Lymph node revealing solution: is it effective on detecting minute lymph nodes?
OBJECTIVE
The aim of this prospective study is to detect the efficiency of a previously described lymph node revealing solution (LNRS) in comparing with conventional lymph node dissection and re-dissection in colon, breast and urinary bladder carcinomas.


METHODS
Total 30 cases in which less than 10 lymph nodes were found by conventional method, were immersed for 6-8 hours in LNRS, dissected and processed. Control group, 12 cases, was first dissected then a second conventional dissection was performed. At the end, specimens were again immersed in LNRS for 6-8 hours and last dissections were done.


RESULTS
In the first group, a total of 150 lymph nodes, 46 of them with metastasis were detected. After using LNRS, 26 additional lymph nodes among which 10 were positive were detected. When compared with the results of conventional dissection, the increase in number of total and metastatic lymph nodes with LNRS was significant (p<0.01). The mean size of the lymph nodes detected by the conventional and LNRS methods was 6.8 and 4.2 mm, respectively. The pathologic lymph node stage was changed in three bladder carcinoma cases, and one breast carcinoma. In the control group, 75 lymph nodes (11 with metastases), 19 lymph nodes (3 with metastases), 14 lymph nodes (one with metastases) were detected after first and second conventional dissection and LNRS methods, respectively.


CONCLUSIONS
LNRS enhanced the number of total and metastatic lymph nodes and is effective in detecting small lymph nodes. This method is useful for accurate staging where the number of detected lymph nodes is too small by the conventional method.
Department of Pathology, Izmir Atatürk Teaching Hospital, Turkey. hasanustun@netscape.net.
M O
MO
Ustün
B
B
Onal
N
N
Tuğyan
T
T
Rezanko
D000230:Adenocarcinoma / Q000175:diagnosis / Q000556:secondary / Q000601:surgery; D001943:Breast Neoplasms / Q000473:pathology / Q000601:surgery; D018270:Carcinoma, Ductal, Breast / Q000175:diagnosis / Q000556:secondary / Q000601:surgery; D002295:Carcinoma, Transitional Cell / Q000175:diagnosis / Q000556:secondary / Q000601:surgery; D003110:Colonic Neoplasms / Q000473:pathology / Q000601:surgery; D005260:Female; D005404:Fixatives; D006801:Humans; D008197:Lymph Node Excision; D008198:Lymph Nodes / Q000473:pathology* / Q000601:surgery; D008207:Lymphatic Metastasis / Q000175:diagnosis*; D009367:Neoplasm Staging; D011446:Prospective Studies; D013194:Staining and Labeling; D001749:Urinary Bladder Neoplasms / Q000473:pathology / Q000601:surgery
D005404:Fixatives