Skin melanocytic tumor
Staging
Sentinel node biopsy for melanoma



Topic Completed: 1 May 2013

Revised: 20 May 2019

Copyright: 2002-2019, PathologyOutlines.com, Inc.

PubMed Search: Sentinel node biopsy melanoma


Christopher S. Hale, M.D.
Page views in 2018: 836
Page views in 2019 to date: 466
Cite this page: Hale CS. Sentinel node biopsy for melanoma. PathologyOutlines.com website. http://www.pathologyoutlines.com/topic/skintumormelanocyticsentinelmelanoma.html. Accessed June 19th, 2019.
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

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)
Videos


Wide excision and sentinel node mapping
Differential diagnosis
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