Update on lymphatic mapping and sentinel node biopsy in the management of patients with melanocytic tumours

Pathology
Alistair J CochranScott W Binder

Abstract

To communicate best practices for sentinel lymph node evaluation and assessment of prognosis for patients with melanoma. Description and justification of approaches derive from experience with management of more than 2000 melanoma patients evaluated by lymphatic mapping and sentinel node biopsy (LMSNB). Pathologists, by detecting blue dye or carbon particles or alterations in nodal cell populations should attempt to confirm that a node submitted as sentinel is truly sentinel. Pathologists must adequately sample the node by examining multiple tissue sections and determine the presence or absence of metastatic melanoma using sections stained by H&E and immunocytochemistry. Approximately 20% of patients have melanoma in the sentinel node (SN) and accurate evaluation of SN tumour status is the most precise technique for staging clinically localised cutaneous melanoma. The remaining non-sentinel nodes (NSN) in the basin are tumour-free in 67% of patients with melanoma in the SN. Breslow thickness of the primary, the area of tumour in the SN (relative to total nodal area) and density of dendritic leukocytes in the SN paracortex (factors that are combinable in prognostic algorithms) predict metastases in the NSN and the likelihood of ...Continue Reading

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Citations

Jun 23, 2010·Nature Reviews. Clinical Oncology·Alexander C J van AkkooiAlexander M M Eggermont
Feb 28, 2008·Current Opinion in Oncology·Alistair J CochranScott W Binder
Feb 20, 2010·Current Opinion in Oncology·Alexander C J van AkkooiAlexander M M Eggermont
Jan 19, 2013·Current Opinion in Oncology·Augustinus P T van der PloegAlexander M M Eggermont
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