Sentinel lymph nodes in cutaneous melanoma: handling, examination, and clinical repercussion.
BACKGROUND
Within the last 15 years, evaluation of sentinel lymph nodes (SLNs) has become the most popular method of early staging of several malignancies, including melanoma. Sentinel lymph nodes are usually examined on formalin-fixed, paraffin-embedded sections and by routine histology/immunohistochemistry (research protocols have used other techniques such as polymerase chain reaction). Approximately 20% of patients with cutaneous melanoma have metastasis in the SLN. In most studies, detection of positive SLN conveys a poorer prognosis for patients with cutaneous melanoma.


OBJECTIVE
To review the morphologic patterns of melanoma metastasis in the SLN, the differential diagnosis, and the quantification of tumor burden as a prognostic factor.


METHODS
Personal observations and review of the pertinent literature.


CONCLUSIONS
Evaluation of sentinel lymph nodes is certainly becoming a widespread technique and most authors agree on its prognostic power for staging patients with cutaneous melanoma. Current studies are evaluating the possible therapeutic value of removal of positive SLNs.
Departments of Pathology and Dermatology, University of Texas M. D. Anderson Cancer Center, Houston, 77030, USA. vprieto@mdanderson.org
Victor G
VG
Prieto
D006801:Humans; D008207:Lymphatic Metastasis; D008545:Melanoma / Q000556:secondary* / Q000601:surgery; D021701:Sentinel Lymph Node Biopsy / Q000379:methods*; D012878:Skin Neoplasms / Q000473:pathology* / Q000601:surgery; D013048:Specimen Handling / Q000379:methods*