Last-intercalated node and direct lymphatic drainage into the thoracic duct from the thoracoabdominal viscera

Murakami, Gen; Abe, Masato; Abe, Tomio

doi:10.1007/bf02913469

Cited by 26 publications

(19 citation statements)

References 33 publications

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“…The authors suggested that transparent nodes had lost the ability to filter malignant cells or microorganisms, rendering the host more susceptible to the spread of disease . Transparent lymph nodes might also offer another mechanism for the development of skip metastases, in addition to the commonly accepted pathway that involves bypass of local regional nodes by collateral lymphatics …”

Section: Lymph Node Morphologymentioning

confidence: 99%

Does senescence affect lymph node number and morphology? A systematic review

2013

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In this first systematic review to examine changes in lymph nodes with senescence, evidence was accrued to suggest a decline in lymph node number and morphological degeneration in older age groups. These changes might adversely affect immune function and the prognosis of infections and selected cancers in the elderly. Further research is required to confirm these morphological changes and to explore their potential immunological and functional effects.

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Section: Lymph Node Morphologymentioning

confidence: 99%

Does senescence affect lymph node number and morphology? A systematic review

2013

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“…According to numerous presentations at the Annual Congress of the Japanese Society of Lymphology in 1996 (Nishi, 1996), N2‐skip metastasis is found in 10–20% of gastric cancer patients with cancer‐positive N3 nodes, the incidence differing depending on the hospital or institute. Skip metastasis has been considered to be a result of collateral lymphatic vessels that make a highway or bypass outside of the N2 node (Murakami et al ., 2002). However, we hypothesize that intranodal shunt flow, as well as the collateral vessels, is involved in skip metastasis.…”

Section: Introductionmentioning

confidence: 99%

Gaps and fragmentation of the superficial cortex in the abdominal and pelvic lymph nodes of elderly Japanese

et al. 2003

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Gaps and fragmentation of the superficial lymph node cortex are considered to provide intranodal shunt flow between the afferent and efferent vessels. Using serial sections of 205 nodes obtained from 27 donated cadavers more than 70 years of age, we examined the histological architecture of the abdominal and pelvic nodes in elderly Japanese. Secondary follicles were rare in the specimens. Cortex gaps were, to a greater or lesser degree, found in all nodes. We classified these nodes into three types according to how often the gap occurred. Type 1 nodes, with a relatively complete shield for the afferent lymph, were most frequently found in gastric nodes, whereas type 3 nodes, with numerous gaps, were often observed in the colic, para-aortic and pelvic nodes. The type 3 nodes showed a specific architecture characterized by a fragmented superficial cortex, three-dimensionally assembled cords and a common sinus between them. Primary follicles were located in the assembled cord structures as well as at the superficial cortex. Irrespective of the type, B and T lymphocyte areas were intermingled in the cortex-like areas. The present results reveal region-specific histological heterogeneity in aged human visceral nodes. Due to increased surface areas, the type 3 architecture seemed to accelerate systemic immunity rather than act as a local barrier in the para-aortic and pelvic nodes, which are located centrally along the lymphatic drainage routes. However, thick trabeculae often seemed to develop in the type 3 sinus to decrease nodal function with aging.

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“…However, in autopsy cases, the rates of cancer cells in bone marrow are reported to be 15%-20%. 22,23 The reasons for this discrepancy are unknown, and it remains to be determined whether bone metastasis may occur more frequently than our clinical experience suggests.…”

Section: Mechanisms Of Bone Metastasismentioning

confidence: 80%

“…Regarding this problem, Kobayashi et al 16 and Murakami et al 23 speculated that there are specifi c routes by which the cancer cells in the stomach and in the lymph nodes can infi ltrate the bone marrow directly, and these types of metastasis in EGC were reported to occur mainly with histology of the diffuse type. 24,25 Tumor Dormancy…”

Section: Mechanisms Of Bone Metastasismentioning

confidence: 99%

Overt bone metastasis and bone marrow micrometastasis of early gastric cancer

et al. 2011

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Recently we encountered two cases of early gastric cancer (EGC) with bone metastasis after surgery. As they were not accompanied by overt liver, lung, or peritoneal metastasis, we examined the clinical significance of bone metastasis in EGC and its mechanisms by a review of the literature. We found only 10 cases of EGC complicated with overt bone metastasis in the English literature, so we also examined the Japanese reports of such cases. The main histologic type of cases of bone metastasis from EGC was the diffuse type, and there were long intervals between surgery and overt bone metastasis. One reason for such long intervals may have been the tumor dormancy. Two types of dormancy, dynamic and static, and two types of postoperative overt metastases, that of micrometastatic origin (normograde metastatic process) and that of bone marrow origin (retrograde metastatic process), were considered. We speculated that there may be specific routes by which the cancer cells infiltrate the bone marrow directly from EGC or lymph node metastasis. The procedures for diagnosing bone micrometastasis using monoclonal antibodies have recently been improved, but their accuracy rates are still not universally accepted. New, more reliable examinations are required to improve the survival rates of EGC.

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Last-intercalated node and direct lymphatic drainage into the thoracic duct from the thoracoabdominal viscera

Abstract: We hypothesize that the most critical sentinel node, if such usage is allowed, is situated as a guard for a limited specific route and for a common drainage route. We term it the "common terminal node".

Cited by 26 publications

References 33 publications

Does senescence affect lymph node number and morphology? A systematic review

Does senescence affect lymph node number and morphology? A systematic review

Gaps and fragmentation of the superficial cortex in the abdominal and pelvic lymph nodes of elderly Japanese

Overt bone metastasis and bone marrow micrometastasis of early gastric cancer

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