Studies of the regional lymph nodus 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 histicyte-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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