Superficial Lymph Research Articles

Development of metastatic inguinal squamous cell carcinoma in a patient with Netherton syndrome: A case report

Introduction: Netherton syndrome (NS) is a rare multisystem disorder with both cutaneous and extra-cutaneous manifestations. The syndrome includes the presence of congenital ichthyosis, exhibited by hyperkeratosis and abnormal skin scaling over the entire body. In rare instances, NS has been associated with the development of squamous cell carcinoma (SCC). Case Report: A 54-year-old male with a history of NS and recurrent squamous cell carcinoma presented with an enlarging left inguinal mass. Biopsy of the mass was positive for a new invasive squamous cell carcinoma with regional lymph node involvement and invasion of the left femoral vein. The patient underwent wide local resection, superficial and deep regional lymph node dissection, and resection of the left femoral vein. His hospital course was further complicated by multiple infections and progression of his cancer. He eventually transitioned to hospice care before receiving any additional treatment for his malignancy. Conclusion: This case highlights a patient with NS and a history of recurrent inguinal squamous cell carcinoma. Further investigation is needed to better highlight the complexity of factors associated with the development of squamous cell carcinoma in patients with NS and other forms of ichthyoses.

Ultrasound-Guided Hook-Wire Localization for Surgical Excision of Non-Palpable Superficial Inguinal Lymph Nodes in Dogs: A Pilot Study.

Simple SummaryThe evaluation of regional/sentinel lymph nodes (LN) plays an important prognostic role and assists the clinical decision making in canine cancer patients; thus, surgeons are frequently asked to perform regional/sentinel lymphadenectomies together with management of the primary tumor sites, even when these are non-palpable and/or normal size LN. Several techniques have been described to localized regional/sentinel LN in a pre-surgical setting. The wire-guided localization is commonly used to localize non-palpable breast masses in women, with the aim to reduce surgical dissection and excision of unnecessary tissue and to reduce surgical time. This study describes the use of an ultrasound-guided hook-wire localization method to facilitate intraoperative localization of non-palpable superficial inguinal LN. The results of the present study suggest that this method is safe and effective and may allow a high rate of successful superficial inguinal LN excisions in dogs.The evaluation of loco-regional lymph nodes (LN) plays an important prognostic role and assists the clinical decision making in canine cancer patients. Excision of non-palpable LN can be challenging. The aim of the study was to evaluate surgical time, successful excision rate and surgical complications associated with the use of an ultrasound-guided hook-wire (UGHW) LN localization method for non-palpable superficial inguinal LN (SILN) in dogs. Dogs that presented for excision of non-palpable SILN, performed with the aid of an UGHW placement, were enrolled. Information including signalment, SILN width, UGHW placement and surgical procedure time, hook-wire position, successful excision and intra- and post-operative complications were reviewed. Seventeen dogs were enrolled. Median LN width was 3 mm (range 2–11). Median time of preoperative UGHW placement and surgical LN excision was 8 min and 15 min, respectively. Successful SILN excision was achieved in all cases. Two minor intra-operative (hook migration and wire fragmentation) and one minor post-operative complications (seroma) were observed. No major intraoperative or post-operative complications occurred. The UGHW LN localization method is safe and effective and may allow a high rate of successful SILN excisions in dogs. This method has the potential to facilitate LN excision for other superficial LN locations.

