子宮頸癌に於ける骨盤内淋巴節の態度
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概要
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The necessity of the radical operation is not too much emphasized in the treatment of carcinoma of the cervix uteri. The present general opinion is that the long term prognosis of that operation depends largely on the completeness of the extirpation of lymph-nodes in the pelvis. In the present study based on 45 cases of carcinoma of the cervix uteri the relation between the cervical findings and the histologic appearances of the regional lymph-nodes was investigated. The results obtained are as follows : (1) Of 45 cases operated by Okabayashi's technic, metastasis in the regional lymph-nodes was noted in 17 cases (37.7%). Even of 9 cases belonging to the first stage of the international classification metastasis was noted in 3 cases (33.3%). (2) Metastasis in the regional lymph-nodes was noted more often on the side, where thickening of the tissues could be detected beyond the cervix by direct examination. (3) Lymph-nodes metastasis was observed more frequently in cases of advanced stage with the infiltration far into the wall of the cervix than in cases of less advanced stage with the lesion localizing only in the portio vaginalis. (4) The thickening of capsules was noted in one-third of the lymph-nodes, a half of which showing infiltration with lymphocytes, plasmacytes and some other leucocytes which were not identified. (5) The peripheral lymph sinuses were found dilated in one half of the cases, a half of which containing cells such as phagocytes, lymphocytes, reticulumcytes, eosinophil leucocytes and plasmacytes. The central sinuses of the lymph-nodes were in general more distended than the peripheral sinuses. Cells detected in them, however, were of the same kind as those found in the peripheral sinuses. (6) The cellular reactions in the center of follicles could be divided into lymphoblastic, reticulum, epitheloid, atrophic and emaciated form respectively. In the "emaciated form" cellular clebris, pycnosis and other degenerative changes were constant findings, which might presumably be interpreted as a reaction to metastasis, because that form was generally associated with the infiltration with cancer cells. (7) In most instances, the second deposit of cancer cells in the lymph-nodes with metastasis was surrounded by a reticulum shieth. In some cases, however, such cancer cells showed a tendency invading into parenchyma of the lymph-nodes.
- 社団法人日本産科婦人科学会の論文
- 1952-03-01