Hepatic Nodes Research Articles

Evaluation of the Local Immune Response to Fasciola Hepatica in Liver and Hepatic Lymph Nodes (HLN) of Goats Immunized with Cathepsin-L1 (CL1)

Evaluation of the Local Immune Response to Fasciola Hepatica in Liver and Hepatic Lymph Nodes (HLN) of Goats Immunized with Cathepsin-L1 (CL1)

Tuberculosis Caused by Mycobacterium microti in South American Camelids

Infection with Mycobacterium microti can cause chronic disease in animals and threaten human health through its zoonotic potential. To describe clinical findings, diagnostic investigations, necropsy, and epidemiology results in South American camelids (SAC) infected with M. microti, member of the Mycobacterium tuberculosis complex. Eleven SAC with tuberculous lesions. Description of 10 llamas and 1 alpaca, aged 4-18 years, from 6 herds with a history of wasting and weakness admitted to the Vetsuisse-Faculty of Berne over 8 years. Clinical signs included weight loss, recumbency, and anorexia in late stages of the disease. Respiratory problems were seen in 6 animals of 11. No consistent hematologic abnormalities were identified. Suspect animals were examined in detail by abdominal ultrasonography and thoracic radiology. Abnormal findings such as enlarged mediastinal, mesenteric, or hepatic lymph nodes were seen only in animals with advanced disease. Single comparative intradermal tuberculin test with bovine protein purified derivate (PPD) and avian PPD was negative in all animals. At necropsy, typical tuberculous lesions were found, and confirmed by bacteriological smear and culture, molecular methods, or both. Infection caused by M. microti should be considered a differential diagnosis in chronic debilitating disease with or without respiratory signs in SAC. Antemortem confirmation of the diagnosis remains challenging at any stage of infection. Because cases of M. microti infection have been reported in immunocompromized human patients, the zoonotic potential of the organism should be kept in mind when dealing with this disease in SAC.

Lymph node evaluation is associated with improved survival after surgery for early stage gallbladder cancer

Guidelines for the current National Comprehensive Cancer Network recommend radical cholecystectomy, including hepatic resection and portal lymph node (LN) dissection, for patients with early stage gallbladder (GB) cancer. We sought to determine the survival benefit conferred by adequate LN evaluation. We used the surveillance, epidemiology and end results (SEER) neoplasm registry to identify patients who had an operation for GB cancer between 1988 and 2004. Patients were classified by stage of disease, operative procedure performed (cholecystectomy alone or radical resection), number of LNs evaluated (0, 1, >1), and receipt of radiation (RT). We included patients with T1B, T2, and T3 neoplasms who were LN positive or negative. Patients with T4 neoplasms and those with metastatic disease were excluded. Multivariate analysis included adjustment for age, race, sex, neoplasm grade, stage, operation performed, receipt of RT, and neoplasm registry. We identified 4,614 patients who underwent operative treatment for stage 1-2B GB (including T1B-T3 and LN positive or negative) cancer between 1988 and 2004. Of 4,614 patients, 9.6% (442) had radical resection, whereas 90.4% (4,172) had cholecystectomy alone. Among patients undergoing radical resection, 56% had LNs evaluated as compared with 28% of patients after cholecystectomy. For patients with T1B and T2 neoplasms who underwent radical resection, pathologic evaluation of at least 1 LN was associated with a significant improvement in median overall survival (OS) compared with those who had no LN evaluated (123 months vs 22 months; P < .0001). Radical resection with no LN evaluation provided similar OS compared with cholecystectomy alone (22 months vs 23 months; P = NS). For patients with T3 neoplasms, radical resection, including pathologic evaluation of at least 1 LN, was also associated with improved OS compared with radical resection with no LN evaluation (12 months vs 7 months; P = .0014). Again, individuals who had radical resection without LN evaluation had similar OS compared with those who had cholecystectomy alone (7 months vs 6 months; P = NS). Individuals who had radical resection with LN evaluation were more likely to receive RT than those who had radical resection without LN evaluation (33.1% vs 19.1%; P = .002). In multivariate analysis (including adjustment for RT), however, LN evaluation was still associated with a decrease in mortality compared with no LN evaluated (HR = 0.611; 95% CI = 0.484, 0.770). The pathologic evaluation of additional LN (>1) did not provide any additional benefit compared with the evaluation of a single node (HR = 0.795; 95% CI = 0.571, 1.107). Radical resection alone (without LN evaluation) did not provide any benefit over cholecystectomy alone (HR = 1.098; 95% CI = 0.971, 1.241). LN evaluation is a critical component of radical resection for GB cancer. In the absence of LN evaluation, radical resection provides no benefit over cholecystectomy alone.

