2008 into pN1 (n= 83, 59.3%) and pN2-3 stages (n= 57, 40.7%), classified ultrasonographic findings into 8 categories, and statistically analyzed differences between the two groups. Results: Complete loss of central echogenicity/fatty hilum and abnormally rounded/irregular shape were statistically significantly higher in pN2-3 stage (P= 0.017 and P= 0.026, respectively). Odds ratios were 2.443 and 2.485, respectively. The number of mean metastatic nodes was more statistically significant in patients with abnormally rounded/irregular shape (P= 0.021). Conclusion: Patients whose ultrasonographic surveys show complete loss of central echogenicity/fatty hilum or abnormally rounded/irregular shape will most likely have a higher metastatic tumor burden in their axillae (≥ 4 positive nodes). Classifications in ultrasonographic findings of axillary node may be of help toward more exact pretreatment clinical axillary nodal staging, especially in neo-adjuvant setting.

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“…In US, normal LN is represented as oval-shaped structure composed of an outer hypoechoic cortex and an inner hyperechoic medulla [24]. The process of LN metastasis is represented as tumor cells initially seen as clusters in afferent lymphatic vessels, and which, in the peripheral sinuses, gradually spread to the medulla, replace the entire LN, and extend into adjacent extranodal tissues [25]. Therefore, in early-stage breast carcinoma, tumor deposits essentially restricted within the LN cortex represent either as microscopic nodules with little to no desmoplastic response or as a thin layer of tumor cells directly beneath the LN capsule or within the subcapsular sinuses, whereas in patients with advanced nodal disease, complete nodal replacement and true extracapsular extension are more frequently present [13].…”

Section: Discussionmentioning

confidence: 99%

Clinical axillary nodal staging in breast cancer using preoperative ultrasonography

Ahn¹,

Chae²,

Song³

et al. 2013

Korean J Clin Oncol

1

0

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Purpose: Among preoperative imaging modalities for axillary nodal staging in patients with breast cancer, Ultrasonography has been shown in many studies to have superior diagnostic accuracy. However, most of them are focused in ultrasonographic criteria toward abnormal nodes. We attempted to compare the differences in ultrasonographic findings according to the nodal stages. Methods: We divided consecutive 140 invasive breast cancer patients with axillary node metastases operated without neo-adjuvant therapy at our institution between January 2004 and June 2008 into pN1 (n= 83, 59.3%) and pN2-3 stages (n= 57, 40.7%), classified ultrasonographic findings into 8 categories, and statistically analyzed differences between the two groups. Results: Complete loss of central echogenicity/fatty hilum and abnormally rounded/irregular shape were statistically significantly higher in pN2-3 stage (P= 0.017 and P= 0.026, respectively). Odds ratios were 2.443 and 2.485, respectively. The number of mean metastatic nodes was more statistically significant in patients with abnormally rounded/irregular shape (P= 0.021). Conclusion: Patients whose ultrasonographic surveys show complete loss of central echogenicity/fatty hilum or abnormally rounded/irregular shape will most likely have a higher metastatic tumor burden in their axillae (≥ 4 positive nodes). Classifications in ultrasonographic findings of axillary node may be of help toward more exact pretreatment clinical axillary nodal staging, especially in neo-adjuvant setting.

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“…It is quite conceivable, however, that similar mechanisms are operating in lymph node metastasis of oral squamous cell carcinomas in humans because the process of lymph node metastasis of this model closely resembles that seen in human oral carcinoma [7,28]. In our study, the manner of extravasation in the regional lymph node was not investigated, but it is most likely that lymph node metastasis takes place when tumor cells are carried in clusters to the regional lymph node because of the lymphatic sinuses widely distributed within it.…”

Section: )I )))))))!I !)I !I I I I !I I I I ! I I !I !I I I I I I I Imentioning

confidence: 99%

Histopathological study of lymphatic invasion in squamous cell carcinoma (O-1N) with high potential of lymph node metastasis

Yoshizawa

¹

,

Shingaki

²

,

Nakajima

³

et al. 1994

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The process of lymph node metastasis was studied in an animal model (termed O-1N) that was successfully established using a metastatic tumor to the submandibular lymph node from a chemically induced squamous cell carcinoma of the hamster tongue. The model has been maintained by serial transplantation of metastatic tumors into the buccal pouch. Lymphovascular invasion of transplanted O-1N in the tongue was examined in serial histologic sections. Lymphatic vessels were distinguished from blood vessels by Masson's trichrome stain for vascular smooth muscle, BSA-I lectin binding for vascular endothelium, and laminin and type IV collagen immunostaining for the vascular basement membrane. Transplanted tumors enlarged progressively with invasion of surrounding tissues of the tongue and resulted in lymph node metastasis in all animals with successful takes. Local growth of the tumors in the tongue was accompanied by stromal proliferation with abundant dilated lymphatic vessels which contained clusters of tumor cells. On serial sections, the carcinoma cell clusters in lymphatics in the close proximity of tumor nests were in continuity with adjacent tumor nests, whereas such continuity was not recognized in those occurring apart from tumor nests. The formation of isolated carcinoma cell clusters resulting from disintegration of elongated processes of tumor nests with invasion of lymphatics and subsequent transport in lymphatics and deposition in lymph nodes in clusters were well demonstrated in other serial sections. The key step of lymph node metastasis therefore appears to be direct invasion of lymphatic vessels by tumor cells, similar to their invasion of adjacent tissues but different from the way that blood cells escape through vessel walls. Proliferation of lymphatics around tumor nests and transport of tumor cells in clusters would also contribute to the production of metastatic deposits in lymph nodes.

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Histologic study on the metastatic process in the experimental model of lymph node metastasis

Cited by 16 publications

References 6 publications

Clinical axillary nodal staging in breast cancer using preoperative ultrasonography

Clinical axillary nodal staging in breast cancer using preoperative ultrasonography

Clinical axillary nodal staging in breast cancer using preoperative ultrasonography

Histopathological study of lymphatic invasion in squamous cell carcinoma (O-1N) with high potential of lymph node metastasis

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