Metastatic adenocarcinoma to the cervical lymph node: a significant proportion of cholangiocarcinoma in Thai patients.

OBJECTIVE: To determine distribution of the primary site of metastatic adenocarcinoma to the cervical lymph node in Thai population with histological correlation. MATERIALS AND METHODS: 72 Thai patients with metastatic adenocarcinoma to the cervical lymph node were retrospectively analyzed. Results: Thyroid gland (papillary carcinoma) was the commonest source of tumor (41%), followed by lung (25%), bile duct (17%) and breast (7%). Metastatic cholangiocarcinoma typically produced distinct glandular pattern, and frequently involved the right supraclavicular lymph node. Brush border of the gland-forming tumor cells was a consistent finding in metastatic cholangiocarcinoma, with 100% sensitivity and 97% specificity. CONCLUSIONS: Cholangiocarcinoma represents a significant portion of primary tumor in Thai patients with cervical nodal metastasis. This figure may hold true for countries where bile duct malignancy is endemic, and may be of clinical usefulness in identification of primary cancer.

Histological variants of colorectal adenocarcinoma and clinicomorphological association.

OBJECTIVE: Besides TNM staging system, some special histological features of colonic carcinomas are associated with variable clinicopathological parameters. The objective was to provide new information of correlation between various histomorphological parameters together with available clinical data and each special feature MATERIAL AND METHOD: A retrospective study of 162 materials collected from subjects with first diagnosed as adenocarcinoma of colorectum in King Chulalongkorn Memorial Hospital over a period of 2 years from 2002 to 2003. RESULT: One hundred and forty-seven cases of prominent cribiform feature are related to patient age (p = 0.025) and infiltrative margin (p = 0.006). Thirty-two cases with mucinous component are associated with patient age (p = 0.009) and tumor depth (p = 0.015). Thirteen cases with signet ring cell morphology are correlated with nodal and distant organ metastasis (p = 0.023 and p = 0.020, respectively) as well as angiolymphatic invasion (p = 0.015). In addition the size of signet ring cell containing carcinomas is also related to location (p = 0.036). It is larger in proximal site and smaller in distal counterpart. The authors did not find any statistical significance in 9 cases of medullary carcinoma. Notably, our 33 cases showed biphasic or triphasic feature. CONCLUSION: Each distinct histological variant of colorectal adenocarcinoma is associated with some different clinicopathological variables,' mostly effecting clinical outcome. Pathologists should be concerned with special histological subtypes of colorectal adeonocarcinomas and communicate with physicians for proper management.