Frequency distribution of plasma cells in the medullary cords of tumour-draining axillary and paracolic lymph nodes.

Abstract

Five hundred and ninety-seven axillary lymph nodes draining 104 invasive ductal breast cancers, and 94 paracolic lymph nodes draining 30 invasive adenocarcinomas of the large bowel were investigated immunohistologically to determine the frequency distribution of plasma cells (PC) in the medullary cords (MC). The degree of plasmacytic infiltration was calculated semiquantitatively using the 3-grade scale (0/+, + +, + + +) of Cottier et al. (1973). Statistical analysis yielded the following results: While a marked reactive plasmacytosis (+ + +) was seen in 28.7% of the paracolic lymph nodes, only 1.5% of the axillary lymph nodes exhibited a comparable degree of plasmacytic infiltration (p less than 0.0001). Conversely, low PC counts (0/+) were encountered in 51.1% of the paracolic lymph nodes, but in 83.9% of the axillary lymph nodes. A comparison of axillary lymph nodes with and without nodal metastasation revealed no significant differences (nodal-negative cases: 0/+: 83.6%, + +: 14.3%, + + +: 2.1%; nodal-positive cases: 0/+: 84.3%, + +: 14.9%, + + +: 0.8%). However, significantly more (p less tha 0.001) paracolic lymph nodes of the nodal-negative group revealed a marked plasmacytosis, whereas in the nodal-positive group lymph nodes with low PC counts were more frequent (nodal-negative cases: 0/+: 27.7%, + +: 29.7%, + + +: 42.6%; nodal-positive cases: 0/+ 74.5%, + +: 10.6%, + + +: 14.9%). The degree of plasmacytic reactions in the tumour-regional lymph nodes was not related to the stage of the primary tumour. Moreover, no correlation exists between the PC content of the MC and the amount of PC in metastatic deposits of the same lymph nodes. Altogether, these results do not support the concept that the plasmacytic reactions in the MC of tumour-draining lymph nodes are chiefly determined by effects (stimulating or suppressing) of the primary carcinomas. The topography of the lymph nodes, however, seems to be the main determinant influencing the PC content of MC.