Skin - Melanocytic tumor
Miscellaneous
Sentinel node biopsy for melanoma

Author: Christopher Hale, M.D. (see Authors page)

Revised: 15 February 2017, last major update May 2013

Copyright: (c) 2002-2017, PathologyOutlines.com, Inc.

PubMed Search: Sentinel node biopsy melanoma

Cite this page: Sentinel node biopsy for melanoma. PathologyOutlines.com website. http://www.pathologyoutlines.com/topic/skintumormelanocyticsentinelmelanoma.html. Accessed April 26th, 2017.
Definition / General
  • Sentinel lymph node is defined as first extracutaneous target of lymphogenous tumor cell spread and potential source of subsequent lymph node metastases and distant metastases (eMedicine)
  • Interval sentinel nodes: nodes receiving direct lymphatic drainage from primary site but lying between tumor and a recognized node field (Ann Surg Oncol 2011;18:3292)
  • Lymphatic mapping and sentinel lymph node biopsy are widely used for staging
Recommendations
Diagrams / Tables

Images hosted on other servers:

Intraoperative lymphatic mapping and sentinel node

Prognostic Factors

Selected protocols for sentinel nodes:
Clinical Images

Images hosted on other servers:

Lymphatic mapping

Intraoperative left axillary node
seen after uptake with blue dye

Micro Images

Images hosted on other servers:

D2-40+ lymphatic in tumor

Increased 11q13 (cyclin D1) by FISH


Metastatic tumor by RT-PCR, H&E, S100, HMB45

Nevus cells and melanoma cells (S100)

HMB45

Tattoo pigment (not tumor)

Positive Stains
Molecular / Cytogenetics Description
  • RT-PCR: prognostic significance of melanocytic mRNA in histologically negative nodes is controversial (significant - APMIS 2008;116:199, not significant - Mod Pathol 2007;20:427)
  • RT-PCR detects significant sentinel node metastases that are missed by histopathology but overestimates number of patients with clinically significant metastases (Melanoma Res 2003;13:313)
  • FISH detects chromosomal aberrations in 83% of nodal metastatic melanoma vs. 6% of nodal nevi (Am J Surg Pathol 2010;34:231)
Videos


Wide excision and sentinel node mapping
Differential Diagnosis