Send an adequately sampled Lymph node fresh in a dry sterile container. Inform Pathology staff regarding the need for lymph node protocol processing prior to the surgery if possible.
Lymphoma Protocol (i.e., to rule out lymphoma, metastasis, or an infectious process):
- Do not use formalin.
- Place the specimen in a sterile specimen cup on saline-moistened gauze, do not immerse the node in saline.
- Be certain to include indications for the protocol on the requisition. Deliver the nodes to the pathology area immediately; or call for a pick-up.
- Place in refrigerator on saline moistened gauze if not immediately delivered to pathology.
Sentinel node biopsy, (i.e., to look for metastatic breast cancer or melanoma—usually with dye or a radioactive tracer):
- Mark the specimen as potentially radioactive and submit it in 10% formalin with the appropriate documentation form from nuclear medicine.
- All radio-labeled specimens excised for pathologic examination (which includes breast tissues, lymph nodes, and sentinel lymph nodes) must be measured and approved as safe by the nuclear medicine department before the specimen may be transported from the hospital to the tissue laboratory. These specimens must be submitted with a completed “Radioactive Specimen Exposure Documentation Form”.
- The primary injection site is allowed to decay overnight, or as specified by the Nuclear Medicine personnel. These specimens may then be transported to the appropriate location. Radioactive specimens marked with 2.0 mR/hr or greater surface exposure may be delivered to pathology in a lead box.
- Sentinel node specimens are typically low in radioactivity and available for frozen sections.
