Sentinel lymph node

Jump to: navigation, search

WikiDoc Resources for Sentinel lymph node

Articles

Most recent articles on Sentinel lymph node

Most cited articles on Sentinel lymph node

Review articles on Sentinel lymph node

Articles on Sentinel lymph node in N Eng J Med, Lancet, BMJ

Media

Powerpoint slides on Sentinel lymph node

Images of Sentinel lymph node

Photos of Sentinel lymph node

Podcasts & MP3s on Sentinel lymph node

Videos on Sentinel lymph node

Evidence Based Medicine

Cochrane Collaboration on Sentinel lymph node

Bandolier on Sentinel lymph node

TRIP on Sentinel lymph node

Clinical Trials

Ongoing Trials on Sentinel lymph node at Clinical Trials.gov

Trial results on Sentinel lymph node

Clinical Trials on Sentinel lymph node at Google

Guidelines / Policies / Govt

US National Guidelines Clearinghouse on Sentinel lymph node

NICE Guidance on Sentinel lymph node

NHS PRODIGY Guidance

FDA on Sentinel lymph node

CDC on Sentinel lymph node

Books

Books on Sentinel lymph node

News

Sentinel lymph node in the news

Be alerted to news on Sentinel lymph node

News trends on Sentinel lymph node

Commentary

Blogs on Sentinel lymph node

Definitions

Definitions of Sentinel lymph node

Patient Resources / Community

Patient resources on Sentinel lymph node

Discussion groups on Sentinel lymph node

Patient Handouts on Sentinel lymph node

Directions to Hospitals Treating Sentinel lymph node

Risk calculators and risk factors for Sentinel lymph node

Healthcare Provider Resources

Symptoms of Sentinel lymph node

Causes & Risk Factors for Sentinel lymph node

Diagnostic studies for Sentinel lymph node

Treatment of Sentinel lymph node

Continuing Medical Education (CME)

CME Programs on Sentinel lymph node

International

Sentinel lymph node en Espanol

Sentinel lymph node en Francais

Business

Sentinel lymph node in the Marketplace

Patents on Sentinel lymph node

Experimental / Informatics

List of terms related to Sentinel lymph node

Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]

Overview

The sentinel lymph node is the hypothetical first lymph node or group of nodes reached by metastasizing cancer cells from a tumor.

Physiology

The spread of some forms of cancer usually follows an orderly progression, spreading first to regional lymph nodes, then the next echelon of lymph nodes, and so on, since the flow of lymph is unidirectional.

Uses

The concept of the sentinel lymph node is important because of the advent of the sentinel lymph node biopsy technique, also known as a sentinel node procedure. This technique is used in the staging of certain types of cancer to see if they have spread to any lymph nodes, since lymph node metastasis is one of the most important prognostic signs.

A blue stained sentinel lymph node in the axilla.

To perform a sentinel lymph node biopsy, the physician performs a lymphoscintigraphy, wherein he first injects blue dye and a harmless radioactive substance near the tumor. This is usually done several hours before the actual biopsy. Then, during the biopsy, the physician visually inspects the lymph nodes for staining and uses a Geiger counter to assess which lymph nodes have taken up the radionuclide. One or several nodes may take up the dye and radioactive tracer, and these nodes are designated the sentinel lymph nodes. The physician then removes these lymph nodes and sends them to a pathologist for rapid examination under a microscope to look for the presence of cancer. A frozen section procedure is commonly employed (which lasts 20-30 minutes), so if neoplasia is detected in the lymph node a further lymph node dissection may be performed. With malignant melanoma, many pathologists eschew frozen sections for more accurate "permanent" specimen preparation due to the increased instances of false-negative with melanocytic staining.

There are various advantages to the sentinel node procedure. First and foremost, it decreases unnecessary lymph node dissections where this is not necessary, thereby reducing the risk of lymphedema, a common complication of this procedure. Increased attention on the node(s) identified to most likely contain metastasis is also more likely to detect micro-metastasis and result in staging and treatment changes. The main uses are in breast cancer and malignant melanoma surgery, although it has been used in other tumor types (colon cancer) with a degree of success (Tanis et al 2001a).

The sentinel node procedure in breast cancer was pioneered by surgical oncologist, Armando Giuliano, MD at the John Wayne Cancer Institute in the 1990s, and confirmative trials followed soon after (Tanis et al 2001b).

References

  • Tanis PJ, Boom RP, Koops HS, Faneyte IF, Peterse JL, Nieweg OE, Rutgers EJ, Tiebosch AT, Kroon BB (2001a). Frozen section investigation of the sentinel node in malignant melanoma and breast cancer. Ann Surg Oncol 8:222-6. PMID 11314938.
  • Tanis PJ, Nieweg OE, Valdes Olmos RA, Th Rutgers EJ, Kroon BB (2001b). History of sentinel node and validation of the technique. Breast Cancer Res 3:109-12. PMID 11250756.

www.sentinelnode.net[2]

da:Skildvagtslymfekirtel de:Wächterlymphknoten nl:Schildwachtklier sk:Sentinelová uzlina



Linked-in.jpg