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The Korean Journal of Pathology 1979;13(3): 223-231.
악성종양의 소속림프절의 검사방법에 관한 고찰
Some Observation on Examination Method of Regional Lymph Nodes of Malignant Neoplasm
Studies of the regional lymph nodes of malignant tumor for search of metastatic lesion has been the most accessible measure to evaluate spreading and metastatic property of maligant tumor. Lymph nodes beating metastatic lesions present some remarkable differences from those without tumor as pointed out by some investigators. This investigation was undertaken to observe on nodal histologic changes and the behavior of metastatic tumor in the regional lymph nodes; e.g. detection rate of metastatic tumor in midsagittal versus parasagittal sections, location of tumor lesions in positive Iymph nodes, and occurrence of tumor emboli in perinodal lymphatics. In this study, 88 lymph nodes from 25 cases of carcinomas (Stomach carcinoma. 11; colon carcinoma, 6; breast carcinoma, 5; cervix carcinoma, 1; thyroid carcinoma. 1) were randomly sampled and examined. Of these, 57 lymph noses showed metastatic involvement. The following observations and conclusions are made; There seemed to be a few cancer-related changes in the regional lymph notes with or without metastases in these given specimens. Sinus histiocytosis was consistently prominent in noses without tumor, and the degree of sinus histiocytosis was inversely proportional to the degree of metastatic tumor involvement These findings might support the view that cellular immunity, especially histiocyte-macrophage system, plays an important role in biologic control of tumor growth. Other findings e.g. enlargement and reactive change of lymphoid follicles, plasma cellular reaction of the pulp, etc. were considered to be nonspecific changes, probably due to concomitant inflammation. All of the metastatic lesions, with the exception of those in two nodes, were presented in the midsagittal section, while parasagittal sections occasionally tailed to show the metastatic lesions. Also noted were pattern of tumor spread within Iymph noses. None of nodes revealed tumor emboli in lymphatics without parenchymal involvement, and notes with subcapsular sinus, no matter where other tumor cell neats may be encountered, thus enabling the speculation that tumor emboli were first lodged in subcapsular sinus, immediately after entering the nods from afferent lymphatics and permeate inward through trabecular and interfollicular sinuses into parenchyme.
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