Morphologic patterns of nodal reactive hyperplasia in primary organ malignancy-architectural changes and evaluation by comparison with other morphological parameters

Preeti Singh; Neha Singh; Vijay Kumar Jaiswal; Nidhi Verma

doi:10.18203/2320-6012.ijrms20231323

Authors

Preeti Singh Department of Pathology, LLRM Medical College, Meerut, Uttar Pradesh, India
Neha Singh Department of Pathology, LLRM Medical College, Meerut, Uttar Pradesh, India
Vijay Kumar Jaiswal Department of Pathology, LLRM Medical College, Meerut, Uttar Pradesh, India
Nidhi Verma Department of Pathology, LLRM Medical College, Meerut, Uttar Pradesh, India

DOI:

https://doi.org/10.18203/2320-6012.ijrms20231323

Keywords:

Lymph node hyperplasia, Lymph node metastases

Abstract

Background: Reactive lymph node hyperplasia can exhibit morphological patterns I to VI. This study was done to evaluate lymph node hyperplasia, lymph node reactive patterns, lymph node metastasis and correlation with tumour stage, lymph node patterns and lymph node size.

Methods: Total 454 lymph nodes were reviewed for metastases and reactivity patterns I to VI as per the World Health Organization (WHO) protocol. Association between qualitative variables was assessed by the chi-square test and Fisher’s exact test, those between quantitative variables using unpaired t-test.

Results: Lymph node hyperplasia was highest in breast and commonest lymph node reactive patterns were lymphocyte predominance, germinal centre predominance, sinus histiocytosis and mixed patterns.

Conclusions: Lymph node hyperplasia and lymph node reactive patterns show organ-wise variation and need standardisation. Most common lymph node reactive patterns included lymphocyte predominance and germinal centre predominance hyperplasia. Studying lymph node reactivity may help to understand host immune reaction against the tumour and thus influence prognosis.

Metrics

Metrics Loading ...

References

Ioachim HL, Mediros LJ eds. Tumor-reactive lymphadenopathy. In: Ioachim’s Lymph Node Pathology. 4th edn. Philadelphia (PA): Wolters Kluwer/Lippincott Williams and Wilkins; 2009:243-247.

Saldanha P. Morphological assessment of lymph nodes draining carcinoma. MGM J Med Sci. 2016;3:190-7.

Yadav ST, Madhu Shankari GS, Chatura K, Dhanuja RJ, Rashmi M. Immunomorphological assessment of regional lymph nodes for predicting metastases in oral squamous cell carcinoma. Indian J Dent Res. 2012;23:121-2.

Raj LSM, Boaz K, Natarajan S. Prognostic significance of lymph node pattern in oral squamous cell carcinoma (OSCC). J Clin Diagn Res. 2014;8:232-5.

Saldanha P, Nuzhath T, Thrilok H. Significance of immune response patterns in lymph nodes draining breast carcinoma. IJIRMS. 2017;2:1468-75.

Tsakraklides V, Tsakraklides E, Good RA. An autopsy study of human axillary lymph node histology. Am J Pathol. 1975;78:7-22.

Ioachim HL, Medeiros JL, eds. Tumor-reactive lymphadenopathy. In: Ioachim's Lymph Node Pathology. 4th edn. Philadelphia: Wolters Kluwer/Lippincott Williams and Wilkins; 2009:243-247.

Tsakrakides V, Anastassiades OT, Kersey JH. Prognostic significance of regional lymph node histology in uterine cervical cancer. Cancer. 1973;31:860-8.

Paladini D, Cross P, Lopes A, Monaghan JM. Prognostic significance of lymph node variables in squamous cell carcinoma of the vulva. Cancer. 1994;74:2491-5.

Di Giorgio A, Mingazzini P, Sammartino P, Canavese A, Arnone P, Scarpini M. Host defence and survival in patients with lung carcinoma. Cancer. 2008;89:2038-45.

Kaufmann M, Wirth K, Scheurer J, Zimmermann Z, Lusceiti P, Stjernsward J. Immunomorphological lymph node changes in patients with operable bronchogenic squamous cell carcinoma. Cancer. 1977;39:2371-7.

Silverberg SG, Chitale AR, Hind AD, Frazier AB, Levitt SH. Sinus histiocytosis and mammary carcinoma. Study of 366 radical mastectomies and an historical review. Cancer. 1970;26:1177-85.

Patt BS, Close LG, Vuitch F. Prognostic significance of sinus histiocytosis in metastatic laryngeal cancer. Laryngoscope. 1993;103:498-502.

Okura M, Kagamicuhi H, Tominanga G, Iida S, Fukuda Y, Kogo M. Morphological changes of regional lymph node in squamous cell carcinoma of the oral cavity. J Oral Pathol Med. 2005;34:214-9.

Cernea C, Montenegro F, Castro I, Cordeiro A, Gayotto L, Ferraz A, et al. Prognostic significance of lymph node reactivity in the control of pathologic negative node squamous cell carcinomas of the oral cavity. Am J Surg. 1997;174:548-51.

Ring AH, Sako K, Rao U, Razack MS, Reese P. Immunologic patterns of regional lymph nodes in squamous cell carcinoma of the floor of the mouth. Prognostic significance. Am J Surg. 1985;150:461-5.