IL‐10 and TGF‐β1 are associated with variations in fluke burdens following experimental fasciolosis in sheep

Infection with Fasciola hepatica causes an economically important disease in ruminants. Variability in parasite load may indicate innate differences in the host immune system. This study aimed to investigate the immunological mechanisms that are associated with variability in parasite burden following experimental F. hepatica infection in cross-bred sheep. Of a total of 16 animals, four were randomly chosen as uninfected controls, and the remainder infected with 100 viable metacercariae. Uninfected animals were used as the control group for evaluation of cytokine gene expression levels. For comparative analysis, specific animals were selected on the basis of extremes of fluke burdens, and were categorised into light (n = 4) and heavy burdened (n = 3) cohorts. Serum antibody levels, haematological parameters, and expression of IL-4 and IFN-gamma genes in hepatic lymph nodes were equivalent in both groups. However, significant differences in mitogen-specific lymphocyte proliferation in vitro and in expression of TGF-beta1 and IL-10 genes in hepatic lymph nodes were observed at acute and chronic phases of infection, respectively. These results provide useful information in developing further understanding of natural resistance to fasciolosis in sheep.

CAN SONOGRAPHIC FINDINGS PREDICT THE RESULTS OF LIVER ASPIRATES IN DOGS WITH SUSPECTED LIVER DISEASE?

While abdominal ultrasound and ultrasound-guided fine-needle aspiration cytology are often combined to help determine the type of liver disease in dogs, little is known about the relationship that may exist between the results of these tests. We hypothesized that specific sonographic findings, or combinations of findings, may predict results of liver ultrasound-guided fine-needle aspiration cytology. Hepatic and extrahepatic sonographic findings were recorded prospectively using a standardized form in 70 dogs with clinically suspected liver disease and in which liver ultrasound-guided fine-needle aspiration cytology was performed. The predictive value of sonographic findings in regard to the category of cytology results was assessed with stepwise logistic regression analysis. Sonographic detection of a hepatic mass (> or = 3cm; risk ratio [RR] 3.83, 95% Wald confidence intervals [95% CI] 2.42-3.93, P = 0.0036), ascites (RR 3.82, 95% CI 1.94-4.28, P = 0.0044), abnormal hepatic lymph node(s) (RR 3.01, 95% CI 1.22-4.88, P= 0.0262), and abnormal spleen (RR 3.26, 95% CI 1.20-3.85, P = 0.0274) were the most predictive of liver neoplasia on cytology. Conversely, sonographic detection of hepatic nodules (< 3cm; RR 1.97, 95% CI 0.95-2.96, P = 0.0666) was most predictive of vacuolar hepatopathy on cytology. In dogs with suspected liver disease, several sonographic findings, alone or combined, are thus predictive of liver ultrasound-guided fine-needle aspiration cytology results. In the light of the fact that ultrasound-guided fine-needle aspiration cytology of the liver has limitations, these predictabilities could influence the selection of diagnostic tests to reach a reliable diagnosis.

