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Tumor cell invasion from the marginal sinus into extranodal veins during early-stage lymph node metastasis can be a starting point for hematogenous metastasis

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Journal of Cancer Metastasis and Treatment 2018年第1期4卷 656-666页

作者： Tetsuya Kodama Shiro Mori masato nose Graduate School of Biomedical Engineering Tohoku UniversitySendai 980-8575Japan Biomedical Engineering Cancer Research Center Graduate School of Biomedical EngineeringTohoku UniversitySendai 980-8575Japan Department of Oral and Maxillofacial Surgery Tohoku University HospitalSendai 980-8575Japan Institute for Promotion of Advanced Science and Technology Ehime UniversityMatsuyama 790-8577Japan

Aim:To investigate whether tumor cells in a lymph node(LN)can invade from the marginal sinus into extranodal veins via vessel branches that communicate with intranodal veins and whether this can be a starting point for hematogenous metastasis at the early stage of LN ***:Vascular and lymphatic networks of LNs in MXH10/Mo-lpr/lpr mice were investigated using three-dimensional micro-computed tomography and histological *** in the blood vessel networks of LNs was investigated by fluorescence *** cells were injected into the subiliac LNs of MXH10/Mo-lpr/lpr mice to induce metastasis to the proper axillary *** development in the proper axillary LN was detected using an in vivo bioluminescence imaging system.A two-dimensional image of the proper axillary LN microvasculature was reconstructed using a contrast-enhanced high-frequency ultrasound ***:Extranodal veins communicated with intranodal veins via branches that penetrated the capsule,and blood flowed from intranodal veins to extranodal *** cells that had metastasized to the marginal sinus invaded these communicating veins to develop hematogenous ***:Metastatic LNs that would be considered by clinical imaging to be stage N0 can be a starting point for hematogenous *** study findings highlight the need for the development of novel techniques for the diagnosis and treatment of early-stage LN metastasis,i.e.,when standard diagnostic imaging might incorrectly classify the LN as stage N0.

关键词： Lymph node metastasis N0 lymph node-mediated hematogenous metastasis

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Polyarteritis nodosa clinically mimicking nonocclusive mesenteric ischemia

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World Journal of Gastroenterology 2013年第23期19卷 3693-3698页

作者： Tsuyoshi Shirai Hiroshi Fujii Shinichiro Saito Tomonori Ishii Hideyuki Yamaya Shigehito Miyagi Satoshi Sekiguchi Naoki Kawagishi masato nose Hideo Harigae Department of Hematology and Rheumatology Tohoku University Graduate School of MedicineSendai 980-8574 Japan Division of Advanced Surgical Science and Technology Tohoku University Graduate School of MedicineSendai 980-8574 Japan Department of Histopathology Tohoku University Graduate School of MedicineSendai 980-8574 Japan

Here, we present the case of a 74-year-old Japanese man with segmental intestinal necrosis, which developed after treatment with pulsed methylprednisolone for mononeuritis multiplex. The patient was weakly positive for myeloperoxidase (MPO)-anti-neutrophil cytoplasmic antibody (ANCA). Computed tomography and surgical findings were compatible with nonocclusive mesenteric ischemia (NOMI). He underwent small intestinal resection by emergency surgery and an intestinal fistula was made. Pathologically, necrotizing vasculitis with fibrinoid necrosis was present in medium to small-sized arteries, which was equivalent to Arkin's classification Ⅱ-Ⅳ. Most of the arteries had fibrous intimal thickening, which was considered to obstruct the arteries and thus cause segmental intestinal necrosis. A diagnosis of polyarteritis nodosa (PAN) was made, and intravenous cyclophosphamide pulse therapy was added to the therapeutic regimen. This patient was successfully treated with these multidisciplinary therapies and his stoma was finally closed. This is a very rare and indicative case of PAN weakly positive for MPO-ANCA and clinically mimicking NOMI, which occurred even after treatment with pulsed methylprednisolone.

关键词： Anti-neutrophil cytoplasmic antibody Intestinal necrosis Myeloperoxidase Nonocclusive mesenteric ischemia Polyarteritis nodosa

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