Cancer in the lymph nodes can be a result of two processes:
- The cancer starts in the lymph nodes, when it is called Primary lymph node cancer.
- The cancer starts elsewhere and spreads to the lymph nodes, a condition called Secondary cancer of the lymph nodes.
Primary lymph node cancer
In primary lymph node cancer, commonly known as lymphoma, the cells present in the lymph node become cancerous and proliferate excessively. The swollen lymph nodes are detected as painless hard lumps in the armpits, groin or the neck region. Lymphomas can be broadly classified into two groups:
- Hodgkin's lymphoma: A rare form of lymphoma usually seen in people between the ages of 15 and 35, Hodgkin's lymphoma is generally limited to a group of lymph nodes and is characterized by the presence of Reed-Sternberg cells in the biopsy tissue. There are five different sub-types of Hodgkin's lymphoma based on their pathological features.
- Non-Hodgkin's lymphoma: This type of lymphoma is far more common than Hodgkin's lymphoma and is usually seen in elderly people above the age of sixty. The tumor is widespread and involves multiple lymph nodes. Based on the cell type and the genetic arrangement, non-Hodgkin's lymphoma is further divided into 30 sub-types.
Some of the common signs and symptoms of lymphoma include pain in the abdomen, loss of appetite, progressive weight loss, night sweats, fever with chills, breathing difficulty, persistent cough and itchiness of the skin. Chemotherapy is the preferred modality of treatment for lymphomas.
Secondary cancer of the lymph nodes
Secondary cancer of the lymph nodes results when some cancerous cells break away from the primary tumor and are carried to the lymph nodes through the lymphatic ducts. As the cancer cells present in the lymph node belong to the primary tumor located elsewhere, they show the same characteristic features when examined under a microscope.
Depending upon the location and the number of lymph nodes involved, the nature of primary cancer can be determined. It also helps in determining the type of treatment required and the prognosis of the disease. When only the local nymph nodes are involved, it generally implies that the cancer is not very aggressive in nature or is in its early stage. Normally, surgery is the line of treatment for such types of cancer. During the surgery, the primary tumor is removed along with the lymph nodes in its vicinity. The prognosis of such types of cancer is generally good. However, if distant lymph nodes are involved, it shows that either the cancer is very aggressive in nature or has progressed to its late stages. Chemotherapy and radiation therapy are the treatment modalities preferred in such cases. The prognosis of such type of cancers is usually not very good.
Doctors use TNM classification for the staging of cancer, where T stands for tumor size, N stands for the number of lymph nodes involved and M stands for metastasis. A tumor which is very small in size with no lymph node involvement and no metastasis is assigned the value T1N0M0. The lower the values of T, N and M, the better the prognosis of the cancer is.
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