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Related Experiment Videos

Lymph-node revealing solution: a new method for detecting minute lymph nodes in cystectomy specimens

R Koren1, A Paz, D Lask

  • 1Department of Pathology, Rabin Medical Center (Campus Golda), Petah Tiqva, Israel.

British Journal of Urology
|July 1, 1997
PubMed
Summary

A new lymph-node revealing solution (LNRS) significantly improves the detection of normal and metastatic lymph nodes in bladder cancer cystectomy specimens. This method aids in more accurate staging and prognosis assessment for patients.

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Area of Science:

  • Urology
  • Surgical Pathology
  • Oncology

Background:

  • Accurate lymph node staging is critical for bladder cancer treatment.
  • Conventional methods for lymph node detection in cystectomy specimens may miss small or metastatic nodes.
  • Transitional cell carcinoma (TCC) is the most common type of bladder cancer.

Purpose of the Study:

  • To evaluate a novel lymph-node revealing solution (LNRS) for enhanced lymph node detection in bladder cancer cystectomy specimens.
  • To compare the efficacy of LNRS with the conventional method of palpation and sectioning.
  • To assess the impact of LNRS on patient staging and treatment decisions.

Main Methods:

  • Six cystectomy specimens from TCC patients, previously assessed by conventional methods, were further analyzed using LNRS.

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  • Specimens were immersed in a prepared LNRS solution (ethanol, diethyl ether, acetic acid, formalin) for 6-12 hours.
  • Lymph nodes were identified as white nodules against adipose tissue, and their number and metastatic status were recorded according to the TNM system.

    • Main Results:

    • LNRS identified an additional 21 lymph nodes, including 12 metastatic ones, compared to the conventional method which found 22 nodes (4 metastatic).
    • The mean size of lymph nodes detected by LNRS was significantly smaller (3.81 mm) than those found by the conventional method (7.96 mm).
    • Patient staging was upgraded for three individuals, leading to adjuvant chemotherapy for two.

    Conclusions:

    • LNRS significantly increases the detection rate of both normal and metastatic lymph nodes in cystectomy specimens.
    • The solution can identify smaller lymph nodes missed by conventional techniques.
    • LNRS facilitates more accurate staging, improved prognostic assessment, and better-informed decisions regarding adjuvant therapy.