RESUMO
BACKGROUND: The significance of techniques used for detecting micro-metastasis (MM) or isolated tumor cells (ITCs) is a controversial issue among investigators. We evaluated the different techniques used on sentinel lymph node (SLN) to detect MM/ITCs. MATERIALS AND METHODS: Ninety-one SLNs of 15 patients underwent serial section with 100 µm interval. In each level, two sections were prepared. One section was stained with H&E and another with anti-cytokeratin antibody (immunohistochemistry). Then the sections were evaluated for detecting MM/ITCs. Results were analyzed by chi-square test. RESULTS: 1656 sections of 91 SLNs of 15 patients were evaluated by a pathologist; MM was found in 1 and ITCs in 1 case. Overall, 2 out of 15 cases (13.3% of the patients) showed MM/ITCs by IHC staining. So, serial section along with using IHC was superior than serial section and routine H&E staining. But it did not affect the 5-year survival of the patients (P = 0.47). CONCLUSION: Using the combined techniques of serial section and IHC staining could up-stage 13.3% of colon cancer patients who were lymph node negative. In other studies with different combination of serial section, IHC staining, and PCR, investigators were able to find MM/ITCs in 3-39% of the cases. In our study, although serial section and IHC staining could up-stage 13.3% of patients, it could not affect the 5-year survival of the patients.
RESUMO
BACKGROUND: Different approaches to treat myasthenia gravis showed variable outcomes probably because of remained ectopic thymic tissue. The aim of this study is to determine incidence of thymic tissue in cases without any thymic disease. MATERIALS AND METHODS: Seventy-two patients scheduled for open heart surgery during 2000 and 2007 without thymic disease that were enrolled in the study at Chamran Hospital. Intraoperative biopsies were taken form aortopulmonary window, aortocaval groove and left and right pericardiophrenic regions. Finally, the distribution of ectopic thymic tissue was evaluated in above regions. RESULTS: Thymic tissue was found overall in 70.85% of patients. The most common sites for thymic tissue were left pericardiophrenic (50%) and right pericardiophrenic (31.9%) regions. Frequencies of ectopic thymus in aortopulmonary window and aortocaval groove were 19.4% and 12.5%, respectively. CONCLUSION: Because of high incidence of ectopic thymic tissue in mediastinum in patients without thymic disease, we recommend wide excision of thymus gland and all of adipose tissue in patients with myasthenia gravis.
RESUMO
BACKGROUND: Incidences of ectopic thymic tissue in the neck have been reported in various conditions. Despite their diversity, there are only a few studies focusing on patients without any thymic disease. The goal of this study was to detect the frequency of ectopic thymic tissue in the necks of adult patients without any thymic disease. MATERIAL/METHODS: Ninety patients with thyroid disorder who were candidate for thyroidectomy were selected. Five specimens were taken from each patient, including two biopsies before thyroidectomy from the right and left thyrothymic ligament just near the thyroid. The other specimens were taken after thyroidectomy: two from right and left carotid sheet at the base of the neck and the fifth from the adipose tissue just above the fourth tracheal cartilage. The specimens were stained with H&E and cytokeratin antibody to detect thymic tissue. RESULTS: Ectopic thymic tissue was found in four cases (4.45%), one by H&E and the others by immunohistochemical staining. CONCLUSIONS: In patients with myasthenia gravis, hyperplasia of thymic tissue occurs in their thymus gland and ectopic thymic tissue as well. As a result, the probability of finding ectopic thymic tissue in such a patient is higher than in patients without any thymic disease. Also, removing of this tissue can improve the outcome of patients.
