Analysis of the Different Lymphatic Drainage Patterns during Sentinel Lymph Node Biopsy for Skin Melanoma
In the last two decades, studies of lymphoscintigraphy imaging in lymphatic mapping reported an extreme heterogeneity of skin lymphatic drainage of some skin area, in contrast with the previous scientific literature. The aim of this study was to investigate the presence of any correlations between t...
| Main Authors: | , , , , , , , , , , , , , , , , , , |
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| Format: | Article |
| Language: | English |
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MDPI AG
2021-11-01
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| Series: | Journal of Clinical Medicine |
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| Online Access: | https://www.mdpi.com/2077-0383/10/23/5544 |
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| author | Roberto Cirocchi Giulio Metaj Michela Cicoletti Fabrizio Arcangeli Angelo De Sol Giulia Poli Paolo Bruzzone Sara Gioia Christos Anagnostou Fabio Loreti Simona Francesconi Linda Ricci Maria Elena Laurenti Andrea Capotorti Marco Artico Vito D’Andrea Brandon Michael Henry Piergiorgio Fedeli Luigi Carlini |
| author_facet | Roberto Cirocchi Giulio Metaj Michela Cicoletti Fabrizio Arcangeli Angelo De Sol Giulia Poli Paolo Bruzzone Sara Gioia Christos Anagnostou Fabio Loreti Simona Francesconi Linda Ricci Maria Elena Laurenti Andrea Capotorti Marco Artico Vito D’Andrea Brandon Michael Henry Piergiorgio Fedeli Luigi Carlini |
| author_sort | Roberto Cirocchi |
| collection | DOAJ |
| description | In the last two decades, studies of lymphoscintigraphy imaging in lymphatic mapping reported an extreme heterogeneity of skin lymphatic drainage of some skin area, in contrast with the previous scientific literature. The aim of this study was to investigate the presence of any correlations between the topographical location of cutaneous melanoma and the topographical location of sentinel lymph nodes. Data from 165 patients undergoing sentinel lymph node biopsy between January 2013 and May 2021 were analyzed, demonstrating that melanomas in the Lumbar region presented a significant more heterogeneous drainage by site than those in the Scapular region (<i>p</i> < 0.01) and that melanomas in the Subscapular region were significantly more heterogeneous by laterality (unilateral vs. bilateral) than those in the Scapular region (<i>p</i> < 0.05). Results of this study supported the evidence of multiple lymphatic drainage as regards the sentinel node biopsy performed in skin melanoma located on the dorsal subscapular region and lumbar region. For this reason, the association of preoperative lymphoscintigraphy with another imaging evaluation is needed in these critical cutaneous areas. Recent technical developments enabling fluorescence lymphography together with indocyanine green have significantly improved the visualization of lymphatic drainage patterns at a microscopic level. In the preoperative phase, any doubt can be resolved by associating the SPET-CT scan to lymphoscintigraphy, while during the intraoperative phase, an additional evaluation with indocyanine green can be performed in doubtful cases. The aim of the duplex lymphatic mapping (pre and/or intraoperative) is an accurate search of sentinel nodes, in order to reduce the rate of false negatives. |
| first_indexed | 2024-03-10T04:51:41Z |
| format | Article |
| id | doaj.art-c60eb8ae607e4470889c72153510aed2 |
| institution | Directory Open Access Journal |
| issn | 2077-0383 |
| language | English |
| last_indexed | 2024-03-10T04:51:41Z |
| publishDate | 2021-11-01 |
| publisher | MDPI AG |
| record_format | Article |
| series | Journal of Clinical Medicine |
| spelling | doaj.art-c60eb8ae607e4470889c72153510aed22023-11-23T02:35:38ZengMDPI AGJournal of Clinical Medicine2077-03832021-11-011023554410.3390/jcm10235544Analysis of the Different Lymphatic Drainage Patterns during Sentinel Lymph Node Biopsy for Skin MelanomaRoberto Cirocchi0Giulio Metaj1Michela Cicoletti2Fabrizio Arcangeli3Angelo De Sol4Giulia Poli5Paolo Bruzzone6Sara Gioia7Christos Anagnostou8Fabio Loreti9Simona Francesconi10Linda Ricci11Maria Elena Laurenti12Andrea Capotorti13Marco Artico14Vito D’Andrea15Brandon Michael Henry16Piergiorgio Fedeli17Luigi Carlini18Department of Surgery, S. Maria Hospital, University of Perugia, 05100 Terni, ItalyDepartment of Surgery, S. Maria Hospital, University of Perugia, 05100 Terni, ItalyDermatologic Clinic, S. Maria Hospital, University of Perugia, 05100 Terni, ItalyDermatologic Clinic, S. Maria