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Lymph Nodes and Lymphadenopathy in Cancer

Lymph nodes and the lymphatic system provide a critical
filtration process for the body that is important
for cancer staging and management.

What Are the Lymphatic System and Lymph Nodes?

Spread of cancer cells
Lymph nodes are kidney beanshaped organs that are arranged in Lymphatic system to lymph nodes
clusters around the body, concentrated around the neck, armpits, Enlarged
groin, and also up and down the middle portions of the chest and lymph
node
abdomen. Lymph nodes are connected to each other by lymphatic Lymph
nodes
channels. Lymphatic fluid drains from all of the tissues of the body Lymphatic
through lymphatic channels to nearby lymph nodes that serve as a Lymph drainage
vessels
form of a filter. When the immune system is activated, such as with
infections or cancer, immune cells within the lymphatic system
known as lymphocytes can multiply. This leads to enlargement of Tumor
1 or several lymph nodes, which is known as lymphadenopathy.
LUNG
Lymph Nodes and Lymphadenopathy
in Cancer Diagnosis and Staging Spleen
Enlarged lymph node
In a person with cancer, lymphadenopathy can occur when cancer cells may be visible and/or
travelthroughthefiltrationsystemoflymphaticvesselstolymphnodes. felt under the skin.
Cancercellscantravelthroughthelymphaticsystemtoanewsiteofcan-
cerapartfromthewheretheprimarycancerfirstdeveloped.Thedrain-
age pathway for a cancer follows a predictable pattern within the body.
Biopsy of a lymph node suspected of being
Lymphadenopathy can be detected either by being felt during affected by cancer may be obtained for
a physical examination, or by imaging studies, such as a computed diagnosis and for staging cancer severity.
tomographic (CT) scan. Enlarged lymph nodes may be biopsied to
look for cancer cells within them under a microscope. Compression of blood vessels, leading to an increased risk of a
Staging a cancer is a process of determining the size and ex- blood clot
tent of spread of a cancer from its initial location. In some cases, Compression of an airway, leading to difficulty breathing
lymph nodes from areas that are located near the main cancer may Obstruction of lymphatic drainage from a part of the body, lead-
be removed and carefully evaluated under a microscope to look for ing to swelling of that area
cancer cells. Detecting cancer cells in the lymph nodes means there Although systemic therapies can shrink enlarged lymph nodes
is a higher chance that cancer cells may have escaped into the blood along with other areas of cancer, radiation therapy to an area of bulky
stream as well, which means they are more likely to lead to spread lymphadenopathy will often lead to a more reliable and dramatic
of distant metastases to other parts of the body. shrinkage and improvement of related symptoms.
Though recommendations depend on the specific type of can-
cer, in general, when lymph nodes are involved, additional treat-
ment with radiation and/or chemotherapy are often recommended. FOR MORE INFORMATION
Lymphadenopathy
Cancer Complications Related to Lymphadenopathy http://emedicine.medscape.com/article/956340-overview
Enlarged lymph nodes may lead to several complications: (free registration required)
Pain
Lymphadenopathy
Hoarseness or cough for lymphadenopathy in the chest http://www.drugs.com/cg/lymphadenopathy.html
Numbness and tingling for lymphadenopathy affecting the spinal
cord or nerves coming out of it

Authors: Howard West, MD; Jill Jin, MD, MPH
Published Online: May 19, 2016. doi:10.1001/jamaoncol.2015.3509.
Conflict of Interest Disclosures: None reported.
Section Editor: Howard (Jack) West, MD.
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