1846 LOCALISATION OF PROSTATE CANCER METASTASES WITHIN THE LYMPH NODE – SUFFICIENT HISTOLOGICAL EVALUATION DEMANDS ANALYSIS OF MORE THAN ONE SECTION
2010-03-23

You have accessJournal of UrologyProstate Cancer: Detection and Screening II1 Apr 20101846 LOCALISATION OF PROSTATE CANCER METASTASES WITHIN THE LYMPH NODE – SUFFICIENT HISTOLOGICAL EVALUATION DEMANDS ANALYSIS OF MORE THAN ONE SECTION David Schilling, Joerg Hennenlotter, Ursula Kuehs, Tatjana Maul, Georgios Gakis, Karl Sotlar, and Arnulf Stenzl David SchillingDavid Schilling Tuebingen, Germany More articles by this author , Joerg HennenlotterJoerg Hennenlotter Tuebingen, Germany More articles by this author , Ursula KuehsUrsula Kuehs Tuebingen, Germany More articles by this author , Tatjana MaulTatjana Maul Tuebingen, Germany More articles by this author , Georgios GakisGeorgios Gakis Tuebingen, Germany More articles by this author , Karl SotlarKarl Sotlar Munich, Germany More articles by this author , and Arnulf StenzlArnulf Stenzl Tuebingen, Germany More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2010.02.1785AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookTwitterLinked InEmail INTRODUCTION AND OBJECTIVES Pathologic routine processing of resected lymph node (LN) specimens usually is limited to a few cross sections per LN. The extent of the metastatic disease might be underestimated and small metastases might be missed. Goal of the study was to assess the localisation and distribution of the metastases within the LN. METHODS 149 LN metastases of 66 patients with prostate cancer were stained with cytokeratine and digitalized using a scanning device (HP ScanJet ADF, H&P). Using the graphic software Universal Desktop Ruler (avpsoft) lymph nodes were subdivided into longitudinal halves and quadrants, drawing a line along the longitudinal axis of the LN plane and a perpendicular line dividing the longitudinal line in two equal halves. Subsequently lymph nodes were investigated, noting the halves and quadrants containing tumor areas. RESULTS LN metastases ranged 1-10 per patient (Median 3), 33 patients exhibited solitary metastases, and 116 patients had more than one metastasic LN. 33 (20.1%) of the LN contained tumor areas only in one longitudinal half, 20 (13.4%) of the LN contained tumor areas only in 1 quarter. In 16/66 (24.2%) of the patients all LN metastases were localized only in one longitudinal half, 12 of them were patients with singular LN metastasis. In 10/66 (15.2%) of the patients all LN metastases were localized only in one quarter, 9 of them were patients with singular LN metastasis. CONCLUSIONS A considerable number of LN metastases are located in a relatively small area of the respective LN. Up to one in four patients may be diagnosed node negative in spite of LN metastases if histological cross section is limited to only one level of the node. Therefore histologic evaluation should include cross sections of more than one level in a LN. © 2010 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 183Issue 4SApril 2010Page: e716 Peer Review Report Advertisement Copyright & Permissions© 2010 by American Urological Association Education and Research, Inc.MetricsAuthor Information David Schilling Tuebingen, Germany More articles by this author Joerg Hennenlotter Tuebingen, Germany More articles by this author Ursula Kuehs Tuebingen, Germany More articles by this author Tatjana Maul Tuebingen, Germany More articles by this author Georgios Gakis Tuebingen, Germany More articles by this author Karl Sotlar Munich, Germany More articles by this author Arnulf Stenzl Tuebingen, Germany More articles by this author Expand All Advertisement Advertisement PDF downloadLoading ...