[Histonet] Sentinel Lymph node microtomy

[Terri Braud]

A very interesting question, and I suspect you will receive a wide range of answers.  I, too, was taught to cut the first level, then 3 unstained for possible IHC, then second and 3rd level.  However, further research has shown that micrometastisis has little effect on patient outcomes so in many labs, the IHC performed on sentinel lymph nodes went out of  "fashion". 
For those nodes that are frozen and show metastatic disease, there is little to gain from additional studies, other than one good H&E for permanent section.  For other lymph nodes, we usually start with 3 levels for H&E, 40 microns apart, though I have worked before where the pathologists required 5 levels.  It will be interesting to see the varied responses.
Thanks for posing this interesting question.  Terri

Terri L. Braud, HT(ASCP)
HNL Laboratories for 
Holy Redeemer Hospital
1648 Huntingdon Pike
Meadowbrook, PA 19046
Ph: 215-938-3689
Fax: 215-938-3874
          Honesty
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Today's Topics:

   1. Sentinel lymph node microtomy (Samantha Golden)


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Message: 1
Date: Sun, 2 Oct 2022 18:38:34 +0000 (UTC)
From: Samantha Golden <samantha.golden at ymail.com>
To: "histonet at lists.utsouthwestern.edu"
	<histonet at lists.utsouthwestern.edu>
Subject: [Histonet] Sentinel lymph node microtomy
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I am certain this question has been asked before, but I could not find a clear, definitive answer; perhaps there isn't one but I'm going to ask anyway...

Is there any type of standard for cutting levels on tissue, this example referring to SLN. I was taught to get a representative section for H&E and IHC, go deeper into block for additional sections (50-100 um, using professional judgement), then repeating for the final level(s).?

This results in varying, representative levels throughout the block, plus it leaves tissue for additional studies if necessary. However I've realized that not everyone was taught this same way. I want to be certain I am teaching others a correct way, and would love to have something concrete to refer to for guidance.?

Thanks for any help!

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