title: Immunomorphological patterns of cervical lymph nodes in oral squamous cell carcinoma.
abstract: BACKGROUND
  Squamous cell carcinoma (SCC) comprises 80% of the cancers of the oral cavity. Metastases to the cervical lymph nodes affects prognosis. Studying lymph node reactivity may help to understand host immune reaction against the tumor and thus influence prognosis.
  
  
  OBJECTIVE
  This study observed patterns of lymph node reactivity, metastases and grades of metastases in cervical lymph nodes and compared them with the histopathology of the primary tumor.
  
  
  METHODS
  Lymph nodes from 30 patients of oral squamous cell carcinoma (OSCC) were taken. 10 of these were well-differentiated SCC (WDSCC), 10 moderately differentiated SCC (MDSCC) and 10 poorly differentiated SCC (PDSCC). Four immunomorphological patterns were observed: lymphocyte predominance, germinal centre predominance, mixed pattern (sinus histiocytosis) and unstimulated pattern.
  
  
  METHODS
  Chi square test.
  
  
  RESULTS
  The predominant lymph node reactive patterns were germinal centre predominance (79.27%), unstimulated pattern (14.63%) and lymphocyte predominance (6.10%). Positive nodes showed invasion in the form of islands (57.14%), cords (39.29%) and total replacement pattern (3.57%). Tumor involvement in positive nodes showed grade 3 invasion, (53.57%), grade 2 invasion (26.79%), grade 4 invasion (17.86%) and grade 1 invasion (1.79%). Statistically significant association was found between: Lymph node reactive pattern and histopathological grade of primary tumor. Higher numbers of germinal centre predominance lymph nodes were found in WDSCC and MDSCCHistopathological grade of primary tumor and the grade of lymph node invasion.
  
  
  CONCLUSIONS
  Immuno-morphological assessment of draining lymph nodes reflects the immune status of the patient with respect to metastases. This may facilitate identification of high and low risk patients and help in planning appropriate therapy for the high-risk patients.
authors.affiliation: Department of Oral Pathology, School of Dental Sciences, Sharda University, Greater Noida, Uttar Pradesh, India.
authors.forename: Vidyadevi
authors.initials: V
authors.lastname: Chandavarkar
authors.affiliation: Department of Oral Pathology, Karnataka Lingayat Education Society Institute of Dental Sciences, Bangalore, Karnataka, India.
authors.forename: K
authors.initials: K
authors.lastname: Uma
authors.affiliation: Department of Oral Pathology, Karnataka Lingayat Education Society Institute of Dental Sciences, Bangalore, Karnataka, India.
authors.forename: R
authors.initials: R
authors.lastname: Sangeetha
authors.affiliation: Department of Oral Pathology, School of Dental Sciences, Sharda University, Greater Noida, Uttar Pradesh, India.
authors.forename: Mithilesh
authors.initials: M
authors.lastname: Mishra
keywords: Cervical lymph node metastasis; germinal centre; immunomorphology; lymphocyte predominant; oral squamous cell carcinoma