Lymphadenectomy in colorectal cancer liver metastases resection: Incidence of hilar limph nodes micrometastasis

Liver resection is considered the best treatment for metastatic colorectal cancer. Several prognostic factors have been investigated, and many studies have shown that hepatic hilum lymph nodes involvement has a negative impact on prognosis. The present study evaluated the frequency of microscopic involvement of hilar lymph nodes, through systematic lymphadenectomy and analysis of micrometastases in patients undergoing hepatectomy due to colorectal metastasis. A total of 28 patients underwent hepatic resection with hilar lymphadenectomy. Lymph nodes considered negative by conventional hematoxylin and eosin (H&E) staining were analyzed by serial sectioning with 100-microm intervals and immunohistochemistry (IHC) with anti-human pancytokeratin antibody AE1/AE3. In average, 6.18 lymph nodes were dissected per patient. No morbidity or mortality was associated to lymphadenectomy. In two patients, conventional H&E analysis showed presence of microscopic lymph node metastasis. IHC analysis allowed the identification of three other patients with lymph node micrometastases. The overall frequency of microscopic metastases, including micrometastasis, was 18%. Systematic lymphadenectomy allowed the detection of microscopic lymph node metastases, resulting in more accurate staging of extrahepatic disease. The inclusion of IHC increased the detection of lymph node micrometastasis.

Ultrasound of the Right Lateral Intercostal Space

When performing an abdominal ultrasound examination in dogs, a right lateral intercostal approach often is indicated. This approach allows for a complete examination of the abdomen, especially in large deep-chested dogs, dogs with microhepatica, or dogs with a large volume of intestinal gas or peritoneal effusion. The right lateral intercostal approach provides an acoustic window for the evaluation of the right side of the liver, porta hepatis, right limb and body of the pancreas, duodenum, right kidney, right adrenal gland, and hepatic lymph nodes.

Long-Term Survival After Liver Resection for Colorectal Liver Metastases in Patients With Hepatic Pedicle Lymph Nodes Involvement in the Era of New Chemotherapy Regimens

Survival benefit, in patients with colorectal liver metastases (CLM) and hepatic pedicle lymph nodes (HPLN) involvement along the common hepatic artery and celiac axis (area 2 or distal) has not been observed. However, these results are based on historical series, using suboptimal chemotherapy drugs. The aim of the present study is to investigate the impact of HPLN involvement on survival after resection for CLM in the era of the new chemotherapy regimens. Between January 2000 and June 2006, 45 high risk consecutive patients presenting all with pathologically proven HPLN metastases were identified from a prospectively maintained database. Prognostic factors for survival and recurrence were analyzed. The mean follow-up was 25.5 months. HPLN involvement was located in area 1 in 17 patients, area 2 in 10, and both area 1 and 2 were involved in 18 patients. The overall 3- and 5-year survival rates were 29.7% and 17.3%, respectively. The median survival was 20.9 months. Three patients are alive and disease-free at 32.4, 33.5, and 46.9 months, respectively. The multivariate analysis showed that the carcinoembryonic antigen blood level before hepatectomy, a curative intent R0 liver resection, the ratio of involved/total resected HPLN, and an adjuvant chemotherapy after liver resection were independent risk factors for overall survival. This study showed that the localization of HPLN metastases within area 1 or 2 does not anymore affect survival after CLM resection. Furthermore, this study provides a support to perform a routine HPLN dissection in high risk patients undergoing liver resection for CLM to recognize HPLN involvement, to improve the ratio of involved/total resected lymph nodes, and to assign the patients for an adjuvant chemotherapy. Finally, these results indicate that curative intent R0 liver resection with HPLN dissection can offer the only potential cure for patients with CLM who present with HPLN involvement.

Effects of Baihe Recipe on expressions of vascular endothelial growth factor and p53 proteins in tumor tissues of nude mice bearing orthotopically transplanted gastric carcinoma BGC-823