Morphogenesis lymph node of domestic pig

The visceral and somatic lymph nodes of a pig of domestic 1-120 day old were examined. Found that the lymph nodes have a common connective tissue capsule and different levels of fusion of individual subunits. In the center of each subunit, the capsule forms invaginations of the capsular trabecula, dividing the parenchyma of each structural unit into «Ʊ»-shaped structures, fused with lateral and lower parts. The number and degree of fusion of subunits is different and depends on the age of the animals and the location of the lymph node. The greatest degree of fusion of individual units of the lymph node was found in the superficial cervical and axillary I ribs. In the mandibular, superficial parotid and superficial inguinal lymph nodes, the segments are clearly contoured already in newborn piglets. Segments are predominantly bean-spherical in shape with a wide base. The fusion of the segments occurs in their central part, and on the surface the gates of the subunits are clearly contoured in the form of numerous depressions. In the visceral lymph nodes, the portal and splenic lymph nodes have the smallest segmentation, and the gastric, tracheobronchial, and iliocolic lymph nodes are the largest. The number of segments varies from two in newborn piglets to five in 120-day-old pigs. The variability of the morphometric parameters of the lymph nodes of a domestic pig is due to a different number of afferent lymphatic vessels, and, accordingly, to different scales of the lymphatic basins. Thus, the lymph nodes of the domestic pig are complexes of subunits fused to varying degrees. Somatic lymph nodes are highly segmented. The degree of consolidation of subunits in the visceral lymph nodes is less pronounced. Linear measurements of organs vary depending on the age of the animals, gradually increasing up to 120 days with a tendency for these indicators to prevail in the somatic lymph nodes. Key words: domestic pig, lymph node, subunit, topography, morphometry

Метод препарування передньої стегнової ділянки для встановлення фетальної анатомічної мінливості судинно-нервових утворень

Determining of projection-syntopic relationships of vasculonervous structures within the femoral ring, femoral triangle, and obturator and adductor canal in human fetuses is particularly important in fetal surgery, and requires the use of an appropriate set of methods of morphological examination. Obtaining data on the topographic and anatomical features of nerves, superficial and deep blood vessels of the anterior femoral region during the fetal period of human ontogenesis is a topical urgent task of fetal anatomy. The purpose of the study was to determine the method of the most rational sequence of actions during the preparation of the vasculonervous structures of the anterior femoral region in human fetuses to obtain standard results suitable for comparison in the age aspect. Material and methods. The study was performed on 80 human fetuses 81.0-375.0 mm parietal-coccygeal length using macromicroscopic preparation. After the selected sequence of preparation of nerves and vessels of the anterior femoral region in human fetuses 4-10 months we used additional methods such as vascular injection, surface staining of dissected vessels and nerves and morphometry to determine the forms of their age and individual anatomical variability. Results and discussion. The chosen sequence of preparation of nerves and vessels of the anterior femoral region in human fetuses allowed determining the forms of their age and individual anatomical variability. In particular, features of intramuscular branching of nerves and arteries in the muscles of the anterior and medial femoral groups, anatomical variability of the femoral artery and its branches, variant anatomy of the great saphenous vein, characterized by variability in shape, topography and bilateral asymmetry of its tributaries and formation of anastomoses were found in human fetuses. The identified connections and complexes of the femur cutaneous nerves, as well as areas of overlap and displacement are compensatory mechanisms in the peripheral nervous system and are observed not only between ontogenetically related nerves, but also nerves of different segmental affiliation. Conclusion. The proposed and tested method of preparation of vasculonervous structures of the anterior femoral region in human fetuses provides a standard for obtaining data on their typical and variant anatomy. The sequence of actions used during the preparation of the vasculonervous formations of the anterior femoral region of the human fetus preserves the natural appearance and relationships between the structures of the object of study. Age-related and individual fetal anatomical variability of vasculonervous formations of the anterior femoral region was discovered during the gradual preparation of the lumbar plexus branches, superficial and deep veins of the lower extremities, superficial and deep inguinal lymph nodes, and femoral artery branches

First case of a dog infected with Aspergillus (Phialosimplex) caninus in Australasia

ABSTRACTCase history: A 2-year-old Rottweiler dog from Perth (WA, Australia) was referred for assessment of a chronic productive cough and weight loss.Clinical findings: Severely enlarged bilateral superficial cervical lymph nodes and severely enlarged abdominal organs were present. The body condition score was poor and there was moderate muscle wasting. Thoracic and abdominal computed tomography images revealed severe diffuse enlargement of thoracic and abdominal lymph nodes, hepatomegaly and diffuse splenomegaly. A diffuse bronchial pattern with severe multifocal saccular bronchiectasis was identified in the lungs.Diagnostic findings: Fungal organisms were seen within macrophages on cytological preparations and on histopathological sections of biopsies of the superficial cervical lymph node. Macrophages contained intracytoplasmic, non-filamentous round-to-ovoid organisms, which varied in size from 5–30 µm in diameter with variable morphology. Budding was not observed, and no hyphae were present. Fungal culture of lymph node tissue resulted in growth of Aspergillus (Phialosimplex) caninus which was confirmed by amplification and sequencing of a segment of the 16S-23S rRNA internal transcribed spacer. Concurrent bacterial bronchitis was diagnosed on culture of broncho-alveolar fluid.Diagnosis: Disseminated aspergillosis caused by Aspergillus caninus.Clinical relevance: This is believed to be the first report of infection caused by A. caninus in a dog in Australasia. The dog was treated with itraconazole for 7 months and was still alive 7 months after the start of treatment.

