Sonographie des sentinel-lymphknotens bei malignem melanom

Background and Objective. In the therapy of malignant melanoma sentinel lymph node(SLN) excision has assumed increased importance. The localisation of the sentinel node is possible by lymphoscintigraphy and gamma probe guidance. Aim of the study was to prove whether SLN can be identified sonographically. Patients/Methods. 23 patients (16 women, 7 men; average age 42.7 years) with malignant melanoma required SLN excision. Before the patient underwent lymphoscintigraphy, sonography of the regional lymph nodes was performed. The position of lymph nodes (LN) with asymmetrical extension of the cortical substance was marked cutaneously according to the probe position in two axis (M1). During lymphoscintigraphy the gamma probe position orthograd to the skin with the highest count rate was marked (M2). Then a second sonography of the region was performed. Results. In all patients M1 and M2 marked the same point. During the Operation the sonographicalliy documented position of the SLN could be confirmed in all cases. The second sonography after the lymphoscintigraphy showed a more blurred distinction between the cortical substance and the center of the lymph nodes. Conclusions. Our results show that sonography allows an identification of SLN. We think that the preoperative sonography of the SLN is an important supplementary method in addition to lymphoscintigraphy.