General
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• See also breast-axillary nodes, breast-sentinel nodes, staging for various malignancies
• Most lymph nodes are near the wall of the organ
• Be aware of minimal number of nodes required for staging some carcinomas
• Either (a) search the fat for nodes while fresh using scissors and forceps and avoid crushing the nodes, or (b) fix overnight, then search for nodes by shredding the tissue; lymph nodes stand out as white nodules; Carnoy’s 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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