Metastases

Our plain-English summary of Metastases, by P. Zeppa, I. Cozzolino (Monographs in Clinical Cytology, 2018).

The study

• Authors: P. Zeppa, I. Cozzolino
• Journal: Monographs in Clinical Cytology
• Published: 2018;23:93-101
• Type of article: Review
• Cited by: 2 articles, as counted by NIH iCite
• Read it: PubMed · Publisher

In plain English

This is a book chapter, not an original study. The authors give a narrative overview of fine-needle cytology (sampling with a thin needle) for recognising cancer spread to lymph nodes. It reports no new data and does not mention asbestos. It described which lymph node sites tend to receive spread from which organs, stating for example that scalene nodes usually receive spread from tumours inside the chest. It also covered cell features of spread, look-alikes such as lymphoma, and antibody stain panels for finding the original tumour. Mesothelioma appeared in two places. The first was an illustrated case: a scalene lymph node from a patient with shortness of breath, labelled a metastasis from mesothelioma, whose cells suggested possible mesothelioma and were calretinin-positive. The second was a suggested staining scheme that lists calretinin, CK5/6 and caldesmon under mesothelioma. Separately, the chapter noted earlier reports of benign mesothelial cell inclusions in mediastinal lymph nodes. These are non-cancerous and are not mesothelioma. The chapter gave a long list of stain markers for lymph node metastases. The authors wrote that, properly applied and interpreted, these markers might solve most cases.

We wrote this plain-English summary from the full article with the help of AI, and a second AI model checked each sentence against the article. It is not the authors' wording; the abstract and the article are their own account.

What the study did and found

• Design: Book chapter giving a narrative review of fine-needle cytology of lymph node metastases; no original study
• Who was studied: No study population. The chapter discusses lymph node metastases in general and illustrates them with individual cases in figures. One of these is a scalene lymph node from a patient with dyspnea.
• Exposure: No exposure was studied; asbestos and asbestos fibers are not mentioned in the chapter
• Main results:
  • In one illustrated case, a scalene lymph node sampled by fine-needle cytology from a patient with dyspnea was shown as a metastasis from mesothelioma. Its cells suggested a possible mesothelioma and were positive for calretinin.
  • The chapter stated that scalene lymph nodes are usually the sites of spread from tumours inside the chest
  • A suggested staining scheme for lymph node metastases lists calretinin, CK5/6 and caldesmon as markers for mesothelioma
  • The chapter noted that benign mesothelial cell inclusions in mediastinal lymph nodes have been reported in earlier literature. This is a cited report of a non-cancerous finding, not a finding of this chapter and not mesothelioma.
  • The chapter stated that carcinoma most frequently produces lymph node metastases, followed by melanoma and germ-cell tumours (citing other publications)
  • The chapter suggested a basic stain panel for poorly differentiated tumours: CKAE1AE3, CD45 (LCA), vimentin and S100
• The authors' conclusion: The authors wrote that, if properly applied and interpreted, evaluating the broad set of stain markers they listed for lymph node metastases might solve most cases. They called occult (hidden) lymph node metastases the main weakness of fine-needle cytology.

Topics

The National Library of Medicine indexes this study under subjects our site covers: Lung cancer.

Related studies

• Cytokeratin 19 expression in primary thoracic tumors and lymph node metastases — K. Masai, K. Nakagawa, et al. (2014)
• Malignant pleural mesothelioma initially diagnosed on cervical lymph node biopsy — S. Ogata, S. Hiroi, et al. (2009)
• Lymph node metastases in diffuse malignant peritoneal mesothelioma — D. Baratti, S. Kusamura, et al. (2010)
• Fine-needle aspiration biopsy of axillary lymph nodes — S. Jaffer, M. Zakowski (2002)
• IMP3/L523S, a novel immunocytochemical marker that distinguishes benign and malignant cells: the expression profiles of IMP3/L523S in effusion cytology — K. Ikeda, G. Tate, et al. (2010)
• Diagnosis of malignant mesothelioma by fine needle aspiration of a cervical lymph node. A case report — N.A. Ansari, N.W. Derias (2000)

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