One of the frequent complications of malignant tumors is metastasis to the lymph nodes. These are secondary foci, which are formed due to the spread of cancer cells. If there are metastases, this indicates a progression of the cancer process.
Reasons for
Metastasis is always due to the growth and development of the primary focus, the cellular structures of which are distributed throughout the body through the lymphatic system.
The most common causes of lymph node metastasis are cancers in organic structures such as:
- Respiratory system( larynx and lungs);
- Heads, for example, cancer of the jaw, mouth or tongue, etc.;
- Glandular tissue type of thyroid, prostate or breast;
- Gastrointestinal organs( gastric, esophageal or colonic cancer);
- of the Genitals;
- Malotazovyh organs, for example, the uterus or ovaries;
- Leg, etc.
In breast cancer
Mammary carcinoma is considered the most common female oncology, which quite often causes death. Milk fermented cancer metastasizes the benefit of lymphogenesis.
With squamous cell carcinoma
Squamous cell carcinoma is formed from flat epidermal or mucous cells, it can eventually grow into the subcutaneous tissue of the cellulose. Such a cancer grows slowly, but rarely metastasizes.
Similar oncology is usually closely associated with excessive ultraviolet radiation, papillomaviruses, immune disorders or the carcinogenic effects of certain substances.
In squamous cell carcinoma, lymph nodes located near the primary focus are first affected. Moreover, the metastasis of such cancer in the lymph nodes occurs already on the 3-4 stages of oncoprocess, so it differs in more severe course of
. The pathways of
. In general, there are several ways of spreading metastases: with blood, with lymph flow and mixed path.
First, tumor cell structures penetrate into the lymphatic pathways, and then into the nearest and distant lymph nodes.
Lymph node structures can metastasize epithelial cancers( melanoma) and inorganic tumor lesions.
The lymphatic system has been extensively studied, therefore such metastasis is revealed already at the early stages of development. Although metastasis in regional lymph nodes can occur within a year, so the oncologist is periodically examined to detect a similar spread of the tumor process in time.
Symptoms of metastases in the lymph nodes
One of the first signs of the proliferation of cancer cells in the lymph nodes is their noticeable increase in size, which can be detected by palpation or visually.
Lymph node metastasis is accompanied by:
- Headache attacks;
- Hyperthermia;
- Slimming;
- Increased liver;
- Chronic weakness;
- Hyperemia of the skin;
- Neurotic disorders;A deficiency of hemoglobin.
Metastases in the neck lymph nodes
In the neck region is located the most important lymphatic complex, which is usually metastasized by the formations localized in the nearest tissues and structures, for example, in the thyroid or larynx, esophagus or pharynx, etc.
Usually such metastasis occurs as a result of hematosarcoma or lymphogranulomatosis, lymphosarcoma or Virchow metastases.
As a result of the spread of a cancerous tumor, the echogenic and structural characteristics, the size and shape of the lymph nodes change.
In general, metastatic lesions of the cervical lymph nodes are observed with:
- Malignant tumors of the neck and head like larynx cancer, thyroid gland, tongue, etc.;
- Pulmonary cancer;
- Mangiston oncology;
- Cancer of the abdominal organs, etc.
A similar phenomenon often indicates the 3-4 stages of oncoprocess. Approximately one third of patients with similar metastases do not succeed in detecting the primary focus.
In the groin
Inguinal lymph nodes are a barrier that protects and destroys microorganic agents trapped in the lymph system from the lower limb organs and legs.
Sometimes in the inguinal lymph nodes cancerous formations or lymphomas of a primary nature are formed. The nodes of the groin with metastasis noticeably increase in size, although they may not cause painful sensations during palpation.
Usually, inguinal lymph nodes metastasize such oncopathologies as:
- Cancer of the reproductive system;
- Hodgkin's lymphoma;
- Catarrhal cancer;
- Skin cancer on the legs;
- Lumbar melanoma.
Retrosternal
Metastatic lesions of retroperitoneal lymph nodes are observed in cancer:
- Kidney;
- Eggs;
- Organs of the gastrointestinal system, etc.
In the presence of retroperitoneal cancer, the patient observes symptoms like paroxysmal cramping abdominal pain, hyperthermia, diarrhea.
With metastasis, lymph nodes increase, which can result in compression of the lumbar muscle and nerve roots. As a result, the oncological patient begins strong back pain.
Paraortal
These lymph nodes are located along the aorta in the anterior zone of the lumbar vertebral part.
Usually metastasis to para-aortic lymph nodes is observed in oncopathologies like:
- Urogenital cancer;
- Malignant adrenal and renal tumors;
- Cancer of the organs of the gastrointestinal system, etc.
