Lymph node revealing solution: A new method for lymph node sampling: Results in gastric adenocarcinoma

Staging of gastric carcinoma depends on exact lymph node status. However, very small nodes are not easily found as they are obscured by the surrounding adipose tissue. The purpose of the present study was to demonstrate the usefulness of a 'lymph node revealing solution' (LNRS) in gastric cancer. The perigastric adipose tissue of ten 'problematic' cases of gastric carcinoma, in which <10 lymph nodes were found using the traditional method, was immersed in LNRS for 6-12 h. Subsequently, the lymph nodes stood out as white chalky nodules. They were excised and processed routinely. The traditional method yielded a total of 30 lymph nodes with a mean size of 6.69±3.43 mm. The LNRS revealed 89 additional nodes with a mean size of 3.03±3.43 mm, which was significantly smaller. The Node (N) stage was changed in four cases from N(x) to N₀, in one case from N₁ to N₂, and in one case from N₀ to N₂. LNRS seems to be the technique of choice for staging of patients with gastric adenocarcinoma in whom <10 lymph nodes were found with the traditional method and accurate staging was not possible.