Melanoma Sentinel Lymph node

Sentinel Lymph Node Biopsy (SLNB)

in Malignant Melanoma

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Melanoma Risk Factors

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Malignat Melanoma

Malignant Melanoma Prognostic factors

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Malignant Melanoma

Sentinel Lymph node procedure in Malignant Melanoma

Malignant Melanoma

Processing of Sentinel Lymph node in malignant melanoma

Cochran Method:

•As majority of metastases are in a central plane, the bivalve technique in which a slice is made through the convex capsule and the hilum, reveals the maximum cut surface

Sentinel Lymph node for melanomaPathology Processing protocol

•The lymph node is either bivalved or cut into 3 mm blocks, depending on the size of the node. •Sections 1, 3, and 5 are stained with haematoxylin and eosin (H&E)

•Sections 2 and 4 are immunohistochemically stained for S-100 and HMB-45

Cook, M G et al. J Clin Pathol 2008;61:897-902

Metastases of melanoma are said to occur close to the median plane of the sentinel lymph node and therefore bivalving, as shown, and embedding face down in the cassette are recommended.

Processing of Sentinel Lymph node in malignant melanoma

The alternative technique recommended by Starz et al

•Consists of slicing the SLN at 2 mm intervals.• It is attractive in that it does not depend on the slightly difficult

identification of a central plane •It does not require multiple sections on each slice. •In larger nodes, there may be a need for several blocks.

Processing of Sentinel Lymph node in Malignant Melanoma

S-100 immunostaining of a sentinel lymph node demonstrating metastatic cells in a subcapsular sinuse.

HMB-45 staining showing metastatic melanoma cells within subcapsular sinuses of a sentinel lymph node.

Sentinel Lymph node in Malignant Melanoma

Melanoma Sentinel Lymph node

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