2004 Volume 114 Issue 10 Pages 1655-1661
We performed sentinel node biopsies (SNB) in 30 melanoma patients using the techniques of blue dye and the combination of blue dye and radiocolloid. The sentinel node (SN) identified was assessed by routine HE (hematoxylin and eosin) stain and immunohistochemistry. SN was identified in 14 out of 18 cases by the technique of blue dye alone and in all of the 12 cases by the use of technique of blue dye and RI. Using RI in combination resulted in many SN being identified more accurately. On the other hand, interpretation of SN posed a problem in some cases. That is, there were cases in which two or more hot nodes were found by RI in the same and/or different lymph node regions, those in which accumulation to lymph nodes was found in a region different from the conventional lymph node region and those in which the SN could be identified by only the technique of blue dye with no accumulation being found by RI. These findings suggest the necessity of a combinational use of the techniques of blue dye and RI. On a histopathological study of SN, metastasis was found by HE stain in 5 out of 26 cases. Moreover, micrometastasis was confirmed in 3 cases by a combinational use of preparation of serial sections and immunohistochemistry (HMB45, Melan A). The results above suggest that using not only the technique of blue dye but also RI is useful for identifying SN and that performing immunohistochemistry using HMB45 and Melan A in addition to HE stain on the serial sections prepared as permanent specimens is useful for assessing SN.
