RESUMO
BACKGROUND: The value of lymphatic mapping and sentinel lymph node biopsy in the treatment of colon cancer is controversial. The purpose of this study was to determine the accuracy of lymphatic mapping in patients with colon cancer. METHODS: Forty-eight patients with colon cancer underwent lymphatic mapping and sentinel lymph node biopsy using isosulfan blue dye followed by standard surgical resection. The sentinel lymph nodes underwent thin sectioning as will as immunohistochemical staining for cytokeratin, in addition to standard hematoxylin and eosin staining. RESULTS: In 47 (98%) patients, a sentinel lymph node was identified. Sixteen patients had lymph nodes containing metastatic disease, and in 6 patients the sentinel lymph node was positive for disease. In no patient was the sentinel lymph node the only site of metastatic disease. In 10 patients the sentinel lymph node was negative for disease, whereas the nonsentinel lymph nodes contained metastatic disease (false negative rate = 38%). CONCLUSIONS: The role of lymphatic mapping and sentinel lymph node biopsy in colon cancer is not as clear as its role in other tumors. Further large prospective studies are needed to evaluate the accuracy and potential benefit of this procedure in patients with colon cancer.
Assuntos
Neoplasias do Colo/patologia , Linfonodos/patologia , Idoso , Idoso de 80 Anos ou mais , Feminino , Humanos , Imuno-Histoquímica , Queratinas/análise , Metástase Linfática/patologia , Masculino , Pessoa de Meia-Idade , Biópsia de Linfonodo SentinelaRESUMO
The indications for, and timing of, surgical intervention for suprarenal masses detected prenatally are unclear. Also, the definitive diagnosis of suprarenal masses using imaging studies is difficult at best. We report 2 cases of antenatally detected suprarenal masses. One case represents an initial cystic mass expanding and becoming solid that had benign pathologic features. The second case was a stable solid mass that, on exploration, was malignant. Management options are discussed.
Assuntos
Doenças das Glândulas Suprarrenais/diagnóstico , Cistos/diagnóstico , Neuroblastoma/diagnóstico , Ultrassonografia Pré-Natal , Doenças das Glândulas Suprarrenais/diagnóstico por imagem , Doenças das Glândulas Suprarrenais/cirurgia , Neoplasias das Glândulas Suprarrenais/diagnóstico , Adulto , Biópsia , Cistos/diagnóstico por imagem , Cistos/cirurgia , Diagnóstico Diferencial , Feminino , Humanos , Recém-Nascido , Rim/patologia , Imageamento por Ressonância Magnética , Masculino , Nefrectomia , Neuroblastoma/cirurgia , Gravidez , Tomografia Computadorizada por Raios XRESUMO
We retrospectively reviewed several risk factors for median sternotomy dihiscence in our cardiac surgery patients for a recent 18-month period. We studied these factors by univariate and multivariate analysis with respect to sternal dehiscence. Univariate analysis showed several factors to be significant: female sex (P = .03), obesity (P = .002), diabetes (P = .01), and prolonged postoperative ventilation (P = .006). Mammary artery bypass versus saphenous vein bypass only approached significance (14% vs 3%, P = .11). Multivariate analysis showed obesity (P = .002), diabetes (P = .041), and prolonged postoperative ventilation (P = .005) to be important. We conclude that obese diabetic women are at extremely high risk for sternotomy dehiscence, and mammary artery bypass in this high-risk population may be a relative contraindication.