Non-organ tumors of the neck and tumor lesions of the cervical lymph nodes. How tumors and metastases appear in the lymph nodes of the abdominal cavity Cancer and inguinal lymph nodes

Lymph nodes are oval or round formations, with volumes of 1 mm - 2 cm. The lymph node is considered an obstacle to the spread of various vascular infections, including cancer cells. It produces lymphocytes, which are protective cells that are involved in the destruction of infected cells and foreign bodies.

All lymph nodes are divided into several groups, which are specially located so as to become an obstacle to the penetration of infection into the body.

A very large number of lymph nodes are located in the abdominal cavity and in the sternum. Lymph nodes can become inflamed due to transmitted diseases. The lymph nodes in the neck are most commonly affected.

What is the lymphatic system?

This is a large network consisting of vessels of small sizes, which are combined into larger ones. All of them are combined and sent to the lymph nodes. All tissues of the human body and its blood vessels are pierced by lymphatic capillaries. Fluid, protein preparations, metabolic products, viruses, toxins are removed from the tissues through the lymphatic system.

In the lymph that fills the system, there are cells that protect the body from the penetration of bacteria.

Capillaries, uniting, form a network of vessels of different diameters. The largest lymphatic duct is sent to the circulatory system. There are nodes in the neck, in the groin, armpits. Swelling of the lymph nodes in the neck is observed due to the rapid increase in the number of white bodies when an infection develops in a nearby organ.

That is why, when doctors suspect the presence of a viral infection, they feel the lymph nodes. If they are enlarged, this may indirectly confirm the diagnosis.

Signs of inflammation of the lymph nodes in the neck

If a swelling is found under the chin or in the upper part of the neck, which is manifested by painful sensations, then it can be assumed that the cervical lymph nodes are inflamed. If bumps are found in the back of the head, this may indicate the development of cancer. In this case, the surface of the skin where the node is located is inflamed and redness appears.

Sometimes inflammation of the lymph nodes can be like a common cold. The patient feels impotence, chills, there is a decrease in appetite, difficulty in swallowing, rapid pulse. If such symptoms take place and they do not go away with time, then you should seek the advice of a doctor, undergo an examination of the vessels.

The defeat of the lymph nodes in the neck can be of the following types:

• primary defeat. The tumor begins to develop from the tissues of the lymph node;
• secondary lesion (metastatic). The tumor can be localized in different places. Tumor cells enter the lymph nodes, moving in the direction of the vessels.

The human immune system is supported by B and T lymphocytes. Being immature, they undergo synthesis in the bone marrow, and their further maturation takes place in the spleen and lymph nodes.

Most of the lymph nodes are located in the groin, armpits and neck. The human lymphatic system has an important function - to protect the body from infections and viruses.

Signs of a tumor

A tumor of the lymph node may appear in the body due to the following reasons:

1. genetic propensity. People whose relatives have had cancer have an increased risk of diseases of the lymphatic system;
2. infection with an immunodeficiency microbe or a sharp decrease in the body's resistance;
3. late pregnancy and childbirth;
4. age factor. Statistics say that the peak incidence of lymphoma falls on the period of 25-30 years, as well as at 50 years of age.

Lymphogranulomatosis is a primary tumor of the lymphatic system. In most cases, lymphogranulomatosis begins with an increase in the size of the cervical lymph nodes, and their volumes can vary from a small pea to a man's fist.

During palpation, they are painless, easily displaced, not interconnected. Almost no changes are observed on the skin. Such an isolated increase in lymph nodes can last 6-8 months.

Later, the lymph nodes in the groin and armpits begin to increase, affecting the liver, lungs and spleen. The disease will be constantly accompanied by fever with chills.

Thirty percent of patients have itching over the area of ​​​​altered lymph nodes. In some cases, itching goes to the whole body, a person loses restful sleep and appetite. When the disease progresses, then the person begins to lose weight dramatically.

His lymph nodes become immobile and tight. To make a diagnosis of lymphogranulomatosis, a biopsy of the lymph nodes is taken, as a result of which Berezovsky-Sternberg cells, which are distinctive for this disease, are revealed.

Lymphoid leukemia is a benign tumor that affects the lymph nodes, spleen and liver.

Causes of a tumor

Often, with injuries or insect bites, infection of the vessels occurs. If these injuries occur in the head area, on the neck, then the bacteria present in the lymph begin to fight against harmful microorganisms. When it is possible to eliminate the source of infection, the cervical lymph nodes acquire normal volumes.

Vaccination of blood vessels can lead to allergic reactions. And then not only the cervical lymph nodes, but also all the rest will be affected by the increase.

With an increase in the lymph nodes in the neck, you should immediately contact a specialist.

He will prescribe the necessary examinations, consultation of an otolaryngologist, dentist. Proper treatment can only be prescribed after the diagnosis is confirmed.

An increase in nodes is a symptom of impaired vascular function or infection with an infectious disease of the ENT organs.

This disease may indicate the presence of a viral infection. In this case, the lymph nodes swell and manifest themselves as soreness, although they still remain soft. In some cases, only one node may increase, or several, but on the one hand.

After the necessary treatment is carried out, the state of the lymph nodes will return to normal. If after 3 weeks the state of health does not improve, it is necessary to contact a specialist for additional research.

Enlarged nodes in the neck are the main symptom of toxicoplasmosis. This disease can be earned if you eat undercooked pork or become infected from animals.

It would seem that ordinary caries can also cause an increase in lymph nodes. Basically, one node is subjected to an increase on the side where the diseased tooth is located.

There are several other reasons that can serve as an impetus for the occurrence of this disease:

• non-compliance with the rules of oral hygiene;
• pulpitis, periodontitis;
• elderly age;
• pathology of internal organs;
• eruption of the wisdom tooth.

Inflammation of the lymph nodes in the neck

As soon as the first signs of lymphadenitis appear, the patient needs to consult a therapist. He will carry out the necessary diagnosis of the disease. Depending on what results are obtained, the patient will be referred to a surgeon, oncologist, hematologist and dentist. One thing is for sure - an increase in lymph nodes can indicate the presence of pathology in the body, which requires immediate elimination.

Experts say that there are about 100 diseases that are accompanied by a reaction from the lymphatic system. When the nodes on the neck become inflamed, then it is worth looking for the pathology in the head area. To make an accurate diagnosis, it is worth considering all the symptoms associated with lymphadenitis.

With inflammation of the lymph nodes in the neck, the patient will need to consult a therapist, an ENT specialist. Self-medication in this matter can greatly harm health. It is forbidden to warm the inflamed area with a heating pad, resort to compresses.

Treatment

When prescribing therapy for lymphadenitis, the doctor must take into account the main cause of the onset of the disease, how widespread the inflammatory process is, the presence of symptoms, and complications. If the cause of the inflammation was a bacterial infection, then antibiotics are prescribed to treat the vessels.

Medicines can be administered intravenously and intramuscularly, everything will depend on the patient's condition. If there are no complications, then the doctor may prescribe pills.

Lymphadenitis of a complicated nature, with the presence of purulent deposits, is treated with surgical intervention. During the operation, the focus of suppuration is opened, after which it is treated with an antiseptic. At the end of the operation, the patient is advised to rest in bed. It is also required to take immunomodulatory drugs.

Most often, people experience inflammation of the lymph nodes in childhood. In children, this pathology can become chronic.

The cause of the appearance of diseases are frequent colds, diseases of the upper respiratory tract. Pediatricians in such cases recommend strengthening the immune system. Immunomodulating agents, vitamin complexes are prescribed.

Lymph nodes in a child may increase due to allergic reactions to the food received, household chemicals. Such reactions in children are manifested due to vaccination of the body. Treatment according to a special scheme is not required.

When should you not be afraid of cancer of the lymph nodes?

A healthy lymph node ranges in size from a grain to a bean. In the case when the node is enlarged, but there is no inflammatory process, there were no injuries, then a complete examination of the blood vessels and the whole body should be completed.

Initially, the oncologist must conduct an examination of the organs that can provoke the onset of the disease. If the examination does not reveal the causes, then most likely the problem lies in the lymphatic system itself. A biopsy is necessary to make an accurate diagnosis. In 99 percent of cases, an increase in the node is in no way associated with an oncological disease.

Therefore, do not worry and be afraid to consult a doctor. Prevention of health and regular visits to doctors will be the key to good health.

