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PubMed1981

Aspiration cytology of lymph nodes in leprosy.

Lymph node aspiration cytology smear patterns were analyzed in 60 cases of leprosy. A Type I smear pattern was found in 51.7%, Type II in 25%, Type III in 16.6%, and Type IV in 6.7% of the cases. Comparing with the histopathological diagnosis, Type I and Type II smears corresponded to LL lesions. Type III smears corresponded to BB lesions toward the lepromatous end of the spectrum, and Type IV smears corresponded to BB lesions toward the tuberculoid end of the spectrum. An increasing degree of lymphocytic cell admixture was noticed from Type I to Type IV smears with a changing appearance from classical foamy histiocytes in Type I and Type II smears to atypical histiocytes in Type III smears and epithelioid histiocytes in Type IV cases. These findings correlated with the better cell-mediated immune reactivity observed in these patients as the disease spectrum crosses from Type I and Type II smears to Type III and Type IV smears. A larger number of cases needs to be studied for definite assessment of these criteria.

Biopsy, Needle↗

PubMed1976

Elevated levels of immunoglobulin E in the acute febrile mucocutaneous lymph node syndrome.

Mucocutaneous lymph node syndrome (MCLS) is a newly recognized disease characterized by fever persisting for more than 5 days, an erythematous skin eruption, conjunctival congestion, dry red fissured lips, reddened tongue, palms, and soles, nonpurulent lymphadenopathy, and sometines diarrhea, arthralgia, and aseptic meningitis. Additional features may include carditis, pericarditis, aneurysmal dilation and thrombosis of coronary arteries, and sudden death. There is a striking similarity of fatal cases to infantile polyarteritis nodosa, a disease recently reported to be associated with elevated levels of serium IgE. Indeed, it is likely that MCLS represents a disease which can progress to polyarteritis nodosa in infants and young children. The paired acute and convalescent serum IgE levels of 20 subjects with acute nonfatal MCLS were studied along with 20 near-age unaffected controls from the same communities in Japan. The results indicate that most if not all subjects with MCLS in the study had an elevation of total serum IgE during the acute phase of the disease (geometric mean 157 IU/ml compared with the control value of 38 IU/ml, P = 0.005). The level appeared to reach a peak 1-2 weeks after onset and declined over the ensuing 1-2 months.

Acute Disease↗

PubMed1986

A histologic study of lymph nodes from patients with the Sézary syndrome.

Lymph node sections from 12 patients with Sézary syndrome (SS) were studied histologically. The histopathologic alterations were compared with those in lymph nodes from four patients with (erythrodermatic) mycosis fungoides (MF) and two patients with a benign form of erythroderma. Most SS lymph nodes showed a rather monotonous and diffuse infiltration of cerebriform mononuclear cells (CMC), which tended to efface the normal lymph node architecture. By contrast, in lymph nodes involved by MF there was not only an increase in the number of CMC, but also a marked increase in the number of interdigitating reticulum cells that often showed a considerable degree of nuclear polymorphia. In the advanced stages of lymph node involvement by MF, blastic transformation was much more pronounced than in the SS lymph nodes. These histologic differences between MF and SS lymph nodes suggest that different pathogenetic mechanisms may be operative in the development of either of these conditions.

Adult↗

PubMed1995

Canine IgE monoclonal antibody specific for a filarial antigen: production by a canine x murine heterohybridoma using B cells from a clinically affected lymph node.

Canine popliteal lymph node cells taken at the onset of clinical disease from a rear limb infected with the filarial nematode Brugia pahangi were fused with mouse myeloma cell line P3X63.Ag8.653 cells. Of the several canine immunoglobulin-producing clones from this fusion, one was found to produce canine IgE specific for a filarial nematode antigen. The cell line has undergone limiting dilution cloning six times over the past 3 years and continues to produce monoclonal antibody of the IgE subclass at a rate of greater than 3 mg/l. Sodium dodecyl sulphate-polyacrylamide gel electrophoresis (SDS-PAGE) of the cell culture supernatant protein that bound to protein A beads, showed bands at molecular weights (MW) of approximately 75,000 and 25,000 that were characteristic of epsilon and kappa or lambda chains, respectively. A mouse monoclonal antibody specific for canine IgE bound the 75,000 MW band, as demonstrated by Western blot. Western blots of aqueous extracts of adult filarial nematodes demonstrated binding of the canine IgE monoclonal antibody to a single 35,000 MW peptide from B. pahangi but not Dirofilaria immitis; immunochemistry using frozen sections of adult worms, microfilariae and fourth stage larvae revealed focal binding of the monoclonal IgE to worm tissue adjacent to dorsal and ventral cords of only Brugia adults.