Berlinger NT, Tsakraklides V, Pollak K, Adams GL, Yang M, Good RA. Immunologic assessment of regional lymph node histology in relation to survival in head and neck carcinoma. Cancer. 1976;37:697-705.

Zeng WJ, Hu WQ, Wang LW, Yan SG, Li JD, Zhao HL, et al. Lymph node ratio is a better prognosticator than lymph node status for gastric cancer: A retrospective study of 138 cases. Oncol Lett. 2013;6:1693-700.

Akagi Y, Kansakar R, Shirouzu K. The prognostic significance of number of lymph node metastasis in colon cancer- based on Japanese techniques of resection and handling of resected specimens. In: Eltarh R, edr. Colorectal Cancer- From Prevention to Patient Care. Croatia: InTech; 2012:509-520.

Chen CC, Lin JC, Chen KW. Lymph node ratio as a prognostic factor in head and neck cancer patients. Radiat Oncol. 2015;10:181.

Rubinstein J, Bar-On T, Bahouth Z, Mano R, Shoshany O, Baniel J, et al. A mathematical model for predicting tumour recurrence within 24 months following surgery in patients with T1 high-grade bladder cancer treated with BCG immunotherapy. Bladder. 2015;2:18.

Jayasinghe UW, Pathmanathan N, Elder E, Boyages J. Prognostic value of the lymph node ratio for lymph-node-positive breast cancer- is it just a denominator problem? Springerplus. 2015;4:121.

Fréneaux P, Nos C, Vincent-Salomon A, Genin P, Sigal-Zafrani B, Al Ghuzlan A, et al. Histological detection of minimal metastatic involvement in axillary sentinel nodes: a rational basis for a sensitive methodology usable in daily practice. Mod Pathol. 2002;15:641-6.

Wright JL, Lin DW, Porter MP. The association between extent of lymphadenectomy and survival among patients with lymph node metastases undergoing radical cystectomy. Cancer. 2008;112:2401-8.

Suchitra G, Puranik RS, Vanaki SS, Prasad BG, Malgaonkar NI. Immuno-reactivity of excised lymph nodes in neck dissections of squamous cell carcinomas of oral cavity. J Oral Maxillofac Pathol. 2015;19:128-33.

Lang BH, Tang AH, Wong KP, Shek TW, Wan KY, Lo CY, et al. Significance of size of lymph node metastasis on postsurgical stimulated thyroglobulin levels after prophylactic unilateral central neck dissection in papillary thyroid carcinoma. Ann Surg Oncol. 2012;19:3472-8.

Schneider DF, Chen H, Sippel RS. Impact of lymph node ratio on survival in papillary thyroid cancer. Ann Surg Oncol. 2013;20:1906-11.

Titipungul T, Intarawichian P, Waraasawapati S, Sangkhamanon S, Chaisuriya N, Pairojkul C, et al. Axillary lymph node ratio is an independent prognostic factor in Thai breast cancer patients. Asian Arch Pathol. 2015;11:26-35.

Silva TL, Damin DC. Lymph node ratio predicts tumor recurrence in stage III colon cancer. Revist Colég Brasil Cirurgiões. 2013;40:463-70.

Märkl B, Rößle J, Arnholdt HM, Schaller T, Krammer I, Cacchi C, et al. The clinical significance of lymph node size in colon cancer. Mod Pathol. 2012;25:1413-22.

Pedrosa JA, Koch MO, Cheng L. Lymph node- positive bladder cancer. Expert Rev Anticancer Ther. 2013;13:1281-95.

Koppie TM, Vickers AJ, Vora K, Dalbagni G, Bochner BH. Standardization of pelvic lymphadenectomy performed at radical cystectomy: Can we establish a minimum number of lymph nodes that should be removed? Cancer. 2006;107:2368-74.

Vered M, Schiby G, Schnaiderman-Shapiro A, Novikov I, Bello IO, Salo T, et al. Key architectural changes in tumour-negative lymph nodes from metastatic-free oral cancer patients are valuable prognostic factors. Clin Exp Metastas. 2014;31:327-38.

Weaver DL. Pathology evaluation of sentinel lymph nodes in breast cancer: Protocol recommendations and rationale. Mod Pathol 2010;23(2):S26-32.

Ong ML, Schofield JB. Assessment of lymph node involvement in colorectal cancer. World J Gastrointest Surg. 2016;8:179-92.

Verrill C, Carr NJ, Wilkinson-Smith E, Seel EH. Histopathological assessment of lymph nodes in colorectal carcinoma: Does triple levelling detect significantly more metastases? J Clin Pathol. 2004;57:1165-7.

Khetarpal S, Mathur S, Sethi D, Sen R. Immune hyperplasia patterns in lymph nodes draining breast cancer: a correlation with histomorphological parameters. Clin Cancer Investig J. 2013;2:330-8.

Ninan RM, Saldanha P, Rai HS. Importance of histomorphological assessment of regional lymph nodes draining colorectal carcinomas. IJRTSAT. 2016;19:171-6.

Burusapat C, Jarungroongruangchai W, Charoenpitakchai M. Prognostic factors of cervical node status in head and neck squamous cell carcinoma. World J Surg Oncol. 2015;13:51.