Metastasis is the most important characteristic of any malignant tumor. This process is associated with the progression of the disease, which often ends in the death of the patient. When the lymphatic system is affected by a carcinoma of another organ, the layman can designate this phenomenon as “cancer of the lymph nodes”, from the point of view of medicine, this is, that is, a secondary lesion.

The cells of a malignant tumor have a number of differences from healthy ones, including not only a local destructive effect in a tissue or organ, but also the ability to separate from each other and spread throughout the body. The loss of specific protein molecules that provide a strong connection between cells (adhesion molecules) leads to the detachment of the malignant clone from the primary tumor and its penetration into the vessels.

Epithelial tumors, that is, metastasize mainly by the lymphogenous route, through the lymphatic vessels that carry the lymph away from the organ. Sarcomas (connective tissue neoplasms) can also affect the lymph nodes, although the predominant route of metastasis for them is hematogenous.

On the way of the lymphatic flow, nature provides "filters" that keep all the "excess" - microorganisms, antibodies, destroyed cell fragments. Tumor cells also fall into such a filter, but they are not neutralized, and instead, the malignant clone begins to actively divide, giving rise to a new tumor.

metastasis

Initially, signs of a secondary tumor lesion are found in regional lymph nodes, that is, those that are closest to the organ affected by the tumor and which are the first to meet the lymph bearing carcinomatous elements. With further progression of the disease, metastases spread further, capturing more distant lymphatic groups. In some cases, lymph nodes located in another part of the body are affected, which indicates an advanced stage of the tumor and an extremely unfavorable prognosis.

An increase in lymph nodes in cancer is a consequence of the multiplication of tumor cells in them, which displace healthy tissue, filling the lymph node. Inevitably, there is a difficulty in lymphatic drainage.

According to the histological structure, metastases usually correspond to the primary tumor, but the degree of differentiation in some cases is lower, so the secondary cancer of the lymph node grows faster and more aggressively. There are frequent cases when the primary tumor manifests itself only as metastases, and the search for their source does not always bring results. This loss is referred to as cancer metastasis from an unknown source.

Possessing all the features of malignancy, cancer (metastasis) in the lymph node poisons the body with metabolic products, increases intoxication, and causes pain.

Any malignant tumor sooner or later begins to metastasize, when this happens depends on a number of factors:

• Age - the older the patient, the earlier metastases appear;
• Concomitant diseases in a chronic form, weakening the body's defenses, immunodeficiencies - contribute to more aggressive tumor growth and early metastasis;
• Stage and degree of differentiation - large tumors that grow into the wall of the organ and damage blood vessels metastasize more actively; the lower the degree of cancer differentiation, the earlier and faster metastases spread.

Not every tumor cell that enters a lymph node will divide and metastasize. With good immunity, this may not happen or it will happen after a long time period.

In the diagnosis, an indication of a metastatic lesion of the lymph nodes is indicated by the letter N.: N0 - lymph nodes are not affected, N1-2 - metastases in regional (nearby) lymph nodes, N3 - distant metastasis, when lymph nodes are affected at a considerable distance from the primary tumor, which corresponds to severe, fourth, stage of cancer.

Manifestations of lymphogenous metastasis

The symptoms of lymph node cancer depend on the stage of the disease. Usually the first sign is their increase. If superficially located lymph nodes are affected, then they can be palpated in the form of enlarged single nodules or conglomerates, which are not always painful.

Such metastases in the lymph nodes are easily determined in the axillary region with breast cancer, in the groin with tumors of the genital tract, on the neck with diseases of the larynx, oral cavity, above and below the collarbone in case of gastric cancer.

If the tumor affects the internal organ, and metastasis occurs in the lymph nodes lying deep in the body, then it is not so easy to detect their increase. For example, the enlarged lymph nodes of the mesentery in case of intestinal cancer, the hilum of the liver in case of hepatocellular carcinoma, the lesser and greater curvature of the stomach in case of tumors of this organ of palpation are inaccessible, and additional examination methods come to the aid of the doctor - ultrasound, CT, MRI.

Large groups of metastatically altered lymph nodes inside the body may manifest as symptoms of compression of those organs or vessels next to which they are located. With an increase in the lymph nodes of the mediastinum, shortness of breath, heart rhythm disturbances and chest pain are possible, enlarged mesenteric lymphatic collectors contribute to pain and bloating, and indigestion.

When the portal vein is compressed, portal hypertension will occur - the liver and spleen will increase, fluid (ascites) will accumulate in the abdominal cavity. Signs of obstruction of the outflow of blood through the superior vena cava - swelling of the face, cyanosis - can indicate the defeat of the lymph nodes with cancer.

Against the background of metastasis, the general condition of the patient also changes: weakness and weight loss increase, anemia progresses, fever becomes constant, and the emotional background is disturbed. These symptoms indicate an increase in intoxication, which is largely facilitated by the growth of cancer in the lymph nodes.

Lymphogenic metastasis in certain types of cancer

The most common types of cancer are carcinomas of the stomach, breast in women, lungs, and genital tract. These tumors tend to metastasize to the lymph nodes, and the pathways of cancer cells and the sequence of damage to the lymphatic apparatus are fairly well understood.

At the first metastases can be found in the axillary lymph nodes already in the second stage of the disease, and in the fourth they are present in distant organs. Lymphogenic spread begins early and often the reason for the search for a tumor is not a palpable mass in the chest, but enlarged lymph nodes in the axillary region.

Breast cancer is manifested by the defeat of several groups of lymph nodes - axillary, parasternal, supraclavicular and subclavian. If the carcinoma grows in the outer areas of the gland, then it is logical to expect cancer metastases in the lymph nodes armpit, the defeat of the internal segments leads to the entry of cancer cells into the lymph nodes along the sternum. Metastasis to the indicated groups of lymph nodes of the side opposite to the tumor, as well as damage to the nodes of the mediastinum, abdominal cavity, and neck will be considered distant.

At groups of regional lymph nodes, affected first, and distant, involved in advanced stages, were identified. Regional are considered paratracheal, bifurcation, peribronchial lymph nodes located near the bronchi and trachea, distant - supra- and subclavian, mediastinal, cervical.

In the lungs, the lymphogenous spread of cancer occurs early and quickly, this is facilitated by a well-developed network of lymphatic vessels necessary for the proper functioning of the organ. The central cancer growing from large bronchi is especially prone to such dissemination.

At metastases in the lymph nodes may have a peculiar location. The nodes are first affected along the greater and lesser curvature, antrum, then the cells reach the celiac lymph nodes (second stage), it is possible to detect gastric cancer in the lymph nodes along the aorta, portal vein of the liver.

Peculiar varieties of lymphogenous metastases of gastric cancer bear the names of the researchers who described them or encountered them for the first time. Virchow's metastasis affects the left supraclavicular lymph nodes, Schnitzler's - the fiber of the rectal region, Krukenberg's - the ovaries, Irish - the lymph nodes in the armpit. These metastases indicate distant dissemination of the tumor and a severe stage of the disease, when radical treatment is impossible or no longer appropriate.

Lymph nodes in the neck affected by tumors of the bottom, gums, palate, jaws, and salivary glands. Submandibular, cervical, occipital groups of lymph nodes are involved in the pathological process. Distant metastasis to the cervical lymph nodes is possible with carcinomas of the breast, lungs, and stomach. With cancer located in the face, oral cavity, lymphogenous spread occurs quickly, which is associated with an excellent lymphatic supply to this zone.

In addition to metastases, in the lymph nodes of the neck primary tumors can form - lymphogranulomatosis, which the layman will also call cancer of the cervical lymph node. In some cases, it is possible to determine whether the primary tumor or metastasis has affected the nodes on the neck only with an additional examination, including a biopsy.

Lymph nodes in the neck tend to increase not only with metastases. Probably, each of us can find at least one enlarged nodule under the lower jaw or between the neck muscles, but this does not necessarily indicate cancer. It is not worth panicking, although it will not hurt to find the cause.

Cervical and submandibular lymph nodes collect lymph from the oral cavity, larynx, pharynx, jaws, which very often have inflammatory changes. All sorts of tonsillitis, stomatitis, caries are accompanied by chronic inflammation, so it is not surprising that there is an increase in regional lymph nodes. In addition, the area of ​​​​the mouth and upper respiratory tract is constantly encountered with various microorganisms that, with the flow of lymph, enter and are neutralized in the lymph nodes. Such enhanced work can also lead to lymphadenopathy.

