Skin melanocytic tumor
Sentinel node biopsy for melanoma

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

Revised: 17 September 2018, last major update May 2013

Copyright: (c) 2002-2018,, Inc.

PubMed Search: Sentinel node biopsy melanoma

Cite this page: Hale, C. Sentinel node biopsy for melanoma. website. Accessed October 16th, 2018.
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
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

Microscopic (histologic) images

Images hosted on other servers:

D2-40+ lymphatic in tumor

Increased 11q13 (cyclin D1) by FISH

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)

Wide excision and sentinel node mapping
Differential diagnosis