Sentinel lymph node biopsy in melanoma patients with clinically negative regional lymph nodes – one institution's experience

2003 ◽  
Vol 13 (1) ◽  
pp. 35-43 ◽  
Author(s):  
Zbigniew I Nowecki ◽  
Piotr Rutkowski ◽  
Anna Nasierowska-Guttmejer ◽  
Wlodzimierz Ruka
2019 ◽  
Vol 65 (6) ◽  
pp. 838-849
Author(s):  
Aleksey Karachun ◽  
Aleksey Belyaev ◽  
Yuriy Pelipas ◽  
D. Asadchaya ◽  
Oleg Tkachenko ◽  
...  

Introduction: Concept of sentinel lymph node biopsy has been discussed during several last decades, because this idea seems perspective in terms of modern minimally invasive and organ-preserving era. However, this method has several limitations including complicated anatomy of gastric lymph nodes distribution and presence of skip-metastases. Materials and methods: 66 Patients with early gastric cancer, intermediate risk of lymph node metastases and technical possibility of ESD were included into our investigation. Patients were assigned to either ESD with sentinel lymph node biopsy (54 patients), or underwent distal gastrectomy or total gastrectomy with D1+/D2 lymphadenectomy (12 patients) by chance. Results: 56 (84,6%) Patients had at least one sentinel lymph node. 11 (16,7%) Patients with T1a-T1b had metastases in regional lymph nodes, 9 of them in sentinel lymph nodes (2 false-negative result). So, we calculated sensitivity of 84,6%. In one case, the metastasis was located outside the sentinel lymphatic basin, and in the other case, metastasis was detected in a patient with unlit lymph nodes. Conclusion: Today sentinel lymph node biopsy thechnique is considered as a well investigated and widly used method. The concept itself is promising for organ-preserving gastric cancer surgery.


2021 ◽  
Vol 10 (19) ◽  
pp. 4319
Author(s):  
Franco Picciotto ◽  
Gianluca Avallone ◽  
Federico Castellengo ◽  
Martina Merli ◽  
Virginia Caliendo ◽  
...  

Sentinel lymph node biopsy has been demonstrated to be an effective staging procedure since its introduction in 1992. The new American Joint Committee on Cancer (AJCC) classification did not consider the lack of information that would result from the less usage of the complete lymph node dissection as for a diagnostic purpose. Thus, this makes it difficult the correct staging and would leave about 20% of the further positive non-sentinel lymph nodes in the lymph node basin. In this paper, we aim to describe a new surgical technique that, combined with single-photon emission computed tomography—computed tomography (SPECT-CT), allows for better staging of melanoma patients. This is a prospective study that includes 104 patients with cutaneous melanoma. Sentinel lymph node biopsy was offered according to the AJCC guideline. Planar lymphoscintigraphy was performed in association with SPECT-CT, identifying and removing all non-biologically “excluded” lymph nodes, guiding the surgeon’s hand in detection and removal of lymph nodes. Even if identification and removal of non-sentinel lymph nodes is unable to increase overall survival, it definitely gives better disease control in the basin. With a “classic” setting, the risk of leaving further lymph nodes out of the sentinel lymph node procedure is around 20%, thus, basically, the surgical sentinel lymph node of first and second lymph nodes would have therapeutic value and complete lymph node dissection classically performed.


2021 ◽  
pp. 1-4
Author(s):  
Jose Antonio Jimenez-Heffernan ◽  
Mariel Valdivia-Mazeyra ◽  
Patricia Muñoz-Hernández ◽  
Consuelo López-Elzaurdia

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.


2006 ◽  
Vol 92 (2) ◽  
pp. 113-117 ◽  
Author(s):  
Roberto Cecchi ◽  
Cataldo De Gaudio ◽  
Lauro Buralli ◽  
Stefania Innocenti

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.


2013 ◽  
Vol 2013 ◽  
pp. 1-8 ◽  
Author(s):  
Marie-Laure Matthey-Giè ◽  
Ariane Boubaker ◽  
Igor Letovanec ◽  
Nicolas Demartines ◽  
Maurice Matter

The management of lymph nodes in nonmelanoma skin cancer patients is currently still debated. Merkel cell carcinoma (MCC), squamous cell carcinoma (SCC), pigmented epithelioid melanocytoma (PEM), and other rare skin neoplasms have a well-known risk to spread to regional lymph nodes. The use of sentinel lymph node biopsy (SLNB) could be a promising procedure to assess this risk in clinically N0 patients. Metastatic SNs have been observed in 4.5–28% SCC (according to risk factors), in 9–42% MCC, and in 14–57% PEM. We observed overall 30.8% positive SNs in 13 consecutive patients operated for high-risk nonmelanoma skin cancer between 2002 and 2011 in our institution. These high rates support recommendation to implement SLNB for nonmelanoma skin cancer especially for SCC patients. Completion lymph node dissection following positive SNs is also a matter of discussion especially in PEM. It must be remembered that a definitive survival benefit of SLNB in melanoma patients has not been proven yet. However, because of its low morbidity when compared to empiric elective lymph node dissection or radiation therapy of lymphatic basins, SLNB has allowed sparing a lot of morbidity and could therefore be used in nonmelanoma skin cancer patients, even though a significant impact on survival has not been demonstrated.


2014 ◽  
Vol 25 ◽  
pp. iv388
Author(s):  
M. Kukushkina ◽  
S. Korovin ◽  
O. Solodiannikova ◽  
G. Sukach ◽  
A. Palivets ◽  
...  

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