Histomorphologic reaction patterns in cervical lymph nodes of different neck sites

Immunologically based studies of host-tumor interactions have gained popula rity in head and neck oncology and histopathological determination of lymph node reactivity has been shown to correlate with survival. However, little is known about lymph node reaction patterns in the "normal" neck. In a pro spective histomorphologic study 1024 cervical lymph nodes (CLN) were dissec ted at autopsy from 25 selected cadavers free of head and neck disease. To investigate regional differences of immune reactivity, these lymph nodes we re grouped according to neck levels. 242 CLN groups of 50 neck sites were m icroscopically classified into one of four distinct histomorphologic immune reaction patterns (RP). 14.5% of CLN groups showed lymphocyte predominance (RP 1), 12% showed germinal center predominance (RP 2), 63.2% were unstimu lated (RP 3) and 10.3% displayed regressive changes (RP 4). Distribution of RP was highly significant according to neck level (p <0.001): RP I and RP 2 were common. in the submandibular (Level I) and the upper parajugular gro ups (Level II) whereas RP 4 was more typical in the inferior parajugular gr oups (Level IV) and posterior triangle (Level V). RP 2 and RP 4 showed sign ificant correlation to age and general condition. These findings suggest th at tumor independent lymph node reactivity related to neck site, age and ge neral condition of the patient needs to be differentiated from tumor induce d patterns in future morphologic investigations of cervical lymph nodes in patients with head and neck carcinoma.