Animals↗

PubMed1982

[Noninvasive evaluation of cardiac involvements and left ventricular function in schoolchildren with the history of mucocutaneous lymph node syndrome].

Mucocutaneous lymph node syndrome (MCLS) in the young has been known to have coronary aneurysms, and then it has been recently suspected as a cause of premature atherosclerosis and cardiomyopathy. Thirty-three schoolchildren who suffered from MCLS were studied to evaluate cardiac involvements and left ventricular function using two-dimensional (2-D) echocardiograms and submaximal stress test. Fifteen normal schoolchildren were studied as normal control. All these MCLS children were asymptomatic and had no significant findings in routine chest X-ray and electrocardiographic examinations. According to submaximal stress test, 8 cases showed a J type ST depression of only 0.5--1.0 mm, and there were no positive cases. Using 2-D echocardiograms, the left coronary artery was detected in 85% and the right coronary in 27%. One case showed an aneurysm of the left coronary artery. However, none of them showed abnormal left ventricular wall motion or the wall motion abnormality compatible with cardiomyopathy. There were no significant differences between MCLS and normal control in ejection fraction, mean VCF, diastolic descent rate of the anterior mitral valve, D/S ratio of the left ventricular wall, and Weissler's index (PEP/ET). These findings suggested that 1) most of MCLS schoolchildren do not have obvious cardiac involvement and their left ventricular function is within normal limits, 2) because of its low sensitivity, submaximal stress test is not so useful in screening coronary lesions, and 3) the 2-D echocardiogram works not only in detecting coronary aneurysms but also in evaluating left ventricular function.

Adolescent↗

PubMed1975

[Volumetric follow-up measurements in normal and pathologic lymph nodes (author's transl)].

Alteration of Lymph node volume are measured in different groups of patients. Irradiated Lymph nodes diminish volume significantly more and faster than non-irradiated ones. Lymph nodes with reactive hyperplasia with/without irradiation show a significantly smaller volume decrease than normal Lymph nodes. Malignant systemic diseases have a significant higher volume decrease than normal or reactive hyperplastic Lymph nodes with identical irradiation-dose.

Diagnosis, Differential↗

PubMed1999

Analysis of paraaortic lymph node involvement in pancreatic carcinoma: a significant indication for surgery?

BACKGROUND: Lymph node status is a key prognostic factor for pancreatic carcinoma. The paraaortic lymph nodes are the highest level of lymph nodes that can be resected safely in the abdomen for pancreatic and other gastrointestinal tumors. The pattern of paraaortic lymph node involvement and its relation with other lymph node groups were analyzed and the significance of this information relative to surgical therapy examined. METHODS: Between 1974-1996, 99 patients with invasive ductal carcinoma of the pancreas underwent pancreatectomy at the study institution. The pattern of lymph node involvement, particularly paraaortic, was evaluated by careful pathologic review of extended lymphadenectomy specimens. RESULTS. Fifty-eight of 76 patients (76%) with carcinoma in the pancreatic head (Ph) and 19 of 23 patients (83%) with carcinoma of the pancreatic body and tail (Pbt) had lymph node involvement. Fourteen patients with Ph disease (18%) and 4 with Pbt disease (17%) had paraaortic lymph node involvement. Tumor size did not correlate with paraaortic lymph node involvement. A correlation was found between Group 13 (posterior pancreaticoduodenal lymph nodes), Group 14 (lymph nodes surrounding the superior mesenteric artery), and the paraaortic lymph nodes for Ph disease. All paraaortic lymph node metastases were located in the 16M region (the region between the celiac trunk and the inferior mesenteric artery). For patients with Pbt disease, the distribution of paraaortic lymph node metastases was the same as for those with Ph disease. Only 33% of cases of paraaortic lymph node metastases were suspected preoperatively or perioperatively. The longest survival for a patient with paraaortic lymph node metastases was 36 months and 17 months, respectively, for patients with Ph and Pbt disease. CONCLUSIONS: The paraaortic lymph nodes are frequent sites of metastasis from pancreatic carcinoma, and are difficult to evaluate preoperatively or perioperatively. This situation mandates paraaortic lymph node dissection, at least in the 16M region.