Clinico-pathological spectrum of filariasis in fine needle aspiration cytology: 7 years retrospective study in a tertiary care hospital of North India

Background: Filarial infestation is common in developing countries like India. It is transmitted by bite of culex mosquito. They usually present with superficial nodular swelling and lymph node enlargement with variety of clinical symptoms, however the index of suspicion is always low. Fine needle aspiration cytology (FNAC) is a very cost effective tool for rapid diagnosis of the disease. It is a retrospective analysis of filarial cases diagnosed on FNAC in the last 7 years to study the clinico-pathological spectrum. Material and Methods: The records of the department of cytology KGMU were searched from Jan 2010 to Dec 2016 and all the cases of filariasis involving different tissues and body fluids were analysed in detail for cytomorphological and clinical features. Results: A total of 32 cases of filariasis were evaluated. Most common age group affected was 30-40 years (range: 12-70 years). Out of 32 cases, 11 cases presented as nodular superficial swellings, 9 cases as lymphadenopathy, 5cases were found in thyroid, 2 cases in breast, 2 cases in salivary gland and each case in testis, lung and ascitic fluid. Majority of cases (62.5%) showed chronic inflammation, 7 cases (21.8%) were associated with malignancies including metastatic as well as primary of various tissues. Microfilariae were also detected with benign phylloides tumor of breast in one case (3.1%) and with colloid goitre thyroid in 4 cases (15.6%). Conclusion: Nodular superficial swelling is the most common presentation; however filarial worms can invade many more organs of the body. It can present solely as granulomatous inflammation or remain asymptomatic and found as an incidental finding. Conventional mode of diagnosis is demonstration of microfilaria in peripheral blood smear and body fluids. Co-existence of microfilaria with neoplastic lesions is rare. Fine needle aspiration cytology plays a vital role in the diagnosis of these lesions.

Radiation therapy for superficial inguinal lymph node metastases from ovarian clear cell carcinoma and associated inguinal hernia

About 3% of ovarian cancer (OC) metastases reportedly involve inguinal lymph nodes, but little published data on their radiosensitivity is available. Here, we report a 53-year-old woman with clear cell OC and left inguinal, supra-inguinal and obturator lymph node metastases (LNMs), and a huge, unresectable mass of adherent inguinal nodes. After standard hysterectomy, bilateral salpingo-oophorectomy, omentectomy, and pelvic lymphadenectomy, she underwent various chemotherapy regimens over 12 months, as the inguinal mass enlarged. Radiotherapy was subsequently successful but complicated by an inguinal hernia. Combined cytoreductive surgery, inguinal metastasectomy, and radiotherapy may be appropriate for patients with OC with inguinal LNMs.

Radiation therapy for superficial inguinal lymph node metastases from ovarian clear cell carcinoma and associated inguinal hernia

Radiation therapy for superficial inguinal lymph node metastases from ovarian clear cell carcinoma and associated inguinal hernia

Deep lobe parotidectomy

Deep lobe parotidectomy (DLP) is a critical procedure to master for any head and neck oncologic surgeon. This procedure is indicated for any deep lobe malignancy, a superficial lobe malignancy with extension into the deep lobe, refractory inflammatory conditions, and the presence of metastatic disease within a superficial or periparotid lymph node. This article describes the relevant anatomy and steps required to perform a deep lobe parotidectomy with and without facial nerve sacrifice. In addition, the history of the procedure, patient work up, indications, and possible complications are discussed.

