Absence of ectopic epithelial inclusions in 3,904 axillary lymph nodes examined in sentinel technique

作者：Iken Sonja; Schmidt Marcus; Braun Claudia; Valentino Antonietta; Lehr Hans Anton^*; Schaefer Stephan C

来源：Breast Cancer Research and Treatment, 2012, 132(2): 621-624.

DOI：10.1007/s10549-011-1923-2

• Benign epithelial inclusions
• Sentinel lymph node
• Polymerase chain reaction
• Autopsy
• Axillary lymph nodes

Intraoperative examination of sentinel axillary lymph nodes can be done by imprint cytology, frozen section, or, most recently, by PCR-based amplification of a cytokeratin signal. Using this technique, benign epithelial inclusions, representing mammary tissue displaced along the milk line, will likely generate a positive PCR signal and lead to a false-positive diagnosis of metastatic disease. To better appreciate the incidence of ectopic epithelial inclusions in axillary lymph nodes, we have performed an autopsy study, examining on 100 mu m step sections 3,904 lymph nodes obtained from 160 axillary dissections in 80 patients. The median number of lymph nodes per axilla was 23 (15, 6, and 1 in levels 1, 2, and 3, respectively). A total of 30,450 hematoxylin-eosin stained slides were examined, as well as 8,825 slides immunostained with pan-cytokeratin antibodies. Despite this meticulous work-up, not a single epithelial inclusion was found in this study, suggesting that the incidence of such inclusions is much lower than the assumed 5% reported in the literature.

• 出版日期2012-4