PET-CT Gamma Probe-Guided Lymph Node Biopsy: A New Diagnostic Surgical Approach

2017 ◽  
Vol 103 (1_suppl) ◽  
pp. S34-S36
Author(s):  
Antonio Piñero-Madrona ◽  
Jorge Luis Monserrat-Coll ◽  
José Ruiz-Pardo ◽  
Juan Cabezas-Herrera ◽  
Francisco Nicolás-Ruiz
Keyword(s):  
Lymph Node ◽  
Lymph Nodes ◽  
Surgical Approach ◽  
Gamma Probe ◽  
Ct Images ◽  
Lymph Node Biopsy ◽  
Diagnostic Tools ◽  
Biopsy Technique ◽  
Node Biopsy ◽  
Pet Ct

Purpose The higher sensitivity of new diagnostic tools makes it easier to detect relapse in asymptomatic stages when classic procedures of lymph node biopsies are difficult to perform. The aim of this article is to describe the combination of gamma probe and 18F-FDG positron emission tomography-computed tomography (PET-CT) images in combination with sentinel lymph node biopsy technique for detection of nonpalpable lymph nodes. Methods After a dose of 18F-FDG was administered and PET-CT images that showed the location of suspected pathologic lymph nodes were obtained, transcutaneous localization of the lymph nodes with the highest captation of the tracer was done. The gamma probe was programmed to detect the radioactive signal from the F18, instead of the Tc99m that is usual in the sentinel node biopsy technique. Once the hottest point was detected, a short incision was made on this area, and suspicious nodes with the highest uptake registered by the gamma probe were localized and removed. After the surgical removal from the operating field, the surgical pieces stood positive to the gamma probe. Lymph node involvement, and subsequent relapse, was diagnosed before their clinical manifestation. Conclusions This methodology confirms new horizons for the surgical approach of lymph node biopsies in patients with previous tumors with 18F-FDG avidity and suspicion of relapse.

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.

67P The role of FDG PET/CT to omit sentinel lymph node biopsy after neoadjuvant chemotherapy in breast cancer

2021 ◽  
Vol 32 ◽  
pp. S50
Author(s):  
E. Tanrikulu Simsek ◽  
E. Çoban ◽  
E. Atag ◽  
S. Gungor ◽  
M. Sarı ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Lymph Node ◽  
Sentinel Lymph Node ◽  
Sentinel Lymph Node Biopsy ◽  
Neoadjuvant Chemotherapy ◽  
Lymph Node Biopsy ◽  
Node Biopsy ◽  
Pet Ct ◽  
Fdg Pet Ct

scholarly journals An AN OBSERVATIONAL STUDY OF SLN MAPPING IN PATIENTS OF LOCALLY ADVANCED BREAST CANCER FOLLOWING NCT

2020 ◽  
Vol 4 (2) ◽  
Author(s):  
Ankur Garg ◽  
Udbhav Kathpalia ◽  
Shweta Bansal ◽  
Manoj Andley ◽  
Sudipta Saha
Keyword(s):  
Lymph Node ◽  
Sentinel Lymph Node ◽  
Adjuvant Chemotherapy ◽  
Lymph Nodes ◽  
Locally Advanced ◽  
Lymph Node Biopsy ◽  
Axillary Lymph Nodes ◽  
Axillary Lymph ◽  
Node Biopsy ◽  
Neo Adjuvant Chemotherapy

Background : Locally advanced breast carcinoma (LABC) includes a wide range of clinical scenarios- advanced primary tumors (T4), advanced nodal disease and inflammatory carcinomas(1). Traditionally, treatment of LABC included a combination of Chemotherapy, Radiation and Surgery(2). However, there has been a shift to Neoadjuvant Chemotherapy in recent times.(3) Histological status and the number of axillary lymph nodes with metastasis is one of the most important prognostic factors and most powerful predictor of recurrence and survival in patients of breast carcinoma and remains so, even after neo-adjuvant chemotherapy. (3) Information derived from the sentinel lymph node is considered valuable, with less discomfort to the patient when compared with axillary dissection.(4) However, its role in detecting nodal metastasis after neo-adjuvant chemotherapy in LABC is still debatable and definitive studies to evaluate its role are still evolving. (5) Materials and Methods: Patients of LABC were evaluated using ultrasonography (USG) of axilla. Neo-adjuvant chemotherapy (NACT) was administered and patients were reassessed by USG of axilla. Thirty patients with node negative axillary status were subjected to Sentinel lymph node mapping using isosulfan blue followed by Modified Radical Mastectomy and Axillary Lymph Node Dissection. Histopathological evaluation of stained and unstained lymph nodes done and the data, thus obtained, was statistically analysed.   Results: Sentinel lymph node biopsy performed using Isosulfan Blue dye alone, after neo-adjuvant chemotherapy predicts the status of axillary lymph nodes with low accuracy.   Conclusions: Further studies would be required to establish the role of sentinel lymph node biopsy in patients with LABC after NACT.

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.

Sign in / Sign up

Export Citation Format

Share Document