Cutaneous lymphatic drainage in patients with grossly involved nodal basins.

Publication Type:

Journal Article


Annals of surgical oncology, Volume 6, Issue 4, p.345-9 (1999)


Adult, Aged, Female, Humans, Lymph Node Excision, Lymph Nodes, Lymphatic Metastasis, Lymphatic System, Male, MELANOMA, Middle Aged, Skin, Skin Neoplasms


The development of lymphatic mapping techniques has facilitated the identification of the sentinel lymph node (SLN), the first node in the regional basin into which cutaneous lymphatics flow from a particular skin area. Previous studies have shown that SLN histology reflects the histology of the entire basin, because melanoma metastases progress in an orderly fashion, involving the SLN before higher nodes in the basin become involved with metastatic disease. It is uncertain whether these orderly cutaneous lymphatic flow patterns are maintained in grossly involved basins. Lymphatic mapping was performed in a population of melanoma patients with clinically palpable lymphadenopathy to address this question. We aimed to determine whether the presence of gross nodal disease in the basin alters lymphatic flow into that basin so that lymphatic mapping techniques are not applicable, and, in patients referred with a grossly involved basin, whether preoperative lymphoscintigraphy should be performed to identify other regional basins at risk for metastases.