Interval Sentinel Lymph Nodes: An Unusual Localization in Patients with Cutaneous Melanoma

Background. Recent studies have demonstrated that there exists a great variation in the lymphatic drainage in patients with malignant melanoma. Some patients have drainage to lymph nodes outside of conventional nodal basins. The lymph nodes that exist between a primary melanoma and its regional noda...

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Main Authors: A. M. Manganoni, R. Farfaglia, E. Sereni, C. Farisoglio, C. Pizzocaro, D. Marocolo, F. Gavazzoni, L. Pavoni, P. Calzavara-Pinton
Format: Article
Language:English
Published: Wiley 2011-01-01
Series:Dermatology Research and Practice
Online Access:http://dx.doi.org/10.1155/2011/506790
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author A. M. Manganoni
R. Farfaglia
E. Sereni
C. Farisoglio
C. Pizzocaro
D. Marocolo
F. Gavazzoni
L. Pavoni
P. Calzavara-Pinton
author_facet A. M. Manganoni
R. Farfaglia
E. Sereni
C. Farisoglio
C. Pizzocaro
D. Marocolo
F. Gavazzoni
L. Pavoni
P. Calzavara-Pinton
author_sort A. M. Manganoni
collection DOAJ
description Background. Recent studies have demonstrated that there exists a great variation in the lymphatic drainage in patients with malignant melanoma. Some patients have drainage to lymph nodes outside of conventional nodal basins. The lymph nodes that exist between a primary melanoma and its regional nodal basin are defined “interval nodes”. Interval node occurs in a small minority of patients with forearm melanoma. We report our experience of the Melanoma Unit of University Hospital Spedali Civili Brescia, Italy. Methods. Lymphatic mapping using cutaneous lymphoscintigraphy (LS) has become a standard preoperative diagnostic procedure to locate the sentinel lymph nodes (SLNs) in cutaneous melanoma. We used LS to identify sentinel lymph nodes biopsy (SLNB) in 480 patients. Results. From over 2100 patients affected by cutaneous melanoma, we identified 2 interval nodes in 480 patients with SLNB . The melanomas were both located in the left forearm. The interval nodes were also both located in the left arm. Conclusion. The combination of preoperative LS and intraoperative hand-held gamma detecting probe plays a remarkable role in identifying these uncommon lymph node locations. Knowledge of the unusual drainage patterns will help to ensure the accuracy and the completeness of sentinel nodes identification.
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spelling doaj-art-3c2fba6ff0584d53b597a33ce9f273f62025-08-20T02:08:16ZengWileyDermatology Research and Practice1687-61051687-61132011-01-01201110.1155/2011/506790506790Interval Sentinel Lymph Nodes: An Unusual Localization in Patients with Cutaneous MelanomaA. M. Manganoni0R. Farfaglia1E. Sereni2C. Farisoglio3C. Pizzocaro4D. Marocolo5F. Gavazzoni6L. Pavoni7P. Calzavara-Pinton8Department of Dermatology, University Hospital Spedali Civili, 25123 Brescia, ItalyDepartment of II Surgery, University Hospital Spedali Civili, 25123 Brescia, ItalyDepartment of Dermatology, University Hospital Spedali Civili, 25123 Brescia, ItalyDepartment of Dermatology, University Hospital Spedali Civili, 25123 Brescia, ItalyDepartment of Nuclear Medicine, University Hospital Spedali Civili, 25123 Brescia, ItalyDepartment of I Pathology, University Hospital Spedali Civili, 25123 Brescia, ItalyDepartment of Dermatology, University Hospital Spedali Civili, 25123 Brescia, ItalyDepartment of Dermatology, University Hospital Spedali Civili, 25123 Brescia, ItalyDepartment of Dermatology, University Hospital Spedali Civili, 25123 Brescia, ItalyBackground. Recent studies have demonstrated that there exists a great variation in the lymphatic drainage in patients with malignant melanoma. Some patients have drainage to lymph nodes outside of conventional nodal basins. The lymph nodes that exist between a primary melanoma and its regional nodal basin are defined “interval nodes”. Interval node occurs in a small minority of patients with forearm melanoma. We report our experience of the Melanoma Unit of University Hospital Spedali Civili Brescia, Italy. Methods. Lymphatic mapping using cutaneous lymphoscintigraphy (LS) has become a standard preoperative diagnostic procedure to locate the sentinel lymph nodes (SLNs) in cutaneous melanoma. We used LS to identify sentinel lymph nodes biopsy (SLNB) in 480 patients. Results. From over 2100 patients affected by cutaneous melanoma, we identified 2 interval nodes in 480 patients with SLNB . The melanomas were both located in the left forearm. The interval nodes were also both located in the left arm. Conclusion. The combination of preoperative LS and intraoperative hand-held gamma detecting probe plays a remarkable role in identifying these uncommon lymph node locations. Knowledge of the unusual drainage patterns will help to ensure the accuracy and the completeness of sentinel nodes identification.http://dx.doi.org/10.1155/2011/506790
spellingShingle A. M. Manganoni
R. Farfaglia
E. Sereni
C. Farisoglio
C. Pizzocaro
D. Marocolo
F. Gavazzoni
L. Pavoni
P. Calzavara-Pinton
Interval Sentinel Lymph Nodes: An Unusual Localization in Patients with Cutaneous Melanoma
Dermatology Research and Practice
title Interval Sentinel Lymph Nodes: An Unusual Localization in Patients with Cutaneous Melanoma
title_full Interval Sentinel Lymph Nodes: An Unusual Localization in Patients with Cutaneous Melanoma
title_fullStr Interval Sentinel Lymph Nodes: An Unusual Localization in Patients with Cutaneous Melanoma
title_full_unstemmed Interval Sentinel Lymph Nodes: An Unusual Localization in Patients with Cutaneous Melanoma
title_short Interval Sentinel Lymph Nodes: An Unusual Localization in Patients with Cutaneous Melanoma
title_sort interval sentinel lymph nodes an unusual localization in patients with cutaneous melanoma
url http://dx.doi.org/10.1155/2011/506790
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