Diagnosis and treatment of metastases in the lymph nodes

Diagnosis of metastases in the lymph nodes is based on their palpation, if possible. If you suspect a lesion of the axillary, cervical inguinal lymph nodes, the doctor will be able to feel them all over, in some cases, palpation of the internal lymph nodes - celiac, mesenteric.

Ultrasound of the vessels of the neck

To confirm a metastatic lesion, additional examination methods are used:

• Ultrasound- it is especially informative with an increase in lymphatic collectors located inside the body - near the stomach, intestines, in the gates of the liver, and in the retroperitoneal space, in the chest cavity;
• CT, MRI- allow you to determine the number, size and exact location of the changed lymph nodes;
• Puncture and biopsy- the most informative ways to see cancer cells in the lymph node, with a biopsy it becomes possible to suggest the source, clarify the type and degree of cancer differentiation.

lymph node biopsy

Molecular genetic studies are aimed at establishing the presence of certain receptors or proteins on cancer cells, which, with a high degree of probability, can be used to judge the type of cancer. Such analyzes are especially indicated when metastases are detected from an unknown source, the search for which was unsuccessful.

Treatment of cancer metastases in the lymph nodes includes surgical removal, radiation and chemotherapy, which are prescribed individually according to the type and stage of the disease.

Surgical removal of the affected lymph nodes is performed simultaneously with the excision of the tumor itself, while lymph node dissection is performed on the entire group of regional collectors into which cancer cells have entered or could have entered.

For many tumors, the so-called "sentinel" lymph nodes are known, where metastasis occurs most early. These nodes are removed for histological examination, and the absence of cancer cells in them indicates the absence of metastasis with a high degree of probability.

When manipulating the tumor itself and the lymph nodes, the surgeon acts very carefully, avoiding squeezing the tissues, which can provoke the dissemination of tumor cells. To prevent cancer cells from entering the vessels, their early ligation is performed.

With metastases, it is almost always prescribed. The choice of drugs or their combination depends on the type of primary tumor and its sensitivity to specific drugs. In stomach cancer, 5-fluorouracil, doxorubicin are most effective; in breast tumors, cyclophosphamide, adriamycin are prescribed; non-small cell lung cancer is sensitive to etoposide, cisplatin, and taxol.

chemotherapy

If the primary focus of a cancerous tumor could not be identified, cisplatin, paclitaxel, gemcitabine, etoposide are prescribed. In poorly differentiated carcinomas affecting the lymph nodes, platinum preparations (cisplatin) are effective; in neuroendocrine tumors, cisplatin and etoposide are included in the treatment regimen.

The goal of chemotherapy for metastatic tumors is to slow down the growth and further spread of the malignant process. It is prescribed before surgery (neoadjuvant chemotherapy) to prevent metastasis and destroy micrometastases in the lymph nodes and after surgery (adjuvant) to prevent further metastasis, the risk of which increases after surgery on the affected organ.

radiation therapy

It is more important for hematogenous metastases than lymphogenous ones, but radiosurgery, or cyberknife, can be effective for lymph nodes, when the cancer in the lymph node is removed using a beam of radiation acting strictly on the affected tissue. This method is justified for late single metastases that appear years after treatment, when reoperation can be avoided.

Metastasis to lymph nodes in cancer, regardless of the type of primary tumor, characterizes the progression of the disease, and the prognosis is the worse, the more lymph collectors are involved in cancerous growth. Metastases respond to treatment in only a fifth of patients in whom the prognosis may be favorable, in the remaining 80%, treatment at the stage of metastasis is aimed at alleviating symptoms or prolonging life. With multiple lymphogenous metastases of poorly and undifferentiated carcinomas, life expectancy is on average six months to a year, in the case of highly differentiated cancers, the prognosis is slightly better.

Video: removal of lymph nodes in the treatment of breast cancer

The author selectively answers adequate questions from readers within his competence and only within the limits of the OncoLib.ru resource. Face-to-face consultations and assistance in organizing treatment are not currently provided.

Metastasis to the lymphatic system is not the initial stage of cancer. The pathological process that has spread to the nodes indicates the intensive reproduction of cancer cells. The reason for this can be various malignant tumors: carcinomas, sarcomas, advanced cases of other tumors. Timely detection and topical treatment is the only way to stop metastasis.

Stage classification

To prescribe therapy, doctors determine the degree of spread of pathological cells. Each stage has a code, in which N is the complexity of the disease:

• Nx - the presence of a tumor is possible, metastases are not looked for;
• N0 - 1 stage of growth of malignant cells, no metastases;
• N1 - stage 2 of the disease, the nodes next to the tumor are affected;
• N2 - stage 3, cells spread to neighboring organs and tissues in large quantities;
• N3 - stage 4, which is characterized by the defeat of even distant nodes.

Benign neoplasms, including retroperitoneal lymphangioma, which is more often found in children, do not metastasize.

Symptoms of a malignant process

There are two ways for damaged cells to spread throughout the body - through the lymphatic or blood fluid. There is a mixed version, but it is less common.

The main symptom of cancer that has affected this system is an increase in the size of the nodes. However, abdominal lymph nodes are difficult to diagnose by palpation, this requires additional methods.

The structure of tissues remains soft, may change over time. A person with the development of the disease experiences various unpleasant sensations:

• unreasonable increase in temperature, which eventually becomes constant;
• regular colds and general signs of decreased immunity;
• headaches, redness of the skin in the area of ​​the affected nodes;
• liver enlargement;
• neuroses;
• weakness, development of anemia;
• drastic weight loss.

When the lymph nodes of the retroperitoneal space are affected, specific signs appear: vague abdominal pain, persistent diarrhea, followed by frequent constipation. Most often, metastases in these parts of the lymphatic system develop as a result of cancer of the kidneys, intestines and other organs of the gastrointestinal tract, ovaries, uterus, testicles and prostate in men. Intensive process of metastasis causes pain in the back, lower back.

Oncological processes are accompanied by complex symptoms, which are difficult to recognize at the initial stages of the disease. Often, signs of metastases are detected earlier than hints directly at the disease of the organ in which the tumor is located.

Diagnostic methods in the lymph nodes

To identify a tumor in the lymph nodes of the abdominal cavity, it is necessary to undergo several diagnostic procedures. The main method of confirming the oncological process is a histological examination of a biomaterial taken from a potentially affected node. However, tissue is taken only if access to it is open without complex invasive intervention.

Additional instrumental procedures are prescribed: computed and magnetic tomography, ultrasound. When a pathological process is detected, the number of damaged lymph nodes is taken into account. With a mild degree, it is equal to 3, with an average degree - up to 9, with a severe degree - 10 or more elements.

Possible treatments

Several approaches are used in the treatment of cancer in the lymphatic system. The patient must be prepared for the fact that therapy requires time, effort and patience from the person. She is never easy. There are no "cancer pills" that can be taken without side effects and with high performance.

The study of the lymphatic system is the main principle in determining the method of therapy, even if the disease is in another organ.

The detection of metastases in the abdominal or other nodes requires a complete review of the treatment and the appointment of a tactic that differs from that used in the absence of proliferation of pathological cells.

In most cases, metastatic cancer is treated according to a plan (steps may vary depending on the individual patient):

• Removal of tissues affected by malignant cells. The excision operation is performed before or after radiation therapy. Lymphadenectomy involves the complete removal of lymph nodes located near the main tumor. If the affected elements are far away, they are affected by radiation or chemical therapy, using a cyber-knife.
• Radiation therapy is the irradiation of a patient with doses of radiation aimed at the destruction of pathological cells. These doses in metastases are usually significant and cause severe side effects, as well as requiring hospitalization of the patient for the period of treatment.
• Chemotherapy - tablets or injection solutions are used to kill cells. The most powerful way to influence the body affected by stage 3-4 cancer. With the help of chemistry, more than 10 nodes involved in the pathological process can be covered, since the drugs act on the whole body. However, chemotherapy is accompanied by the most intense side effects.

In some cases, tumors and metastases recur even after removal. Then a new course of treatment is carried out.

Survival prognosis

The survival of patients after surgical removal of the tumor and metastases, a course of chemotherapy or radiation depends on many other factors. Age, the relevance of the selected treatment, concomitant diseases and the degree of cancer detected add up to the overall picture of a person’s health.

Distant metastases in severe disease lead to a disappointing diagnosis. Sometimes there is no possibility for an operation, and the period that remains for a person is measured in 5-12 months. At best, 2 years.

With favorable treatment, five-year survival reaches over 60% of patients. However, in many of them the disease recurs. Repeated treatment prolongs life by 12-25 months.

