Conceptos Categóricos

GANGLIO "CENTINELA" EN EL CARCINOMA DE LARINGE E HIPOFARINGE

GANGLIO "CENTINELA" EN EL CARCINOMA DE LARINGE E HIPOFARINGE

(especial para SIIC © Derechos reservados)
El examen histopatológico intraoperatorio simple de los ganglios "centinela" en el carcinoma de laringe e hipofaringe permitiría a los cirujanos controlar la difusión locorregional de la neoplasia y reducir la disección cervical total.
resta9.jpg Autor:
Leonardo Resta
Columnista Experto de SIIC

Institución:
University of Bari


Artículos publicados por Leonardo Resta
Coautores
Anna Altavilla* Roberta Rossi** Vincenzo Di Nicola*** Maria Luisa Fiorella*** Andrea Marzullo**** 
Medical Doctor, Resident in Pathological Anatomy, University of Bari, Bari, Italia*
Biologist, University of Bari, Bari, Italia**
University of Bari, Bari, Italia***
Medical Doctor specialized in Pathological Anatomy, University of Bari, Bari, Italia****
Recepción del artículo
3 de Marzo, 2007
Aprobación
5 de Noviembre, 2007
Primera edición
11 de Febrero, 2008
Segunda edición, ampliada y corregida
7 de Junio, 2021

Resumen
La técnica del ganglio linfático centinela localiza el ganglio que drena primariamente el territorio neoplásico anatómico. Más tarde, este procedimiento ha sido aplicado a pacientes con carcinoma epidermoide (CE) de cabeza y cuello. Nuestra experiencia de veinte años con las disecciones cervicales funcionales en el cáncer de laringe e hipofaringe nos permite asegurar que existe un ganglio linfático centinela natural en estos órganos. En nuestro estudio, examinamos una serie de 170 pacientes con disecciones funcionales del cuello con metástasis mediante el uso de un procedimiento quirúrgico de acuerdo con la anatomía topográfica clásica. En los casos con metástasis ganglionares únicas, resultaban afectados en alto porcentaje los ganglios de Küttner, supraomohioideo y prelaríngeo (46%, 38% y 6%, respectivamente), lo que representa una prueba in vivo de ganglio linfático centinela. En los casos con más de tres metástasis ganglionares, los ganglios de Küttner y supraomohioideo siempre estaban afectados primariamente. En cambio, en las metástasis detectadas en otros ganglios, podría suponerse la aparición de un drenaje linfático inconstante del pedúnculo laríngeo superior o un cambio patológico del flujo linfático. Por lo tanto, el examen histopatológico intraoperatorio simple de estos ganglios permitiría a los cirujanos controlar la difusión locorregional de la neoplasia y reducir la disección cervical total. Esta acción no es predecible cuando se emplea la división de los ganglios cervicales por niveles que se utiliza actualmente.

Palabras clave
cáncer de cabeza y cuello, metástasis ganglionar, ganglio centinela


Artículo completo

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Abstract
Sentinel lymph node technique locates that node which primarily drains anatomic neoplastic territory. Lately, this procedure has been applied to patients with head and neck squamous cell carcinoma. Our twenty-year experience in functional neck dissections for larynx and hypo pharynx cancer let us to assert that there exists a natural sentinel lymph node in these organs. In our study, we examined a series of 170 patients with metastasized functional neck dissections using a surgical procedure according to classic topographic anatomy. In the cases with single nodal metastasis, Küttner, Supraomohyoid, Pre-laryngeal nodes were involved with a high percentage (46%, 38%, 6% respectively) representing an "in vivo" evidence of sentinel lymph node. In cases with more than three nodal metastases, Küttner and supraomohyoid were always primarily interested. Instead, for the metastases detected in other nodes, it might be supposed the occurrence of an unsteady lymphatic drainage of the superior laryngeal peduncle or a pathological change of the lymphatic flow. Therefore, the simple intraoperative histopathological examination of these nodes would allow surgeons to control locoregional diffusion of neoplasia and to reduce total neck dissection. This acting is not predictable using the division of cervical nodes by levels currently used.

Key words
head and neck cancer, nodal metastasis, sentinel node


Full text
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Clasificación en siicsalud
Artículos originales > Expertos del Mundo >
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Especialidades
Principal: Oncología
Relacionadas: Anatomía Patológica, Diagnóstico por Laboratorio, Medicina Interna



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Enviar correspondencia a:
Leonardo Resta, University of Bari Department of Pathological Anatomy, Policlinico, 70124, Piazza Giulio Cesare, N°11, Bari, Italia
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