Adult↗

PubMed2003

The utility of sentinel lymph node biopsy in head and neck melanoma in the pediatric population.

Intraoperative lymph node mapping and sentinel lymph node biopsy have proven beneficial techniques in staging adult patients with melanoma of the head and neck, where there is great variability in lymphatic drainage. This technique has also been applied to pediatric patients with truncal cutaneous melanomas in an effort to determine nodal status without the morbidity associated with complete lymph node dissection. Nevertheless, the utility of sentinel lymph node biopsy in head and neck melanoma in the pediatric population has not been established. The objective of the authors' study was to determine the clinical utility of intraoperative lymph node mapping and sentinel lymph node biopsy of head and neck melanoma in the pediatric population. The authors reviewed the records of seven pediatric patients with head and neck melanoma or borderline melanocytic proliferations of unknown biologic potential who underwent intraoperative lymph node mapping and sentinel lymph node biopsy between 1998 and 2001. All sentinel lymph node specimens were examined by a melanoma dermatopathologist for the presence of metastatic melanoma. The mean operative time for each case was 3 hours, 8 minutes (range, 2 hours, 15 minutes to 3 hours, 50 minutes). All seven pediatric patients who underwent extirpation of a primary head and neck melanoma and preoperative lymphoscintigraphy had unique and identifiable basins of drainage to regional nodal groups. Four of seven patients had at least one positive sentinel lymph node. Overall, five of 19 sentinel nodes (26 percent) resected had evidence of metastatic melanoma. Of the patients with positive sentinel lymph nodes, two of the primary lesions were diagnosed as melanoma while two were initially considered atypical melanocytic proliferations of uncertain biologic potential with melanoma in the differential diagnosis. Sentinel lymph nodes in pediatric patients with melanoma of the head and neck can be successfully mapped and biopsied, as in adult patients. In addition, this procedure can provide critical diagnostic information for those pediatric patients with diagnostically challenging, controversial, or borderline melanocytic lesions.

Child, Preschool↗

PubMed2004

Lymphatic mapping and sentinel node identification as related to the primary sites of lymph node metastasis in early stage ovarian cancer.

OBJECTIVE: We evaluated the primary sites of lymph node (LN) metastasis in patients during the early stage of ovarian cancer. METHODS: Study 1: patients with clinical stage I and II common epithelial ovarian carcinoma (n = 150) underwent systematic retroperitoneal LN dissection of the pelvic and paraaortic areas. The relationship between the incidence and location of LN metastasis and clinical and histological characteristics was examined. Study 2: we studied 11 women with endometrial or fallopian tube tumors. At laparotomy, activated charcoal solution was injected into the unilateral cortex of the ovary. Ten minutes later, the retroperitoneal spaces were opened and charcoal uptake within the pelvic lymph node (PLN) and paraaortic node (PAN) as far as the level of renal vein was examined. RESULTS: Study 1: The incidence of LN metastasis by stage was 6.5% (8/123) in stage I and 40.7% (11/27) in stage II. Among 19 patients with LN metastasis, 14 had only PAN, 2 had only pelvic LN, and 3 had both PAN and PLN metastases. Metastasis was limited to the ipsilateral side in 12 (63%) patients, but was bilateral in 5 (26%) and contralateral to the neoplastic ovary in 2 (11%). Positive peritoneal cytology was significantly (P < 0.05) correlated with lymph node metastasis. Study 2: Lymphatic channels along the ovarian vessels were identified in all injected ovaries. Charcoal was deposited in the LN of all patients. The locations of these nodes included PAN in all patients, common iliac node in three, and external iliac node in one. CONCLUSION: PAN is the primary site of LN metastasis in ovarian cancer. Bilateral PAN dissections are necessary to determine the extent of tumors even in stage I ovarian carcinoma.

Adult↗

PubMedDate not supplied

Sentinel node biopsy performed before preoperative chemotherapy for axillary lymph node staging in breast cancer.

