Table of Contents
Definition / generalCite this page: DePond W. Lymph node dissection. PathologyOutlines.com website. http://www.pathologyoutlines.com/topic/lymphnodeslymphnodedissection.html. Accessed February 21st, 2019.
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:
- Search the fat for nodes while fresh using scissors and forceps and avoid crushing the nodes or
- 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