HISTOMORPHOLOGIC REACTION PATTERNS IN CERVICAL LYMPH NODES OF DIFFERENT NECK SITES

Abstract

Immunologically based studies of host-tumor interactions have gained popularity in headand neck oncology and histopathological determination of lymph node reactivity has been shownto correlate with survival. However, little is known about lymph node reaction patterns in the“normal” neck. In a prospective histomorphologic study 1024 cervical lymph nodes (CLN) weredissected from 25 selected cadavers at autopsy free of head and neck disease. To investigateregional differences of immune reactivity, these lymph nodes were grouped according to necklevels. 242 CLN groups of 50 neck sites were microscopically classified into one of four distincthistomorphologic immune reaction patterns (RP). 14.5% of CLN groups showed lymphocytepredominance (RP 1), 12% showed germinal center predominance (RP 2), 63.2% wereunstimulated (RP 3) and 10.3% displayed regressive changes (RP 4). Distribution of RP washighly significant according to neck level (p<0.001): RP 1 and RP 2 were common in thesubmandibular (Level I) and the upper parajugular groups (Level II) whereas RP 4 was moretypical in the inferior parajugular groups (Level IV) and posterior triangle (Level V). RP 2 andRP 4 showed significant correlation to age and general condition. These findings suggest thattumor independent lymph node reactivity related to neck site, age and general condition of thepatient needs to be differentiated from tumor induced patterns in future morphologicinvestigations of cervical lymph nodes in patients with head and neck carcinoma.