Soran Atilla, Menekse Ebru, Kanbour-Shakir Amal, Tane Kaori, Diego Emilia, Bonaventura Marguerite, Johnson Ronald
Division of Surgical Oncology, Department of Surgery, University of Pittsburgh School of Medicine, Magee-Womens Hospital of UPMC, Pittsburgh, PA, USA.
University of Pittsburgh, Department of Pathology - Magee-Womens Hospital of UPMC, Pittsburgh, PA, USA.
Breast Dis. 2017;37(2):73-76. doi: 10.3233/BD-170282.
The presence of pigment in axillary lymph nodes (LN) secondary to migration of tattoo ink can imitate the appearance of a blue sentinel lymph node (SLN) on visual inspection, causing the operator to either miss the true SLN or excise more than is needed.
We present patients with tattoos ipsilateral to an early stage breast cancer who underwent a SLN biopsy.
Patients were retrospectively reviewed from medical records and clinicopathologic data was collected. A total of 52 LNs were retrieved from 15 patients for sentinel mapping and 29 of them had tattoo pigmentation on pathologic evaluation.
Of those 29 SLNs, 2 of them (6.9%) were pigmented, but did not contain either blue dye or Tc-99m (pseudopigmented SLN). Two (3.8%) SLNs were positive for metastasis; both of these had either blue dye or Tc99m uptake, and 1 demonstrated tattoo pigment in the node.
In this cohort of patients with ipsilateral tattoos, removed more LNs lead to unnecessary excision which may important for increasing the risk of arm morbidity from SLN biopsy. However, the presence of tattoo pigment did not interfere with understaging for axillary mapping and it did not effect of pathological identification of SLNs positivity.
纹身墨水迁移导致腋窝淋巴结（LN）中出现色素，在视觉检查时可模仿蓝色前哨淋巴结（SLN）的外观，导致操作者要么错过真正的SLN，要么切除过多不必要的组织。
我们报告同侧有纹身的早期乳腺癌患者接受前哨淋巴结活检的情况。
回顾性查阅患者病历并收集临床病理数据。从15例患者中总共获取了52个淋巴结用于前哨淋巴结定位，其中29个在病理评估时有纹身色素沉着。
在这29个前哨淋巴结中，2个（6.9%）有色素沉着，但未含有蓝色染料或锝-99m（假色素沉着前哨淋巴结）。2个（3.8%）前哨淋巴结有转移；这两个都有蓝色染料或锝-99m摄取，其中1个在淋巴结中显示有纹身色素。
在这群同侧有纹身的患者中，切除更多的淋巴结会导致不必要的切除，这可能对增加前哨淋巴结活检导致手臂并发症的风险很重要。然而，纹身色素的存在并不干扰腋窝定位的分期，也不影响前哨淋巴结阳性的病理识别。
