The lymph nodes of 32 patients operated on for carcinomas of the larynx and pharynx, were evaluated for the pattern of lymph node response. Pattern 1 (predominantly lymphocytes) and pattern 2 (predominantly germinal centres) showed a fewer number of nodal metastases than pattern 3 (non-stimulated nodes). Well-differentiated carcinomas predominated in patterns 1 and 2, whereas moderately and poorly differentiated predominated in pattern 3. Patterns 1 and 2 predominated in clinical stages I-III, and pattern 3 in stage IV. The survival decreased progressively from pattern 1 to pattern 3.