The Experts below are selected from a list of 297 Experts worldwide ranked by ideXlab platform
Fan Wang - One of the best experts on this subject based on the ideXlab platform.
-
Anatomy of lymphatic Drainage of the esophagus and lymph node metastasis of thoracic esophageal cancer
Cancer management and research, 2018Co-Authors: Yichun Wang, Liyang Zhu, Wanli Xia, Fan WangAbstract:The lymphatic Drainage of the inner layers (mucosa and submucosa) and the outer layers (muscularispropria and adventitia) of the thoracic esophagus is different. Longitudinal lymphatic vessels and long Drainage territory in the submucosa and lamina propria should be the bases for biDirectional Drainage and Direct Drainage to thoracic duct and extramural lymph nodes (LN). The submucosal vessels for Direct extramural Drainage are usually thick while lymphatic communication between the submucosa and intermuscular area is usually not clearly found, which does not facilitate transversal Drainage to paraesophageal LN from submucosa. The right paratracheal lymphatic chain (PLC) is well developed while the left PLC is poorly developed. Direct Drainage to the right recurrent laryngeal nerve LN and subcarinal LN from submucosa has been verified. Clinical data show that lymph node metastasis (LNM) is frequently present in the lower neck, upper mediastinum, and perigastric area, even for early-stage thoracic esophageal cancer (EC). The lymph node metastasis rate (LNMR) varies mainly according to the tumor location and depth of tumor invasion. However, there are some crucial LN for extramural relay which have a high LNMR, such as cervical paraesophageal LN, recurrent laryngeal nerve LN, subcarinal LN, LN along the left gastric artery, lesser curvature LN, and paracardial LN. Metastasis of thoracic paraesophageal LN seems to be a sign of more advanced EC. This review gives us a better understanding about the LNM and provides more information for treatments of thoracic EC.
Gen Murakami - One of the best experts on this subject based on the ideXlab platform.
-
Anatomy of right recurrent nerve node: why does early metastasis of esophageal cancer occur in it?
Surgical and Radiologic Anatomy, 2006Co-Authors: Masaomi Mizutani, Gen Murakami, Shin-ichi Nawata, Ichiro Hitrai, Wataru KimuraAbstract:Early, distant and/or skip metastasis of squamous-cell thoracic esophageal cancer frequently occurs in the right recurrent nerve node (recR). However, the specific lymphatic route without a nodal relay, such as the submucosal ascending route, was not known for the recR afferent. Using 20 donated cadavers, macroscopic, and histological observations were performed on the recR and its surrounding lymphatics, especially afferent routes from the esophagus to the recR. Most afferent vessels of the recR originated from the right paratracheal node. However, the recR often (12/20) received a major submucosal lymphatic Drainage route ascending along the thoracic esophagus. The submucosal vessel came out of the esophagus and ran in a longitudinal connective tissue mass along the right tracheo-esophageal groove. A Direct Drainage route was often (13/20) seen from the recR to the venous system. Moreover, because of the specific histology, collaterals seemed to be present around the recR. In the regional nodes of the intrathoracic esophagus, the recR histology was characterized by the high proportion of lymphocyte accumulating areas or the cortex. From the midthoracic level, metastatic cancer cells seemed to reach the recR via esophageal submucosal vessels in the early stage. Large lymphocyte accumulating areas of the recR suggested higher filtration capacity than other distal nodes. However, the collateral of the recR and its Direct Drainage to the venous system suggested that the recR involvement often corresponds to a systemic disease.
