Fluorescence-guided laparoscopic lymph node biopsy in a lymphoma patient: a possible new clinical application of indocyanine green. Issue 3 (9th March 2022)

• Record Type: Journal Article
• Authors: Casaccia, Marco; Testa, Tommaso; Martigli, Sofia Paola; Santoliquido, Matteo; Lemoli, Roberto Massimo
• Is Part Of: Journal of surgical case reports. Volume 2022:Issue 3(2022)
• Publication Date: 2022-03-09
• Subjects: indocyanine green -- ICG -- laparoscopic surgery -- laparoscopic biopsy -- lymphoma; Surgery -- Periodicals; Surgery -- Case studies -- Periodicals; 617.005
• DOI: 10.1093/jscr/rjac047
• Languages: English
• ISSNs: 2042-8812

Abstract

Abstract: To date, there are no reports indicating the use of indocyanine green (ICG) fluorescence to detect pathologic lymphatic tissue when a laparoscopic lymph node biopsy (LLB) for suspected new or recurrent lymphoma is performed. We present the case of a 72-year-old female patient admitted for suspicion of recurrent lymphoma. A preoperative imaging work-up showed solid tissue enveloping the terminal portion of the abdominal aorta with a standardized uptake value (SUV) of 10. Therefore, an LLB was planned. After induction of anesthesia, a ICG solution was injected intravenously and subcutaneously at both inguinal regions. At laparoscopy, a complete visualization of the pathologic lymph nodes was achieved, enabling an incisional biopsy of the lymphomatous mass. LLB with ICG-fluorescence offers a simple and safe method for pathologic lymph node detection in the suspicion of intra-abdominal lymphoma. More studies with large case series are needed to confirm the efficacy of this application.