Pathologic Evaluation of Sentinel Nodes

Messina, Jane L.; Rosa, Marilin

doi:10.1097/ppo.0000000000000087

Cited by 5 publications

(5 citation statements)

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“…Deeper, parenchymal location worsened survival [ 35 ]. In some types of cancer, including breast cancer, nodal tumor deposits below 0.2 mm are considered N0 [ 36 ]. According to the AJCC melanoma database, the long-term survival rate of patients with SN metastases <0.2 mm was excellent (96%) [ 5 ].…”

Section: Discussionmentioning

confidence: 99%

The sentinel node invasion level (SNIL) as a prognostic parameter in melanoma

et al. 2021

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Sentinel lymph node (SN) tumor burden is becoming increasingly important and is likely to be included in future N classifications in melanoma. Our aim was to investigate the prognostic significance of melanoma infiltration of various anatomically defined lymph node substructures. This retrospective cohort study included 1250 consecutive patients with SN biopsy. The pathology protocol required description of metastatic infiltration of each of the following lymph node substructures: intracapsular lymph vessels, subcapsular and transverse sinuses, cortex, paracortex, medulla, and capsule. Within the SN with the highest tumor burden, the SN invasion level (SNIL) was defined as follows: SNIL 1 = melanoma cells confined to intracapsular lymph vessels, subcapsular or transverse sinuses; SNIL 2 = melanoma infiltrating the cortex or paracortex; SNIL 3 = melanoma infiltrating the medulla or capsule. We classified 338 SN-positive patients according to the non-metric SNIL. Using Kaplan–Meier estimates and Cox models, recurrence-free survival (RFS), melanoma-specific survival (MSS) and nodal basin recurrence rates were analyzed. The median follow-up time was 75 months. The SNIL divided the SN-positive population into three groups with significantly different RFS, MSS, and nodal basin recurrence probabilities. The MSS of patients with SNIL 1 was virtually identical to that of SN-negative patients, whereas outgrowth of the metastasis from the parenchyma into the fibrous capsule or the medulla of the lymph node indicated a very poor prognosis. Thus, the SNIL may help to better assess the benefit-risk ratio of adjuvant therapies in patients with different SN metastasis patterns.

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Section: Discussionmentioning

confidence: 99%

The sentinel node invasion level (SNIL) as a prognostic parameter in melanoma

et al. 2021

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“…It has been reported that detecting metastasis from ILC intraoperatively can be challenging . This is attributed to the presence of metastasis usually as single cells instead of the glandular clusters seen in case of ductal carcinoma, to the morphological similarity of lobular carcinoma cells to normal lymph node elements, and also to the more common subcapsular location of metastatic deposits in the SLN (Figure A,B) .…”

Section: Discussionmentioning

confidence: 99%

“…Frozen section (FS) and intraoperative imprint cytology (IC; touch‐preparations) are two methods used to evaluate SLN, with intraoperative IC being the preferred method because of its rapid turnaround time (TAT) and tissue preservation . However, cytologic evaluation in cases of invasive lobular carcinoma (ILC) can be challenging, with a reported higher rate of false‐negative results when compared to cases of ductal carcinoma . At our institution, intraoperative evaluation of SLNs of patients with breast carcinoma is performed using IC.…”

Section: Introductionmentioning

confidence: 99%

“…1,2 However, cytologic evaluation in cases of invasive lobular carcinoma (ILC) can be challenging, with a reported higher rate of false-negative results when compared to cases of ductal carcinoma. 3 At our institution, intraoperative evaluation of SLNs of patients with breast carcinoma is performed using IC. In addition, rapid cytokeratin immunostaining has been added to cases of ILC.…”

Section: Introductionmentioning

confidence: 99%

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Diagnostic value of intraoperative rapid cytokeratin immunostain in the cytological evaluation of sentinel lymph nodes in patients with invasive lobular carcinoma

