Lymph nodes > 1 cm in size are regarded as metastatic nodes. The surgical approach and potential application of neoadjuvant therapy regimens are dependent on this evaluation.
Lymph nodes measuring more than 1 cm in the short axis diameter are considered malignant. However, the size threshold does vary with anatomic site and underlying tumour type; e.g. in rectal cancer, lymph nodes larger than 5 mm are regarded as pathological.
All metastatic lymph nodes arise from primary tumors elsewhere in the body. Therefore, the cause of a metastatic lymph node is related to the cause of the primary tumor itself—a combination of genetic and environmental factors. The most common warning sign is an enlarging neck mass or lump.
Metastasis can be identified in lymph nodes as small as 1 mm. It is of note that 74% of lymph nodes larger than 10 mm were free of cancer (Table 1). All 18 patients with positive nodes measuring 1 or 2 mm had metastases in larger nodes.
Metastatic nodes tend to be round with a short to long axes ratio (S/L ratio) greater than 0.5, while reactive or benign lymph nodes are elliptical in shape (S/L ratio <0.5)18,,[35–37].
stage 3 – the cancer is larger and may have spread to the surrounding tissues and/or the lymph nodes (or "glands", part of the immune system) stage 4 – the cancer has spread from where it started to at least 1 other body organ, also known as "secondary" or "metastatic" cancer.
The survival rate often falls once cancer reaches the lymph nodes. According to the American Cancer Society , the survival rate for colon cancer is 91% if a person receives a diagnosis in the early stages. However, if cancer spreads to the lymph nodes, it drops to 72%.
Sometimes in leukemia or lymphoma, the disease is in an 'active' state and is producing lots of dysfunctional white blood cells. However, at times the disease can also 'slow down' and some of the cells can die. This can mean that the swollen lymph nodes can fluctuate in size, growing and shrinking over time.
Several noninvasive imaging modalities are currently used for the detection of metastasis in tumor-draining lymph nodes, including computed tomography (CT), magnetic resonance imaging (MRI), positron emission tomography (PET), single photon emission computed tomography (SPECT), and ultrasound (3–7).
Metastatic cancer occurs when cancer cells break off from the original tumor, enter your bloodstream or lymph system and spread to other areas of your body. Most metastatic cancers are manageable, but not curable. Treatment can ease your symptoms, slow cancer growth and improve your quality of life.
Metastatic lymph nodes are usually painless and thus, remain undetected by the patient until they reach considerable dimensions. Characteristically, these nodes are stony-hard and freely movable until the tumour cells penetrate the node capsule and invade the surrounding tissue.
Stage 4. Stage 4 is the most advanced stage of lymphoma. Lymphoma that has started in the lymph nodes and spread to at least one body organ outside the lymphatic system (for example, the lungs, liver, bone marrow or solid bones) is advanced lymphoma.
Surgery may be used to treat some forms of metastatic cancer that has spread to the lymph nodes. Other treatment options for cancer in the lymph nodes may include chemotherapy, radiation therapy, a stem cell transplant, immunotherapy or targeted therapy.
If the lymph node is cancerous, the rapidity with which the lump arises and grows depends on the type of lymphoma that is present. In rapidly growing lymphomas, lumps can appear in a matter of days or weeks; in slower-growing types, it can take months or even years.
Normal nodes are usually less than ½ inch (12 mm) across. This is the size of a pea or baked bean.
If your doctor thinks your swollen lymph nodes could be cancer, tests and imaging can confirm the diagnosis or point to something else. Based on where the cancer might be, you could get a chest X-ray, an ultrasound, a CT scan, or an MRI.
Computed Tomography (CT) Scans
A CT scan of the chest or abdomen can help detect an enlarged lymph node or cancers in the liver, pancreas, lungs, bones and spleen. The noninvasive test is also used to monitor a tumor's response to therapy or detect a return of cancer after treatment.
Typically, one or more of your lymph nodes will become hard or swollen. However, due to the variance of size and location of your lymph nodes, you might not even feel anything.
Swollen lymph nodes usually occur as a result of infection from bacteria or viruses. Rarely, swollen lymph nodes are caused by cancer.
Risk factors and associated cancers
Most cases of lymphadenopathy aren't caused by cancer. Malignancies are reported in as few as 1.1 percent of primary-care patients with swollen lymph nodes, according to a review in American Family Physician.
Overall, the 5-year survival rate for stage 4 Hodgkin lymphoma is 65 percent .
Undifferentiated-type carcinoma has a high incidence of lymph node metastasis. The independent risk factors for lymph node metastasis in undifferentiated-type carcinoma are invasion depth, tumor size, lymphovascular invasion, and presence of ulcer.
Lymphoma most often spreads to the liver, bone marrow, or lungs. Stage III-IV lymphomas are common, still very treatable, and often curable, depending on the NHL subtype.
Cancer that spreads from where it started to a distant part of the body is called metastatic cancer. For many types of cancer, it is also called stage IV (4) cancer. The process by which cancer cells spread to other parts of the body is called metastasis.