Detection of metastases without the main source of the tumor is a positive thing. In this case, a detailed diagnosis allows you to detect a nearby neoplasm, then an operation and a course of treatment are performed. Complete elimination of pathology and long-term remission (over 5 years) are possible.

If 5 years have passed, and there has been no recurrence of the disease, the threat of an oncological process may decrease. However, the patient must undergo regular examinations - at least once a year.

Metastases in the lymph nodes of the abdominal cavity can be distant or close to the main source - the tumor. To increase the chances of a successful cure, the patient must undergo an emergency examination and recommended therapy, selected taking into account the characteristics of his condition.

In the skin, the tumor node is delimited by a pink connective tissue capsule. Tumor cell bundles are randomly distributed. At higher magnification, rod-shaped hyperchromic cell nuclei are determined.

Essential elements: 1. tumor smooth muscle cells

2. connective tissue capsule

No. 127. Myxoma

The tumor consists of rare loosely lying cells. At higher magnification, the outgrowth character of the cells is noted. The cells lie in a basophilic mucus-like homogeneous substance.

Essential elements: 1. process cells

2. basophilic substance

№ 128. Lymphangioma of the tongue

In a micropreparation, a section of the tongue. A stratified squamous non-keratinizing epithelium is visible from the surface, the papillae are distinctly expressed. The epithelial layer is thickened, with acanthosis (submerged growth of the epithelium). Under the epithelium in the muscle tissue is determined by the formation of the lymphatic vessels. Vessels are located chaotically, collapsed, dilated and filled with lymph. The stroma is fibrous, with round cell infiltrates. The tumor has an infiltrative growth pattern.

Essential elements: 1. tumor vessels

2. round cell infiltrates

3. acanthosis of the epithelium

№ 129. Tongue hemangioma

In the preparation, a section of the tongue with squamous epithelial lining and papillae. In the subepithelial muscle tissue, a rounded tumor nodule is determined. The structure of the tumor in different areas is not the same. In the center - compactly lying polygonal cells forming small vessels of the capillary type. On the periphery of the node, cavernous vessels with a wide, irregularly shaped lumen containing single erythrocytes are visible.

Essential elements: 1. capillary tumor vessels

2. cavernous tumor vessels

№ 130. Capillary angioma of the skin

The microscopic structure of the skin is changed. In the stratified squamous epithelium, the stratum corneum is wide (hyperkeratosis), the epithelial layer and the interpapillary processes of the epidermis are thickened (acanthosis), there are horny cysts and plugs. In the dermis, numerous and full-blooded capillaries are located randomly, in places in the form of plexuses. At higher magnification, forming capillaries and cellular infiltrates are noted.

Essential elements: 1. tumor capillaries

2. altered epithelium

3. cellular infiltrates

№ 131. Cavernous and angioma of the liver

In the liver there are full-blooded vascular formations of the cavernous type. At higher magnification, thin vessel walls are visible, the stroma is fibrous and hyalinized in places. Surrounding hepatic cells without pronounced changes.

Essential elements: 1. tumor vessels

2. liver cells

No. 132. Chondroma

The tumor in structure resembles hyaline cartilage, in which the cells are unevenly distributed, and in the interstitial substance there is mosaic basophilia. At higher magnification, unsharp cellular polymorphism is noted, individual cells without capsules, and in some capsules there are two or more nuclei.

Essential elements: 1. tumor cartilage-like cells

2. basophilic foci in the cartilaginous substance

№ 133. Fibrosarcoma

Tumor of cellular (histoid) structure. Cell strands and bundles are randomly intertwined, forming fan-shaped and ring-shaped structures. At higher magnification, cellular and, especially, nuclear polymorphism is noted, and various figures of nuclear fission are often found.

Essential elements: 1. cell strands

2. cell polymorphism

3. polymorphism of nuclei

4. nuclear fission figures

№ 134 Angiosarcoma

At low magnification, the tumor is defined as individual cell clusters located in a structureless pink mass. At a higher magnification, in the center of the tumor complexes, an undifferentiated blood vessel is visible, around which the tumor cells are arranged in a muff-like manner. Structureless pink masses around the tumor are necrotic tumor tissue.

Essential elements

2. vessel in the center of the complex

3. zone of necrosis in the tumor tissue

No. 135 Myxosarcoma

The tumor is represented by soft-fibrous cellular tissue, which forms randomly directed strands and contains a large number of small vessels. At higher magnification, polymorphic tumor cells are visible, partly elongated, partly stellate. Cell nuclei are hyperchromic, pathological mitoses occur in a few of them.

Essential elements: 1. bundles of tumor tissue

2. cellular polymorphism

No. 136. Myosarcoma

Muscle tumor cells are folded into bundles of unequal size, located randomly. At a higher magnification, a pronounced polymorphism of tumor cells is visible - they are of unequal shape, the nuclei in them are of different sizes, in some of them there are figures of pathological mitoses. There are also multinucleated cells. Vessels in the tumor are dilated, plethoric, on their periphery - hemorrhages.

Essential elements: 1. bundles of tumor cells

2. cellular polymorphism

№ 137. Chondrosarcoma

The tumor somewhat resembles the structure of hyaline cartilage. Tissue and cellular atypism is expressed in the tumor. Cells are unevenly distributed. The intermediate substance is spotted lilac-pink, and in places where lime salts are deposited it is dark blue. At higher magnification, polymorphism and hyperchromia of cells are noted.

Essential elements: 1. polymorphic cells

2. nuclear hyperchromia

3. lime deposits

№ 138. Retinoblastoma

Histological specimen shows the posterior chamber of the eyeball. The vascular and retinal membranes are flattened, atrophic. Close to the retina is a tumor formed by elongated basophilic cells. Tumor growths have a rosette-like structure: a blood vessel lies in the center of the complex, and tumor cells are arranged radially around in the form of a sleeve. On the periphery of the complexes, necrosis is visible - a pale colored eosinophilic mass with small dark blue inclusions of nuclear dust. Calcifications are also found in the tumor - clumpy large dark blue conglomerates.

Essential elements: 1. tumor "rosettes"

2. foci of tumor necrosis

3. calcifications in the tumor

No. 139. Pigmented nevus (birthmark)

In the papillary layer of the skin and deeper, as well as on the border with the epidermis, there are clusters of cells, intensely stained brown. At higher magnification, there is a dense content of melanin in the cytoplasm of large cells (nevus cells) and in elongated connective tissue cells (melanophores).

Essential elements: 1. melanin in nevus cells

2. melanin in melanophores

No. 140. Blue nevus

In the dermis, in its papillary and reticular layers, randomly arranged clusters of cells with a high content of the brown pigment melanin are visible. This is a tumor. The cells contain clumps and grains of melanin pigment, which are clearly visible at higher magnification. Accumulations of pigment lie freely among the cells.

Essential elements: 1. melanin in tumor cells

2. loose pigment

No. 141. Melanoma

In the section of the eye, a choroid with a large amount of brown-brown pigment (melanin) and a tumor layer consisting of closely adjacent cells stand out. In the tumor, mainly on the periphery, there are also large deposits of melanin. At higher magnification, a chaotic arrangement of polymorphic cells with figures of nuclear fission is noted. Small grains and clumps of melanin are visible in the cytoplasm and outside the cells.

Essential elements: 1. choroid

2. tumor

3. polymorphic cells

4. melanin

No. 142. Sympathogonioma

The tumor is lobular in structure, consists of small rounded cells arranged randomly and compactly. At higher magnification, cells are determined that have a hyperchromic round-oval nucleus and a very narrow rim of the cytoplasm. They resemble sympathogonia. Tumor cells in some places form the so-called pseudorosettes. Pseudorosettes are built of cells arranged in a ring-shaped manner, in the center there is a soft-fibrous content, colored pink.

Essential elements: 1. tumor lobules

2. tumor sympathogonia

3. pseudo sockets

No. 143. Galionevroma

A tumor of a cellular-fibrous structure with fields of necrosis and foci of deposition of lime salts of a dark blue color. Pieces of stroma form strands that go in different directions. Fibrous structures of a felt type. Ganglion cells are unevenly distributed. At a higher magnification, these cells are polymorphic, the nuclei and cytoplasm are stained with different intensity. There are cells with two nuclei. Ganglion cells are surrounded by satellite cells.

