Ganglion of the groin in a child: an unusual cause of soft-tissue swelling of the groin

A case of groin ganglion with asymptomatic compression of the femoral vein is described. A 2-year-old girl was referred because of a symptomless groin mass. A mass was palpable in the right femoral triangle. Computed tomography and ultrasonography revealed a cystic lesion compressing the femoral vein ventrally. Prompt surgical removal of the cystic lesion was done without complications. Histopathological examination showed a benign structure similar to that of a ganglion.     

Detection of the sentinal node by lymphoscintigraphy in squamous-cell carcinoma of the oral cavity: a prospective study of 31 patients

INTRODUCTION: This study aimed at evaluating the relevance of sentinel node detection by lymphoscintigraphy in patients diagnosed with squamous-cell carcinoma of the oral cavity in the absence of neck adenopathy. PATIENTS AND METHODS: A prospective study was carried out in 31 patients diagnosed with T1 to T3 squamous-cell carcinoma of the oral cavity without any clinically detectable neck adenopathy. A lymphoscintigraphy was performed the day before surgery. All patients underwent sentinel lymph node biopsy guided by a gamma-ray detecting probe and modified neck dissection. Pathologic evaluation of the sentinel lymph node included, in addition to the standard protocol, immunohistochemical analysis and thin sections of E stained preparations. RESULTS: In 3 patients, the lymphoscintigraphy failed to detect any sentinel lymph node. In the remaining group of 28 patients, 20 patients showed a negative sentinel node concordant with a histologically negative neck dissection. In 5 patients, a positive lymph node was found although the rest of the neck dissection was negative. In 3 patients, sentinel lymph node was found to be negative but other neck nodes were positive. The overall sensitivity of lymphoscintigraphy in our study was 62%. DISCUSSION: Surprisingly, the results of our study do not support the clinical usefulness of sentinel lymph node detection as a reliable and accurate staging method in patients with oral squamous cell carcinoma. We observed that lymphoscintigraphy was not a reliable method for detecting micrometastases in patients diagnosed with a squamous-cell carcinoma of the oral cavity without clinical evidence of neck matastases.     

Quantitative morphometric analysis of the submucous plexus in age-related control groups

An increased number and density of the so-called giant ganglia (seven or greater ganglion cells per ganglion) serve as histopathological criteria for a bowel motility disorder called intestinal neuronal dysplasia of the submucous plexus (IND B). However, because these morphological criteria have been defined based upon observations in constipated patients, the diagnostic value of previous studies is open to controversy. Moreover, no age-related reference data from unaffected controls are available. This study reports on data from unaffected controls on the variability of size and distribution of ganglia in the submucous plexus during development. Therefore, for the first time, the normal status has been defined. Four age groups have been defined: (a) premature births, gestational age less than 35 weeks; (b) 1–365 days; (c) 1–14 years and (d) 15 years to greater than 70 years). All of these groups revealed giant ganglia in the submucous plexus. With advancing age, there was a decrease in the number of giant ganglia (from 32.7% in group a to 11.2% in group d) accompanied by an inverse increase in the mean distance between all ganglia (from 0.52 mm in group a to 1.17 mm in group d). The data presented permit the conclusion that the criteria mentioned above are not apt to define IND B as an entity, since they do not allow a sufficient demarcation from the age-correlated normal values presented here.     

Prolactin-producing pituitary adenoma with incomplete neuronal transformation: an intermediate adenoma–neuronal tumor

We present a unique case of a prolactin (PRL)-producing pituitary adenoma showing incomplete neuronal differentiation without ganglion cells. A 27-year-old man presented with nausea, headaches, and instability over the last 2 months. Clinical examination revealed obesity with no other endocrinological signs. His serum PRL levels were slightly elevated (38 ng/ml), whereas concentrations of the other adenohypophysial hormones were within normal range. Histology revealed an unusual pituitary adenoma containing many hypocellular areas with fibrillar appearance. The sizable tumor cells were polyhedral or elongated harboring an ovoid, vesicular nucleus with prominent nucleolus, lacking, however, the typical features of ganglion cells. By immunohistochemistry, many adenoma cells were positive for PRL. Immunostain for neurofilament protein revealed variable amounts of fibrils dispersed throughout the stroma, mostly in the hypocellular areas. In addition, neurofilament protein and chromogranin were strongly reactive in approximately 15% of the tumor cell population, whereas reactivity for synaptophysin was uniform throughout the tumor. These findings led to the conclusion that part of the tumor-cell population expressed a hybrid immunoprofile of adenoma–neuronal cell. Our case is the first PRL-producing pituitary adenoma showing incomplete neuronal differentiation lacking mature ganglion cells.     

Is sentinel lymph node mapping relevant for colon cancer?: a feasibility study

BACKGROUND: Sentinel lymph node (sln) technique using blue injection is controversial for colon cancer. The aim of this study was to evaluate the feasibility and interest of sentinel node detection to identify the ultrastaging rate detecting occult nodal micrometastases missed on routine H&E examination. METHODS: During surgery blue dye was injected subserously around the tumor in 30 patients operated for a colon cancer. The first lymph nodes to turn blue were noted as sln. For each sln three examination levels were performed; if no tumor was detected by H&E examination, a cytokeratine immunohistochemistry study was performed. RESULTS: For each case, one or more sln were found (100%). The median number of lymph nodes examined and of sln found was, respectively, 23 (range 10-55) and 2 (1-4). There were 21 pN0 tumors, among which we found two cases (9%) with a micrometastasis and one case of isolated tumor cells detected, resulting in a 14% (3/21) ultrastaging for pTxN0. The sln was positive in five patients out of nine with a N+ disease. CONCLUSIONS: Sln detection was a successful technique when there was no evident lymph node involvement, no primary large lesion or no associated liver metastasis. Focused examination of the sln identified 10-20% of additional ultrastaging disease for staged pT1, 2, 3N0M0 tumor. This may have an important implication for follow-up and adjuvant treatment in future protocols.     

中西医结合治疗椎动脉型颈椎病临床研究

目的：探讨中西医结合综合治疗椎动脉型颈椎病的疗效。方法：运用星状神经节阻滞结合推拿综合治疗与单纯采用推拿治疗进行对照，观察患者治疗前后眩晕症状评分以及TCD的变化。结果：推拿组、星状神经节阻滞结合推拿组在眩晕症状评分和椎动脉（VA）、基底动脉（BA）的平均血流速度（Vm）等方面与治疗前比较差异有统计学意义（P〈0．05）。星状神经节阻滞结合推拿组各项指标与单纯推拿组比较差异有统计学意义（P〈0．05）。结论：星状神经节阻滞结合推拿综合治疗椎动脉型颈椎病有较好疗效。     

The Influence of a chronic vitamin a deficiency on the acoustic sensory cells and the ganglion spirale cochleae of the rat

Summary Microscope studies of the inner ear in rats with chronic vitamin A deficiency have rendered contradicting results. In our electron microscope study of the sensory cells of the inner ear in young rats with vitamin A deficiency we found that the cuticle is missing in outer hair cells. In the inner hair cells the cuticle is subtotally lacking. Furthermore, we found changes in the reticular system of the intermediate zone and massive degenerative changes in the afferent nerve system including the ganglion cells of the ganglion spirale cochleae. These morphological changes together with the recent findings of high concentrations of vitamin A in Corti's organ support the hypothesis that the acoustic sensory receptors contain of functionally depend upon vitamin A.First presented at the 51th Jahrestagung der Deutschen Gesellschaft für Hals-Nasen-Ohren-heilkunde, Kopf- und Halschirurgie, May 1980, Bad Reichenhall