Pathologic analysis of sentinel lymph nodes

Paul J. Van Diest, Hans Torrenga, Sybren Meijer, Chris J L M Meijer

Research output: Contribution to journalArticlepeer-review

Abstract

The sentinel lymph node (SLN) procedure enables selective targeting of the first draining lymph node, where the initial metastases will form. A negative SLN predicts the absence of tumor metastases in the other regional lymph nodes with a high degree of accuracy. This means that in case of a negative SLN, regional lymph node dissection is no longer necessary. Besides saving patients the significant morbidity associated with lymph node dissection, it will also save costs. Crucial for the success of the SLN procedure is the screening of the SLN for metastases by the pathologist. To this end, several techniques are available such as standard histo- and cytopathological techniques, immunohistochemistry, flow cytometry, and molecular biological techniques. In this paper, the value of these methods for detecting SLN metastases is discussed. Some of these techniques have also appeared to be quite useful for intraoperative evaluation of SLNs. The standard protocol for detection of SLN metastases consists of extensive histopathological investigation including stepped sections stained with hematoxylin and eosin (HE) and immunohistochemistry. Intraoperative frozen section analysis and imprint cytology of SLNs have been shown to be reasonably reliable for detecting breast cancer metastases in SLNs. Further studies are necessary to establish the role of multiparameter flow cytometry and sophisticated molecular biological techniques such as reverse transcription polymerase chain reaction (RT-PCR) in detecting SLN metastases.

Original languageEnglish (US)
Pages (from-to)238-245
Number of pages8
JournalSeminars in Surgical Oncology
Volume20
Issue number3
DOIs
StatePublished - 2001
Externally publishedYes

Keywords

  • Fine needle aspiration biopsy
  • Flow cytometry
  • Frozen section
  • Immunohistochemistry
  • Imprint cytology
  • Pathology
  • PCR
  • Sentinel lymph node

ASJC Scopus subject areas

  • Surgery
  • Oncology

Fingerprint Dive into the research topics of 'Pathologic analysis of sentinel lymph nodes'. Together they form a unique fingerprint.

Cite this