Essential elements: 1. ganglion type cells

2. satellite cells

3. cell strands

4.poly necrosis

5. foci of lime deposits

№ 144. Meningioma

In a tumor, the cells are arranged in concentric structures and whorls, in the center of which there is a blood vessel. In some concentric structures lie psammomas - formations of a dark blue color, sometimes layered, rounded. These are deposits of lime salts in necrobiotic, fibrous and hyalinized tumor sites. At higher magnification, oval, elongated or polygonal cells are noted, the cell nuclei are round-oval, pale.

Essential elements: 1. cellular concentric structures
2. psammoma

No. 145. Neurogenic sarcoma (malignant neurilemmoma )

The tumor consists of polymorphic cells, the bulk of which has a spindle-like shape. The nuclei are polymorphic, figures of their division are visible. There are multinuclear formations (symplasts). Cells form bundles going in different directions. "Palisade" structures (Verokai bodies) are determined - the alternation of sections of parallel nuclei with sections consisting of fibers. Nerve trunks of the usual structure can be found in the tumor.

Essential elements: 1. tumor cells

2. nuclear fission figures

3. symplasts

4. bodies of Verocai

5. nerve trunks

No. 146. Teratoma

The tumor consists of connective tissue, in which areas of well-differentiated mature stratified squamous epithelium, epithelium of the intestinal and respiratory type, forming organoid structures, randomly alternate. There are elements of peripheral nerves, adipose tissue, smooth muscles, cartilage.

Essential elements: 1. connective tissue

2. epithelium

3. nerve trunks

4. adipose tissue

№ 147. Teratoblastoma

In the tumor, foci of proliferation of immature intestinal, respiratory, stratified squamous epithelium, immature striated muscles, cartilage, located among immature, loose, sometimes myxomatous mesenchymal tissue, are determined. Areas corresponding to neuroblastoma are visible. Among the immature elements of the embryonic type, there are areas of mature teratoma tissue.

Essential elements: 1. mucosal foci of mesenchymal tissue

2. immature epithelium

3. immature striated muscles

4. areas of neuroblastoma

5. areas of mature teratoma

No. 148. Fibrous epulis

The surface of the epulis is covered with squamous epithelium with acanthotic growths. Epulis consists of bundles of mature connective tissue, arranged in no particular order, chaotically, with a small number of blood and lymphatic vessels. Inflammatory infiltrates are located perivascularly and among the connective tissue structures. At higher magnification, inflammatory infiltrates consist mainly of plasma and lymphoid cells, among which neutrophils are found.

Essential elements: 1. connective tissue bundles

2. inflammatory cell infiltrate

3. epithelium with acanthotic growths

No. 149. Giant cell epulis

Epulis cellular structure. Its main structural component is irregularly shaped giant cells with a large number of nuclei. At a higher magnification - among the giant cells are mononuclear cells with an oval nucleus and erythrocytes, free-lying and in the form of clusters (blood islands).

Essential elements: 1. giant cells

3. erythrocytes

4. blood islands

No. 150. Angiomatous epulis

Epulis is covered with stratified squamous epithelium with massive acanthotic growths. Epulis contains a large number of vessels of predominantly venous type. At a higher magnification, cellular elements and thin layers of connective tissue, leukocytes are located between the vessels.

Essential elements: 1. vessels

2. connective tissue bundles

3. neutrophils

4. epithelium with acanthotic growths

№ 151. Fibrous bone dysplasia

In the bone, a tumor-like proliferation of cellular fibrous tissue is determined without the formation of a capsule. At the border, accumulations of osteoclasts are visible, due to which the pre-existing bone is resorbed. Cellular fibrous tissue is represented by collagen, reticulin fibers and fibroblast-like cells, among which there are haphazardly primitive bone beams and areas of incomplete osteogenesis (areas of osteoid tissue).

Essential elements: 1. collagen and reticulin fibers

2. fibroblast-like cells

3. primitive bone beams

4. osteoclasts

No. 152. Eosinophilic granuloma

In the bone, a focus of destruction is determined, in which large histiocytes are visible with clearly defined rounded or oval nuclei, fine chromatin and well-marked one or two nucleoli, with a wide zone of cytoplasm stained oxyphilically. In addition to histiocytes, the eosinophilic granuloma contains eosinophils, a small number of lymphocytes, plasma cells, non-core leukocytes, multinucleated giant cells, fibroblasts, and xanthoma cells. Areas of cell decay, hemorrhages, foci of growth of connective tissue are visible.

Essential elements: 1. histiocytes

2. eosinophils

3. sites of cell decay

4. foci of fibrosis

№ 153. Radicular cyst

The inner layer of the cyst wall consists of stratified squamous epithelium of varying thickness. In some places, the epithelium is desquamated and the surface is represented by a granulation shaft. The epithelium is located on the connective tissue sheath of the bundle structure. In the capsule, perivascular round cell infiltrates, cholesterol crystals and xanthoma cells are found in places.

Essential elements: 1. cyst wall

3. connective tissue sheath

4. cellular infiltrates

№ 154. Follicular cyst

The wall of the cyst consists of granulation tissue of varying degrees of maturity and bundles of collagen fibers. The inner surface of the cyst is lined with stratified squamous epithelium, which is located on the granulation tissue.

Essential elements: 1. granulation tissue

2. bundles of collagen fibers

3. stratified squamous epithelium

No. 155. Primordial cyst (keratocyst)

The wall of the cyst is thin, represented by connective tissue fibers, the inner surface is lined with stratified squamous epithelium with pronounced parakeratosis. Islets of odontogenic epithelium are visible in the cyst wall. The contents of the cyst are horny masses.

Essential elements: 1. fibrous capsule

2. stratified squamous epithelium

3. islands of odontogenic epithelium

№ 156 Mixed tumor of the salivary gland

The structure of the tumor is varied. Cells form strands and nests of irregular shape. In some places, glandular tubes are visible, in the lumen of which there is an accumulated homogeneous secret of pink color. Among the tumor cells there are "lakes" of basophilic substance (mucoid component), in which stellate cells (myxoid component) lie. There are areas with cartilaginous cells (chondroid component). At higher magnification, the tumor cliques are round-oval, forming primitive glands in some places.

Essential elements: 1. strands of tumor cells

2. mucoid lakes

3. foci of myxoid

4. sections of the chondroid

№ 157. Mucoepidermoid tumor

The tumor consists of epithelial strands and glands, which are mostly cystic and contain eosinophilic secretion. The stroma is developed and represented by bundles of collagen fibers with a small amount of fibrocytes and fibroblasts. At higher magnification, the epithelial cells are epidermoid in places, and clearly glandular in places.

Essential elements: 1. Epidermoid cell sheets

№ 158. Papillary cystadenolymphoma

The tumor consists of glandular structures, in which cysts and papillary growths are determined, as well as lymphoid tissue with the presence of light centers of reproduction. At higher magnification, glandular structures, cystic cavities of the papilla of the papilla are lined with a two-layer epithelium. Eosinophilic masses in cysts.

Essential elements: 1. glandular structure

2. papillae

4. lymphoid tissue

5. bright breeding centers

№ 159. Acinar cell tumor

Tumor of the glandular structure. Tumor nicknames are grouped into small and rather large alveolar structures. Sometimes there are small cystic formations filled with basophilic contents.

Essential elements: 1. alveolar tumor structures

2. cystic formations

№ 160. Adenocarcinoma of the salivary gland

In the connective tissue, growths of tumor polymorphic glands are determined. Gland-forming cells are cuboidal, cylindrical, irregularly shaped with hyperchromic nuclei. In the lumen of the glands, basophilic or oxyphilic contents. There are lymphohistiocytic infiltrates in the tumor stroma.

Essential elements: 1. polymorphic glands

2. polymorphic cells

3. lymphohistiocytic infiltrates

No. 161. Ameloblastoma

Tumor of the nest structure. On the periphery of the nests, high cylindrical cells are located in a palisade, and as they approach the center, they loosen more and more, become stellate and form an epithelial reticulum, in which cavities are visible. Homogeneous masses lie in the center of some nest formations.

Essential elements: 1. nested structures

2. columnar epithelium

3. epithelial reticulum

No. 162. Malignant ameloblastoma

The tumor is represented by islets or follicles of epithelial cells located in the connective tissue. The central sections of the follicles consist of polygonal cells resembling the pulp of a dental organ. At a higher magnification, it can be seen that the epithelial cells that form follicles are hyperchromic, polymorphic, in some of them mitoses, including atypical ones, are determined.

Essential elements: 1. epithelial tumor follicles

2. cellular polymorphism

3. mitoses in epithelial cells

No. 163. Cementoma

The tumor consists of cellular-fibrous connective tissue, in which intensely calcified, rounded or lobular cement-like masses - cementicles - are located in purple. Cementicles are mostly isolated, but some merge with each other.