Sentinel node (SN) biopsy in breast cancer patients following preoperative chemotherapy is associated with a decreased identification rate and an increased false-negative rate when compared to SN biopsy performed in untreated patients. We performed SN biopsy in 21 breast cancer patients scheduled for preoperative chemotherapy using either vital blue dye alone (n = 11) or in combination with a radiocolloid (n = 10). Following a mean of four cycles of preoperative chemotherapy, surgery to the breast and complete axillary lymph node dissection was performed irrespective of the SN status. A mean of 1.9 SNs were identified in all 21 patients, 12 were SN negative and 9 were SN positive. Preoperative chemotherapy decreased mean tumor size from 40.2 to 17.7 mm and breast conservation was possible in 14 of 21 patients (67%). All SN-negative patients and three of nine SN-positive patients had negative lymph nodes in the axillary specimen, whereas six of nine patients with a positive SN revealed lymph node metastases following preoperative chemotherapy. SN biopsy performed before preoperative chemotherapy found a 100% identification rate with no false-negative results. Following preoperative chemotherapy, SN-negative patients may forego a complete axillary dissection.

Adult↗

PubMedDate not supplied

Fine needle aspiration cytology of Langerhans cell histiocytosis confined to lymph nodes. A case report.

BACKGROUND: Lymph node involvement in Langerhans cell (LC) histiocytosis (LCH) can be seen as a component of the systemic form, or it may be the initial and sometimes exclusive manifestation of the disease. Descriptions of patients with LCH whose disease is confined to lymph nodes are rare. CASE: We present a case of LCH confined to lymph nodes initially diagnosed by fine needle aspiration (FNA) cytology in a 43-year-old male. The cytologic findings in LCH included high cellularity, isolated LCs with prominent nuclear indentations and grooves, multinucleate giant cells, eosinophils and lymphocytes. Confirmation of LCH was obtained by positive S-100 protein immunohistochemical staining and the demonstration of Birbeck granules on electron microscopy. CONCLUSION: The presence of LCs with prominent nuclear indentations and grooves is characteristic of LCH confined to lymph nodes and serves as a key point in suggesting the diagnosis of LCH.

Adult↗

PubMedDate not supplied

The patterns of IL2, IFN-gamma, IL4 and IL5 gene expression in Hodgkin's disease and reactive lymph nodes are similar.

BACKGROUND AND OBJECTIVE: The lymph nodes involved in classic Hodgkin's disease (HD), i.e. mixed cellularity (MC) and nodular sclerosis (NS) subtypes, usually contain few (1-2%) Reed-Sternberg (RS) cells scattered in a background of lymphocytes, eosinophils, plasma cells and neutrophils. CD4+ T-lymphocytes are increased in number, express activation markers and cluster around RS cells. The presence of eosinophilia in most HD patients and the presence of hyper-IgE in a subset of them may suggest that activated lymph node T cells release large amounts of IL5 and IL4, respectively. METHODS: The expression of four T-cell-associated cytokine genes, i.e. interleukin (IL)2, IL4, IL5 and interferon (IFN)-gamma, in frozen sections of 14 HD (7 MC, 7 NS) and 10 reactive lymph nodes was investigated by qualitative and quantitative reverse transcriptase-polymerase chain reaction (RT-PCR). T-cell clones were also raised from purified CD4+ lymphocytes of one HD lymph node and one reactive lymph node and tested for IL2, IL4, IL5 and IFN-gamma secretion in culture supernatants by immunoassays. RESULTS: The transcripts of all the cytokine genes were detected in every lymph node irrespective of the HD or reactive nature. HD or reactive lymph node-derived CD4+ T-cell clones released the four cytokines according to a predominant T-helper (Th)0-type pattern. In more than half of the lymph nodes of either HD or reactive nature, there was a predominance of IL4 over IFN-gamma mRNA production (Th2-type pattern). In the remaining HD or reactive lymphadenopathies, either a balanced IL4/IFN-gamma mRNA ratio (Th0-type pattern) or a predominance of IFN-gamma over IL4 mRNA expression (Th1-type pattern) was observed. INTERPRETATION AND CONCLUSIONS: The overall pattern of cytokine gene expression in classic HD is similar to that detected in reactive lymph nodes. Further studies are needed to determine whether differences in the absolute concentrations of cytokines released in HD versus reactive lymph nodes and the long-standing course of HD versus the self-limiting nature of reactive adenopathies may explain certain peculiar features of HD, such as eosinophilia, for example.

Adolescent↗

PubMed1997

[The clinical study of radical cystectomy for lymph node positive bladder cancer].

