Exame histopatológico de congelação e citologia na análise de linfonodos no melanoma cutâneo

• Autor(a) principal: Oliveira, Andrea Fernandes de [UNIFESP]
• Data de Publicação: 2016
• Tipo de documento: Tese
• Idioma: por
• Título da fonte: Repositório Institucional da UNIFESP
• dARK ID: ark:/48912/0013000001d9m
• Texto Completo: https://sucupira.capes.gov.br/sucupira/public/consultas/coleta/trabalhoConclusao/viewTrabalhoConclusao.jsf?popup=true&id_trabalho=4148546; http://repositorio.unifesp.br/handle/11600/47125
• topic: Lymph nodes; Mmelanoma; Freezing; Cytology; Linfonodos; Melanoma; Congelação; Citologia

Background: The sentinel lymph node biopsy brought great advance to melanoma treatment bringing better disease staging. This technique allows the lymph node complete histology analysis with a less invasive procedure. Nevertheless, the presence of metastasis in the sentinel lymph node requires additional lymphadenectomy. The intraoperative diagnosis of metastasis is an alternative to avoid the morbidity, but it is not a standard procedure. Purpose: The purpose was to analyze the accuracy of the cytopathology imprint and freezing biopsy in the sentinel limph node biopsy for the melanoma metastasis detection. Methods: A sample of 47 non-sentinel lymph nodes was evaluated by two independent pathologists using three histological techniques (cytology imprint, frozen section and permanent section).. The lymph nodes were excised during the lymphadenectomy. The presence or absence of atypical cells suggesting metastasis and lymph nodes were classified as positive or negative by pathologists. Results: Cytology imprint and frozen section had high concordance to permanent section for both pathologists (Kappa > 0,8). Specificity and positive predictive value were 100% to each sample, while sensibility and negative predictive value reached values higher then 75%. Conclusion: Cytology imprint and frozen section were able diagnose melanoma metastasis to the non-sentinel lymph nodes in the clinical stage III patients.