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Ultrasound Assessment of Regional Lymph Nodes in Melanoma Staging
Ivana Prkačin
; Department of Dermatology and Veneorology, Sestre milosrdnice University Hospital Center, Zagreb, Croatia
Mirna Šitum
; Department of Dermatology and Veneorology, Sestre milosrdnice University Hospital Center, Zagreb, Croatia
Marija Delaš Aždajić
orcid.org/0000-0003-3619-0216
; Department of Dermatology and Venereorlogy, Sestre milosrdnice University Hospital Center, Zagreb, Croatia
Zvonimir Puljiz
; Department of Plastic Surgery, Sestre milosrdnice University Hospital Center, Zagreb, Croatia
Sažetak
Background: Melanoma can early metastasize to regional lymph nodes.
The sentinel lymph node (SLN) is the first lymph node draining directly
from the site of primary melanoma, and the pathohistological status of
the SLN is the most significant prognostic factor for overall survival prevalence
and prognosis in patients with melanoma. Ultrasound is a very useful
for the imaging of regional lymph node metastases, combined with
Doppler and cytopuncture.
Objective: The aim of this study was to investigate the role of ultrasound
assessment of regional lymph nodes in melanoma staging.
Patients and methods: The study included all patients with primary melanoma
detected in the period between 2003 and 2012, in whom diagnostic
processing has not proven distant metastases or physical examination did
not find enlarged lymph nodes. In total, 202 surgically treated patients were
included in the study, of which 101 patients underwent ultrasound examination
of regional lymph nodes using a linear probe of at least 12 MHz, while
ultrasound of regional lymph nodes was not performed for 101 patients.
Results: The results of this study emphasize the importance of ultrasound
in the diagnostics and treatment of patients with melanoma.
Based on the observation of the occasional positive ultrasound and
fine needle aspiration cytology (FNAC) in regional lymph nodes, our results
indicate that a proportion of patients can avoid sentinel lymph
node biopsy (SLNB). In case of a positive ultrasound findings (complemented
with FNAC of suspicious nodes), direct dissection of regional
lymph nodes is recommended. However, negative ultrasound findings
do not exclude the presence of micrometastases due to poor
sensitivity of this method and is not a contraindication for SLNB.
Conclusion : Therefore, there is a need for further studies on metastatic
melanoma, especially those in the sentinel lymph nodes and in its early
stage.
Ključne riječi
melanoma, ultrasound, lymph nodes, sentinel
Hrčak ID:
274461
URI
Datum izdavanja:
11.5.2021.
Posjeta: 510 *