BACKGROUND: The impact of pelvic lymph node dissection on the survival of patients with lymph node positive bladder cancer is controversial. We analyzed the records of the bladder cancer patients treated with radical cystectomy. METHODS: Between 1976 and 1993, 84 patients with transitional cell carcinoma of the bladder were treated with radical cystectomy at Tokyo Metropolitan Komagome General Hospital. Sixteen patients (19.0%) had pathologically proved nodal metastases. These patients' records were reviewed with regard to pathological status, and the outcome compared with negative lymph node patients. The two patients with pN3, which we could not completely undergo lymph node dissection of, were excluded from the analyses for recurrence and survival. RESULTS: There were 10 males and 6 females, aged between 47 and 83 with a mean of 68.3 years. There were significant differences between the patients with positive lymph node and negative in the rate of grade 3 and the rate of infiltration of cancer to the vein and lymphatics of the bladder walls. The frequency of the patients of positive lymph node was 5.3% in pT1, 10.0% in pT2, 28.6% in pT3a, 32.0% in pT3b, 50.0% in pT4, and none in pTis, pTa and pT4is. The five-year survival rates estimated by the Kaplan-Meier method were 68.6% over all 82 patients, 75.7% for the patients with negative lymph node and 30.7% for positive. Of the patients with positive lymph node, two-year survival was 80.0% for pT2-3a, versus 0% for pT3b-4. This difference was highly significant (p < 0.01). But survival analysis for pT2-3a showed no significant difference between the lymph node negative patients and positive. The recurrence rate was 57.1% (8 of 14) in patients with positive lymph node and seven patients suffered from distant metastases. All the patients which had recurrent tumors died by bladder cancer. CONCLUSION: Radical cystectomy with lymph node dissection can provide favorable outcome in lymph node positive patients with low stage (pT2-3a). But the patients with high stage (> or = pT3b) were poor prognosis. Most of the patients died by distant metastases.

Aged↗

PubMed2000

[Initial experiences with sentinel lymph node biopsy in malignant melanoma].

Elective versus therapeutic lymph node dissection has been a controversial field of the surgical treatment of cutaneous malignant melanoma for more than two decades. The identification and biopsy of the sentinel lymph node in different solid malignancies has become feasible by the method described by Morton in 1992. The sentinel lymph node is the first tumor draining lymph node in the regional lymph node basin. If metastasis is not proven in the sentinel node by detailed histological study those are unlikely in other regional lymph nodes and formal lymph node dissection can be omitted. Patients undergoing surgery for primary cutaneous (intermediate or high risk) melanoma have been initiated in this feasibility study. Of the 40 patients the sentinel lymph node biopsy was unsuccessful in two and at least one positive sentinel lymph node was found in nine patients. The duration of the procedure is between five and 15 minutes. After this feasibility study further prospective and randomized studies are projected.

Adult↗

PubMed2001

Aberrant drainage and missed micrometastases: the value of lymphatic mapping and focused analysis of sentinel lymph nodes in gastrointestinal neoplasms.

Lymph node analysis is essential for staging gastrointestinal (GI) neoplasms. Our group has conducted several studies of intraoperative lymphatic mapping and sentinel lymphadenectomy (LM/SL) for the staging of GI neoplasms. LM is performed following injection of 0.5-1 ml of isosulfan blue dye, and blue-stained sentinel lymph nodes (SLNs) are analyzed by hematoxylin and eosin (H&E) staining, multiple sectioning, and cytokeratin immunohistochemistry. In feasibility trials, LM identified at least one SLN in 121 of 126 patients. Of the 58 cases with nodal metastasis, 50 (89%) had at least one positive SLN and 24 (42%) had nodal metastasis only in the SLN. In 25 cases, tumor deposits were identified by multiple sectioning (n = 8) or immunohistochemistry (n = 17) only. In 10 cases (8%), LM identified aberrant lymphatic drainage that altered the extent of the lymphadenectomy. Our cumulative experience indicates that focused analysis of the SLNs draining GI neoplasms can increase the detection of micrometastases and may improve selection of patients for adjuvant treatment.

Adenocarcinoma↗

PubMed2005

VEGF-D expression and lymph vessels play an important role for lymph node metastasis in papillary thyroid carcinoma.

