Sentinel lymph node

Pfutzner, W. et al.. Intraoperative labeling of sentinel lymph nodes with a combination of vital dye and radionuclide tracer results in sentinel lymph node-positive patients, J. Deutsch. Dermatol. Ges., 4, 229, 2006. 

Local therapy of early-stage breast cancer consists of modified radical mastectomy or lumpectomy plus external-beam radiation therapy. The surgical approach to the ipsilateral axilla may consist of a full level I/II axillary lymph node dissection or a lymph node mapping procedure with sentinel lymph node biopsy. 

For patients with melanomas that are at risk of spreading to the lymph nodes, a sentinel lymph node (SLN) biopsy is performed. The SLN, the first lymph node to receive lymph draining from the tumor, is identified by injecting a radioactive material, technetium-99m-labeled radiocolloids, and vital... 

Melanoma Thickness Margin of Excision Sentinel Lymph Node Biopsy... 

Jylling AMB, Lindebjerg J, Nielsen L, et al. Immunohistochemistry on frozen section of sentinel lymph nodes in breast cancer with improved morphology and blocking of endogenous peroxidase. Appl. Immunohistochem. Mol. Morphol. 2008 16 482-484. 

Axillary lymph nodes should be sampled for staging and prognostic information. Lymphatic mapping with sentinel lymph node biopsy is a new, less invasive alternative to axillary dissection however, the procedure is controversial because of the lack of long-term data. 

Rapid immunohistochemical study of frozen sections is necessary for intraoperative diagnosis in some cases. Rapid immunostaining is also helpful in confirming or excluding tumor clearance in resection margins or in detecting micrometastases in sentinel lymph nodes in breast cancer patients. Two methods to immunostain frozen sections are the enhanced polymer one-step staining (EPOS) system and the EnVision system both systems are detailed later. 

Kim S, Lim YT, Soltesz EG, De Grand AM, Lee J, Nakayama A, Parker JA, Mihaljevic T, Laurence RG, Dor DM, Cohn LH, Bawendi MG, Frangioni JV. Near-infrared fluorescent type II quantum dots for sentinel lymph node mapping. Nature Biotechnology 2004, 22, 93-97. 

Hsueh EC, Hansen N, GiuUano A. Intraoperative lymphatic mapping and sentinel lymph node dissection in breast cancer. CA Cancer J CUn 2000 50 279-291. 

Sentinel" Lymph Node Biopsies for Metastatic Melanoma 196... 

SENTINEL LYMPH NODE BIOPSIES FOR METASTATIC MELANOMA ... 

Yu LL, Flotte TJ, Tanabe KK, et al. Detection of microscopic melanoma metastases in sentinel lymph nodes. Cancer. 1999 86 617-627. 

Pellegrino D, Beilina CR, Manca G, et al. Detection of melanoma cells in peripheral blood and sentinel lymph nodes by RT-PCR analysis a comparative study with immunohistochemistry. Tumori. 2000 86 336-338. 

Prieto VG, Clark SH. Processing of sentinel lymph nodes for detection of metastatic melanoma. Ann Diagn Pathol. 2002 6 257-264. 

Spanknebel K, Coit DG, Bieligk SC, et al. Characterization of micrometastatic disease in melanoma sentinel lymph nodes by enhanced pathology recommendations for standardizing pathologic analysis. Am J Surg Pathol. 2005 29 305-317. 

Shidham VB, Komorowski R, Macias V, et al. Optimization of an immunostaining protocol for the rapid intraoperative evaluation of melanoma sentinel lymph node imprint smears with the MCW melanoma cocktail . Cytojournal. 2004 1 2. 

Wick MR. Principles of evidence-based medicine as applied to sentinel lymph node biopsies. Pathol Case Rev. 2008 13 102-108. 

Medalie N, Ackerman AB. Sentinel lymph node biopsy has no benefit for patients with primary cutaneous melanoma an assertion based on comprehensive, critical analysis. 2nd ed. New York Ardor Scribendi Press 2004 1-95. 

Abrahamsen HN, Hamilton-Dutoit SJ, Larsen J, et al. Sentinel lymph nodes in malignant melanoma extended histopathologic evaluation improves diagnostic precision. Cancer. 2004 100 1683-1691. 

Xu X, Roberts SA, Pasha TL, Zhang PJ. Undesirable cytokeratin immunoreactivity of native nonepithelial cells in sentinel lymph nodes from patients with breast carcinoma. Arch Pathol Lab Med. 2000 124 1310-1313. 

Detection of metastatic disease may occasionally require the use of immunohistochemical stains in challenging specimens such as postradiation lymph nodes. Subtle post-treatment residual tumors can be detected clinically using PET/CT scans, but histologically these isolated foci may show only granulomatous or necrotic tissue without viable tumor. In these cases, cytokeratin stains can be helpful to identify the etiology of the necrotic deposits. Sentinel lymph node examinations are occasionally used in head and neck surgery. Currently no standard practice for using immunohistochemistry to examine the sentinel lymph nodes exists, and indeed the procedure is fairly unreliable for mucosally based tumors. 

Lymph Node Metastasis and Sentinel Lymph Node Evaluation... 

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