To investigate the effects of Baihe Recipe, a compound traditional Chinese herbal medicine, on growth and metastasis of orthotopically transplanted gastric carcinoma and the expressions of vascular endothelial growth factor (VEGF) and p53 proteins in the tumor tissues in nude mice. Forty-five nude mice orthotopically transplanted with BGC-823 human gastric cancer cells were randomly divided into three groups: Baihe Recipe group, 5-fluorouracil (5-FU) group and untreated group. The mice in the Baihe Recipe group received intragastric administration of 0.5 mL Baihe Recipe (crude drug content was 0.2 g/mL) for 6 weeks, and the mice in the untreated group received 0.5 mL normal saline. The mice in the 5-FU group received an intraperitoneal injection of 5-FU dilution (0.2 mL, 60 mg/kg per week, for 3 weeks). All mice were sacrificed after 6-week treatment. The weights of tumor and the growth-inhibiting rate were measured and the expressions of VEGF and p53 proteins were detected by immunohistochemical method. The growth inhibition rates in the Baihe Recipe and 5-FU groups were 52.86% and 42.87% respectively. The incidence rates of metastasis to perigastric and hepatic portal lymph nodes, and to liver and peritoneum in the Baihe Recipe and 5-FU groups were lower than those in the untreated group. The metastasis rates in Baihe Recipe group, 5-FU group and untreated group were 33.33%, 35.71% and 80.00% respectively, with significant difference (P<0.05), and the expressions of VEGF and p53 proteins in tumor tissues in the Baihe Recipe group were lower than those in the untreated group and the 5-FU group (P<0.01, P<0.05). Baihe Recipe has inhibitory effects on tumor growth and metastasis of gastric cancer orthotopically transplanted in nude mice by down-regulating the expressions of VEGF and p53 proteins.

Hepatic infestation of Echinococcus multilocularis with extension to regional lymph nodes

The objective of this paper is to prove lymph node infestation by Echinococcus multilocularis and provide evidence for systematic lymph node dissection in curative resections for alveolar echinococcosis (AE). Human AE is a life threatening parasitic condition, usually caused by an intrahepatic infiltrative and destructive growth of the larvae E. multilocularis. WHO guidelines provide radical hepatic resection for curative treatment. However, the current norms do not consider dissection of regional lymph nodes. No report to date has visualized concurrent lymph node infestation. Radical excision of infested liver including regional lymph nodes with subsequent histological examination was carried out in a patient suffering from AE. The literature was reviewed and a revised state-of-the-art treatment of AE deduced. Upon inspection the liver displayed macroscopic features of AE, in contrast to the regional lymph nodes which appeared unsuspicious. Further histological analysis confirmed regional lymph node infestation of E. multilocularis. This is the first publication on histological evidence of E. multilocularis in regional hepatic lymph nodes, and thus, demonstrating dissemination from the liver. Since AE can spread through lymphatic drainage, even without causing macroscopic conspicuity, resection should not be resumed to the liver tissue only, but rather to consider the routine removal of regional lymph nodes as well. Omission of lymph node dissection can leave behind parasitic tissue and surgical procedures erroneously judged as curative.

Study of the local immune response to Fasciola hepatica in the liver and hepatic lymph nodes of goats immunised with a peptide of the Sm14 antigen

The nature of the local immune response was assessed studying the distribution of CD2+, CD4+, CD8+, γδ+ T lymphocytes, IgM+ B cells, IL-4+ and IFN-γ+ cells in the liver and hepatic lymph nodes (HLN) of goats immunised with a synthetic peptide of the Sm14 antigen from Schistosoma mansoni and challenged with Fasciola hepatica. A morphometric study of HLN was also carried out in order to evaluate the hyperplasia of lymphoid follicles. Despite the decrease in fluke burdens found in the immunised group (45.9%) respect to the infected control group, this difference was not statistically significant due to the high individual variability. In liver, a significant increase of CD2+, CD4+, CD8+, γδ+ T lymphocytes was found in the infected groups respect to the uninfected control and in the infected control respect to the immunised group. HLN showed a significant enlargement due to the hyperplasia of lymphoid follicles and infiltration of CD2+, CD4+, CD8+, γδ+ T lymphocytes in both infected groups respect to the uninfected control, with no significant differences between the infected control and immunised group. IFN-γ+ lymphoid cells was absent or very occasional in HLN where the number of IL-4+ cells was higher than that of IFN-γ, suggesting a polarized Th2 response in immunised and in infected control group.

