ADASP recommendations for processing and reporting of lymph node specimenssubmitted for evaluation of metastatic disease

It is well known that different pathologists in different laboratories foll ow different protocols for the processing and examination of these specimen s. There is also extensive literature (some of which is summarized in the r eferences appended to the present report) on the likelihood of identifying metastases of varying sizes with different methods of preparation, as well as on the clinical significance of this identification, which varies not on ly from site to site but also from report to report on the same site. The A ssociation of Directors of Anatomic and Surgical Pathology (ADASP) has revi ewed this literature as well as the personal experience of its own members to present a set of recommendations for lymph node biopsies. lymph node dis sections, sentinel node biopsies, lymph node fine needle aspiration (FNA) a nd core needle biopsies. It should be noted that these recommendations are intended specifically for lymph nodes being studied for metastatic neoplasm s, and are not intended to apply to lymph nodes being evaluated for lymphom a, infections. and other disease processes. They are, however, formulated g enerically enough to apply regardless of whether the primary tumor is a car cinoma of the breast, carcinoma of the prostate, melanoma, or any other mal ignant, potentially metastasizing tumor. The Association has published nume rous documents with recommendations for reporting surgical pathology specim ens involving particular organ sites (for example, breast, pancreas, thyroi d, etc.) However. the Association has not yet considered the generic questi on of dealing with lymph node specimens in which the intent is to search fo r and document the presence of metastatic disease. We are also unaware of g uidelines for pathologists published by any other organization on this subj ect.