Houston Methodist. Leading Medicine

Hand FAQ

Question:

Can you tell me why I need a sentinel node biopsy of my armpit for a swollen, red index finger? I'm not getting the connection.

Answer:

Sentinel lymph node biopsy is a test reserved for patients who may have cancer that has traveled outside the confines of the tumor. Even though you describe your primary problem as a red and swollen index finger, it sounds like your surgeon or primary care physician is trying to rule out cancer as a possible cause. Other tests may be ordered depending on what type of tumor is present (or what the physician is suspicious of). Soft tissue sarcomas (a malignant tumor affecting bone or surrounding soft tissue structures) will require a sentinel lymph node biopsy. For this test, a dye is injected into the tissue around the tumor. The dye flows through the lymph system to the lymph nodes. The surgeon removes lymph nodes near the tumor and sends them to the lab where they are examined for the presence of any dye. A positive sentinel node suggests tumor cells have reached the lymph nodes and traveled beyond (a process called metastasis). The results of this test help physicians stage the cancer, which in turn, helps determine treatment. Staging tells us how far advanced the disease is and helps determine the prognosis. Early diagnosis and treatment is always advised and often linked with better long-term outcomes. Another potential test for problems like this is the use of a PET scan (PET stands for Positron Emission Tomography). A scan of the upper body may help show tumors in the chest or other areas other than the hand/fingers. PET scans also help sort out benign from malignant tumors. You are more likely to undergo tests of this nature if there is a previous history of cancer anywhere else in the body. The most likely primary (original or first) sites of cancer that can spread or metastasize to the bones (and bones of the hand) are lung, breast, and kidney cancer. If this doesn't seem to fit your family history or personal situation, don't hesitate to ask your surgeon for his or her reasons behind the node biopsy. Mark E. Puhaindran, MBBS, and Edward A. Athanasian, MD. Malignant and Metastatic Tumors of the Hand. In The Journal of Hand Surgery. November 2010. Vol. 35A. No. 11. Pp. 1895-1900.

*Disclaimer:* The information contained herein is compiled from a variety of sources. It may not be complete or timely. It does not cover all diseases, physical conditions, ailments or treatments. The information should NOT be used in place of visit with your healthcare provider, nor should you disregard the advice of your health care provider because of any information you read in this topic.
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