Search

BACKGROUND: The sentinel lymph node (SLN) procedure is a method for ascertaining the axillary lymph node status in patients with breast cancer. Intraopearative examination of the SLN is important because a positive result directs surgery to a complete axillary lymph node dissection (ALND) and negative result avoids unnessesary lymphadenectomy. The purpose of this study was to evaluate the utility and accuracy of intraoperative touch imprint cytology (ITIC) in patients undergoing SLN for metastatic breast cancer. METHODS: Within three years (2003 – 2006) a total of 79 SLNs from 63 patients (62 female and one male) with T1 to T2 breast carcinoma were examined by ITIC. SLNs were identified by technetium-labelled sulphur colloid and blue dye. They were bisected along the long axis or sliced into 3 mm sections. Imprints were made of each cut surface, stained with Hemacolor rapid staining and reviewed by a cytologist. Later SLNs were submitted for paraffin embedding and serial sectioning. They were stained with HE and immunohistochemical staining for cytokeratin. Intraoperative imprint cytology results were compared with final histological diagnosis. RESULTS: Definitive histology revealed metastases in 17/63 patients (27%) in 20/79 SLNs (25%). Intraoperative cytology showed a sensitivity of 70%, a specificity of 94.9%, a negative predictive value of 90.3%, a positive predictive value of 82.4% and an accuracy of 88.6% per sentinel node basis. There were 6 false-negative cases due to micrometastases in the SLN and 3 “ false positives” in the group with 59 negative SLNs in 46 patients. CONCLUSION: Intraoperative touch imprint cytology of SLN in breast carcinoma patients is a simple, quick and accurate method for detecting metastatic disease in the SLN. Despite its limitations, ITIC evaluation of SLN could spare a second operation to a large number of patients with breast cancer. Results may be improved by an appropriate enlargement of the surface sampled and the use of rapid immunocytochemistry on the touch imprint smears

OBJECTIVE: Sentinel lymph nodes (SLNs) predict the axillary’ s status and may allow lymphadenectomy on a selective basis. The purpose of this study was to evaluate the usefulness and accuracy of intraoperative imprint cytology (IIC) in comparison with definitive histological evaluation of SLN in early breast cancer patients. METHODS: From February 2003 to March 2006 total of 79 SLNs from 63 patients with T1 – T2 breast carcinoma were examined by IIC. SLNs were identified by technetium-labelled sulphur colloid and blue dye and bisected along the long axis. Intraoperative imprints were made of each cut surface, stained with Hemacolor and reviewed by a cytologist. The time taken for procedure was recorded. Histological analysis of SLN involved serial sectioning of the whole node with HE and immunostaining for cytokeratin. RESULTS: Definitive histology revealed metastases in 17/63 patients in 20/79 SLNs. IIC identified metastases in 11 patients (sensitivity 64.7%) in 14 SLNs (sensitivity 70%). All 6 false-negative cases were due to micrometastases in the SLN. In the group with negative SLN (59) in 46 patients, 3 cases were &laquo ; false positives&raquo ; (specificity 94.9% per sentinel and 93.5% per patient basis). The average time to perform intraoperative analysis was 10 min (range: 5 – 20 min). CONCLUSION: Intraoperative imprint cytology of SLN in breast carcinoma patients is a simple, quick and accurate method for detecting metastatic disease in the SLN and enables the surgeon to determine whether or not an axillary lymph node dissection is necessary at the time of the initial surgery

AIMS: To evaluate the utility and to asses the accuracy of intraoperative imprint cytology (IIC) of sentinel lymph nodes(SLNs) in patients with melanoma and to establish this diagnostic procedure in Croatia. METHODS: Seventy two sentninel lymph nodes from patients with melanoma were identified by techentium-labelled sulphur colloid and blue dye. SLNs were evaluated intraoperatively by slicing them into 3 mmsections. Imprints were made of each cut surface and stained with Hemacolor quick method and examined bya cytologist. Permanent cytological imprints were stained with Pappenheim and immunocytochemical staining for S-100 and HMB-45 proteins. Intraoperative imprint cytology results were compared with final histological ones. RESULTS: A total of 72 SLNs were excised from 47 patients with malignant melanoma(1, 6 SLNs per patient). Metastases were identified in 13 patients (27, 5%). The sensitivity of IIC for SSLN was 75%(12/16) per sentinel node and 69%(9/13) per patient basis. All 4 false-negative SLNs by IIC were detected in patients with isolated cellsof melanoma in permanent histopathological sections. No false-positive results were identified(specificity 100%). CONCLUSIONS: Intraoperative imprint cytology of sentinel lymph nodes of metastatic melanoma is reliable and accurate intraoperative technique. It could be used as an alternative to frozen section especially because it is rapid, cost-effective and conserves tissue.

Authors present initial expirience in imprint citology in sentinel lymph nodes.

McCune-Albrightov sindrom u 17-godišnje bolesnice