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Updated: Jun 7, 2026
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Visualizing Lymph Node Structure and Cellular Localization using Ex-Vivo Confocal Microscopy
Published on: August 9, 2019
The popliteal fossa - a problem zone for sentinel lymphonodectomy
Lutz Kretschmer1, Carsten Oliver Sahlmann, Pawel Bardzik
1Department of Dermatology, Verereology and Allergology, University of Göttingen, Germany. lkre@med.uni-goettingen.de
Summary
Popliteal sentinel lymph nodes (SLNs) are rarely identified in melanoma patients. Lymphoscintigraphy for popliteal SLNs should occur on the day of surgery due to rapid radioactivity decay.
Area of Science:
- Oncology
- Surgical Oncology
- Dermatology
Background:
- The lymphatic drainage patterns to popliteal sentinel lymph nodes (SLNs) in melanoma patients remain underexplored.
- Understanding these patterns is crucial for accurate staging and treatment planning.
Purpose of the Study:
- To investigate the incidence and identification rates of popliteal SLNs in patients with lower extremity melanomas.
- To evaluate the diagnostic utility of lymphoscintigraphy for popliteal SLNs.
Main Methods:
- Lymphoscintigraphy was performed on 663 melanoma patients, followed by sentinel lymphonodectomy.
- Histology and immunohistochemistry were used to analyze SLNs.
- Specific focus was placed on 166 patients with melanomas on the foot, lower leg, or knee.
Main Results:
- Popliteal SLNs were identified in only 9.6% of patients via lymphoscintigraphy.
- Surgical identification of popliteal SLNs was achieved in just 6 of these patients.
- Metastases were diagnosed in 3 popliteal SLNs, 7 inguinal SLNs, and 4 iliac lymph nodes, indicating multi-nodal basin involvement.
Conclusions:
- Popliteal SLNs are infrequently involved in melanoma patients with distal leg lesions.
- Lymphoscintigraphy for popliteal drainage should be conducted on the day of surgery due to rapid signal attenuation.
- The potential involvement of multiple nodal basins (popliteal, inguinal, iliac) complicates lymphadenectomy decisions.
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