Abdominal lymph node metastasis from prostatic adenocarcinoma in a patient with esophageal squamous cell carcinoma

We report a case of prostate cancer that was discovered by lymph node metastasis to along the common hepatic arterial nodes. The patient was a 72-year-old man who had undergone esophagectomy as surgical treatment of esophageal cancer. The obtained specimen of along the common hepatic arterial lymph node showed adenocarcinoma, which was positive for prostate-specific antigen (PSA). The histological findings of the esophageal lesion demonstrated squamous cell carcinoma. Serum PSA was 350 ng/ml and prostate needle biopsy revealed adenocarcinoma. The patient commenced on total androgen blockade consisting of LH-RH analogue and bicalutamide (anti-androgen). However, the patient died due to recurrence of esophageal carcinoma.

Perioperative Carcinoembryonic Antigen Measurements to Predict Curability After Liver Resection for Colorectal Metastases

Perioperative carcinoembryonic antigen (CEA) blood level is a predictor of outcome after resection of colorectal liver metastases (CLMs). Prospective clinical study. Department of digestive surgery and transplantation. Between January 1, 2000, and December 31, 2004, CEA levels were routinely measured 1 week before and 6 weeks after CLM resection in 213 patients. The patients were divided into the following 3 groups: group A (n = 69) with normal preoperative and postoperative CEA levels, group B (n = 111) with elevated preoperative and normal postoperative CEA levels, and group C (n = 33) with elevated preoperative and postoperative CEA levels. The use of perioperative CEA levels to predict outcome after resection. The median survival was 45.4 months. The 5-year overall and disease-free survival rates were 50.2% and 21.9%, respectively, in group A, 38.5% and 18.3% in group B, and 0.0% and 0.0% in group C (P < .001). Univariate analysis showed that patients with elevated preoperative and postoperative CEA levels, multiple CLMs, large CLMs (> or =5 cm), advanced Fong clinical risk score, bilobar distribution, and hepatic pedicle lymph node involvement had significantly poorer overall and disease-free survival. By multivariate analysis, only perioperative CEA level, hepatic pedicle lymph node involvement, and number and size of CLMs were independent prognostic factors. The 5-year survival rates showed good correlation with perioperative CEA levels in all 3 patient groups. The predictive value of perioperative CEA levels is demonstrated. Carcinoembryonic antigen levels as early as 6 weeks after surgery may be helpful in assigning patients to adjuvant chemotherapy after resection of CLMs.

Intraokuläre Blutung bei einer Ziege mit Thrombozytopenie und Karzinommetastase in der Iris

This case report describes the findings in a 10-year-old goat with metastasis of an adenocarcinoma in the iris. Two weeks before admission, the owner had noticed blepharospasm of the left eye. Clinical examination by the referring veterinarian revealed unilateral intraocular hemorrhage. The goat was referred to our clinic for further work-up. The rectal temperature was 40 degrees C. The most important haematological result was severe thrombocytopenia. There was mild corneal oedema of the left eye. Approximately 75 per cent of the anterior chamber was filled with non-coagulated blood. The fluid in the anterior chamber dorsal to the blood was cloudy, and the corpora nigra could not be seen clearly. All other internal parts of the eye could not be seen. Ultrasonography of the left eye confirmed cloudiness of the anterior chamber and revealed moderate thickening of the iris. The right prescapular lymph node was markedly enlarged. Cytological examination of a fine needle aspirate of the lymph node showed a mixed population of neoplastic cells. Based on immunohistochemical evaluation of the cells metastasis of a carcinoma was diagnosed. The goat was subjected to euthanasia, and a postmortem examination was carried out. The anterior chamber of the left eye contained blood, and the iris was thicker than normal and adhered to the posterior surface of the cornea. There were neoplastic alterations in the iris, the oesophagus, the lung lobes, the liver, the kidney and in the prescapular, retropharyngeal, mediastinal and hepatic lymph nodes. Histologically, a diagnosis of carcinoma was confirmed, but the origin of the tumour could not be determined.

