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Involvement of the cervical lymph nodes with metastatic cancer is the single most important prognostic factor in head and neck squamous cell carcinoma and may be associated with a halving of survival. Where the cancer has penetrated the capsule of the lymph gland (extracapsular extension) survival may be decreased by a further 50%.
Lymph nodes may become enlarged in malignant disease. This cervical lymphadenopathy may be reactive or metastatic. [1] Alternatively, enlarged lymph nodes may represent a primary malignancy of the lymphatic system itself, such as lymphoma (both Hodgkin's and non-Hodgkin's), [6] lymphocytic leukemia, [1] Lymphadenopathy that lasts less than two weeks or more than one year with no progressive ...
Due to the genetic differences within and between tumours, biomarkers that may predict treatment response or prognosis may not be widely applicable. However, it has been suggested that the level of heterogeneity can itself be used as a biomarker since more heterogeneous tumours may be more likely to contain treatment-resistant subclones. [31]
[3] [13] [14] Diagnosis, if enlarged lymph nodes are present, is usually by lymph node biopsy. [1] [2] Blood, urine, and bone marrow testing may also be useful in the diagnosis. [2] Medical imaging may then be done to determine if and where the cancer has spread. [1] [2] Lymphoma most often spreads to the lungs, liver, and brain. [1] [2]
Radiotherapy is the use of radiation to eradicate cancer. [2] As the electron beams in radiotherapy only penetrate to the level of the dermis, it is a common method of treatment for skin lymphoma which may only occur locally such as Cutaneous T-cell lymphoma, however, it is not recommended for patients with systemic lymphoma conditions. [7]
Modified radical neck dissection. To describe the lymph nodes of the neck for neck dissection, the neck is divided into 6 areas called Levels. The levels are identified by Roman numeral, increasing towards the chest. A further Level VII to denote lymph node groups in the superior mediastinum is no longer used. Instead, lymph nodes in other non ...