If the metastases spread to the para-aortic lymph nodes, the tumor process, as a rule, has already reached the 3-4 stages of development.
Abdominal cavity
A sufficiently large number of lymph nodes is located in the cavity of the peritoneum, they are subdivided into parietal( near the waist) and intra-wall.
Metastasis to the lymphatic fractions of the abdominal cavity occurs usually in the presence of malignant tumors of low-tidal and abdominal organs, for example, the ovary or stomach.
Usually a metastatic lesion is indicated by an enlarged lymph node up to 10 centimeters or more. Identify such lymph nodes can be using magnetic resonance or computer diagnostics.
Axillary
Lymphatic metastases in the axillary nodes are most often observed with skin oncology of the trunk and hands, as well as in breast and breast cancer. In this case, axillary nodes become larger, which is noticeable during normal visual inspection.
In addition, the patient can constantly experience weakness, lose weight without cause, often sick with ARI, etc.
It also happens that metastases in the axillary lymph nodes are detected by specialists earlier than the primary malignant tumor.
In supraclavicular
Usually, in supraclavicular lymph nodes metastasize such tumors as:
- Cancer of the organs of the gastrointestinal system;
- Pulmonary oncology;
- Undifferentiated cancers, provided that the primary tumor is located in the head or neck.
When lesions of right-sided supraclavicular lymph nodes often indicate a prostatic or pulmonary localization of the primary malignant focus. If the metastases are localized in the right-sided supraclavicular area, the primary focus may be located in the peritoneum.
Stomach cancer most often metastasizes to the left supraclavicular lymph nodes. In general, the increase in supraclavicular lymph node fractions refers to very disturbing symptoms, which indicates an oncology in the abdomen or chest.
Mediastinal
The mediastinum region includes the chest lymphatic ducts, anterior and posterior lymph nodes. Usually these lymph nodes are metastasized:
- Thyroid tumors;
- Seminoma of the testis;
- Melanosarcomas;
- Esophageal cancer;
- Renal hypernephrosmus;
- Chorionic epithelium of the uterus;
- Mammary cancer, etc.
Even small tumors of malignant origin can lead to extensive metastasis of the mediastinum. In this case, neck tissue can swell, hoarseness and dysphagia, interlacing and swelling of the veins located on the chest, stridor breathing, etc.
Diagnosis
Diagnostic tests for lymph node metastasis are mandatory.
If the lymph node is located in the access zone, then a biomaterial is taken from it by the puncture method and subjected to its histology. If the node affected by the metastases is located inside the body, then it is subjected to such studies as computed tomography or MRI, ultrasound diagnosis or PET, etc.
Specialists use several criteria for determining the degree of secondary lesion of the lymph nodes:
- Mild degree - 1-3 lymph nodes are affected;
- Average degree - 4-9;
- Extensive defeat - when the secondary tumor process spread to 10 or more lymph nodes.
Define visually lymph node lesions in the inguinal, axillary, cervical and supraclavicular lymph nodes. With other localizations, detection requires the use of specialized equipment.
Treatment of
Treatment of lymphatic metastases is practically the same as primary tumor therapy, that is, it involves the use of surgical, chemotherapeutic and radiotherapy.
These methods are combined in accordance with the stage and degree of involvement of the lymph nodes. When a primary tumor is removed from the patient, all regional lymph nodes are removed, that is, lymphadenectomy is performed.
And on those lymph nodes that are located further away from the tumor, experts work with radio-therapy or bloodlessly remove metastases with the help of Cyber knife.
With the timely detection and treatment of lymphatic metastases, the growth of the tumor process is blocked and life forecasts are significantly improved.
Forecast
It is rather difficult to predict the further course of oncoprocess by metastases alone in the lymph system. Everything depends on the localization, the degree of malignancy and the prevalence of the primary focus.
If metastases are detected only near the primary cancer site, the prognosis for recovery is more positive.
- If metastatic lesions are observed in the axillary lymph nodes , then most likely the primary focus is located in the mammary gland. In this situation, relapses are often observed, and the life expectancy after therapy is about one and a half to two years. Although with isolated lymphatic involvement, the 5-year survival rate is higher than 64%.
- In the lymph nodes of the abdominal cavity of , metastases of internal organs are usually detected. With gastric and kidney cancer, the forecasts are disappointing.
- Metastasis in the neck lymph nodes occurs with neck and scalp melanomas that are characterized by unfavorable prognosis, a five-year survival rate of about 48%.
- With an isolated metastatic lesion of the inguinal lymph nodes , survival for 5 years occurs in 63% of cancer patients.
Sometimes when detecting metastases in the lymph nodes it is possible not to notice small formations, which reduces the effectiveness of anticancer therapy.