Papillary thyroid carcinoma frequently metastasizes to regional lymph nodes, and lymph node metastasis increases the risk of local regional relapse. Recent evidence suggests that vascular endothelial growth factor-D (VEGF-D) promotes lymphangiogenesis, which in turn promotes lymphatic metastasis. Therefore, the role of VEGF-D messenger RNA transcript levels and VEGF-D immunoreactivity in lymph node metastasis in papillary thyroid carcinoma was investigated. In addition, the role of blood vascular vessel, lymph vessel, and Flt-4-positive vessel densities were studied in relation to their suspected association with lymph node metastasis, and with VEGF-D expression. VEGF-D messenger RNA transcript levels by quantitative real-time reverse transcription-polymerase chain reaction and VEGF-D immunoreactivity by immunohistochemistry in 49 papillary thyroid carcinomas were also studied. This was followed by quantitative immunohistochemical staining for CD34, podoplanin, and Flt-4. Lymph node metastasis was significantly correlated with VEGF-D messenger RNA transcript levels (P=0.027) and VEGF-D immunoreactivity (P=0.019). Increased lymph vessel density was also correlated with VEGF-D expression and lymph node metastasis. In conclusion, our findings indicate that VEGF-D expression and increased lymph vessel density may have an important role for lymph node metastasis in papillary thyroid carcinoma.

Adolescent↗

PubMed1995

[Pelvic lymph node invasion in cancer of the uterine cervix].

Pelvic lymph node invasion is an important prognostic factor for cervical cancer. It is generally accepted that iliac lymph nodes must be treated systematically, but the extent of lymph node dissections is open to discussion. One hundred and eighty two cases of cervical cancer with lymph node invasion were treated at the Institut Curie between 1960 and 1988, by colpohysterectomy with lymph node dissection (168 cases) combined with preoperative brachytherapy and, in some cases, pre- and/or postoperative radiotherapy; in 14 cases, only an exploratory operation was performed. External iliac lymph node invasion was found in 95% of cases, situated in the middle and internal chains. Common iliac lymph node invasion was found in 24% of cases, but was only exceptionally isolated (3%). It is therefore possible, by means of well defined, localized external iliac dissection, with frozen section histological examination, to determine the exact lymph node status. Lumboaortic lymph node invasion was found in 8.2% of cases. The overall survival rate was 49% at 5 years and 40.5% at 10 years. Factors which influence survival are: the cervical volume (p = 0.015), the unilateral or bilateral nature of invasion (p = 0.0015), the number of lymph nodes invaded (two or more than two) (p = 0.0001), capsular rupture (p = 0.0008), lymph node adhesions other than venous (p = 0.0002), common iliac invasion (p = 0.0001). On Cox's model, the principal factors were the number of lymph nodes invaded, adhesion other than venous, common iliac invasion; on the other hand, venous adhesion does not modify the prognosis. The five-year survival rates following external iliac dissections and complete pelvic dissections were not significantly different. Finally, postoperative radiotherapy ensured a higher five-year survival rate than preoperative radiotherapy, but the cervical volume was greater and primary invasion was more frequent in these cases. Postoperative radiotherapy of 15 grays after preoperative radiotherapy did not appear to modify the survival and therefore appears to be useless.

Adult↗

PubMed2001

Neck-dissection surgical specimens treated by lymph node revealing solution.

The detection of metastatic lymph nodes in cancer patients is essential for determining the cancer stage, and thus, the therapeutic modalities. However, very small lymph nodes can easily be missed during routine examination. We described a "Lymph Node Revealing Solution" (LNRS) that helps to detect tiny lymph nodes in neck dissection specimens. Twenty-one consecutive specimens of neck-dissection were investigated. The entire surgical specimen, fixed at first in formalin, was searched for lymph nodes by the traditional method. These were excised and sent for processing. The remaining tissue was immersed for 24 hours in LNRS. The lymph nodes stood out as white chalky nodules on the background of the yellow fat. They were then excised, and examined. A total of 227 lymph nodes were detected by the traditional method; 38 (17%) were positive for metastasis. Using the LNRS method, an additional 72 nodes were identified, among them 8 (11%) were positive for metastases and 2 cases were upstaged. LNRS is an inexpensive and easy method of detecting tiny lymph nodes; it enhances significantly the yield of normal and metastatic nodes of neck-dissection specimens and helps to establish a more accurate staging.

Carcinoma, Squamous Cell↗