Use of FDG-PET (PET) to select patients for metastasectomy for high-grade soft tissue sarcomas (HG-STS)

10596 Background: In sarcomas, particularly for lung presentation, there is a general consensus to metastasectomy if complete surgery is foreseeable on the basis of accurate imaging. Recently, PET has become a validated tool to improve staging in other neoplasms. Lung cancer experience with PET made thoracic surgeons unwilling to entail thoracotomy unless PET confirms the uniqueness of HG-STS metastases. We evaluated our prospective database to study the role of PET in modifying eligibility to surgery in HG-STS metastatic patients. Methods: Between January 2004 and June 2007, thirty-one subjects (median age 57.4) with HG-STS were candidates to surgical removal of their metastases (lung 24 pts, liver 4 pts, soft tissue 3 pts). After a preliminary CT (helical scanner), all patients underwent a PET (CT-PET). Eligibility criteria to metastasectomy were as follows: absence of other metastatic sites, < 4 lung nodules, unique hepatic nodule or metastatic lymph node. A test was considered accurate if no further m...

Abstract 4740: Selective ablation of metastatic disease with integrin ανβ3 targeted nanoparticle drug delivery

Abstract Angiogenic blood vessels found within growing tumors express high levels of integrin ανβ3 while mature vessels fail to express this integrin. Based on this we developed a ανβ3-targeted nanoparticle (NP) in an attempt to selectively deliver therapeutics to the tumor neovasculature. A cyclic peptide ligand (cRGDfK) coupled to a phospholipid and incorporated into a nanoparticle demonstrated specific binding to ανβ3 on cultured endothelial cells. To characterize the in vivo targeting capacity of these NPs, we monitored NP accumulation using intravital microscopy of tumor neovasculature. A dorsal skin-fold window chamber implanted with GFP-labeled melanoma cells lacking integrin ανβ3 were imaged at various times after NP injection into the bloodstream. By 5h post injection, the cRGDfK NPs targeted the neovasculature at the angiogenic tips adjacent to the tumor margin, whereas untargeted (cRADfK) NPs failed to bind. After establishing in vivo targeting, these ανβ3-targeted NPs were loaded with doxorubicin via an ammonium phosphate gradient for therapeutic studies. The cRGD-Dox particles disrupted angiogenesis in the mouse matrigel model leaving only small fragments of disrupted vessels within the FGF loaded plugs. Next, we utilized an orthotopic pancreatic cancer model to study the ability of the NPs to target the vasculature of both primary pancreatic tumors as well as metastatic sites including the hepatic hilar lymph node and mesenteric lymph nodes. cRGD-Dox particles injected systemically at 1 mg/kg produced a profound anti-metastatic effect while only marginally influencing the pre-established primary tumor within the pancreas. This is much improved compared to the free doxorubicin treatments in which 1 mg/kg of free doxorubicin had no effect and 15 mg/kg of free doxorubicin was required for a similar therapeutic effect in this orthotopic model. Animals treated with 15 mg/kg of free doxorubicin lost over 20% of their body weight within 7 days, whereas no decrease in body weight was observed in the cRGD-Dox treated animals, confirming the reduction in overall toxicity. Histology confirmed that the cRGD-Dox particles induced apoptosis in regions co-localized with β3 expressing tumor vasculature. Additionally, we tested the cRGD-Dox particles in an orthotopic renal cell carcinoma model. Similar to the pancreatic carcinoma, the cRGD-Dox particles had a slight effect on primary tumor growth but greatly reduced metastasis to several sites including the pancreas, liver, spleen, and diaphragm. These findings reveal that ανβ3 targeted NP drug delivery may preferentially disrupt newly forming metastatic lesions by delivery of chemotherapeutic agents to sites of active angiogenesis in which the endothelium expresses high levels of ανβ3.