Hospital, University of Perugia, 05100 Terni, ItalyDepartment of Surgery, S. Maria Hospital, University of Perugia, 05100 Terni, ItalySection of Pathology, Department of Medicine and Surgery, University of Perugia, 06132 Perugia, ItalyDepartment of General and Specialist Surgery “Paride Stefanini”, Sapienza University, 00100 Rome, ItalyAzienda Ospedaliera Santa Maria Terni, Legal Medicine, University of Perugia, 05100 Terni, ItalyNuclear Medicine Service, “S. Maria” Hospital, 05100 Terni, ItalyNuclear Medicine Service, “S. Maria” Hospital, 05100 Terni, ItalyPathology Unit, Azienda Ospedaliera S. Maria di Terni, University of Perugia, 06121 Perugia, ItalyPathology Unit, Azienda Ospedaliera S. Maria di Terni, University of Perugia, 06121 Perugia, ItalyPathology Unit, Azienda Ospedaliera S. Maria di Terni, University of Perugia, 06121 Perugia, ItalyDepartment of Mathematics and Informatics, University of Perugia, 06121 Perugia, ItalyDepartment of Sensory Organs, “Sapienza” University of Rome, 00100 Rome, ItalyDepartment of Surgical Science, “Sapienza” Università di Roma, 00100 Rome, ItalyCardiac Intensive Care Unit, The Heart Institute, Cincinnati Children’s Hospital Medical Center, Cincinnati, OH 45229, USASchool of Law, Legal Medicine, University of Camerino, 62032 Camerino, ItalyDepartment of Surgery, S. Maria Hospital, University of Perugia, 05100 Terni, ItalyIn the last two decades, studies of lymphoscintigraphy imaging in lymphatic mapping reported an extreme heterogeneity of skin lymphatic drainage of some skin area, in contrast with the previous scientific literature. The aim of this study was to investigate the presence of any correlations between the topographical location of cutaneous melanoma and the topographical location of sentinel lymph nodes. Data from 165 patients undergoing sentinel lymph node biopsy between January 2013 and May 2021 were analyzed, demonstrating that melanomas in the Lumbar region presented a significant more heterogeneous drainage by site than those in the Scapular region (<i>p</i> < 0.01) and that melanomas in the Subscapular region were significantly more heterogeneous by laterality (unilateral vs. bilateral) than those in the Scapular region (<i>p</i> < 0.05). Results of this study supported the evidence of multiple lymphatic drainage as regards the sentinel node biopsy performed in skin melanoma located on the dorsal subscapular region and lumbar region. For this reason, the association of preoperative lymphoscintigraphy with another imaging evaluation is needed in these critical cutaneous areas. Recent technical developments enabling fluorescence lymphography together with indocyanine green have significantly improved the visualization of lymphatic drainage patterns at a microscopic level. In the preoperative phase, any doubt can be resolved by associating the SPET-CT scan to lymphoscintigraphy, while during the intraoperative phase, an additional evaluation with indocyanine green can be performed in doubtful cases. The aim of the duplex lymphatic mapping (pre and/or intraoperative) is an accurate search of sentinel nodes, in order to reduce the rate of false negatives.https://www.mdpi.com/2077-0383/10/23/5544melanomasentinel lymph nodebiopsy |
| spellingShingle | Roberto Cirocchi Giulio Metaj Michela Cicoletti Fabrizio Arcangeli Angelo De Sol Giulia Poli Paolo Bruzzone Sara Gioia Christos Anagnostou Fabio Loreti Simona Francesconi Linda Ricci Maria Elena Laurenti Andrea Capotorti Marco Artico Vito D’Andrea Brandon Michael Henry Piergiorgio Fedeli Luigi Carlini Analysis of the Different Lymphatic Drainage Patterns during Sentinel Lymph Node Biopsy for Skin Melanoma Journal of Clinical Medicine melanoma sentinel lymph node biopsy |
| title | Analysis of the Different Lymphatic Drainage Patterns during Sentinel Lymph Node Biopsy for Skin Melanoma |
| title_full | Analysis of the Different Lymphatic Drainage Patterns during Sentinel Lymph Node Biopsy for Skin Melanoma |
| title_fullStr | Analysis of the Different Lymphatic Drainage Patterns during Sentinel Lymph Node Biopsy for Skin Melanoma |
| title_full_unstemmed | Analysis of the Different Lymphatic Drainage Patterns during Sentinel Lymph Node Biopsy for Skin Melanoma |
| title_short | Analysis of the Different Lymphatic Drainage Patterns during Sentinel Lymph Node Biopsy for Skin Melanoma |
| title_sort | analysis of the different lymphatic drainage patterns during sentinel lymph node biopsy for skin melanoma |
| topic | melanoma sentinel lymph node biopsy |
| url | https://www.mdpi.com/2077-0383/10/23/5544 |
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