A Half a Node or a Whole Node:<i>A Comparison of Methods for Submitting Lymph Nodes</i>

Niemann, Theodore H.; Yilmaz, Asli G.; Marsh, W.; Lucas, Joel G.

doi:10.1093/ajcp/109.5.571

Cited by 17 publications

(6 citation statements)

References 22 publications

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“…Although a large The individual parameters of the TNM categories are number of staging systems have been developed for colorectal cancer over the years, use of the TNM (tumor, discussed in detail below. 71 …”

Section: =3%mentioning

confidence: 99%

“…Any extramural tions to improve visualization of small lymph nodes in the pericolonic or perirectal fat; (2) the submission of tumor nodule with the regional lymph node distribution of the tumor that measures ?3 mm in diameter but lacks one half vs. both halves of each node for microscopic examination, and (3) the preparation of one vs. more complete surgical resection. A tumor that remains after treatment (definitive or palliative) of any type (prior surthan one tissue level per paraffin block of submitted nodal tissue [44,71]. Thus, even by acceptable practices of gery alone, radiation therapy alone, chemotherapy alone, or any combined modality treatment) is codified by a 'routine' lymph node examination, the thoroughness of the assessment varies.…”

Section: Pathology Report In Colon Cancermentioning

confidence: 99%

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Pathology Report in Colon Cancer: What Is Prognostically Important?

Compton

1999

Dig Dis

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Surgical resection is the primary treatment modality for colorectal cancer, and the most powerful tool for assessing prognosis following surgery is pathologic analysis of the resection specimen. Although the parameters that determine the pathologic stage are the strongest predictors of postoperative outcome, a number of additional pathologic features have prognostic significance that is independent of stage. These include: histologic grade; small vessel (lymphatic or venular) invasion; extramural venous invasion; perineural invasion; tumor border configuration; host lymphoid response to tumor, and the status of surgical margins. For specimens in which the radial (circumferential) margin is applicable, surgical clearance around the tumor is also of import. It is self-evident that, compared to data derived from additional assays, prognostic information that can be derived directly from standard histologic sections of a tumor is of the greatest cost-benefit to the patient. In the current era of cost containment, it is essential that surgical pathologists evaluate and report the pathologic features that are of prognostic and/or predictive significance in every case of colorectal cancer and, in turn, that the import of these be understood by the treating physicians.

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Section: =3%mentioning

confidence: 99%

Section: Pathology Report In Colon Cancermentioning

confidence: 99%

Pathology Report in Colon Cancer: What Is Prognostically Important?

Compton

1999

Dig Dis

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“…Durkin and Haagensen [10] report that Monroe, in 1948, was probably the first researcher to use fat clearance methods to identify lymph nodes in 87 radical mastectomy specimens and found 31 lymph nodes per specimen. Most authors agree that there is benefit to the number of lymph nodes dissected however there is controversy as to whether the extra time and resources consumed by these processes justify its routine use [11]. The present study addresses this controversy.…”

Section: Introductionmentioning

confidence: 85%

Improved Fat Clearance Techniques for the Examination of Breast Cancer Lymph Nodes

Rodrigues¹,

Pires²,

Fonseca³

et al. 2014

J Cancer Sci Ther

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Introduction:The isolation of lymph nodes less than 4.0 mm in diameter from the fatty tissue of surgical breast cancer specimens through the traditional method of tactile perception is difficult, time consuming and failed the identification of smaller lymph nodes. The reported numbers of lymph nodes detected through this technique vary widely in the literature demonstrating its inappropriateness. The use of fat clearance techniques however may contribute to the isolation of additional nodes, allowing for appropriate pathological staging of the disease.Objective: To evaluate the impact of the use of fat clearance machinery and solutions in the dissection and identification of lymph nodes from axillary dissections of patients with breast cancer.Materials and methods: Fat clearance techniques (cooker, electric spiral, modified Koren clearing solution and formaldehyde-acetic alcohol solution) were applied to 100 breast cancer axillary dissections from males and females with no age restriction over a period of two years (2009-2011).Results: Through the use of fat clearance methods, additional 174 metastases in 564 lymph nodes were found, more than the classical method, from which 449 metastases in 1426 lymph nodes were identified. There was no statistical difference between the fat clearance methods; however the cooker method demonstrated greater efficiency than the modified Koren clearing solution method. Conclusion:The fat clearance methods described here have various advantages over the classical method. These methods are viable, rapid, practical, inexpensive and do not alter the quality of histological analysis or immunohistochemical reactions. The findings show that examination of a minimum of 20 isolated lymph nodes is necessary for optimal identification and diagnosis of lymph node metastases. The main outcome from this study were the immediate benefits generated by adopting new technical procedures resulting in a change in pathological staging classification in 14% of the patients.

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“…Recommendations include submitting one half of a bisected lymph node, submitting a representative sample, or processing up to one full cassette of tissue per lymph node. [2][3][4][5] What are sentinel lymph nodes, and how can they be identified?…”

Section: Savitri Krishnamurthymentioning

confidence: 99%

Pathology of Regional Lymph Nodes

Krishnamurthy¹

2005

Breast Cancer

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A Half a Node or a Whole Node:A Comparison of Methods for Submitting Lymph Nodes

Cited by 17 publications

References 22 publications

Pathology Report in Colon Cancer: What Is Prognostically Important?

Pathology Report in Colon Cancer: What Is Prognostically Important?

Improved Fat Clearance Techniques for the Examination of Breast Cancer Lymph Nodes

Pathology of Regional Lymph Nodes

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