Lymph nodes - not lymphoma
OLD Lymph node dissection

Topic Completed: 1 June 2006

Minor changes: 12 May 2020

Copyright: 2003-2020,, Inc.

PubMed Search: Lymph node dissection[TI] pathology free full text[sb]

See also: Breast - axillary nodes, Breast - sentinel nodes

Page views in 2020 to date: 3
Table of Contents
Definition / general
Cite this page: DePond W. OLD Lymph node dissection. website. Accessed August 6th, 2020.
Definition / general
  • Most lymph nodes are near the wall of the organ
  • Be aware of minimal number of nodes required for staging some carcinomas
  • Either:
    1. Search the fat for nodes while fresh using scissors and forceps and avoid crushing the nodes or
    2. Fix overnight, then search for nodes by shredding the tissue
      • Lymph nodes stand out as white nodules
      • Carnoy solution helps clear the fat
  • Clearing solutions (such as ethanol, diethyl ether, glacial acetic acid and formalin) may help identify additional lymph nodes (Am J Surg Pathol 1997;21:1387, Arch Pathol Lab Med 2003;127:1552, Arch Pathol Lab Med 2001;125:642)
  • For each anatomic group, describe the number of nodes, the size of the largest node and any gross features
  • Submit all lymph nodes for histology; section node if 5 mm or greater in diameter
  • For large nodes grossly involved by tumor, only one section needs to be submitted to demonstrate tumor and possible extranodal extension but save remainder for resampling if necessary
  • For other large nodes, submission of entire node detects additional metastases in some cases (Am J Clin Pathol 1998;109:571)
  • Describe number of nodes in each cassette and whether whole or sectioned
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