Iliac Lymphadenectomy following Intrauterine Mapping in a Female Dog with Breast Neoplasm

Background: The lymphatic system plays an important role in the local control of neoplasms as well as in the transportation of tumor cells, which represents the most common pathway of metastasis. From the tumorigenesis, there is a remarkable enlargement of the tumor drainage network towards the regional and target lymph nodes. Since the mammary lymphatic system of animals with neoplasms as well as the demarcation of the pelvic and abdominal caudal chain are poorly studied, the aim of the present study is to report a case of iliac lymphadenectomy after intrauterine lymphatic dyeing in a dog with breast neoplasm, which allowed the identification of metastasis in the medial iliac lymph node.Case: A 7-year-old, 13.4 kg, non neutered, mixed breed, female dog was diagnosed with ulcerative neoplasm in the left caudal abdominal breast, which presented evolution of approximately 90 days, presenting ulceration for 10 days, according to the tutor. After a clinical evaluation, thoracic radiography and abdominal ultrasonography were requested, whichdid not present metastasis suggestive images. Therefore, left unilateral total mastectomy was indicated. Retro-umbilical celiotomy was performed for the administration of 0.5 mL of 1% intrauterine methylene blue (body of the uterus), which allowed lymphatic mapping and medial iliac lymphadenectomy. Subsequently, ovariohysterectomy was performed andafter celiorrhaphy, axillary lymphadenectomy was performed, followed by left unilateral mastectomy and concomitant removal of the superficial inguinal lymph node. The patient had a prompt recovery and was discharged from hospital in six hours postoperatively. The excised material was referred for histopathological examination, which revealed the presence of metastasis of simple tubulopapillary carcinoma of the mammary gland in the left medial and superficial inguinal lymph nodes, while the axillary lymph node had no metastases. At the end of 10 days, the patient was clinically stable, with good healing of the surgical wound. After a 120-day postoperative period, the patient had a good clinical status, with no respiratory alterations, and there was no evidence of metastasis on the chest X-ray as well as abdominal ultrasound.Discussion: Considering the great occurrence of breast neoplasms, it is important to develop studies on new approaches in the therapeutic management of this condition and sharing of reports as described. The objective of the lymphadenectomy was to evaluate the possible involvement of regional lymph nodes, since, according to the condition of the lymph nodes in the histopathological examination, it appears as an important prognostic factor, seeing that the survival time is less thantwo years for 85.7% in dogs with regional lymph node metastases. In animals, there are no studies based on the therapeutic alternative of lymphadenectomy, which is believed to be palliative in the reported patient, due to the fact that it is a tubulopapillary carcinoma with different foci of lymph node metastases. Otherwise, lymphadenectomy enabled a better definition of the prognosis and proved to be an important tool for staging. The use of methylene blue was chosen because it was reportedly used in dogs, with excellent results in sentinel lymph nodes mapping, and due to its ease of obtaining and low cost of application. It is concluded that in canines with breast neoplasms, it is important to perform lymphatic mapping to identify possible metastases in cellular tissues and to delimit regional lymph vessels and lymph nodes, thus facilitating the surgical removal of these structures with safety margins. In addition, it is important to perform lymphadenectomy even to lymph nodes that are not infarcted or present macroscopic changes, given that in this case, it already existed metastasis, even in a lymph node of 4 mm.Keywords: metastasis, sentinel lymph node, lymphatic mapping, mastectomy, canine.

A first report of robotic-assisted sentinel lymph node mapping and inguinal lymph node dissection, using near-infared fluorescence, in vulvar cancer.

