J Korean Assoc Oral Maxillofac Surg.  2019 Oct;45(5):267-275. 10.5125/jkaoms.2019.45.5.267.

Role of immunoreactive patterns of lymph nodes in neck dissection cases of oral squamous cell carcinoma: a clinical and histopathological study

• Bhatlawande HC
• Kale AD
• Desai KM
• Hallikerimath S
• Belaldavar C
• Mane D
• Angadi PV
• M M
• Muttagi S

• KMID: 2461479
• DOI: http://doi.org/10.5125/jkaoms.2019.45.5.267

Abstract

OBJECTIVES
Metastasis in oral squamous cell carcinoma (OSCC) can occur in a variety of ways, and draining lymphatics and lymph nodes serve as a common route. Prior to metastasis, lymph nodes elicit an immune response to either wall off or create a favorable environment for homing of tumor cells. This immune response to tumor stimuli is visualized by recognizing various immunoreactive patterns exhibited by the lymph node. The present study aims to evaluate the role of immuno-morphologic patterns of the lymph node in neck dissection for cases of OSCC.
MATERIALS AND METHODS
Our retrospective study included 50 neck dissection cases of OSCC and a total of 1,078 lymph nodes. The grades of primary tumors with eight different immunoreactive patterns were compared. Vascularity and metastasis in lymph nodes were also evaluated.
RESULTS
The lymphocyte predominant pattern was the most common immunoreactive pattern found in 396 of 1,078 lymph nodes. Patterns of lymphocyte predominant (P=0.0005), sinus histiocytosis (P=0.0500), paracortical hyperplasia (P=0.0001), cortical hyperplasia (P=0.0001), and increased vascularity (P=0.0190) were significantly associated with tumor grade.
CONCLUSION
The present study adds to the understanding of lymph node immunoreactivity patterns and their correlation with tumor grade. We recommend further study of lymph node patterns for all sentinel lymph node biopsies and routine neck dissections for OSCCs.

Keyword

Lymph node; Lymphatic metastasis; Squamous cell carcinoma; Neck dissection; Germinal center

MeSH Terms

Biopsy
Carcinoma, Squamous Cell*
Epithelial Cells*
Germinal Center
Histiocytosis, Sinus
Hyperplasia
Lymph Nodes*
Lymphatic Metastasis
Lymphocytes
Neck Dissection*
Neck*
Neoplasm Metastasis
Retrospective Studies

Figure

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  Fig. 1 Reactivity patterns of lymph node.

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  Fig. 2 H&E stained microscopy images (4× or 10×) of reactive patterns most commonly seen in metastatic and adjacent immunoreactive nodes. Selected regions in the pattern (black circles) show greater metastatic potential due to the respective cell predominance.

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