RESUMO
Suspicious malignant supraclavicular lymphadenopathy provides a challenge for diagnosis and treatment. The wide variety of primary tumours that metastasise to this region should alert the clinician to look beyond the head and neck, particularly if it is the only site in the neck with suspected disease. As metastatic spread to these nodes from primaries not in the head and neck often indicates wide spread disease, neck dissection is controversial. In this article we review the lymphatic anatomy and discuss the investigation of supraclavicular lymphadenopathy. We discuss the evidence for the management of the neck in patients with subclavicular primary cancers (excluding lymphoma and melanoma) and the role of neck dissection.
Assuntos
Metástase Linfática/diagnóstico , Neoplasias da Mama/diagnóstico , Diagnóstico Diferencial , Feminino , Neoplasias Gastrointestinais/diagnóstico , Humanos , Neoplasias Pulmonares/diagnóstico , Sistema Linfático/anatomia & histologia , Pescoço/patologia , Esvaziamento Cervical , Trato Gastrointestinal Superior/patologia , Neoplasias Urogenitais/diagnósticoRESUMO
We describe a previously unreported anatomical variant of the posterior auricular nerve found during parotidectomy, and discuss its clinical implications.
Assuntos
Variação Anatômica , Meato Acústico Externo/inervação , Cartilagem da Orelha/inervação , Orelha Externa/inervação , Adenolinfoma/cirurgia , Idoso , Estimulação Elétrica , Músculos Faciais/inervação , Nervo Facial/anatomia & histologia , Humanos , Masculino , Contração Muscular/fisiologia , Glândula Parótida/cirurgia , Neoplasias Parotídeas/cirurgiaRESUMO
We have previously used genome-wide transcript profiling to investigate the relationships between changes in gene expression and physiological alterations during the response of the immature mouse uterus to estrogens. Here we describe the identification of a functionally inter-related group of estrogen-responsive genes associated with iron homeostasis, including the iron-binding protein lactotransferrin, the ferroxidase ceruloplasmin, the iron delivery protein lipocalin 2 and the iron-exporter ferroportin. Quantitative real-time PCR revealed that the expression of these genes increases with time during the uterotrophic response, reaching maximal levels in the post-proliferative phase (between 48 and 72 h). In contrast, the heme biosynthesis genes aminolevulinic acid synthase 1 and 2 were maximally induced by estrogen at 2 and 4 h, respectively, prior to increased cell proliferation. Together, these data reveal that estrogen induces the temporally coordinated expression of iron homeostasis genes in the mouse uterus, and suggest an important role for iron metabolism during sex steroid hormone-induced uterine cell growth and differentiation.
