DOI: https://doi.org/10.36347/sjams.2026.v14i11.005

Pages: 1269-1277

Background: There is still a controversy about the existence and nature of HLN in the human body since Gibbes found some structures forming lymph nodes with blood in sinuses instead of the lymph between the renal artery and vein in three human subjects in 1884. Methods: A total of 412 paraffin blocks of peritumoral lymph nodes were retrieved from 20 patients who had been surgically treated for digestive tract and breast cancers from June 1, 2021, to February 6, 2022. Histological sections were mounted on slides, hematoxylin and eosin staining was performed as a routine procedure, and immunohistochemical staining was performed using enzyme-linked immunosorbent assay kits. All slides were scanned using a slide scanner and observed using CaseViewer software. Twenty slides were observed using a confocal laser scanning microscope with a Leica Application Suite X. All data were collected and analyzed. Results: After 412 slides were observed, 334 were non-metastatic and 78 were metastatic. The phenomenon with characteristics of HLN was found in both non-metastatic (197 out of 334) and metastatic (18 out of 78) lymph nodes. Four pathological or histological types were identified based on the distribution characteristics of erythrocytes, macrophageerythrocyte-lymphocyte (MEL), and macrophage-lymphocyte (ML) rosettes in the dilated sinuses of the nodes. The detailed cellular features of the MEL and ML rosettes were determined. Binuclear macrophages, as well as binuclear, trinuclear, and tetranuclear lymphocytes, were detected in some lymph nodes. Conclusion: HLN were found in the peritumoral tissue of 20 cancer patients. The various histopathological and cytological changes of HLN were static manifestations of dynamic regeneration process of the degenerating lymph node in tumor immunity.