The lymph drainage routes from the abdominal cavity in rats were observed at 3 min, 1, 2 and 4 h after India ink was administered intraperitoneally. Four systems of lymph drainage routes from the peritoneal cavity were observed. Three minutes after injection, the drainage route travelled via the intrathoracic lymph vessels located along the internal thoracic artery and returned to the anterior mediastinal lymph nodes. One hour after injection, the drainage route travelled via the lymph vessel located along the left phrenic nerve in addition to the drainage route observed at 3 min. Two and four hours after injection, in addition to the above-mentioned routes, the drainage that had travelled via the thoracic duct continued along the right side of the aorta and was also observed in the lateral lymph vessel located on the vertebra. These findings suggest that lymph or cells absorbed into the peritoneal cavity at first travel towards the anterior mediastinal lymph nodes in the thorax via the ventral lymphatic channels, and then gradually course through the dorsal lymphatic channels. These routes may serve as a route for transporting cancer cells and other cells from the peritoneal cavity.
There are some reports in the literature that among squamous cell carcinomas (SCCs) that occur in the oral cavity, most are often observed in the tongue, which then metastasize to cervical lymph nodes at a relatively early stage (1 -6) . Cervical lymph node metastasis is an important factor that affects patient outcome (1 -7) . Prediction of cervical lymph node metastasis is, thus, considered to improve treatment results.It has also been reported that the proliferative activity and biological properties of the tumor cells in the inva-sive front of the tumor are important predictors of cervical lymph node metastasis in oral squamous cell carcinoma (OSCC) (8, 9) . It has also been suggested that budding, defined as the presence of single cancer cell or cluster of less than 5 cancer cells at the invasive front, which has been shown to be a predictor of lymph node metastasis in colon cancer (10) , may also have a similar role in cervical lymph node metastasis in OSCC (11,12) . Furthermore, an association between the expression of stemcellassociated factors and prognosis of SCC (hypopharynx (13) , esophagus (14) , lung (15) , etc.
the most common type being oral squamous cell carcinoma (OSCC). OSCC may arise in any part of the oral cavity, including the tongue, gingiva, hard palate, buccal mucosa, and floor of the mouth. The most frequent location of occurrence is the tongue, followed by the lower gingiva and the floor of the mouth (1). Important clinical factors in the evaluation of tumor progression are primary tumor size, cervical lymph node metastasis, and distant metastasis. Therefore, the tumor/node/metastasis (TNM) classification of the Union for International Cancer Control (UICC) is used to determine treatment regimens for oral cancer. Among them, cervical lymph node metastasis is one of the important factors affecting the prognosis of patients. OSCC often metastasizes to the cervical lymph nodes (CLN). CLN are removed by cervical dissection, and the levels, number of metastases, size, and extracapsular nodule infiltration of lymph nodes are recorded as histopathological findings (2). However, evaluation by immunohistochemical staining has not been performed.
The incidence of pleomorphic adenoma (PA) of the minor salivary glands is reported to be 10%, and while the histological findings in PA can be diverse, keratin-filled cysts lined by squamous epithelium are rarely reported. The condition can, however, present with cyst formation in some cases. We review a rare case of pleomorphic adenoma in the buccal mucosa that involved the formation of multiple squamous epithelium-lined cysts in a 69-year-old woman. Magnetic resonance imaging (MRI), fine needle aspiration cytology, and histopathological examination were performed. Physical examination revealed a painless, mobile, elastic hard mass in the right buccal mucosa, measuring 2.5 × 1.0 cm. The MRI revealed a well-defined lesion with different signal intensities in the medial and distal regions of the right cheek. The medial side of the lesion showed a low signal intensity on T1-weighted imaging (T1WI) and T2-weighted imaging (T2WI), while the distal side showed a low signal intensity on T1WI, and a high signal intensity on T2WI and short tau inversion recovery (STIR) imaging. Fine needle aspiration of the lesion was performed under local anesthesia and a cytological diagnosis of an epidermoid or dermoid cyst was made. The tumor was completely resected under local anesthesia combined with intravenous sedation. The histopathological examination demonstrated the proliferation of atypical tumor cells with poor atypia and the formation of glandular, alveolar, large, and small cysts. The cysts were lined by keratinized squamous epithelial cells, their cavities were filled with keratinous material, and foreign body reaction was observed
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