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ORIGINAL ARTICLE
Year : 2014  |  Volume : 42  |  Issue : 2  |  Page : 58-63

Sentinel lymph node biopsy using blue dye as guidance for central neck dissection in patients with clinically node-negative papillary thyroid carcinoma


1 Department of Surgery, Faculty of Medicine for Girls, Al-Azhar University, Cairo, Egypt
2 Department of ENT, Faculty of Medicine for Girls, Al-Azhar University, Cairo, Egypt

Correspondence Address:
El-Sayed Mahmoud Abd-Elwahab
Surgical Department, Faculty of Medicine for Girls, Al-Azhar University, 11759 Cairo
Egypt
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DOI: 10.4103/1110-1415.137803

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Background Sentinel lymph node biopsy has recently been used to detect occult lymph node metastases. Occult lymph node metastasis of papillary thyroid carcinoma (PTC) can be detected by sentinel lymph node (SLN) biopsy, but studies in larger patient cohorts undergoing complete central neck dissection are required to assess the diagnostic accuracy of SLN. Materials and methods A total of 25 consecutive patients with clinically and ultrasonographically node-negative PTC were enrolled and underwent sentinel lymph node biopsy. After injection of 0.2-0.3 ml methylene blue around the tumor or 0.5-1.0 ml into the thyroid nodule, blue-stained SLNs were collected from the central compartments. Results SLNs were identified in 21 of 25 patients (84%); of these, 14 SLNs were positive and seven SLNs were negative by hematoxylin and eosin staining. The false-negative rate was detected in two patients (8%), identified by immunohistochemical staining. The non-SLNs were positive in five patients (20%) from positive SLN patients, and no positive non-SLNs were present in negative SLN patients. Conclusion SLN biopsy in patients with PTC without gross clinical or ultrasonographical lymph node involvement was able to detect occult metastasis and may have the potential to select patients who require central neck dissection using methylene blue dye technique in PTC, and it is a safe and technically feasible procedure.


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