599 Intramammary Melanoma Micrometastasis Within A Silicone Implanted Breast

2021 ◽  
Vol 108 (Supplement_6) ◽  
Author(s):  
A Payne ◽  
T Welman ◽  
M Stodell
Keyword(s):  
Lymph Node ◽  
Lymph Nodes ◽  
Sentinel Node ◽  
Subcutaneous Fat ◽  
Lymphatic Drainage ◽  
Lymph Node Biopsy ◽  
Sentinel Lymph Nodes ◽  
Whole Body ◽  
Superficial Spreading ◽  
Implant Rupture

Abstract Case Summary Melanoma of the abdominal wall is not uncommon, and sentinel lymph nodes are usually located in the lymphatic drainage basins of the axilla or inguinal region. Less frequently, interval sentinel lymph nodes can be found along the lymphatic vessels between the primary cancer and nearest basin. We present the case of a 53-year-old female with silicone breast implants who underwent scar excision and sentinel lymph node biopsy for a 1mm Breslow thickness superficial spreading melanoma of the abdomen. Two lymph nodes were excised; both lying in the subcutaneous fat at the lateral aspect of the right breast capsule. Lymph node histology revealed a subcapsular melanoma deposit along with silicone lymphadenopathy in the sentinel node, and silicone lymphadenopathy in the second node. Whole body positron emission tomography (PET/CT) and magnetic resonance imaging (MRI) of the brain showed no evidence of metastases or implant rupture. Subsequent MRI breast revealed likely intracapsular implant rupture. The patient was offered removal of implants and remains under follow-up. The unusual location of the sentinel node in our patient highlights the possibility that previous breast augmentation may have altered the pattern of lymphatic drainage to the axilla. In addition, to our knowledge, this is the first reported case of silicone and melanoma deposits in a single sentinel node.

Cytologic Features of Lipogranulomatous Reaction in an Axillary Sentinel Lymph Node

2021 ◽  
pp. 1-4
Author(s):  
Jose Antonio Jimenez-Heffernan ◽  
Mariel Valdivia-Mazeyra ◽  
Patricia Muñoz-Hernández ◽  
Consuelo López-Elzaurdia
Keyword(s):  
Lymph Node ◽  
Sentinel Lymph Node ◽  
Sentinel Lymph Node Biopsy ◽  
Lymph Nodes ◽  
Breast Biopsy ◽  
Lymph Node Biopsy ◽  
Sentinel Lymph Nodes ◽  
Fat Necrosis ◽  
Histologic Analysis ◽  
Node Biopsy

Introduction: Multinucleated giant cells (MGC) are a rare finding when evaluating axillary sentinel lymph nodes. Some are described as foreign body-type MGC accompanied by foamy macrophages. They have been rarely reported in nodes from patients in which a previous breast biopsy was performed. The tissue damage induced by biopsy results in secondary changes including fat necrosis and hemorrhage that can migrate to axillary nodes. In this report, we illustrate a lipogranulomatous reaction in cytologic samples obtained during a sentinel lymph node examination of a woman previously biopsied because of breast carcinoma. We have found no previous cytologic descriptions and consider it an interesting finding that should be known to avoid diagnostic misinterpretations. Case: A 51-year-old woman underwent mastectomy of the right breast with a sentinel lymph node biopsy at our medical center. One month before, a control mammography revealed suspicious microcalcifications and a vacuum-assisted breast biopsy resulted in a diagnosis of high-grade intraductal carcinoma with comedonecrosis. Surgery with a sentinel lymph node biopsy was performed. The sentinel node was processed as an intraoperative consultation. Frozen sections and air-dried Diff-Quik stained samples were obtained. They showed abundant lymphocytes with MGC and tumoral cells. MGC showed ample cytoplasm with evident vacuoles of variable size. Occasional hemosiderin-laden macrophages were also present. The complete histologic analysis and immunohistochemical studies revealed no malignant cells. Histologic analysis showed, in subcapsular location, occasional MGC phagocyting lipid droplets. Hemosiderin-laden macrophages were a common finding. Conclusion: Lipogranulomas may appear at axillary sentinel lymph nodes because of fat necrosis induced by previous breast biopsy. The most important consideration is not confounding MGC with epithelial cell clusters. This can occur with not well-processed samples, especially if unmounted.

scholarly journals Relationship between Upper Extremity Lymphatic Drainage and Sentinel Lymph Nodes in Patients with Breast Cancer