-
submucosal territory of the Direct lymphatic Drainage system to the thoracic duct in the human esophagus
The Journal of Thoracic and Cardiovascular Surgery, 2003Co-Authors: Kenshi Kuge, Gen Murakami, Shunji Mizobuchi, Yoichi Hata, Takashi Aikou, Shiro SasaguriAbstract:Abstract Objective To investigate how large submucosal Drainage territory extends in lymphatic Drainage vessels of the esophagus with and without nodal delay and which morphologies are shown when passing through the muscularis propria. Methods Submucosal territories of the 22 highly selected Direct Drainage vessels of 17 esophagi were histologically examined using transverse or sagittal serial sections. Afferent vessels from the esophagus to the subcarinal (6 esophagi) and para-esophageal (5 esophagi) nodes were also examined to identify their courses and Drainage territories. Results We found the Direct Drainage vessel from the esophagus in 17 of 75 cadavers macroscopically (22.7%). A single submucosal Drainage unit gave off 1-3 thick Drainage vessels passing through a complete muscle gap of the 2 muscular layers. The unit extended longitudinally for >40 mm but was restricted to the right and/or dorsal quadrants of the esophagus. In contrast, Drainage routes with a nodal relay originated from the intermuscular area, except 1 case when the adjacent or concomitant esophageal artery and vein provided the complete muscle gap. Conclusions Due to the extended longitudinal but restricted transverse territory of the Direct Drainage system without a nodal relay and because of the suggested much more frequent occurrence in patients than in cadavers, when superficial carcinoma is found in the dorsal and/or right quadrants of the esophagus, we recommend detailed presurgical investigations of cervical nodes. In contrast, afferents from the esophagus to the first regional node usually seemed to be less responsible for early nodal metastasis than the Direct Drainage route because of their intermuscular origins.
-
Direct lymphatic Drainage from the esophagus into the thoracic duct
Surgical and radiologic anatomy : SRA, 1994Co-Authors: Gen Murakami, Iwao Sato, K Shimada, C Dong, Y Kato, T ImazekiAbstract:The lymphatic vessels from around the esophagus which drain into the thoracic duct were identified macroscopically and histologically in 106 cadavers. Direct lymphatic Drainage to the duct was macroscopically demonstrated by 84 vessels in 46 cases (43.4%). In 23 cases (19.8%), large collecting vessels arose from the thoracic esophagus and opened Directly imto the duct. In most of these cases (15/23) these lymphatic connections were found at the levels of the 1st–3rd or 6th–8th thoracic vertebrae. Histologic study revealed that two vessels originated from the fine lymphatic plexus in the esophageal adventita, which showed monocytic infiltration. In 11 of the 23 cases, an intercalated node was found along the thoracic duct. The results suggest that lymph drains rapidly into the systemic circulation via the thoracic duct. In view of the clinical applications in esophageal carcinoma, previous accounts of the extramural esophageal lymphatics concerned in Direct Drainage are discussed.
Takanori Ohnishi - One of the best experts on this subject based on the ideXlab platform.
-
Ethmoidal dural arteriovenous fistula with unusual Drainage route treated by transarterial embolization.
Journal of neurointerventional surgery, 2014Co-Authors: Akihiro Inoue, Masahiko Tagawa, Yoshiaki Kumon, Hideaki Watanabe, Daisuke Shoda, Kenji Sugiu, Takanori OhnishiAbstract:Ethmoidal dural arteriovenous fistulas (AVFs) are rare intracranial lesions associated with a high risk of intracranial hemorrhage. In particular, this entity with reflux Drainage Directly into the ophthalmic vein is extremely rare. We report a case of ethmoidal dural AVF with Direct Drainage of the superior ophthalmic vein (SOV) and inferior ophthalmic vein (IOV), successfully treated by endovascular surgery. A 58-year-old man presented with progressive diplopia. Angiography and contrast-enhanced CT showed an ethmoidal dural AVF supplied via the bilateral anterior ethmoidal arteries and venous Drainage through the left SOV and IOV. A transarterial approach through the bilateral anterior ethmoidal arteries was used to place the microcatheter close to the fistula site. After intra-arterial embolization with 20% N-butyl cyanoacrylate, the dural AVF was completely occluded. In patients with good vascular access, endovascular transarterial embolization may be an effective and less invasive treatment strategy for ethmoidal dural AVF.
-
Case Report: Ethmoidal dural arteriovenous fistula with unusual Drainage route treated by transarterial embolization
BMJ case reports, 2014Co-Authors: Akihiro Inoue, Masahiko Tagawa, Yoshiaki Kumon, Hideaki Watanabe, Daisuke Shoda, Kenji Sugiu, Takanori OhnishiAbstract:Ethmoidal dural arteriovenous fistulas (AVFs) are rare intracranial lesions associated with a high risk of intracranial hemorrhage. In particular, this entity with reflux Drainage Directly into the ophthalmic vein is extremely rare. We report a case of ethmoidal dural AVF with Direct Drainage of the superior ophthalmic vein (SOV) and inferior ophthalmic vein (IOV), successfully treated by endovascular surgery. A 58-year-old man presented with progressive diplopia. Angiography and contrast-enhanced CT showed an ethmoidal dural AVF supplied via the bilateral anterior ethmoidal arteries and venous Drainage through the left SOV and IOV. A transarterial approach through the bilateral anterior ethmoidal arteries was used to place the microcatheter close to the fistula site. After intra-arterial embolization with 20% N-butyl cyanoacrylate, the dural AVF was completely occluded. In patients with good vascular access, endovascular transarterial embolization may be an effective and less invasive treatment strategy for ethmoidal dural AVF.
