Intraoperative estimation of sentinel lymph nodes in breast cancer by imprint cytology.

BACKGROUND: Frozen section biopsy has been widely used for intraoperative diagnosis and evaluation of sentinel lymph nodes, so a decision can be made regarding whether to perform axillary clearance during primary surgery. This study aims to discuss the reliability of a simpler and faster method - touch imprint cytology - in the interpretation of metastasis from breast cancer. METHODS: A retrospective review of 41 sentinel lymph node biopsies from patients with breast cancer were examined by intraoperative imprint cytology using rapid Diff-Quick staining. Paraffin-embedded permanent sections were examined using hematoxylin and eosin stained sections from the sentinel lymph nodes in collaboration with the employment of an anti-cytokeratin antibody. RESULTS: Sixteen of all sentinel nodes harbored metastases in the paraffin sections, of which all 16 were identified by imprint cytology (sensitivity 93%). CONCLUSION: Touch imprint cytology is a fast and reliable alternative for intraoperative evaluation of sentinel lymph nodes in breast cancer patients.

Expression of the intermediate filament vimentin and fibrillar proteins of the extracellular matrix related to embryonal heart development.

During organogenesis, the heart is one the first organs to develop and the earliest organ to function. The early appearance of cardiac activity in the tubular hearts of chick and rat embryos was noted many years ago. It arises from two plates of the splanchnic mesoderm which fuse to form a single tubular structure composed of endocardial and myocardial cells and, between them, the extracellular cardiac matrix. There is considerable variation in the formation of the extracellular matrix in the various regions of the heart during development. The endocardial lining cells of the vertebrate embryos show a regional specificity that remains an unexplained phenomenon in cardiac morphogenesis. The great majority of the endocardial lining cells remain epithlial. However, a restricted population of endothelial cells, lining the atrioventricular (AV) canal and the reputed proximal outflow tract (OT), transforms into mesenchyme; the latter being the reputed progenitor of the valves and membranous septa. The purpose of this study was to investigate the extracellular cardiac matrix of the human fetal heart in different regions and in various stages of development, and also the heterogeneity of the endocardial cell lining, in connection with the endothelial cells of other cardiac vessels. Identification of the mesenchymal cells/extracellular matrix was confirmed by immunohistochemical techniques using the following monoclonal antibodies: actin, desmin, vimentin, collagen IV and fibronectin. The present results provide evidence that the extracellular matrix of the heart is of mesodermal origin but at the level of the valves the mesenchyme is derived from the endothelial lining cells rather than the primitive mesenchyme.