Regional lymph node morphology in malignant melanomas and their prognostic value.

The occurrence of granulomatous epithelioid cell reaction, hyperplasia of lymphatic paracortex and existence of histiocytosis of the intermediary-medullary sinuses observed on sections of lymph nodes of 582 patients suffering from high-risk melanomas, examined during a ten-year period, have been established as reliable indicators of survival. On the other hand, lymphocytic infiltrative processes of the lymph node capsule, medullar plasmocytosis, and hyperplasia of germinal centres have been seen as indicators of a bad prognosis. Lymphocytic paracortical depletion and a predominance of postcapillary venules within the T zone were found to be less important in patients with a low chance of survival. We were able to establish a connection between lymphonodular parameters and the survival rate of the patients. In a multivariate test we found that there were four factors for statistical ascertainment of the prognosis of melanoma patients with lymphadenectomy: mitotic rate of primary tumour, lymphocytic infiltration of the lymph node capsule, existence of paracortical hyperplasia, and sex of the patient.