LYMPHATIC SYSTEM
Sentinel Lymph Node Study
Procedure description:
Sentinel lymph node is the first regional lymph node that directly drains the lymph from the primary tumour. The sentinel lymph nodes are the first nodes to receive seeding lymph-borne metastatic cells.
Sentinel lymph node mapping and biopsy is a routine technique in breast cancer and melanoma surgery, providing for less-invasive surgical procedures, prognostic information on nodal status and help avoid morbidity.
It is a highly reliable method for screening lymph nodes and identifying metastatic and micro-metastatic disease in regional lymphatic nodes.
Indication
The procedure is a “standard of care” for early breast cancer, melanoma and penile cancer.
Vulvular cancer - The superficial location of vulvar cancer facilitates injection and the surgical approach, as well as a fast and successful drainage to inguino-femoral nodes.
Cervical cancer - The most important prognostic factor is locoregional nodal invasion, including the pelvic and paraaortic nodes.
Oral squamous cell carcinoma - The incidence of occult metastases in patients with clinically node-negative OSCC is high, with many series reporting rates greater than 30%.
Patient preparation:
No special preparation is required of a patient prior to arrival in the nuclear medicine facility.
Lymphoscintigraphy
Procedure description:
Lymphoscintigraphy is a non-invasive procedure for the differentiation of lymphedema from other causes of limb or truncal edema, such as heart failure, lipedema, and deep vein thrombosis.
The procedure is indicated in suspected primary lymphatic dysplasia, secondary lymphatic dysplasia, primary lymphedema, congenital lymphedema, secondary lymphedema, and chylous leakage (chylous ascites and chylothorax).
Patient preparation:
No special preparation is required of a patient prior to arrival in the nuclear medicine facility.