[Histonet] Revealing lymph nodes

[rsrichmond <@t> aol.com]

I think that a clearing fixative (such as the examples already given; there are also commercial products) is essential for finding the small lymph nodes that are often positive for colon cancer in colon resection specimens. Remember that just one tiny positive lymph node upstages the tumor, and makes chemotherapy mandatory - so there's a real patient care decision involved here.
 
In my travels as a locum tenens pathologist I noted that about half of pathologists were using clearing fixatives, and about half were not. As far as I know there have been no official pronouncements on the subject.
 
Clearing fixatives are less necessary in axillary dissection material for breast cancer - the specimensare smaller and the lymph nodes - and metastases - are usually much bigger. The mesenteries from a colon cancer resection are voluminous and hard to search through.
 
Bob Richmond
Gastonia NC