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Expert Answers

JoseEstebanMDPhD (Physician - Pathology (Verified) ) - 05 / 10 / 2012

During surgery the sentinel lymph nodes are evaluated microscopically using the frozen section technique. The stained lymph node tissue glass slides are observed under the microscope and if there are tumor cells present, the lymph node is said to be positive for metastasis (the tumor cells have spread into the lymph nodes). Tumor cells are different than the cells that compose the lymph nodes (mostly lymphocytes). By recognizing the different morphology (size, shape, chromatin pattern, etc) of the various cells the pathologist is able to establish whether the tumor has metastasized to the nodes. However, the cell morphology in some breast tumors (i.e.: lobular carcinomas) can be similar to that of the lymphocytes. Additionally, the cells can be isolated among hundreds of lymphocytes making very difficult to recognize them. In those cases a histologic technique called Immunohistochemistry highlights tumor cells by staining specifically the epithelial cells and not the lymphocytes.
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