![]() ![]() Nowadays, a hepatectomy has become one of the most popular treatments for HCC, and understanding lymph node metastasis in HCC is indispensable at surgery for improving the patient’s prognosis. Hilar lymph nodes and para-aortic nodes are the major metastatic sites. Lymphatic metastasis has been documented in 25.5% of patients at different stages of HCC. Hematogenous dissemination is common, whereas lymphatic metastasis is uncommon. The patient rapidly declined and died one month later.ĭistant metastasis of HCC occurs in three main ways: Hematogenous dissemination, lymphatic metastasis and implantation metastasis. His alpha-fetoprotein (AFP) level was 695.4 ng/mL (normal 1050 ng/mL. Laboratory examination revealed a platelet count of 89 × 10 9/L. Neurological examination did not demonstrate any deficit. Varicose veins on the thoracic and abdominal wall were not observed. Examination of the chest did not reveal any signs of bronchospasm. On examination, a 1 cm long left supraclavicular lymph node was palpated and it was slightly tender. He had hypertension that was successfully treated with oral medication. These are very important for making the correct diagnosis and for selecting reasonable therapies.Ī 56-year-old man suffering from HCC was referred to our hospital. If the results are negative, an excisional biopsy and subsequent Positron emission tomography - computed tomography scanning should be performed. When left supraclavicular lymphadenopathy of unknown origin is encountered, FNAC should be performed initially. Surgeons should always consider an overall physical examination. It is possible for HCC to metastasize to the left supraclavicular lymph node. The patient’s HCC rapidly progressed and he died one month later. An excisional biopsy of the left supraclavicular lymph node was performed, and its findings confirmed metastatic HCC. However, 14 d after surgery, significantly enlarged left supraclavicular lymph nodes, a new intrahepatic lesion, and pulmonary and mediastinal metastasis appeared. Hepatectomy was performed and HCC was confirmed by Hematoxylin-Eosin staining. Fine needle aspiration cytology (FNAC) of the enlarged lymph node was performed however, only necrosis was found. ![]() Auxiliary examination indicated a lesion located in the right lobe of the liver. On examination, a 1cm long left supraclavicular lymph node was palpated. This phenomenon is easily neglected in the clinic. This study showed that supraclavicular lymphadenopathy is associated mostly with serious disease like tuberculosis and malignancy.Left supraclavicular lymph node metastasis is a rare presentation of hepatocellular carcinoma (HCC). FNAC result was also of simillar type and finally it was found that frequency of tuberculosis (20 of 53, 37.7%) was highest and bronchial carcima was the second most frequent diagnosis (14 of 53, 26.4%). Increased frequency (11 of 28, 39.3%) of granulomatous inflammation from the tuberculoid lymphadenitis were found among the patient undergone supraclavicular lymphnode biopsy. Discrete, hard, non tender either fixed or non fixed supraclavicular lymphadenopathy was found malignant (18 of 18 cases, 100%) and discrete, firm, tender lymphnode were found non malignant (5 of 5 cases, 100%). Male patient have suffered more (60%) from malignant disease than that of female patient (40%). The study showed that mean age of the patient of supraclavicular lymphadenopathy that finally diagnosed as malignant was 49.7 years and that of non malignant was 33.7 years. Patient of either sex, 18 years or above presented with supraclavicular lymphadenopathy were included. ![]() This prospective type of observational study carried out in the indoor and out patient department of medicine of Mymensingh Medical College Hospital over a period of 6 month from April 2011 to September 2011 to diagnose the causes of supraclavicular lymphadenopathy. Patients presented with the supraclavicular lymphadenopathy in the medicine department have a strong suspicion of serious illness like tuberculosis, sarcoidosis, toxoplasmosis and malignancy of lymphnode, blood, lung, upper GIT, breast, ovary, testes, and other sites of body. ![]()
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