- Lymph node size and its association with nodal metastasis in ductal adenocarcinoma of the pancreas
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Jaehoon Shin, Seungbeom Shin, Jae Hoon Lee, Ki Byung Song, Dae Wook Hwang, Hyoung Jung Kim, Jae Ho Byun, HyungJun Cho, Song Cheol Kim, Seung-Mo Hong
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J Pathol Transl Med. 2020;54(5):387-395. Published online July 21, 2020
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DOI: https://doi.org/10.4132/jptm.2020.06.23
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- Background
Although lymph node metastasis is a poor prognostic factor in patients with pancreatic ductal adenocarcinoma (PDAC), our understanding of lymph node size in association with PDAC is limited. Increased nodal size in preoperative imaging has been used to detect node metastasis. We evaluated whether lymph node size can be used as a surrogate preoperative marker of lymph node metastasis.
Methods We assessed nodal size and compared it to the nodal metastatic status of 200 patients with surgically resected PDAC. The size of all lymph nodes and metastatic nodal foci were measured along the long and short axis, and the relationships between nodal size and metastatic status were compared at six cutoff points.
Results A total of 4,525 lymph nodes were examined, 9.1% of which were metastatic. The mean size of the metastatic nodes (long axis, 6.9±5.0 mm; short axis, 4.3±3.1 mm) was significantly larger than that of the non-metastatic nodes (long axis, 5.0±4.0 mm; short axis, 3.0±2.0 mm; all p<.001). Using a 10 mm cutoff, the sensitivity, specificity, positive predictive value, overall accuracy, and area under curve was 24.8%, 88.0%, 17.1%, 82.3%, and 0.60 for the long axis and 7.0%, 99.0%, 40.3%, 90.6%, and 0.61 for the short axis, respectively.
Conclusions The metastatic nodes are larger than the non-metastatic nodes in PDAC patients. However, the difference in nodal size was too small to be identified with preoperative imaging. The performance of preoperative radiologic imaging to predict lymph nodal metastasis was not good. Therefore, nodal size cannot be used a surrogate preoperative marker of lymph node metastasis.
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Citations
Citations to this article as recorded by 
- Prevalence of Adenopathy at Chest Computed Tomography After Vaccination for Severe Acute Respiratory Syndrome Coronavirus 2
Georgeann McGuinness, Jeffrey B. Alpert, Geraldine Brusca-Augello, Lea Azour, Jane P. Ko, Farah Tamizuddin, Elliott K. Gozansky, William H. Moore Journal of Computer Assisted Tomography.2023; 47(1): 50. CrossRef - Regional lymph node metastasis detected on preoperative CT and/or FDG-PET may predict early recurrence of pancreatic adenocarcinoma after curative resection
Ja Kyung Yoon, Mi-Suk Park, Seung-Seob Kim, Kyunghwa Han, Hee Seung Lee, Seungmin Bang, Ho Kyoung Hwang, Sang Hyun Hwang, Mijin Yun, Myeong-Jin Kim Scientific Reports.2022;[Epub] CrossRef - Role of CA 19.9 in the Management of Resectable Pancreatic Cancer: State of the Art and Future Perspectives
Alessandro Coppola, Vincenzo La Vaccara, Tommaso Farolfi, Michele Fiore, Roberto Cammarata, Sara Ramella, Roberto Coppola, Damiano Caputo Biomedicines.2022; 10(9): 2091. CrossRef - Evaluation of the 8th Edition AJCC Staging System for the Clinical Staging of Pancreatic Cancer
Huapyong Kang, Seung-seob Kim, Min Je Sung, Jung Hyun Jo, Hee Seung Lee, Moon Jae Chung, Jeong Youp Park, Seung Woo Park, Si Young Song, Mi-Suk Park, Seungmin Bang Cancers.2022; 14(19): 4672. CrossRef - Comparison of MRI and CT-based radiomics for preoperative prediction of lymph node metastasis in pancreatic ductal adenocarcinoma
Piaoe Zeng, Chao Qu, Jianfang Liu, Jingjing Cui, Xiaoming Liu, Dianrong Xiu, Huishu Yuan Acta Radiologica.2022; : 028418512211425. CrossRef - Does direct invasion of peripancreatic lymph nodes impact survival in patients with pancreatic ductal adenocarcinoma? A retrospective dual-center study
Daisuke Hashimoto, Sohei Satoi, Mitsuaki Ishida, Kenji Nakagawa, Masaya Kotsuka, Tadataka Takagi, Hironori Ryota, Taichi Terai, Tatsuma Sakaguchi, Minako Nagai, So Yamaki, Takahiro Akahori, Tomohisa Yamamoto, Mitsugu Sekimoto, Masayuki Sho Pancreatology.2021; 21(5): 884. CrossRef - CA19.9 Serum Level Predicts Lymph-Nodes Status in Resectable Pancreatic Ductal Adenocarcinoma: A Retrospective Single-Center Analysis
Alessandro Coppola, Vincenzo La Vaccara, Michele Fiore, Tommaso Farolfi, Sara Ramella, Silvia Angeletti, Roberto Coppola, Damiano Caputo Frontiers in Oncology.2021;[Epub] CrossRef
- Coexisting Mucinous Cystic Neoplasm of the Pancreas and Type 1 Autoimmune Pancreatitis
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Mee-Jeong Kim, Tae Jun Song, Hyoung Jung Kim, Song-Cheol Kim, Myung-Hwan Kim, Seung-Mo Hong
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J Pathol Transl Med. 2019;53(2):125-128. Published online November 14, 2018
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DOI: https://doi.org/10.4132/jptm.2018.10.25
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6,604
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- Type 1 autoimmune pancreatitis (AIP1) is an IgG4-related systemic disease that mimics tumors. We report a rare case of AIP1 accompanied by mucinous cystic neoplasm (MCN). A pancreatic lesion was incidentally detected in a woman in her 60s. After 6 years of follow-up, the lesion abruptly increased in size. Computed tomography showed a 3.5 cm unilocular cyst in the tail of the pancreas and distal pancreatectomy was performed. On microscopic examination, the cyst was lined by mucinous and non-mucinous epithelial cells with mild cytologic atypia. The surrounding stroma comprised ovarian-type spindle cells with progesterone receptor positivity. The pericystic pancreas exhibited multifocal lymphoid follicles, lymphoplasmacytic infiltrations, obliterative phlebitis, and storiform fibrosis. IgG4-positive plasma cell infiltration (215 cells high-power field) and the IgG4/IgG ratio (57%) were increased. Cases of MCN coexisting with AIP1 are extremely rare; only two such cases have been reported in the English-language literature. This third case featured low-grade MCN with AIP1.
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Citations
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- Histological features of autoimmune pancreatitis and IgG4-related sclerosing cholangitis with a correlation with imaging findings
Kenji NOTOHARA Choonpa Igaku.2023; 50(1): 55. CrossRef - Histological features of autoimmune pancreatitis and IgG4-related sclerosing cholangitis with a correlation with imaging findings
Kenji Notohara Journal of Medical Ultrasonics.2021; 48(4): 581. CrossRef - 自己免疫性膵炎診療ガイドライン2020
Suizo.2020; 35(6): 465. CrossRef - Mucinous cystic neoplasm of the pancreas with type-1 autoimmune pancreatitis-like lesion
Kevin Gowing, David F. Schaeffer, Hui-Min Yang Human Pathology: Case Reports.2019; 18: 200339. CrossRef
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