Grenzlymphknoten

English translation: apical lymph node

14:08 Jun 19, 2019

German to English translations [PRO]
Medical - Medical (general) / histology cancer

German term or phrase: Grenzlymphknoten

This is from a histology report on a right hemicolectomy specimen. "m Stromgebiet der Arteria Ileocolica 1 Grenzlymphknoten von 0,2 cm Durchmesser"

The only term I could come up with in "bordering lymph node", but I'm pretty certain that this is not quite right.

Sanni Kruger (X) KudoZ activity Questions: 85 (1 open) (8 without valid answers) (15 closed without grading) Answers: 77 United Kingdom
Local time: 06:07

English translation:apical lymph node

Explanation:
At the suggestion of the asker my suggestion is to use

apical lymph node

This is based on my contribution under Reference comment, Note added (please see there)
and also the following additional example:
Indications for regional radiotherapy were more than 3 positive axillary lymph nodes or a positive apical lymph node. The apical lymph node was defined as the most craniallypositioned lymph node in the axillary dissection specimen as marked by the surgeon.
https://www.rug.nl/research/portal/files/23581906/Chapter_5....

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Note added at 6 days (2019-06-26 08:54:10 GMT)
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Regarding Thomas Anderson's reservation I would like to add the following:
Initially I shared Thomas' reservation of using "apical lymph node" as the asker referred to a 'Grenzlymphknoten' found in a hemicolectomy specimen. I looked a bit further into this and came to a different conclusion based on the following references:
GE: Pathologie 2:Verdauungstrakt - Kolon und Rektum (page 656)
Hinsichtlich der lymphogenen Metastasierung (pN) wird die Angabe der Zahl der untersuchten und befallenen Lymphknoten gefordert. Der apikale Lymphknoten, der vom Tumor am weitesten entfernt an der Resektionslinie des Mesokolons bzw. an der Ligatur des enstpsrechenden Gefäßstammes liegt ("Grenzlymphknoten") muss gesondert untersucht werden.
https://books.google.co.uk/books?id=iymbBwAAQBAJ&pg=PA656&lp...
There are a number of other relevant references.

Figure 14.
Left hemicolectomy: involvement of apical lymph nodes
(the arrow indicates a metastatic lymph node) by a sigmoidorectal
cancer (lower third).
https://www.archivesofpathology.org/doi/pdf/10.1043/1543-216...

The identification of lymph nodes should begin with the highest (apical) lymph node. This is the first node identified by sectioning serially and distally from the sutured arterial margin(s), regardless of the actual distance between node and surgical tie (Figure 1); it should be identified and blocked separately.
https://www.google.com/url?sa=t&rct=j&q=&esrc=s&source=web&c...

Selected response from:

Marga Shaw
United Kingdom
Local time: 06:07

Grading comment

Thank you all, especially Marga, for all the effort you put into finding the answer that best fits.
4 KudoZ points were awarded for this answer

Summary of answers provided

3 +1

sentinel lymph node

Jakub Rychter, PhD

farthest regional ileocolic lymph node

Stuart and Aida Nelson

apical lymph node

Marga Shaw

Summary of reference entries provided

Sentinel-Lymphknoten/Wächterlymphknoten vs. Grenzlymphknoten

Marga Shaw

Discussion entries: 1

Answers

4 mins confidence:

peer agreement (net): +1

sentinel lymph node

Explanation:
The sentinel lymph node is the hypothetical first lymph node or group of nodes draining a cancer. In case of established cancerous dissemination it is postulated that the sentinel lymph node/s is/are the target organs primarily reached by metastasizing cancer cells from the tumor.

https://en.wikipedia.org/wiki/Sentinel_lymph_node

Jakub Rychter, PhD
Spain
Local time: 07:07
Specializes in field
Native speaker of:

English,

Dutch
PRO pts in category: 153

18 hrs confidence:

farthest regional ileocolic lymph node

Explanation:

According to the excellent references by Marga, see below, I understand that the 'Grenzlymphknoten' is the lymph node that is situated furthest away from the primary tumour and it is marked as a reference for the pathologist. It has a diameter of 0.2 cm and according to its size is within normal size.

... Die jeweilig vom Primärtumor am weitesten distanziert gelegenen Lymphknoten, die sich überwiegend an großen Gefäßverläufen orientieren, werden dabei als Grenzlymphknoten bezeichnet und für den Pathologen ggf. gesondert markiert.
https://epdf.pub/praxis-der-viszeralchirurgie-onkologische-c...

The source text describes that the lymph node is situated within the area of the ileocolic artery, thus, it must be an ileocolic lymph node (probably situated in the lower part of the trunk of the artery).

The ileocolic lymph nodes, from ten to twenty in number, form a chain around the ileocolic artery, but tend to subdivide into two groups, one near the duodenum and the other on the lower part of the trunk of the artery. Where the vessel divides into its terminal branches the chain is broken up into several groups.
https://en.wikipedia.org/wiki/Ileocolic_lymph_nodes

Size. Nodes are generally considered to be normal if they are up to 1 cm in diameter; however, some authors suggest that epitrochlear nodes larger than 0.5 cm or inguinal nodes larger than 1.5 cm should be considered abnormal
https://www.aafp.org/afp/1998/1015/p1313.html

Therefore, I would describe the sentence as follows:

1 farthest regional ileocolic lymph node with a diameter of 0.2 cm (situated furthest away from the primary tumour, within the area of the ileocolic artery)

• M1a The cancer has spread to the lungs or distant lymph nodes furthest away from the testicle.
https://orchid-cancer.org.uk/testicular-cancer/results/

Cancer that has spread to nodes further away from the primary cancer will more likely need extra treatment with chemo or radiation.
https://www.cancer.org/cancer/cancer-basics/lymph-nodes-and-...

