23. Pathology of nodal and bone marrow metastasis

Question 1

Likely primary site of metastasis in inguinal node

Answer 1

• anything that drains the lower half of the gut

- melanoma of skin of lower limb

Question 2

Likely primary site of metastasis in supraclavicular node

Answer 2

• upper GIT carcinoma

- bronchogenic carcinoma

Question 3

Likely primary site of metastasis in cervical node

Answer 3

• nasopharyngeal carcinoma
• oropharyngeal carcinoma
• head and neck carcinoma

Question 4

Likely primary site of metastasis in axillary node

Answer 4

breast carcinoma

Question 5

Histological features that help identify the type of malignancy in a node

Answer 5

1. carcinoma
   - keratin (squamous cell carcinoma)
   - mucin (adenocarcinoma)
   - tubules (adenocarcinoma)

Question 6

Likely primary site of squamous cell carcinoma

Answer 6

lungs, mouth, oropharynx, cervix

Question 7

Likely primary site of melanoma

Answer 7

skin, anus, retina

Question 8

Tumour markers for

a) Epithelial
b) Mesenchymal
c) Lymphoid
d) Melanoma

Answer 8

a) cytokeratin
b) vimentin
c) CD45
d) S100P nad HMB45

Question 9

Stains in recognising metastases

Answer 9

1. reticulin
2. periofic acid-Schiff stain (PAS)
3. Alcian blue - PAS