Shiro Sasaguri - One of the best experts on this subject based on the ideXlab platform.
-
submucosal territory of the Direct lymphatic Drainage system to the thoracic duct in the human esophagus
The Journal of Thoracic and Cardiovascular Surgery, 2003Co-Authors: Kenshi Kuge, Gen Murakami, Shunji Mizobuchi, Yoichi Hata, Takashi Aikou, Shiro SasaguriAbstract:Abstract Objective To investigate how large submucosal Drainage territory extends in lymphatic Drainage vessels of the esophagus with and without nodal delay and which morphologies are shown when passing through the muscularis propria. Methods Submucosal territories of the 22 highly selected Direct Drainage vessels of 17 esophagi were histologically examined using transverse or sagittal serial sections. Afferent vessels from the esophagus to the subcarinal (6 esophagi) and para-esophageal (5 esophagi) nodes were also examined to identify their courses and Drainage territories. Results We found the Direct Drainage vessel from the esophagus in 17 of 75 cadavers macroscopically (22.7%). A single submucosal Drainage unit gave off 1-3 thick Drainage vessels passing through a complete muscle gap of the 2 muscular layers. The unit extended longitudinally for >40 mm but was restricted to the right and/or dorsal quadrants of the esophagus. In contrast, Drainage routes with a nodal relay originated from the intermuscular area, except 1 case when the adjacent or concomitant esophageal artery and vein provided the complete muscle gap. Conclusions Due to the extended longitudinal but restricted transverse territory of the Direct Drainage system without a nodal relay and because of the suggested much more frequent occurrence in patients than in cadavers, when superficial carcinoma is found in the dorsal and/or right quadrants of the esophagus, we recommend detailed presurgical investigations of cervical nodes. In contrast, afferents from the esophagus to the first regional node usually seemed to be less responsible for early nodal metastasis than the Direct Drainage route because of their intermuscular origins.
Yichun Wang - One of the best experts on this subject based on the ideXlab platform.
-
Anatomy of lymphatic Drainage of the esophagus and lymph node metastasis of thoracic esophageal cancer
Cancer management and research, 2018Co-Authors: Yichun Wang, Liyang Zhu, Wanli Xia, Fan WangAbstract:The lymphatic Drainage of the inner layers (mucosa and submucosa) and the outer layers (muscularispropria and adventitia) of the thoracic esophagus is different. Longitudinal lymphatic vessels and long Drainage territory in the submucosa and lamina propria should be the bases for biDirectional Drainage and Direct Drainage to thoracic duct and extramural lymph nodes (LN). The submucosal vessels for Direct extramural Drainage are usually thick while lymphatic communication between the submucosa and intermuscular area is usually not clearly found, which does not facilitate transversal Drainage to paraesophageal LN from submucosa. The right paratracheal lymphatic chain (PLC) is well developed while the left PLC is poorly developed. Direct Drainage to the right recurrent laryngeal nerve LN and subcarinal LN from submucosa has been verified. Clinical data show that lymph node metastasis (LNM) is frequently present in the lower neck, upper mediastinum, and perigastric area, even for early-stage thoracic esophageal cancer (EC). The lymph node metastasis rate (LNMR) varies mainly according to the tumor location and depth of tumor invasion. However, there are some crucial LN for extramural relay which have a high LNMR, such as cervical paraesophageal LN, recurrent laryngeal nerve LN, subcarinal LN, LN along the left gastric artery, lesser curvature LN, and paracardial LN. Metastasis of thoracic paraesophageal LN seems to be a sign of more advanced EC. This review gives us a better understanding about the LNM and provides more information for treatments of thoracic EC.