Experimental tuberculosis in the European badger ( Meles meles) after endobronchial inoculation with Mycobacterium bovis: II. Progression of infection

The aim of the study was to describe, over a period of 24 weeks, the pathological and bacteriological changes in badgers experimentally infected with Mycobacterium bovis. The badgers were infected by endobronchial instillation of 2.5 × 10 4 colony forming units (cfu) M. bovis. After infection, the badgers were examined at 3 weekly intervals when blood and tracheal aspirates were collected. At 6, 12, 18 and 24 weeks post-infection (pi) three animals were euthanized and a detailed pathological and bacteriological examination was performed to assess the nature of the experimental disease. During the course of the study only one badger developed clinical signs of disease: a subcutaneous swelling on its head, first observed at 18 weeks pi. At post-mortem examination gross and histological lesions of tuberculosis were observed and M. bovis was recovered from all, except one badger. In the majority of badgers the endobronchial route of inoculation resulted in the establishment of infection that over 24 weeks was non-progressive with limited dissemination of infection from the thoracic cavity, mainly to the hepatic and mesenteric lymph nodes. However, in one of the badgers examined at 18 weeks pi and one at 24 weeks pi, infection was widely disseminated. The disease induced by the endobronchial inoculation displayed the characteristics of disease observed in naturally infected badgers.

Trafficking of recirculating lymphocytes in the rat liver: rapid transmigration into the portal area and then to the hepatic lymph

We have investigated how recirculating lymphocytes patrol the liver in a normal steady state. Thoracic duct lymphocytes of congeneic rats were intravenously transferred to host rats and donor cell trafficking in the liver and hepatic lymph was examined. Host hepatic lymph nodes (HLNs) were selectively removed, which allowed liver-derived donor cells to collect in the thoracic duct without transit in the intervening HLNs. The number of donor cells in the thoracic duct lymph significantly increased over the baseline 3, 5 and 11 h after transfer in the HLN-removed, non-pretreated, and HLN-ligated (in which a lymph efflux was blocked) groups, respectively. Histologically, donor cells appeared in the portal area from 0.5 h after transfer and frequently attached to the basal lamina of portal vein both externally and internally. Three hours after transfer, a few donor cells appeared in the subcapsular sinus of HLNs. The minimal transit time of rat recirculating lymphocytes is 3-4 h in the liver and 5-8 h in the hepatic LNs, in a normal steady state. Recirculating lymphocytes might transmigrate through the portal vein as well as the sinusoid in the periportal zone. This rapid transit might enable an efficient surveillance of the liver portal area by the recirculating lymphocytes.

ULTRASONOGRAPHIC ANATOMY OF ABDOMINAL LYMPH NODES IN THE NORMAL CAT

Lymph nodes are essential structures to be evaluated in an ultrasonographic examination of the feline abdomen. It was hypothesized that current technical proficiency would allow all feline abdominal lymph nodes to be identified ultrasonographically. Ten clinically normal, adult, domestic shorthair cats were examined using real-time compound ultrasonographic imaging. The medial iliac lymph nodes were visible in 100% of the cats, the jejunal lymph nodes in 90%, the hepatic lymph nodes in 70%, the aortic lumbar, the splenic, and the pancreaticoduodenal lymph nodes in 60% each, the ileocecal and the colic lymph nodes in 50% each, and the renal, the gastric, the sacral and the caudal mesenteric lymph nodes in 40%, 30%, 20%, and 10% of the cats, respectively. The inconsistent presence of lymph nodes, their poor echocontrast and interposed gas of the gastrointestinal tract explain the lower percentages of identification. The ultrasonographic length and diameter of the lymph nodes were determined. The majority of these measurements corresponded to those in the literature. We conclude that ultrasonography is a valuable tool for the identification and evaluation of most abdominal lymph nodes in the normal cat. Average ultrasonographic measurements are presented as a preliminary guideline for normal feline abdominal lymph nodes. ete

Deleted DOI: Management of the Hepatic Lymph Nodes during Resection of Liver Metastases from Colorectal Cancer: A Systematic Review

Deleted DOI: Management of the Hepatic Lymph Nodes during Resection of Liver Metastases from Colorectal Cancer: A Systematic Review