Cytokeratin staining for intraoperative evaluation of sentinel lymph nodes in patients with invasive lobular carcinoma

Intraoperative evaluation of sentinel lymph nodes in breast cancer: comparison of frozen sections, imprint cytology and immunocytochemistry

“…Because keratin is not present in normal lymph nodes, it is believed to be useful for the detection of micrometastasis. [32][33][34][35][36][37][38] Although many studies have demonstrated the usefulness of rapid IHC, these findings have been challenged by others who found no benefits from this method. 1,[3][4][5] In our prospective study, we simultaneously applied three different intraoperative methods (frozen section analysis, touch imprint cytology, and rapid immunocytochemistry) to identify the most sensitive and specific method or combination of methods with which to detect tumour cells within an SLN.…”

“…38 The intraoperative detection of lobular carcinoma in a lymph node is difficult because of its low-grade cytomorphology and its tendency to infiltrate metastatic sites in a single-cell pattern. In our experience, occasional large metastases are missed both in intraoperative evaluation and on permanent H&E sections because of the architectural and cytomorphological features of metastatic lobular carcinoma, only to be discovered, to the surprise of the pathologist, on cytokeratin-stained sections.…”

Accuracy of intraoperative imprint cytology for sentinel lymph node evaluation in the treatment of breast carcinoma

“…(Details regarding the intraoperative CK staining procedure are described elsewhere. 34 ) Because the majority of breast surgeons at our institution did not consider suspicious findings on IIC N alone to be grounds for total axillary lymph node dissection, suspicious findings were treated as negative findings in the current study. Atypical results also were considered negative by surgeons.…”

Pathological Examination of Sentinel Lymph Node Biopsy

“…Frozen kesit ve imprintlere sitokeratin (AE1/AE3) uygulandığında, mikrometastazların saptanma oranı artmıştır (1,31). İnvaziv lobüler karsinomda imprintlere sitokeratin uygulandığında tanıya %12,9 katkı sağladığı belirtilmiştir (44). Postoperatif kesin tanı ile hızlı İHK sonuçları birlikte değerlendirilmiş, hızlı İHK sensitivitesi %95,2-85, spesifitesi %100 olarak bildirilmiş, bu yöntemin doğruluk ve maliyet açısından uygulanabilir olduğu vurgulanmıştır (41,43).…”

“…İnvaziv lobüler karsinomda, tümör hücreleri tek tek, ya da birkaç hücrelik gruplar halinde metastaz yaptıklarında, bunların H&E boyalı preparatlarda saptanması zordur, İHK tümör hücrelerinin ayırt edilmesinde yardımcı olur (Resim 12), parafin kesitlerde metastaz görülmeyen olgularda, SLN'nin doğru bir şekilde incelenmesi için rutin olarak birçok merkezde uygulanmaktadır (5,11,32,44).…”