A new histological scheme for the evaluation of cervical lymph node metasases in squamous cell carcinoma of the head and neck.

Background: Update literature comprises no uniform scheme for the evaluatio n of cervical lymph node metastases in SCC of the head and neck region. As a measure of improvement, a new histological evaluation differentiating bet ween seven histo-morphological types of lymph node metastases was applied. Method: In a retrospective histopathological examination, a total of 355 me tastatic lymph nodes (derived from 153 neck dissection specimens from patie nts with metastasised SCC of the head and neck) were examined. The new sche me evaluated specifically the pattern of intranodal tumour growth, capsular infiltration, desmoplasia and furthermore capsular rupture and morphology of extracapsular spread. Results and Conclusions: The application of qualit ative and quantitative histomorphological criteria, such as e.g. capsular r upture and the number of lymph node metastases may not fully consider the m ultidimensional situation of a patient with malignant disease. However, it may lead to a more exact evaluation of patient prognosis and choice of trea tment as well as possible peri- and postoperative therapy modifications.