e17027 Background: Vulvar carcinoma is a rare gynecologic malignancy which has seen a considerable evolution in surgical techniques over the last several decades. However, the morbidity associated with inguinal lymph node dissections remains significant. The majority of patients undergoing full lymphadenectomy will have some complication, with wound breakdown being the most common. In males, robotic inguinal lymph node dissection has been described for penile cancer. This report represents a first use of near-infared fluorescence for sentinel inguinal lymph node mapping, and the first description of complete robotic inguinal lymph node dissection for patients with vulvar malignancies. Methods: Bilateral robotic-assisted inguinal lymph node mapping and and lymphadenectomy was performed using the daVinci Xi system with a near-infared fluourescence. Results: The patient presented at 81 years old with a 3 cm lesion on the left labia. In the operating room, the vulvar lesion was injected circumferentially with indocyanine green. A 1 cm incision was made in the skin over the apex of the left femoral triangle carried past the underlying campers fascia. The tissue plain was developed overlying the femoral triangle using a tissue expander balloon. Under visual guidance, an 8 mm camera port and two 8 mm instrument ports were placed and the robot docked. The ipsilateral sentinel lymph nodes were identified using near-infared fluorescence and resected. We then performed a complete left superficial inguinal lymph node dissection. The right side was then performed in identical fashion. No sentinel node was identified on the right side. Radical hemivulvectomy was then performed without difficulty. All 11 lymph nodes were negative for disease. She was returned to the OR once for replacement of her JP drains. Her postoperative course was otherwise unremarkable and she is currently 15 months postoperative without complications or recurrence. Conclusions: Sentinel lymph node mapping and superficial inguinal lymph node dissection using robotic-assisted techniques and near-infared fluorescence is feasible and warrants further investigation.

Retraction Note: Comparative value of clinical, cytological, and histopathological features in feline mammary gland tumors; an experimental model for the study of human breast cancer.

The diagnosis of breast lesions is usually confirmed by fine-needle aspiration cytology (FNAC) or histological biopsy. Although there is increasing literature regarding the advantages and limitations of both modalities, there is no literature regarding the accuracy of these modalities for diagnosing breast lesions in high-risk patients, who usually have lesions detected by screening. Moreover, few studies have been published regarding the cytopathology of mammary tumors in cats despite widespread use of the animal model for breast cancer formation and inhibition. The objective of the present study was to evaluate the diagnostic interest of cytological and histopathological analysis in feline mammary tumours (FMTs), in order to evaluate its possible value as an animal model. The study was performed in 3 female cats submitted to surgical resections of mammary tumours. The mammary tumours were excised by simple mastectomy or regional mastectomy, with or without the superficial inguinal lymph nodes. Female cats were of different breeds (1 siamese and 2 persians). Before surgical excision of the tumour, FNA cytology was performed using a 0.4 mm diameter needle attached to a 8 ml syringe held in a standard metal syringe holder. The cytological sample was smeared onto a glass slide and either air-dried for May-Grunwald-stain and masses were surgically removed, the tumours were grossly examined and tissue samples were fixed in 10%-buffered-formalin and embedded in paraffin. Sections 4 μm thick were obtained from each sample and HE grade III, (2/3) with high mitotic index. The preferential localization of mammary neoplasms was in the inguinal lobe (1/3 case) and abdominal lobes (2/3 cases). Furthermore, 1case of the inguinal mass affected the left caudo-inguinal lobe and 2cases right cranio and caudo abdominal lobes. The study concluded that cytology could be used as a quick, rapid, field diagnostic technique in combination with histopathology for the diagnosis of feline mammary tumors (FMTs). Our findings in feline MTs indicate that FMTs could be useful as an animal model of human breast cancer. Moreover, because of the similarity of the cytohistopathological findings in the human and feline mammary gland tumours, it is possible to use the same cytopathological criteria applied in human pathology for the diagnosis of feline mammary gland tumours. The virtual slide(s) for this article can be found here: http://www.diagnosticpathology.diagnomx.eu/vs/2047361423103295

Orbital venous pattern in relation to extraorbital venous drainage and superficial lymphatic vessels in rats.

