Re: Sentinel Lymph Node Biopsy Specimens

From:Patricia Bourne <>

Hi Michelle,

Sentinel Lymph Nodes....being doing them for six
years.  Started by serial sectioning sentinel lymph
nodes that were negative by routine H & E for 21
sections.  Taking sections 1, 4, 8, 12, 16, 20 for
Cytokeratin staining. Slide #20 was used for the
negative.  Slides 2, 5, 9, 13, 17, and 21 for H&E. 
This gave the Pathologist's a chance become familiar
with looking for those very tiny micromet's.  That was
then, now...we serial section to 12 taking sections 1,
4, 8, and 12 for cytokeratin staining.  The negative
section is #2 and there are no H & E's.  All unstained
sections are kept for difficult cases were additional
staining may be necessary.

For those just starting on this adventure, I would
recommend adjacent H & E staining.  Many of the
Pathologists that I have worked with over the years
found this very helpful in screening these lymph nodes
in the beginning.  

For melanoma cases, we started the same way but now
have scaled back to the following:
Sections 1, 3, 5, 7, 9 are H& E's.  Sections 4 is
stained with S-100 and section 6 is stained with
HMB45.  Section 10 is used for the negative.

Now the down side is that you can only charge one
immuno charge for all these sections.  Also if there
are multiple lymph nodes identified under the same
part, again its only one charge.   We do try to put
most lymph nodes in one block.  

Let me know if you need more details.  pat bourne

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