Better pic of sentinal node preoperative localization in bre | Figure 1

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Better pic of sentinel node preoperative localization in breast cancer. Left arm raised. The four bright spots are where the activity was injected around areola, and the arrows show drainage to the sentinel node.

Why you should join Figure 1

Research Summary

Can tests to identify the main draining lymph nodes in women with endometrial cancer accurately diagnose if the cancer has spread to the lymph nodes?

Women who have endometrial cancer (cancer arising from the lining of the womb) may have cancer cells spread to lymph nodes in the pelvis and/or the para‐aortic area (main blood vessel in the upper abdominal cavity) and need additional radiotherapy treatment, with or without chemotherapy, following initial hysterectomy.

Why is this review important?

Several studies used dyes or traceable agents to identify SLNs in women with womb cancer. It is not clear whether all of these agents are sufficiently accurate to predict which women have cancerous spread to lymph nodes and whether it is better to inject dye to the cervix or the muscle of the womb. This review summarises the evidence and produces overall estimates of the relative accuracies of the available tests.

How was the review conducted?

We included studies that tested the accuracy of tracer agent/s to identify SLN against the standard method of removing all pelvic nodes, with or without para‐aortic lymph nodes. We restricted the studies to those that examined the SLNs by taking multiple slices of the node and staining for cancer cells using antibody markers (immunohistochemistry (IHC)) before examining them under a microscope (ultrastaging).

What are the findings?

We included 33 studies (2237 women) that evaluated any techniques used to identify the SLN draining from the womb.

What is the diagnosis? Follow us and come back later for the answer!
Presented by Jonathan Edwards MD, under the supervision of Shabnam Jaffer MD, while on the Breast rotation.
Age: 73 years
Sex: Female
Site: Left breast
Procedure: Breast core biopsy
Clinical history: 73-year-old female with a red skin lesion. Past medical history of invasive ductal carcinoma with lobular features. One sentinel lymph node positive for carcinoma. Had an axillary node dissection and radiation therapy.
Ancillary tests: Positive for CD31, CD34, FVIII and c-myc. Negative for cytokeratins (AE1/AE3).

breast #Mastectomy with blue radioactive #Sentinel-node-biopsy blue dye.


A 52-year-old man presented with a 20-minute history of chest pain radiating to the left shoulder and neck, associated with dyspnea and diaphoresis.
On physical examination, bibasilar crackles were noted on lung auscultation. An electrocardiogram (ECG) was performed in the primary care setting, and the patient was promptly referred to the emergency department.


A 28-year-old woman presented with a 3-day history of intense pruritus over the lower back.
Physical examination revealed multiple small vesicles, some clustered and others scattered, predominantly involving the lumbar region and the left gluteal area.

A 4-month-old male infant presented with skin lesions localized to the chin for the past 3 days. Physical examination revealed multiple small pustules with surrounding inflammatory signs on the chin, along with a few scattered papules on the chest.


Patient in late teens presenting after a collapse, no chest pain, no previous cardiac history, no history of sudden death in family, are there any features in this ekg that would warrant further work-up or is this just a pediatric ekg?