Nguyen

Khazai

Hakam

et al. 2018

Diagnostic Cytopathology

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Background Sentinel lymph node (SLN) biopsy is the standard of practice in clinically node‐negative patients with breast carcinoma. Intraoperative imprint cytology (IC) is often used in this setting. In cases of invasive lobular carcinoma (ILC), interpretation of IC slides may be challenging. Rapid cytokeratin immunohistochemistry (R‐CK) has been used in this scenario. This study evaluated if the combination of IC and R‐CK improves the sensitivity of intraoperative SLN evaluation of ILC in our setting. Methods SLN of all cases of ILC in which IC and R‐CK were performed in a 4 year period were included. Final tissue diagnosis was used as the gold standard. Results Four hundred and twenty‐seven of the 802 IC performed during the study period corresponded to paired IC and R‐CK for ILC. Independently, IC and R‐CK correctly classified the SLN as negative or positive in 355 cases (83%) and 324 (76%) cases, respectively. In combination, IC and R‐CK correctly classified 304 (71%) of cases. R‐CK failed in 56 cases. R‐CK aided in rendering an accurate diagnosis in 59% of atypical cases (19/32). Patients with atypical IC and positive R‐CK did not undergo axillary dissection. The addition of R‐CK increased the turnaround time (TAT) by 24 minutes. Conclusions In this study, the addition of R‐CK did not improve the diagnostic accuracy in cases classified as negative or positive by IC, but resulted in a considerable increase in TAT. Although R‐CK proved to be of diagnostic value in atypical IC cases, it did not appear to influence clinical management.

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“…Los ganglios pequeños (de menos de 4 mm de diámetro), generalmente se envían en su totalidad, y los más grandes se seccionan en serie a intervalos de 2-3 mm a lo largo de su eje más largo, se incrustan en parafina y se tiñen con Hematoxilina y Eosina (H&E) y otros métodos de tinción (69,70). Las metástasis de los ganglios linfáticos se pueden dividir en macrometástasis (depósitos tumorales de más de 2 mm de diámetro), micrometástasis (depósitos tumorales de 0,2-2 mm de diámetro) y células tumorales aisladas (células individuales o grupos aislados de células con un diámetro máximo de 0,2 mm o menos de 200 células en una sola sección histológica) (71).…”

Section: Trazadores Utilizados Para La Biopsia De Ganglio Centinela E...unclassified

Tumores de ovario: evaluación del estatus ganglionar mediante el uso de azul patente. Experiencia en Venezuela

Freytez¹,

Ruggiero²

2023

Gac Méd Caracas

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El cáncer epitelial de ovario (CEO) es causante de una alta tasa de mortalidad a nivel mundial, siendo diagnosticado en un alto porcentaje en estadios avanzados. La cirugía citorreductora continúa siendo el tratamiento estándar donde se incluye la linfadenectomía paraaórtica infrarrenal y pélvica iliaco obturatriz, con el propósito de resecar toda enfermedad macroscópica visible y todo ganglio retroperitoneal con posibilidad de enfermedad metastásica. No obstante, la linfadenectomía acarrea gran morbilidad y alta tasa de complicaciones como: lesión vascular, hemorragia intraoperatoria, lesión de nervios, linfocele, linfedema, mayor tasa de trasfusiones sanguíneas y prolongación del tiempo quirúrgico, resultando en mayor estancia hospitalaria, retraso en el inicio de terapia adyuvante y disminución en la calidad de vida. Hoy en día, se conoce que este procedimiento no se asocia significativamente a mejor pronóstico aun en pacientes con cáncer de ovario en estadio inicial.

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Pathologic Evaluation of Sentinel Nodes

Cited by 5 publications

References 43 publications

The sentinel node invasion level (SNIL) as a prognostic parameter in melanoma

The sentinel node invasion level (SNIL) as a prognostic parameter in melanoma

Diagnostic value of intraoperative rapid cytokeratin immunostain in the cytological evaluation of sentinel lymph nodes in patients with invasive lobular carcinoma

Tumores de ovario: evaluación del estatus ganglionar mediante el uso de azul patente. Experiencia en Venezuela

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