Essential elements: 1. connective tissue

2. cementicle

№ 164. Abrikosov's tumor

The tumor consists of large cells, their nuclei are rounded and located centrally. Cytoplasm stained in pale pink. At higher magnification, the granularity of the cytoplasm is noted. The grains in the cell are dispersed evenly. The stroma in the tumor is poorly represented. Delicate fibrous structures surround small complexes of tumor cells, forming cells.

Essential elements: 1. tumor cell complexes

2. grains in the cytoplasm of tumor cells

№ 165. Osteoblastoclastoma

The tumor consists of elongated cells with a round or oval nucleus, among which are located multinucleated giant cells - osteoclasts. In the tumor, newly formed bone beams are visible, which are surrounded by mononuclear cells - osteoblasts.

Essential elements: 1. giant cells - osteoclasts

2. bone beams

3. osteoblasts

№ 166. Osteoma of the jaw bones

At low magnification, the tumor is represented by a solid bone mass of fibrous and lamellar structure with very narrow vascular channels. At higher magnification, moderate cellular polymorphism is noted.

Essential elements: 1. fibrous bone mass

2. bone mass of lamellar structure

3. narrow vascular channels

4. tumor cells

№ 167. Brain in leukemia

In the brain, foci of leukemic infiltration are clearly identified, surrounded by a zone of diapedetic hemorrhages. At a higher magnification, myeloid-like low-differentiated cells of a round shape are determined, the nuclei of which are poor in chromatin.

In the brain, there is a picture of pericellular and perivascular edema.

Essential elements: 1. leukemic infiltrate

2. hemorrhage

№ 168. Myocardium in leukemia

The structure of the myocardium and endocardium is preserved. In the myocardial stroma and in the thickness of the endocardium, there are leukemic infiltrates from poorly differentiated cells. At a higher magnification, the infiltrates consist of myeloid, poorly differentiated cells. Their nuclei are large, irregular in shape, the rim of the cytoplasm is narrow.

Essential elements: 1. leukemic infiltrates in the myocardial stroma

2. leukemic infiltrates in the endocardium

3. tumor polymorphic cells

№ 169. Lymph node in leukemia

The follicular structure of the lymph node is changed due to the proliferation of round small cells. At higher magnification, small cells with a hyperchromic nucleus are determined; almost completely occupying the cytoplasm. They resemble lymphocytes. Similar cells are also seen in the capsule of the lymph node and the surrounding fatty tissue.

Essential elements: 1. lymphocyte-like elements

№ 170. Bone marrow of the tubular bone of an adult in the norm and in chronic myelogenous leukemia

There are two cuts in the preparation. In one of them, the bone marrow of the tubular bone of an adult is normal: the bone marrow cavities are filled with adipose tissue, there are no foci of hematopoiesis. In another section, the medullary cavities are enlarged, the bone beams are thinned. In the bone marrow spaces diffuse growth of tumor immature and mature cells of the granulocytic series, megakaryocytes and a small amount of fat cells are determined.

Essential elements: 1. diffuse infiltrates of mature and immature granulocytes

2. megakaryocytes

3. atrophic bone beams

№ 171. Liver with myeloid leukemia

At low magnification, it can be seen that the structure of the liver is erased due to diffuse infiltration by tumor cells. At higher magnification, their pronounced polymorphism is visible: some of the cells are large, with a bean-shaped nucleus and granular chromatin. In other cells, the nuclei are weakly segmented, they resemble stab leukocytes in appearance. There are single marks with a segmented nucleus and eosinophilic cytoplasm. The surviving hepatocytes are atrophic, with granular cytoplasm, and contain a yellow-brown pigment, lipofuscin.

Essential elements: 1. polymorphic diffuse tumor proliferate

2. atrophic hepatocytes

№ 172. Leukemic infiltrates in the kidney with lymphocytic leukemia

The preparation contains a section of a kidney. The stroma shows diffuse and focal leukemic infiltrates from poorly differentiated cells. At a higher magnification, the infiltrates consist of blasts of lymphocellular origin, which are characterized by a high nuclear-cytoplasmic ratio.

Essential elements: 1. leukemic infiltrates in the stroma

2. blast cells

No. 173. Plasmacytoma

In the histological section, diffusely overgrown plasma cells of various types are determined. Basically, they contain dark-colored eccentrically located nuclei and rather abundant basophilic cytoplasm. Nuclei with fine chromatin structure and pale cytoplasm are visible.

Essential elements: 1. Plasma cell fields

№ 174. Lymphogranulomatosis

The structure of the lymph node is lost, lymph follicles are absent, fields of sclerosis are visible. At higher magnification, large basophilic cells with a large hyperchromic nucleus are determined - Hodgkin cells; giant cells with a central location of two or more nuclei - Berezovsky-Sternberg cells; eosinophils; reticular and lymphoid cells, neutrophils. There are foci of necrosis.

Essential elements: 1. Hodgkin cells

2. Berezovsky-Sternberg cells

3. eosinophils

4. foci of necrosis

5. fields of sclerosis

No. 175. Lipoidosis and liposclerosis of the aorta.

Hematoxylin + Sudan III staining

In the preparation is a section of the aorta. In the place of thickening of the intima, deposits of lipoids in the form of grains and clumps of yellowish-orange color are visible - lipoidosis. The intima at the site of deposition of lipoids is thickened due to overgrown connective tissue - liposclerosis. At higher magnification, it is noted that Lipoids are located in the interstitial substance and in the cytoplasm of cells (xanthoma cells).

Essential elements: 1. lipoids in the interstitial substance of the intima

2. intimal sclerosis

3. xanthoma cells

№ 176. Atheromatous plaque in the aorta
Coloring according to van Gieson.

In the preparation, a transverse section of the aorta. The inner layer of the aorta (intima) has a plaque-like thickening that bulges into the lumen. From the surface, the plaque is covered with connective tissue (fibrous cap), and in the underlying sections, an unstructured mass of atheromatosis and transparent, needle-shaped cholesterol crystals are visible. At a higher magnification - in some places on the periphery of the detritus lie xanthoma cells - large cells with a light foamy cytoplasm.

Essential elements: 1. plaque cover

2. atheromatous mass

3. cholesterol crystals

4. xanthoma cells

№ 177. Vessels of the brain in arterial hypertension

In the preparation, a section of the brain. Arterioles have a narrow lumen and thickened walls. Layers are not defined. When stained with hematoxylin and eosin, the wall of the arterioles is homogeneous, pink. When stained according to van Gieson, the wall is yellow-pink: overgrown fibrous tissue of pink color and structureless yellow masses (hyalinosis) are visible. The endothelium in the vessels is preserved.

Essential elements: 1. hyalinized walls of arterioles

2. overgrown connective tissue in the wall of arterioles

№ 178. The brain in hypertensive crisis

In the preparation, a section of the brain. Corrugation and destruction of the basement membrane of the endothelium of the arterioles and a peculiar arrangement of its nuclei in the form of a palisade are noted, which is an expression of spasm. The wall of the arterioles is thickened, homogeneous, pale, the structure is erased. Sometimes visible proliferation of adventitia cells and glial elements of the brain tissue. In the walls of other arterioles, areas of intense pink color, structureless, slightly granular are determined - fibrinoid necrosis. Around the vessels, glial and ganglion cells, a light rim is edema. Focal accumulations of erythrocytes are located in the brain tissue.

Essential elements: 1. Plasma impregnation of arteriole walls

2. fibrinoid necrosis of arteriole walls
3. swelling

4. hyalinized walls of arterioles

5. diapedetic hemorrhages

№ 179. Arternosclerosis of the kidney

Coloring according to Gizon wines + according to Gornovsky.

The surface of the kidney is uneven, wavy. Under the capsule, in places of retraction, the glomeruli are sclerotic, small and pink, the tubules are collapsed and close together (atrophy). Large glomeruli and tubules (hypertrophy) are visible in places of swelling under the capsule. The walls of the arteries of the muscular type are significantly thickened, their lumen is narrowed. In the stand of such vessels there are many black elastic fibers (hyperelastosis), smooth muscle cells and connective tissue (myofibrosis).

