[Histonet] Re: Sentinel node protocol

[RSRICHMOND <@t> aol.com]

Michelle Seagle at Rutherford Hospital (where?) asks: >>I was interested in 
knowing what other hospital labs use for their sentinel lymph node protocols 
for breast cases and melanoma cases. I think our hospital's is a little over 
kill.<<

This topic is very controversial and very little standardized. The service I 
just left did a great many of these, many breast cases, many with multiple 
sentinel nodes. They did one H & E, with S100 and MELAN-A for melanoma, and 
cytokeratin AE1/AE3 for breast and squamous carcinoma. Unfortunately, frozen 
sections were also performed, more often than not. 

My personal preference would be no frozen section (except for nodes grossly 
positive on gross examination, which should be done with great care), overnight 
fixation before processing, with the slides as above, and the 
histotechnologist checking them for adequacy before handing them to me.

If Michelle Seagle's question includes how to deal with the radioactivity of 
the specimen: ignore it.

Bob Richmond
Samurai Pathologist
Knoxville TN