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Lymph node-revealing solution: simple new method for detecting minute lymph nodes in colon carcinoma
1Department of Pathology, Petach-Tiqua and the Sackler School of Medicine, Tel-Aviv University, Israel.
Diseases of the Colon and Rectum
|April 1, 1997
Summary
A new lymph node-revealing solution (LNRS) effectively detects tiny metastatic lymph nodes in colon cancer specimens. This easy technique improves cancer staging and influences treatment decisions by identifying previously missed small nodes.
Area of Science:
- Oncology
- Surgical Pathology
Background:
- Accurate staging of colon cancer relies on detecting metastatic lymph nodes.
- Small lymph nodes are frequently missed during routine pathological examination, potentially leading to understaging.
Purpose of the Study:
- To introduce a novel, straightforward method for identifying minute lymph nodes in colon cancer specimens.
- To enhance the detection rate of metastatic lymph nodes in challenging cases.
Main Methods:
- A lymph node-revealing solution (LNRS) was developed using fixatives and fatty solvents.
- Mesocolonic fat specimens were immersed in LNRS for six hours, causing lymph nodes to appear as distinct white nodules.
- Excised lymph nodes were processed and stained for histological examination.
Main Results:
- LNRS identified 258 additional lymph nodes (0.5-7 mm) across 30 problematic cases, significantly increasing the yield compared to traditional methods (88 nodes).
- The technique led to upstaging in several cases, including changes in N classification and from Dukes B to C.
- Histological and immunohistochemical staining quality remained comparable to standard formalin-fixed tissues.
Conclusions:
- The lymph node-revealing solution (LNRS) is a simple, rapid, and cost-effective technique for detecting small lymph nodes.
- Improved detection of small metastatic lymph nodes can alter colon cancer staging and guide therapeutic strategies.