Benign glandular inclusions a rare cause of a false positive sentinel node

An 84-year-old female underwent a wire-guided lumpectomy and sentinel lymph node biopsy. Two sentinel nodes were identified and sent for immediate pathological evaluation. One of the nodes was reported as "glandular epithelium consistent with metastatic adenocarcinoma." Permanent sections of the sentinel node initially considered positive revealed glandular structures primarily within the fibrous capsule of the involved lymph node. These glands were lined by tall columnar epithelial cells, which had cilia on the luminal surface and did not show significant cytologic atypia. The limitations of intra-operative evaluation of sentinel nodes make differentiation of uncommon pathology difficult. A conservative approach should be taken with these lesions as permanent sections will often elucidate the diagnosis.