![]() ![]() The secondary lymphoid organs include lymph nodes and spleen. The primary lymphoid organs include bone marrow and thymus, as these organs generate lymphocytes, integral to the immune system. The lymphatic system is intimately connected to the vascular system and is made up of a large network of lymphatic vessels, lymphatic organs, and lymphoid tissues. This has many implications for the management of the neoplasm and can be of great importance and benefit for the patient and clinical decision making. If the correctly identified sentinel lymph node is negative for metastasis, it is likely that the neoplasm is contained within the primary tumor location. ![]() The sentinel lymph node idea, which is identified by either the radioisotope, visual dye, or both, is based on the principle that primary tumors drain to one or a few initial lymph nodes before spreading to the entire body. The most up-to-date lymphoscintigraphic technique is through the use of technetium 99m-labeled sulfur colloid as a tracer. In the late 1900s, this method would be used to discover methods of imaging the lymphatic system through injection of radiopaque contrast agents for visualization, which subsequently allowed for visualization of the first lymph node to receive the agent, termed the “sentinel lymph node.” A switch from radiopaque contrast agent to a radioactive isotope with labeled gold colloid was made with the addition of visual dye injections for the purposes of identifying sentinel lymph nodes for biopsy purposes. With this knowledge, the modern-day intralymphatic injection is via the intradermal route. Later it was observed that intradermal or parenchymal injection would be an intralymphatic injection in theory. In 1786 the first description of the lymphatic system in the breast was written containing information on two main drainage pathways axillary and internal mammary. Attempts at understanding and mapping the lymphatic system began in the 1600s upon discovery of the cisterna chyli and thoracic duct. Lymphoscintigraphy is a method used to map the lymphatic system. ![]()
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