Essential elements: 1. sclerosed glomeruli

2. hypertrophied glomeruli

3. arterial hyperelastosis

4. arterial myofibrosis

№ 180. Recurrent myocardial infarction

In the myocardium, areas of necrosis of an irregular shape, pink in color, are determined. They show the contours of cardiomyocytes and nuclear dust. Around infarctions are plethoric vessels and round cell infiltrates (demarcation shaft). In other areas of the myocardium, granulation tissue formed at the site of dead muscle cells.

Essential elements: 1. site of necrosis

2. demarcation zone

3. granulation tissue

№ 181. Progressive cardiosclerosis

In the Myocardium, there are foci of necrobiosis and necrosis of cardiomyocytes, areas of granulation and mature connective tissue, round cell infiltrates, full-blooded vessels.

Essential elements: 1. Foci of necrobiosis of cardiomyocytes

2. Foci of necrosis of cardiomyocytes

3. areas of granulation tissue

4. areas of connective tissue

№ 182. Myocarditis Abramov-Fiedler

In the myocardium, uneven blood supply, foci of "devastation" (necrosis). In the cytoplasm of cardiomyocytes, a weak transverse striation is noted. At the ends of individual muscle cells there are flask-shaped swellings containing 2-3 nuclei - “muscle buds”. The stroma is loose (edematous), infiltrated by plasma cells, lymphocytes, eosinophils, macrophages.

Essential elements: 1. Foci of myocardial devastation

2. "muscle kidneys"

3. loose (edematous) stroma

4. plasma cells

5. lymphocytes

6. eosinophils

№ 183. Diffuse endocarditis (Talalaev's valvulitis)

The leaflet of the mitral valve on the transverse section is unevenly thickened and is mainly defibrated due to edema. Focal basophilia is noted - places of disorganization and accumulation of acid mucopolysaccharides. At higher magnification, the endothelium covering the valve leaf is preserved.

Essential elements: 1. areas of defibration

2. foci of basophilia

3. preserved endothelium

№ 184. Acute warty endocarditis

On the transverse section of the leaflet of the mitral valve, its uneven thickening is noticeable. Warty deposits of fibrin of intense pink color are visible on the surface. At higher magnification, there is a violation of the integrity of the endothelium at the site of fibrin deposition. In the thickness of the valve leaflet, accumulations of histiocytes and fibrinoid necrosis (unstructured pink mass).

Essential elements: 1. fibrin deposits (wart)

2. accumulations of histiocytes

3. defect in the endothelial lining

№ 185. Recurrent warty endocarditis

In the preparation, the leaflet of the mitral valve in the section with part of the atrium and ventricle. In the distal section, the valve leaflet is club-shaped thickened, with a warty overlay of fibrin of intense pink color. A club-shaped thickening is an organized fibrinous mass, where bundles of collagen fibers and newly formed vessels are visible. Fresh foci of disorganization are basophilic. Areas of fibrinoid necrosis are structureless and pink in color are visible in the thickness of the organized wart. On the surface of the wart, there are fresh deposits of fibrin, and in its thickness there are accumulations of histiocytes.

Essential elements: 1. organized wart

2. fibrin deposits

3. newly formed vessels

4. accumulation of histiocytes

№ 186 Sclerotic valve in rheumatic heart disease

Cancer of the lymph nodes or lymphoma is the most dangerous pathological process in which the formation of malignant neoplasms in the lymph nodes occurs. The oncological process affects the lymphatic system as a whole, and tumors can form in any regional lymph nodes. To counter this type of oncology, it is necessary to consult a doctor in a timely manner, diagnose and start treatment as soon as possible.

The photo shows the lymphatic system and the defeat of the lymph node by a cancerous tumor.

Lymph nodes are peripheral organs of the lymphatic system that act as a filter in our body. Through the aforementioned nodes flows all the lymph coming from the organs and various parts of the body. At the same time, individual lymph nodes are responsible for filtering certain lymph flows, therefore they are called regional. Such nodes are located in the groin, neck, etc.

Lymph is a biological fluid that flushes out products from the tissues of the body and stimulates the production of immune bodies. According to its physical characteristics, it is transparent, contains special blood cells - lymphocytes, the mutation of which increases the likelihood of formation.

The purpose of the lymphatic system is to protect the body from the development of infections of any type. Passing through the lymph, the lymph nodes trap bacteria, pathogenic microorganisms and atypical cells, neutralize them, increasing immunity. In a healthy person, lymphocytes are responsible for eliminating inflammation, blocking the development of the disease. With oncology, the reverse process starts and a change in the composition of the blood begins.

Scientists have proven that periodically atypical cells appear in every person. They enter the system with the lymph flow and pass through the capillaries. They are detained by sentinel lymph nodes, which are located in close proximity to the organ affected by cancer. Sometimes such cells are destroyed by the immune system on their own, thereby stopping the possible development of cancer.

The main feature of the development of cancer of the lymph nodes is that all dangerous processes are concentrated in the lymphatic system, and metastasis to organs begins in the later stages. Cancer of the lymph nodes develops faster than other types of oncology, because the immune system is completely destroyed and cannot contain the disease. The prognosis of survival depends on the type of disease and the causes of its occurrence.

Types and classification of cancer of the lymph nodes

Diagnosis of cancer of the lymph nodes helps to identify the main types of this dangerous disease:

1. or Hodgkin's disease. It occurs in 11% of all patients who were admitted with suspected lymph node damage by cancer cells. This rare species accounts for 25–30%.
2. . An extended group that includes more than 30 types of disease. Some of them were diagnosed relatively recently, so they are being actively studied and do not have a clearly defined treatment strategy.

The prognosis for cancer of the lymph nodes largely depends on the type of tumor identified as a result of the tests. Atypical cells react differently to drugs and hormones. Age, concomitant pathologies of internal organs, genetic predisposition and heredity matter. No doctor can predict the behavior of an oncotumor, even if he has all the information about the patient.

Cancer of the lymph nodes can be classified according to the degree of spread:

1. Limited - inflammation begins in 1 or 2 nodes located along the same network of capillaries.
2. Common - more than 2 lymph nodes in different parts of the body are involved in the process.
3. Generalized - cancer cells can be detected in each node.

According to the type of damage to blood cells, doctors divide cancer of the lymph nodes into 2 types:

1. B-cell (B-lymphocytes are reborn);
2. T-cell (T-lymphocytes are affected).

Hodgkin's lymphoma is also distinguished by a large number of morphological types, each of which requires special treatment and selection of drugs:

• modular;
• classical with the development of sclerosis of the spinal cord;
• classical with lymphoid predominance;
• mixed cell;
• classic with lymphoid depletion.

The survival rate for classic forms of Hodgkin's lymphoma is quite high. The tumor responds well to treatment, especially subtypes with nodular sclerosis. The mixed cell type is almost always detected against the background of the active stage of AIDS.

Non-Hodgkins have the most pessimistic outlook. With these types, symptoms of damage to the digestive organs, hematopoiesis, and the excretory system are observed. In most cases, generalized lymphoma provokes dysfunction of the spinal cord and the development of leukemia in the spinal column.

The defeat of the lymph nodes in different localizations of cancer

Doctors warn that the symptoms of lymph node cancer rarely appear at an early stage, and the disease itself begins to develop in any part of the body. Therefore, if a person has inflamed lymph nodes and swelling persists for more than a month, it is necessary to see a specialist and do the necessary tests, biopsy the inflamed lymph nodes.

More than 25% of primary malignant processes in cancer are diagnosed in the lymph nodes located near and. With late treatment, oncology also affects the patient's organ itself, so the complaint of a digestive disorder is more often the reason for treatment. This late diagnosis has a negative impact on survival.

In addition to the peripheral organs of the lymphatic system mentioned above, the lymph nodes that are located near the following organs are affected, which corresponds to such types of cancer:

• oncology - axillary or affected;
• - para-aortic and retroperitoneal lymph nodes;
• and - lymph nodes along the abdominal aorta;
• - axillary and supraclavicular lymph nodes.

From the point of view of identifying developing oncology, it is easiest to diagnose. This is explained by the fact that the lymph nodes of this localization are most easily palpated, and even the patient himself notices their increase, because even a banal turn of the head is accompanied by discomfort.

Cancer of the lymph nodes in women often occurs after the appearance of primary foci in the breast, ovaries or uterus. Sometimes this is a consequence of metastasis with damage to the cervix or neoplasms of the vagina. Enlarged lymph nodes are localized in the pelvic area, inguinal folds.

With Hodgkin's lymphoma, in 80% of cases, an increase in lymph nodes occurs in the occipital region, the chin or collarbone, behind the patient's ears. The second most common area is the armpit. With a generalized form of the disease of the entire system, swelling is observed in several places at once.