The purpose of this study was to demonstrate the normal and variant anatomy of extraorbital and intraorbital venous drainage together with retroorbital communication, and determine the lymphatic drainage from the superficial orbital region with a potential outlet of lymphatic vessel into the venous bloodstream. The study of the venous system was carried out on 32 Wistar rats by using corrosion casts methods and radiography, while the lymphatic system was studied in 12 Wistar rats following ink injection. Superficially, orbital veins are connected with extraorbital veins running through angular vein of the eye and the superficial temporal vein, and via the pterygoid plexus with the maxillary vein, which provide readily accessiblecommunication routes in the spreadofinfection. The extent of intraorbital and periorbital venous drainage was ensured by the dorsal and ventral external ophthalmic vein through the infraorbital vein, which together formed the principal part of the ophthalmic plexus. Venousdrainageofthe eyeballwas carried out mainly by the vortex veins, ciliary veins and internal ophthalmic vein. The highest variability, first presented by differences in structural arrangement and formation of anastomoses, was observed within the ventral external ophthalmic vein (22 cases) and the medial vortex vein (10 cases). Four vortex veins, one vein in each quadrant of the eye, were observed in rats. The vortex vein located on the ventral side of the eyeball was occasionally found as two veins (in four cases) in the present study. The lymphatic vessel from the lower eyelid entered into the mandibular lymph centre, and from the upper eyelid entered into the superficial cervical lymph centre, but both drained into the deep cranial cervical lymph node. The direct entry of lymph entering the veins without passing through lymph nodes was not observed.

Expression kinetics of miRNA involved in dermal toluene 2,4-diisocyanate sensitization

Allergic disease is an important occupational health concern, with work-related asthma and allergic contact dermatitis being the most frequently diagnosed occupational illnesses. Diisocyanates, particularly toluene 2,4-diisocyanate (TDI), have been the leading cause of occupational asthma for many years. Understanding the mechanisms behind allergic disease is critical for treatment and prevention. Recently, the study of post-transcriptional regulation by microRNAs (miRNA) has shed light on mechanisms of allergic disease. The present studies report the expression of miRNA during the sensitization phase of an allergic response to TDI in a murine model. Female BALB/c mice were dermally exposed to TDI (0.1–15% [v/v]) or vehicle. RNA was isolated from superficial parotid lymph nodes at timepoints between 1 h and 15 days post-exposure and then miRNA expression was analyzed using array and real-time quantitative PCR analysis. Consistent changes in miRNA expression were identified for miR-21, miR-22, miR-27b, miR-31, miR-126, miR-155, miR-210, and miR-301a. Following TDI exposure, peak expression was observed by Day 4 for the majority of miRNA evaluated with trends in expression correlated to exposure concentration. Confirmed and predicted targets were identified using Diana-microT, miRanda, miRwalk, and Targetscan algorithms. Evaluation of mRNA expression of cytokine and transcription factor targets suggests that miRNA may have a central role early in TDI sensitization. Understanding the role of these miRNA and their specific mechanism of action in sensitization to TDI may provide pertinent information for the identification of other chemical sensitizers while also contributing to the treatment and prevention of allergic disease.

Tuberculose em caprinos e ovinos abatidos no semiárido da Paraíba, Brasil

O objetivo do presente trabalho foi isolar e tipificar micro-organismos presentes em linfonodos hipertrofiados ou lesões macroscópicas sugestivas de tuberculose colhidos de 12 caprinos e 28 ovinos abatidos no matadouro público do município de Patos, Paraíba. A identificação de micobactérias foi feita com o método PRA (PCR-Restriction Enzyme Analysis). Também foi realizado o exame histopatológico das lesões. Os órgãos afetados foram fígado, pulmão, glândula mamária, bexiga e linfonodos mediastínicos, mesentéricos, submandibulares, parotídeos, poplíteos, pré-crural, pré-escapular e inguinal superficial. O exame histopatológico apontou a presença de granulomas em 8 (20,00%) animais. Dos 12 caprinos, 1 (8,33%) foi positivo no cultivo de micobactérias, e pelo método PRA o isolado foi classificado como pertencente ao complexo M. tuberculosis. Dois (7,14%) ovinos foram positivos para a presença de micobactérias ambientais. Houve isolamento de Corynebacterium pseudotuberculosis em 8 (66,66%) caprinos e em 17 (60,71%) ovinos, e isolamento simultâneo de micobactérias e C. pseudotuberculosis em 1 (8,33%) caprino e 1 (3,57%) ovino. O isolamento de micobactéria do complexo M. tuberculosis em caprinos no presente trabalho levanta preocupações do ponto de vista de saúde pública, uma vez que profissionais envolvidos na manipulação destes animais, bem como a população consumidora de carne e leite, estão expostos ao risco de infecção.