2019 ◽  
Vol 2019 ◽  
pp. 1-7 ◽  
Author(s):  
Xiaokai Ma ◽  
Shishuai Wen ◽  
Baofeng Liu ◽  
Dumin Li ◽  
Xiaolong Wang ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Lymph Node ◽  
Lymph Nodes ◽  
Upper Extremity ◽  
Axillary Lymph Node ◽  
Lymphatic Drainage ◽  
Sentinel Lymph Nodes ◽  
Blue Dye ◽  
Axillary Lymph ◽  
Axillary Reverse Mapping

Purpose. The purpose of this study was to identify the relationship between upper extremity lymphatics and sentinel lymph nodes (SLNs) in breast cancer patients.Methods. Forty-four patients who underwent axillary reverse mapping (ARM) during axillary lymph node dissection (ALND) with SNL biopsy (SLNB) between February 2017 and October 2017 were investigated. ARM was performed using indocyanine green (ICG) to locate the upper extremity lymphatics; methylene blue dye was injected intradermally for SLN mapping.Results. ARM nodes were found in the ALND fields of all examined patients. The rate of identification of upper extremity lymphatics within the SLNB field was 65.9% (29 of 44). The ARM nodes were involved in metastases arising from primary breast tumors in 7 of the patients (15.9%), while no metastases were detected in pathologic axillary lymph node-negative patients. Lymphatics from the upper extremity drained into the SLNs in 5 of the 44 patients (11.4%); their ARM-detected nodes were found to be in close proximity to the SLNs.Conclusions. The ARM nodes and SLNs are closely related and share lymphatic drainage routes. The ARM procedure using fluorescence imaging is both feasible and, in patients who are SLN negative, oncologically safe. ARM using ICG is therefore effective for identifying and preserving upper extremity lymphatics, and SLNB combined with ARM appears to be a promising surgical refinement for preventing upper extremity lymphoedema.Clinical Trial Registration. This trial is registered with ClinicalTrial.gov:NCT02651142.

Lymphatic Mapping and Sentinel Lymph Node Biopsy in the Management of Primary Cutaneous Melanoma: Report of a Single-centre Experience

2006 ◽  
Vol 92 (2) ◽  
pp. 113-117 ◽  
Author(s):  
Roberto Cecchi ◽  
Cataldo De Gaudio ◽  
Lauro Buralli ◽  
Stefania Innocenti
Keyword(s):  
Lymph Node ◽  
Sentinel Lymph Node ◽  
Sentinel Lymph Node Biopsy ◽  
Lymph Nodes ◽  
Cutaneous Melanoma ◽  
Lymphatic Mapping ◽  
Lymph Node Biopsy ◽  
Sentinel Lymph Nodes ◽  
Primary Cutaneous Melanoma ◽  
Node Biopsy

Aims and Background Lymphatic mapping and sentinel lymph node biopsy provide important prognostic data in patients with early stage melanoma and are crucial in guiding the management of the tumor. We report our experience with lymphatic mapping and sentinel lymph node biopsy in a group of patients with primary cutaneous melanoma and discuss recent concepts and controversies on its use. Patients and Methods A total of 111 patients with stage I-II AJCC primary cutaneous melanoma underwent lymphatic mapping and sentinel lymph node biopsy from December 1999 through December 2004 using a standardized technique of preoperative lymphoscintigraphy and biopsy guided by blue dye injection in addition to a hand-held gamma probe. After removal, sentinel lymph nodes were submitted to serial sectioning and permanent preparations for histological and immunohistochemical examination. Complete lymph node dissection was performed only in patients with tumor-positive sentinel lymph nodes. Results Sentinel lymph nodes were identified and removed in all patients (detection rate of 100%), and metastases were found in 17 cases (15.3%). The incidence of metastasis in sentinel lymph nodes was 2.1%, 15.9%, 35.2%, and 41.6% for melanomas < or 1.0, 1.01-2.0, 2.01-4.0, and > 4.0 mm in thickness, respectively. Complete lymph node dissection was performed in 15 of 17 patients with positive sentinel lymph nodes, and metastases in non-sentinel lymph nodes were detected in only 2 cases (11.7%). Recurrences were more frequently observed in patients with a positive than in those with negative sentinel lymph node (41.1% vs 5.3% at a median follow-up of 31.5 months, P<0.001). The false-negative rate was 2.1%. Conclusions Our study confirms that lymphatic mapping and sentinel lymph node biopsy allow accurate staging and yield relevant prognostic information in patients with early stage melanoma.

