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What Pathologists Look For To Determine If Lymph Nodes Contain Cancer
Author(s) -
Weidner Noel
Publication year - 2008
Publication title -
the faseb journal
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.709
H-Index - 277
eISSN - 1530-6860
pISSN - 0892-6638
DOI - 10.1096/fasebj.22.1_supplement.388.3
Subject(s) - lymph , pathology , lymphatic system , lymphoma , metastatic carcinoma , lymph node , medicine , cytokeratin , carcinoma , immunohistochemistry
Cancers spread via lymph nodes, especially carcinoma and lymphoma. Carcinomas spread from their primary sites of origin to regional lymph nodes via lymphatics after carcinoma cells invade lymphatics. The metastatic cells first involve the regional sentinel lymph nodes followed by other nodes, eventually entering the thoracic duct and systemic vasculature. Tumor appears first seen in subcapsular and peri‐sinusoid spaces, but the entire node may be replaced by metastatic carcinoma. Carcinoma cells are easily separated from lymph nodal cells, but immunostains for cytokeratin can highlight tumor cells, making them easier to recognize. Most lymphomas originate within lymph nodes, and by clinical presentation, lymphoma has replaced the normal architecture by monotonous sheets or nodules of cells. Further spread is via lymphatic and/or blood vessels. Lymphoma cells (small or large) are routinely subtyped with immunohistochemistry as B‐cell, T‐cell, Hodgkin cells, or otherwise. Flow cytometry and molecular techniques are also useful in subtyping malignant lymphoma. Patterns created by malignant cells are separated from benign processes that preserve normal nodal architecture and/or induce characteristic inflammatory reactions. Other malignant processes can involve lymph nodes, such as leukemia and sarcoma.