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Detailed Structure and Function of Lymph Nodes01:23

Detailed Structure and Function of Lymph Nodes

Lymph nodes are bean-shaped structures that cluster along the lymphatic vessels in the inguinal, axillary, and cervical regions. Each node is divided into compartments by a capsule that extends trabeculae inward.
From a histological perspective, lymph nodes can be split into two main areas: the superficial cortex and the deep medulla. The outer cortex is populated by dendritic cells, macrophages, and B lymphocytes, which are densely packed into follicles. When these B-lymphocytes are presented...

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Epitrochlear lymph node dissection.

Steven N Hochwald1, Nicole Kissane, Stephen R Grobmyer

  • 1Department of Surgery, University of Florida College of Medicine, Gainesville, FL, USA. steven.hochwald@surgery.ufl.edu

Annals of Surgical Oncology
|August 4, 2010
PubMed
Summary
This summary is machine-generated.

Epitrochlear lymph node involvement is rare in melanoma but frequently metastatic when found. Detailed preoperative imaging and intraoperative searches for these in-transit nodes are crucial for accurate staging.

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Area of Science:

  • Oncology
  • Surgical Oncology
  • Dermatology

Background:

  • Melanoma of the forearm and hand can metastasize to epitrochlear lymph nodes.
  • In-transit sentinel lymph nodes (SLNs) are infrequently identified but often contain metastatic disease.

Purpose of the Study:

  • To demonstrate the incidence of epitrochlear lymph node involvement in melanoma.
  • To outline technical considerations for epitrochlear lymph node dissection.

Main Methods:

  • Review of patient data for epitrochlear lymph node involvement.
  • Demonstration of lymphoscintigraphy and surgical techniques for epitrochlear lymph node dissection.

Main Results:

  • Epitrochlear node involvement occurs in a small minority of patients.
  • Positive in-transit SLNs are a significant site of nodal metastasis, sometimes the only one.
  • Recovery rates of epitrochlear nodes are low but increasing with lymphatic mapping.

Conclusions:

  • Despite low incidence, epitrochlear lymph node metastasis is significant in melanoma.
  • Preoperative lymphoscintigraphy and meticulous intraoperative searches are essential.
  • Lymphatic mapping and sentinel lymph node biopsy improve detection and dissection of these nodes.