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| Metastatic malignancy in a lymph node |
| Etiology •Secondary to malignancies elsewhere. •Most common in carcinoma or as systemic involvement with lymphoma. •Rare in sarcomas. |
| Pathogenesis •Tumors invade lymphatics and spread to the local draining lymph node. •Here, colonization occurs first underneath the capsule in the marginal sinus. •Subsequently, the entire lymph node may be involved., |
| Epidemiology •Common |
| General Gross Description •Grossly, the lymph node may be of normal size or significantly enlarged. •Depending upon the rate of growth of the tumor, there may be necrosis, cystic change or hemorrhage. •In extreme cases, cross section may reveal a completely or partially necrotic node, with the center appearing as a white pus-like material. |
| General Microscopic Description •Microscopically, the tumor may be seen initially as small deposits of tumor resembling the primary tumor in the marginal sinus. •Subsequently, deposits may be seen in the medullary region of the lymph node. •In extreme cases, the entire lymph node may be replaced by tumor, leaving behind very little normal lymphoid tissue. •Significant areas of necrosis, hemorrhage and liquefaction degeneration may be seen. |
| Clinical Correlation •The presence of metastatic deposits in draining lymph nodes generally worsens the prognosis. •In some malignancies, particularly those of internal viscera, lymph node metastases may be the first indication of a tumor. |
| References • Cotran RS, Kumar V, Robbins SL: Robbins Pathologic Basis of Disease. 5th ed. Philadelphia, W.B. Saunders, 1994, pp. 297. |
| Metastatic malignancy in a lymph node |
| Synopsis by: T.V.Rajan, M.D., Ph.D (T08000M87206)[608] |
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