scholarly journals THE ROLE OF INTRAOPERATIVE FROZEN SECTION OF SENTINEL LYMPH NODES IN UPFRONT BREAST CONSERVATION CANCER SURGERY

2019 ◽  
Vol 5 (2) ◽  
Author(s):  
Ruqayya Naheed Khan ◽  
Awais Amjad Malik ◽  
Sameen Mohtasham ◽  
Amina Iqbal Khan ◽  
Muhammad Asad Parvaiz ◽  
...  
Keyword(s):  
Lymph Node ◽  
Lymph Nodes ◽  
Frozen Section ◽  
False Negative ◽  
Breast Conservation ◽  
Lymph Node Biopsy ◽  
Sentinel Lymph Nodes ◽  
Axillary Lymph ◽  
Breast Cancer Patients ◽  
American College Of Surgeons

Objective: Sentinel lymph node biopsy is the standard of care in clinically negative axilla in breast cancer patients for which frozen section (FS) is routinely performed intraoperatively. The objective of this study was to justify the use of FS in terms of number of tests performed and their impact on decision-making and cost saving. Materials and Methods: We retrospectively reviewed our prospectively maintained data from January 2014 to January 2018 for intraoperative FS in upfront breast conservation surgery patients. Results: A total of 357 patients were studied. All were female. Median age was 50 years (24–84). Mean tumour size was 29.11 mm. Numbers of sentinel lymph nodes identified were 1 in 50 (14.2%) patients, 2 in 121 (33.89%) patients and ≥3 in 186 (52%) patients. Number of positive sentinel lymph nodes was 0 in 264 (73.9%) patients, 1 in 62 (17.4%) patients, 2 in 20 (5.6%) patients and ≥3 in 11 (3.08%) patients. Axillary lymph node dissection (ALND) was offered to 30 (8.4%) patients as per the American College of Surgeons Oncology Group Z0011. The results for ALND showed that only 8 (2.3%) out of 30 patients had positive nodes identified in the additional axillary nodes dissected. Sensitivity of FS was 97% and specificity was 98.86%. False-negative rate was 3.22%. Conclusion: Intraoperative FS can be safely omitted in early breast cancer patients undergoing upfront breast conservation cancer surgery due to high sensitivity and specificity leading to low false-negative rates. ALND can be performed as a second operation as warranted only in a minority of patients. Key words: American College of Surgeons Oncology Group Z0011 trial, axillary lymph node dissection, intraoperative frozen section, sentinel lymph node biopsy

Triple detection method for sentinel lymph node detection

2009 ◽  
Vol 27 (15_suppl) ◽  
pp. e11605-e11605
Author(s):  
S. Lee ◽  
J. Yang ◽  
S. Nam ◽  
J. Lee ◽  
W. Kim ◽  
...  
Keyword(s):  
Lymph Node ◽  
Sentinel Lymph Node ◽  
Sentinel Lymph Node Biopsy ◽  
Lymph Nodes ◽  
Detection Rate ◽  
Detection Method ◽  
Lymph Node Biopsy ◽  
Sentinel Lymph Nodes ◽  
Node Biopsy ◽  
Radioisotope Uptake

e11605 Background: Sentinel lymph node biopsy is widely accepted method to determine nodal stage of breast cancer. There are several reported method for detecting sentinel lymph node. The aim of this study was to show the new detection method of sentinel lymph node and show the effectiveness of this method. Methods: We did prospective study and enrolled 25 patients who underwent partial mastectomy and sentinel lymph node biopsy. We injected indigocyanine green (green dye) at peritumoral lesion, indigocarmine dye (blue dye) in subareolar area and radioisotope (Tc-99m) injection. Sentinel lymph nodes are identified by color change or radioisotope uptake, and classified by each color (blue or green) and radioisotope uptake. We compared the detection rate from our study with that from the previous studies. Results: Sentinel lymph nodes were detected in all patients (25/25). Green color stained sentinel lymph nodes were identified in 18 patients (18/25), blue color stained sentinel lymph nodes were identified in 15 patients (15/25) and radioactive lymph nodes were identified in 19 patients (19/25). Conclusions: The triple mapping method showed higher detection rate than the previous studies and this method is recommendable to detect sentinel lymph node. No significant financial relationships to disclose.

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