What do lymph nodes look like in cancer? They retain their rounded shape, but noticeably increase in volume, exceeding the original parameters up to 10 times. Of course, the increase occurs gradually, as the pathological process progresses. In this case, the affected lymph nodes are not only enlarged, pressure on them is accompanied by painful sensations, and the mobility of the lymph nodes may be lost. At the last stage, necrosis and destruction of the peripheral organs of the lymphatic system begins.

Causes of cancer of the lymph nodes

In most cases, the causes of lymph node cancer are hidden in the presence of autoimmune diseases in patients. They can be congenital or acquired, but they equally affect the human immune system, disrupt the production of protective antibodies and blood cells responsible for protecting against infection. Predisposing factors are infection with HIV or Epstein-Barr viruses.

Suppression of the lymphatic system and the development of cancer can cause the following problems:

• long-term work with pesticides;
• living in conditions of a high degree of environmental pollution;
• age-related decline in immune cell production in the elderly;
• first birth in a woman after 35 years;
• exposure;
• smoking;
• genetic predisposition to the appearance of a malignant tumor.

As a result of many years of observation, doctors confirmed that cancer of the lymph nodes develops mainly in the age range of 15–30 years and after 55 years. This may be due to hormonal imbalances, hormonal fluctuations in young people, and menopause in older women.

Symptoms of lymph node damage in cancer

The main problem of the disease is the long absence of the first symptoms of cancer of the lymph nodes. It is especially difficult to suspect a problem if internal lymph nodes in the abdominal cavity or retroperitoneal space are affected, which cannot be detected by palpation.

It is also important to understand that the clinical picture varies depending on which lymph nodes are affected:

• cervical and supraclavicular - an increase in volume, compaction, pain on palpation, tilting and turning the head. In the later stages, several lymph nodes of the indicated localization can grow together, due to which they lose their mobility;
• axillary - there is also an increase in size, painful sensations are manifested by movements of the hands, their intensity increases with exertion and squeezing;
• inguinal - the symptoms are similar to the defeat of the lymph nodes mentioned above, only localization changes;
• mediastinal nodes - shortness of breath, frequent and prolonged dry cough, another characteristic symptom - swelling of the veins in the neck. There is also pain in the retrosternal region, and a vascular network appears on the skin in the sternum;
• damage to the nodes near the aorta - the pain syndrome is localized in the lumbar region, aggravated at night.

The clinical picture also includes general symptoms, including:

• temperature rise to subfebrile indicators;
• constant fatigue;
• drowsiness;
• weight loss;
• loss of appetite.

Often, patients attribute such symptoms to chronic fatigue, work overload. With the development of cancer in the lymph nodes, a blood test may show anemia. Sometimes there are specific signs associated with damage to internal organs (stomach pain, bleeding from the intestines, yellow skin tone).

Stages of development and classification of cancer

Doctors use the international TNM system, which is based on the number and location of inflamed lymph nodes:

• T (from lat. Tumor - tumor) - indicates the volume and size of the neoplasm, it is considered on a scale from 0 to 4.

1. TX - primary tumor not assessed;
2. T0 - data on the presence of a primary tumor are absent;
3. Tis - carcinoma in situ;
4. T1-T4 - an increase in the size and / or prevalence of the primary tumor.

• N (from lat. Nodus - node) - determines the presence of metastasis in human lymph nodes. The generalized form is indicated by the indicator N3.

1. NX - regional lymph nodes not assessed;
2. N0 - no metastases in regional lymph nodes;
3. N1-N3 - an increase in the degree of involvement of regional lymph nodes.

• M (from lat. Metastasis - movement) - indicates the presence of distant metastases in other organs of the patient.

1. M0 - distant metastases are absent;
2. M1 - distant metastases are present.

The stages of cancer of the lymph nodes are conditionally divided depending on the spread of the oncological process and the onset of metastasis:

• At stage 1, the tumor is difficult to determine due to its small size. Only one node is involved in the process (sometimes 2 if they are close) or an organ, there are no metastases.
• At stage 2, tumors are found in nearby lymph nodes and the diaphragm. The organ loses its efficiency, the first symptoms appear, there are single metastases (no more than 3-4).
• At stage 3, atypical cells are found in symmetrically located lymph nodes, the symptoms become more pronounced, the digestion process is disturbed, and a cough appears. Pain appears with cancer of the lymph nodes located near the nerve plexuses. There is multiple metastasis in adjacent tissues.
• At stage 4, nodes in each part of the body are affected and enlarged, bleeding, pain, and breathing problems are observed. The process of metastasis affects distant lymph nodes, metastases are found in various tissues and organs of the body. Treatment is highly complex.

It is possible to accurately determine the stage only after a series of examinations and analyzes.

What does the diagnosis of lymph node cancer include?

Begins with a patient interview. Any complaints present in the patient, past or current diseases, genetic predisposition - all this will help the specialist in conducting high-quality diagnostics and choosing a successful treatment.

After the survey, a total examination is performed, which implies palpation of the main lymph nodes. This method should be considered simple and, at the same time, the most informative test.

After a visual examination and palpation of the lymph nodes, the patient will have to undergo a series of procedures:

• Ultrasound of the digestive organs;
• CT of bone tissue;
• MRI with the addition of a contrast agent, which helps to identify metastases in the lymph nodes;
• blood tests.

Also, patients need to be tested for a number of. When conducting a biopsy, the doctor can identify the type of cells, small cell or papillary cancer of the lymph nodes, and what is necessary for the correct selection of treatment tactics.

What does lymph node cancer treatment include?

The most effective way to get rid of cancer of the lymph nodes at the initial stage of development is the removal of the lymph nodes. The surgeon excised not only the lymph nodes affected by oncology, but also located nearby, which may contain tumor cells and subsequently give a relapse. After healing of the sutures and normalization of the patient's condition, further treatment is selected.

Chemotherapy for cancer of the lymph nodes is one of the highest quality methods of treatment. The oncologist can change treatments on the fly, adding or removing drugs if there is no response. Hodgkin's lymphoma is well treated with cytotoxic chemotherapy, which inhibits the growth of new lesions. Despite the large number of side effects, special poisons help get rid of the disease. Doctors resort to this method at any stage of the progression of the pathological process.

Radiation therapy for cancer of the lymph nodes is especially effective at stages 3-4, but at the discretion of the doctor, earlier stages 1 and 2 can also be used. The patient is exposed to radiation when neoplasms are detected in the internal organs, which are well visualized on CT. With the help of dosed irradiation of the inflamed area, the growth of oncogenic cells and metastases stops, the tumor decreases in size. Depending on the situation, the technique is recommended both before and after the operation at the site of tumor removal. In the second case, irradiation reduces the likelihood of recurrence of the disease.

In the early stages of oncology, donor bone marrow transplantation can achieve a good result.

Recently, a technique has also been developed for transplanting lymph nodes from a healthy donor. Such an operation for cancer of the lymph nodes is simply necessary if the cause of rebirth is not clear. The unique transplantation has already shown positive results in the form of a significant increase in immunity, elimination of swelling and improvement of the patient's well-being.

Metastasis and recurrence of cancer of the lymph nodes

One of the most dangerous conditions is the recurrence of cancer of the lymph nodes. On average, it develops in 5–7 years against the background of continuous maintenance therapy in 30–40% of patients. At risk are people with bad habits, malnutrition, living in a stressful mode.

Even the right treatment does not guarantee a complete recovery. At stages 3-4, cells actively move through the vessels of the lymphatic system, settle in the internal organs, and provoke the growth of secondary neoplasms - metastases. Sometimes, with a biopsy, they show a mixed type of oncology, a combination of several types of atypical tissues. Therefore, doctors recommend strictly adhering to the therapeutic regimen, not ignoring regular CT scans, and donating blood for tumor markers in a timely manner.

How long do patients with cancer of the lymph nodes live?

The prognosis of life depends on several factors:

• patient's age;
• process steps;
• degree of damage to internal organs;
• blood quality;
• the presence of diseases that complicate treatment (HIV, hepatitis C, diabetes mellitus).

With the initial treatment at stages 1–2, the survival rate reaches 82–85%. The indicator is calculated on the basis of observations of the patient for 5 years. If cancer is found with metastases to the lymph nodes, the prognosis is less favorable: from 45 to 63% over 5 years. The most positive effect of treatment is given by Hodgkin's lymphoma with a complex combination of chemotherapy and radiation therapy.

Informative video