Record the farthest specific regional lymph node chain that is involved by tumor either clinically or pathologically.
https://training.seer.cancer.gov/collaborative/system/tnm/n/...

Describes farthest lymph node involvement
https://seer.cancer.gov/archive/manuals/SEER.Lymph.Node.Fiel...

Regional also means 'near to' but in this context it means in the region of the tumour.

Hope it helps,

Cheers

Aida

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Note added at 4 days (2019-06-24 11:08:07 GMT)
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On further thoughts, I suggest it is best to translate 'Grenzlymphknoten' just as 'farthest regional lymph node'. I added ileocolic in my original answer because of the context but the 'Grenzlymphknoten' can be found in other parts of the body depending on where the tumour is found.

Stuart and Aida Nelson
United Kingdom
Local time: 06:07
Specializes in field
Native speaker of:

English,

Spanish
PRO pts in category: 31

4 days confidence:

apical lymph node

Marga Shaw
United Kingdom
Local time: 06:07
Specializes in field
Native speaker of: German
PRO pts in category: 700

Grading comment

Thank you all, especially Marga, for all the effort you put into finding the answer that best fits.

Reference comments

2 hrs peer agreement (net): +6

Reference: Sentinel-Lymphknoten/Wächterlymphknoten vs. Grenzlymphknoten

Reference information:
Ich bin der Ansicht, dass Wächterlymphknoten und Grenzlymphknoten definitionsgemäß nicht gleich sind.

z. B. siehe hier:
Der Lymphszintigraphie liegt das Konzept des Wächterlymphknotens (»sentinel lymph node«, SLN) zugrunde. Dieses Konzept besagt, dass die ersten Lymphknoten (i. d. R. 1–3 je nach Region) im Abflussgebiet eines malignen Tumors auch die ersten metastatisch befallenen sind. Sind diese Lymphknoten tumorfrei, kann davon ausgegangen werden, dass auch die übrigen regionalen Lymphknoten keinen metastatischen Befall zeigen (daher »Wächter«-Lymphknoten). ...

... Die jeweilig vom Primärtumor am weitesten distanziert gelegenen Lymphknoten, die sich überwiegend an großen Gefäßverläufen orientieren, werden dabei als Grenzlymphknoten bezeichnet und für den Pathologen ggf. gesondert markiert.
https://epdf.pub/praxis-der-viszeralchirurgie-onkologische-c...

Der Befall des Grenzlymphknotens repräsentierte eine weitere wichtige klinische Variable. Diesbezüglich handelte es sich um den histologisch aufgearbeiteten LK im fadenmarkierten Resektionsgebiet, der vom Primärtumorabfluss nach zentral am weitesten distanziert gelegen war. ...

... Der SLN oder Wächterlymphknoten ist definiert als erster LK, der im
lymphogenen Abflussgebiet des Primarius liegt.
https://edoc.ub.uni-muenchen.de/19053/7/Heidemanns_Christian...

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Note added at 18 hrs (2019-06-20 08:20:28 GMT)
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Als englische Entsprechung möchte ich nach weiterer Recherche mit etwas Vorsicht apical lymph node vorschlagen:
DE:
Bei Tumorresektionen mit systemischer Lymphadenektomie wird der Befall des Grenzlymphknotens (apikaler Lymphknoten, am weitesten vom Primärtumor entfernter Lymphknoten nahe der Resektionslinie) in der R-Klassifikation nicht berücksichtigt. ...
https://books.google.co.uk/books?id=AMAjBAAAQBAJ&pg=PA372&lp... (Seite 372)
EN:
The prognostic significance of apical lymph node metastasis in colorectal cancer has been widely debated in the past. Current AJCC staging guidelines do not explicitly take this pathological variable into account but most structured reporting schemes recommend that the apical lymph node status be determined and recorded.
https://www.sciencedirect.com/science/article/pii/S003130251...

Amongst pathological indices of interest, lymph node yield and the apical lymph node specifically are increasingly being shown to be reliable markers of the adequacy of oncologic resection. However, the position of the apical node in particular, is highly subjective and may not always correlate with the anatomical boundaries ultimately defining resection.
https://www.sciencedirect.com/science/article/pii/S074879831...

The node classification outlined in the seventh edition of the TNM classification is based solely on the number of metastasized lymph nodes. This study examined the prognostic value of apical lymph node (ALN) metastasis and the additional value of incorporating ALN status into a risk model based on the seventh edition.
https://www.bjs.co.uk/article/incorporation-of-apical-lymph-...

Marga Shaw
United Kingdom
Specializes in field
Native speaker of: German
PRO pts in category: 700

Note to reference poster

Asker: Dear Marga, Would you like to suggest "apical lymph node"? I can then award you the points.

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Grenzlymphknoten

English translation: apical lymph node

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