RETRACTED ARTICLE: Comparative value of clinical, cytological, and histopathological features in feline mammary gland tumors; an experimental model for the study of human breast cancer

BackgroundThe diagnosis of breast lesions is usually confirmed by fine-needle aspiration cytology (FNAC) or histological biopsy. Although there is increasing literature regarding the advantages and limitations of both modalities, there is no literature regarding the accuracy of these modalities for diagnosing breast lesions in high-risk patients, who usually have lesions detected by screening. Moreover, few studies have been published regarding the cytopathology of mammary tumors in cats despite widespread use of the animal model for breast cancer formation and inhibition. The objective of the present study was to evaluate the diagnostic interest of cytological and histopathological analysis in feline mammary tumours (FMTs), in order to evaluate its possible value as an animal model.MethodsThe study was performed in 3 female cats submitted to surgical resections of mammary tumours. The mammary tumours were excised by simple mastectomy or regional mastectomy, with or without the superficial inguinal lymph nodes. Female cats were of different breeds (1 siamese and 2 persians). Before surgical excision of the tumour, FNA cytology was performed using a 0.4 mm diameter needle attached to a 8 ml syringe held in a standard metal syringe holder. The cytological sample was smeared onto a glass slide and either air-dried for May-Grünwald-stain and masses were surgically removed, the tumours were grossly examined and tissue samples were fixed in 10%-buffered-formalin and embedded in paraffin. Sections 4 μm thick were obtained from each sample and H&E stained.ResultsCytologically, atypical epithelial cells coupled to giant nucleus, chromatin anomalies, mitotic figures, spindle shape cells, anisocytosis with anisokaryosis and hyperchromasia were found. Histologically, these tumors are characterized by pleomorphic and polygonal cell population together with mitotic figures, necrotic foci and various numbers inflammatory foci. Also, spindle shaped cells, haemorrhage localized in the different regions, local invasiveness and enlarged nuclei were observed. The samples included 3 tumors of mammary glands mammary tumors were complex carcinomas (n = 2) and adenocarcinoma (n = 1). The histological grades of the 3 cases were as follows: grade II, (1/3); grade III, (2/3) with high mitotic index. The preferential localization of mammary neoplasms was in the inguinal lobe (1/3 case) and abdominal lobes (2/3 cases). Furthermore, 1case of the inguinal mass affected the left caudo-inguinal lobe and 2cases right cranio and caudo abdominal lobes.ConclusionThe study concluded that cytology could be used as a quick, rapid, field diagnostic technique in combination with histopathology for the diagnosis of feline mammary tumors (FMTs). Our findings in feline MTs indicate that FMTs could be useful as an animal model of human breast cancer. Moreover, because of the similarity of the cytohistopathological findings in the human and feline mammary gland tumours, it is possible to use the same cytopathological criteria applied in human pathology for the diagnosis of feline mammary gland tumours.Virtual slideThe virtual slide(s) for this article can be found here: http://www.diagnosticpathology.diagnomx.eu/vs/2047361423103295

