Incidental findings in pelvic lymph nodes at radical prostatectomy

Winstanley, Ali M.; Sandison, A. J. P.; Bott, Srj; Doğan, Adnan; Parkinson, M. C.

doi:10.1136/jcp.55.8.623

Cited by 20 publications

(18 citation statements)

References 10 publications

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“…Cervical lymph nodes might be especially prone to involvement by a clinically silent lymphoma compared with other lymph node groups. In our patients with prostate cancer, for example, the prevalence rate of clinically undetected lymphoma in pelvic lymph nodes was only 0.2%, a prevalence rate also reported by Winstanley et al 20 in their review of 854 patients with prostate cancer. Thus, patients who had undergone cervical lymph node dissections were twice as likely to be diagnosed with malignant lymphoma compared with men with prostate cancer who had undergone bilateral pelvic lymph node dissections (0.4% vs 0.2%; p ‫ס‬ .05, Fisher exact, two-tailed).…”

Section: Discussionsupporting

confidence: 59%

The prevalence and significance of clinically unsuspected neoplasms in cervical lymph nodes

Ansari-Lari

Westra

2003

Head & Neck

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Section: Discussionsupporting

confidence: 59%

The prevalence and significance of clinically unsuspected neoplasms in cervical lymph nodes

Ansari-Lari

Westra

2003

Head & Neck

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“…52 Based on this information, our current approach is to classify individuals with the incidental discovery of a CLL phenotype infiltrate in a normal-sized lymph node (eg, Tissue involvement. Clonal CLL-like cells can be detected in up to 0.4% of prostatic tissues at the time of prostatectomy 57,58 and in 1.9% of liver biopsy specimens 59 in the absence of meeting any other diagnostic criteria for CLL and SLL. Progression to first therapy has been only rarely reported in these cases, suggesting the concept of "tissue MBL."…”

Section: 30mentioning

confidence: 99%

Monoclonal B-cell lymphocytosis and early-stage chronic lymphocytic leukemia: diagnosis, natural history, and risk stratification

Strati

Shanafelt

2015

Blood

209

149

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Monoclonal B lymphocytosis (MBL) is defined as the presence of a clonal B-cell population in the peripheral blood with fewer than 5 × 109/L B-cells and no other signs of a lymphoproliferative disorder. The majority of cases of MBL have the immunophenotype of chronic lymphocytic leukemia (CLL). MBL can be categorized as either low count or high count based on whether the B-cell count is above or below 0.5 × 109/L. Low-count MBL can be detected in ∼5% of adults over the age of 40 years when assessed using standard-sensitivity flow cytometry assays. A number of biological and genetic characteristics distinguish low-count from high-count MBL. Whereas low-count MBL rarely progresses to CLL, high-count MBL progresses to CLL requiring therapy at a rate of 1% to 2% per year. High-count MBL is distinguished from Rai 0 CLL based on whether the B-cell count is above or below 5 × 109/L. Although individuals with both high-count MBL and CLL Rai stage 0 are at increased risk of infections and second cancers, the risk of progression requiring treatment and the potential to shorten life expectancy are greater for CLL. This review highlights challenging questions regarding the classification, risk stratification, management, and supportive care of patients with MBL and CLL.

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“…This however is unusual with a frequency of 1.8% in a series of 854 patients. [3] In a study of incidentally diagnosed lymphomas, 18 cases were identified from a cohort of 1,160 prostatectomies (1.5%). [4] Lymphomas (B cell, lymphocytic, and follicular), histiocytosis following prosthetic joint replacement, noncaseating granulomas, and foreign body reactions have all been described [Table 1].…”

Section: Discussionmentioning

confidence: 99%

Incidental metastatic endocrine tumor diagnosed at laparoscopic radical prostatectomy and bilateral lymph node dissection

2012

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The introduction and expansion of laparoscopic and robotic radical retropubic prostatectomy (LRRP and RRRP) for organ-confined prostate cancer have led to an increase in pelvic lymphadenectomy specimens. Extended lymph node dissection (eLND) involves removing nodes over the obturator fossa, external ileac vessels as well as the internal iliac and increases the number of nodes examined. This has the potential to increase incidental nonprostatic nodal pathology identified in prostatectomy specimens. For the first time in the current literature we report the incidental diagnosis of a metastatic small bowel endocrine tumor in a 69-year-old gentleman, made at the time of LRRP and bilateral lymph node dissection. This report suggests that the benefit of an extended lymph node dissection is not only to prostate cancer control and staging, but also to the possibility of diagnosing potentially treatable incidental disease. It is a possibility that both pathologists and urologists alike should be aware of.

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Incidental findings in pelvic lymph nodes at radical prostatectomy

Cited by 20 publications

References 10 publications

The prevalence and significance of clinically unsuspected neoplasms in cervical lymph nodes

The prevalence and significance of clinically unsuspected neoplasms in cervical lymph nodes

Monoclonal B-cell lymphocytosis and early-stage chronic lymphocytic leukemia: diagnosis, natural history, and risk stratification

Incidental metastatic endocrine tumor diagnosed at laparoscopic radical prostatectomy and bilateral lymph node dissection

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