title: Histopathological mapping of metastatic tumor cells in sentinel lymph nodes of oral and oropharyngeal squamous cell carcinomas.
abstract: BACKGROUND
  Sentinel lymph node biopsy is a reliable technique for accurate determination of the cervical lymph node status in patients with early oral and oropharyngeal cancer but analyses on the distribution pattern of metastatic spread within sentinel lymph nodes are lacking.
  
  
  METHODS
  The localizations of carcinoma deposits were analyzed with a virtual microscope by creating digital images from the microscopic glass slides.
  
  
  RESULTS
  Metastatic deposits were not randomly distributed within sentinel lymph nodes but were predominant in the central planes closer to the lymphatic inlet. Initial evaluation of the 4 most central slices achieved a high rate of 90% for the detection of micrometastases and of 80% for the detection of isolated tumor cells (ITCs).
  
  
  CONCLUSIONS
  Based on the distribution we recommend an initial cut through the hilus and to proceed with the 4 most central 150-µm slices. Complete step sectioning is only required in case of a so far negative result.
authors.affiliation: Department of Otorhinolaryngology, Head and Neck Surgery, Kantonsspital St. Gallen, Switzerland.
authors.forename: Seraina
authors.initials: S
authors.lastname: Denoth
authors.affiliation: Department of Otorhinolaryngology, Head and Neck Surgery, Kantonsspital St. Gallen, Switzerland.
authors.forename: Martina A
authors.initials: MA
authors.lastname: Broglie
authors.affiliation: Department of Otorhinolaryngology, Head and Neck Surgery, University Hospital Zurich, Switzerland.
authors.forename: Stephan K
authors.initials: SK
authors.lastname: Haerle
authors.affiliation: Department of Otorhinolaryngology, Head and Neck Surgery, University Hospital Zurich, Switzerland.
authors.forename: Gerhard F
authors.initials: GF
authors.lastname: Huber
authors.affiliation: Clinical Trials Unit, Kantonsspital St. Gallen, Switzerland.
authors.forename: Sarah R
authors.initials: SR
authors.lastname: Haile
authors.affiliation: Department of Clinical Pathology, University Hospital of Zurich, Switzerland.
authors.forename: Alex
authors.initials: A
authors.lastname: Soltermann
authors.affiliation: Institute of Pathology, Kantonsspital St. Gallen, Switzerland.
authors.forename: Wolfram
authors.initials: W
authors.lastname: Jochum
authors.affiliation: Department of Otorhinolaryngology, Head and Neck Surgery, Kantonsspital St. Gallen, Switzerland.
authors.forename: Sandro J
authors.initials: SJ
authors.lastname: Stoeckli
mesh_terms: D000328:Adult; D002294:Carcinoma, Squamous Cell / Q000473:pathology*; D005260:Female; D006801:Humans; D008198:Lymph Nodes / Q000473:pathology*; D008207:Lymphatic Metastasis / Q000473:pathology; D008297:Male; D008875:Middle Aged; D009062:Mouth Neoplasms / Q000473:pathology*; D061206:Neoplasm Micrometastasis; D009367:Neoplasm Staging; D009959:Oropharyngeal Neoplasms / Q000473:pathology*; D011446:Prospective Studies; D021701:Sentinel Lymph Node Biopsy
keywords: 3D distribution; head and neck squamous cell carcinoma; histopathological mapping; occult metastases; sentinel node biopsy