Tattooing: more than skin deep

In March 2012, an otherwise fit 35-year-old Caucasian male was referred to the surgical outpatient clinic with a history of a left inguinal hernia. This was confirmed on clinical examination and a date was set for an elective Lichtenstein repair under general anaesthetic as a day case procedure. The patient’s groin was reexamined as routine on the day of surgery, marked and informed consent was obtained. Following induction of general anaesthesia his hernia was manually reduced. A routine oblique skin incision along Langer’s lines, 2 cm above the inguinal ligament was made and extended laterally. Whilst retracting the subcutaneous tissues, a firm lump was unexpectedly felt at the level of the inguinal ligament. The subcutaneous tissue was carefully dissected revealing a large rubbery black pigmented superficial inguinal lymph node. The lymph node was excised and an emergency frozen section procedure was requested. Whilst awaiting the pathology report and with the patient still under anaesthetic, the incision was covered and the sterile drapes removed to expose the patient’s torso and lower limbs. A primary melanoma lesion was searched for, however, examination revealed a large tattoo along the outer aspect of his left leg that had not been appreciated preoperatively (Fig. 1). No other abnormality was identified. Emergency pathology reported a lymph node with prominent pigment deposit. No obvious malignancy was seen. Hence, the procedure was resumed and the patient had a Lichtenstein hernia repair in routine fashion using a self adhesive mesh (ParietexProGrip, Covidien, Dublin, Ireland). A subsequent full pathology report of the paraffin embedded specimen confirmed the presence of dense pigment deposit within the lymph node and no evidence of neoplasia (Fig. 2). The node measured 25 9 10 9 5 mm. Body art in western societies has seen a dramatic surge in popularity in recent years. Once the domain of specific subcultures, tattoos are now commonly seen on mainstream male and female celebrities, including athletes and

Morphological identification of lymph node vasculature using contrast enhanced ultrasonogaphy (CEUS).

Small superficial normal canine lymph nodes often appear as vascular at classic Dopplertechnique evaluation. The aim of present research is to describe the characteristics of lymph nodesvasculature after administration of the contrast agent. Contrast enhanced ultrasonography (CEUS) wasperformed on a total of 6 subjects, after intravenous administration of SonoVue (Bracco - Italy),containing stabilized micro bubble of sulphur hexafluoride. The sentinel lymph nodes of the mammarygland, the axillary and superficial inguinal lymph nodes were examined. In advance, for comparison, thesame lymph nodes were evaluated using color Doppler and power Doppler. Imaging characteristicsfollowed after contrast agent administrations were: the beginning of contrast agent in lymph nodepenetration (time to wash in), maximum intensity time of visualization of contrast agent and time whenwash out is complete. Besides these periods were followed, echogenicity, ecotexture of lymph nodes,during phases mentioned above. Also the way of lymph nodes parenchyma filling was followed, duringthe same periods. In normal lymph nodes, contrast wash in phase was viewed at 7 sec from the time ofinjection, with a maximum intensity of micro bubble visualization, at 13 sec. Normal lymph nodes have acentral artery with an hilar centrifugal branching oriented towards the capsule. Lymph nodeangioarhitecture was best visualized after intravenous contrast agent administration, compared withDoppler techniques. The results of this preliminary study shows that CEUS is a noninvasive method witchcan be successfully applied to describe the lymph node vasculature in carnivores, making an improvedvisualization compared with conventional technique.

Lymphangiography of the Mouse Ear

The lymphatic system is an important route for metastasis of cancer cells. Lymphatic microvessels have been studied by adapting lymphangiography to the mouse ear. In this technique, a high-molecular-weight fluorescently labeled tracer is injected into the interstitial compartment of the ear chamber. The tracer migrates to the local lymphatic vessels and fills the network, allowing visualization. Lymphangiography with Evan's blue dye or fluorescein isothiocyanate (FITC)-dextran reveals a dense auricular network of lymphatic capillaries, draining to a larger vessel at the ear base and subsequently to the exposed superficial cervical lymph node.

Marjolin's Ulcer of the Leg Secondary to Nonhealing Chronic Venous Stasis Ulcer

We report on a 79-year-old man with a chronic venous stasis ulceration of >20 years' duration in the left medial leg presenting to our clinic after admission for bleeding and suspected infection of his ulceration. This lesion had been biopsied in 1999 and was found to be a benign, chronic venous insufficiency ulceration. Plain film radiographs as well as a bone scan did not identify osteomyelitis. Because of the hypertrophic, nodular appearance of this ulceration, it was the clinicians' discretion to perform a repeat biopsy of the lesion. Biopsy revealed invasive, well-differentiated squamous cell carcinoma. A computed tomography scan subsequently identified a suspicious inguinal lymph node, and an ultrasound-guided needle aspiration revealed metastatic squamous cell carcinoma of the biopsied lymph node. Above-knee amputation was indicated at this time and was performed in conjunction with local superficial inguinal lymph node resection, after which the patient was discharged from our service.