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Sentinel node identification by scintigraphic methods in cutaneous melanoma.

R Dias Moreira1, S Altino de Almeida, C M Maliska Guimarães

  • 1Hospital Universitário Clementino Fraga Filho, Universidade Federal do Rio de Janeiro, Brasil.

Journal of Experimental & Clinical Cancer Research : CR
|August 23, 2005
PubMed
Summary

Lymphoscintigraphy and sentinel lymph node biopsy accurately identify melanoma metastasis risk. Further histopathological analysis, including immunohistochemistry, is crucial due to false negatives with frozen sections alone.

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Area of Science:

  • Oncology
  • Surgical Pathology

Background:

  • Lymph node metastasis is a key prognostic factor in melanoma, guiding therapeutic decisions.
  • Sentinel lymph node biopsy (SLNB) with preoperative lymphoscintigraphy is standard for staging early-stage melanoma without detectable metastases.

Purpose of the Study:

  • To assess the reproducibility of lymphoscintigraphy and SLNB in detecting micrometastases in cutaneous melanoma.

Main Methods:

  • Prospective analysis of 74 melanoma patients (Breslow thickness > 0.7 mm).
  • Intradermal injection of Technetium-99m sulfur colloid for lymphoscintigraphy and SLNB.
  • Histopathological analysis of sentinel lymph nodes: frozen section, H&E staining, and immunohistochemistry.

Main Results:

  • Lymphoscintigraphy successfully identified sentinel lymph nodes in all patients.

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  • Sentinel node biopsy detected metastases in 27.2% of patients.
  • Frozen section analysis had a high false-negative rate (only 35% of micrometastases detected); immunohistochemistry identified additional positive cases.

    • Conclusions:

    • Lymphoscintigraphy is a reliable tool for locating sentinel lymph nodes in melanoma patients.
    • Comprehensive histopathological analysis (H&E and immunohistochemistry) of all sentinel lymph nodes is essential to avoid false negatives from frozen sections alone.