Neck-dissection surgical specimens treated by lymph node revealing solution

The detection of metastatic lymph nodes in cancer patients is essential for determining the cancer stage, and thus, the therapeutic modalities. Howeve r, very small lymph nodes can easily be missed during routine examination. We described a "Lymph Node Revealing Solution" (LNRS) that helps to detect tiny lymph nodes in neck dissection specimens. Twenty-one consecutive speci mens of neck-dissection were investigated. The entire surgical specimen, fi xed at first in formalin, was searched for lymph nodes by the traditional m ethod. These were excised and sent for processing. The remaining tissue was immersed for 24 hours in LNRS, The lymph nodes stood out as white chalky n odules on the background of the yellow fat. They were then excised, and exa mined. A total of 227 lymph nodes were detected by the traditional method; 38 (17%) were positive for metastasis. Using the LNRS method, an additional 72 nodes were identified, among them 8 (11%) were positive for metastases and 2 cases were upstaged. LNRS is an inexpensive and easy method of detect ing tiny lymph nodes; it enhances significantly the yield of normal and met astatic nodes of neck-dissection specimens and helps to establish a more ac curate staging.