Article title: Nodal lymphatic mapping in 22 dogs bearing solid malignant tumors and enlarged regional lymph nodes: a descriptive study (2022-2025).

SLN mapping in dogs with enlarged regional lymph nodes identifies additional metastatic sites missed by palpation alone.

This descriptive study evaluated sentinel lymph node (SLN) mapping in 22 dogs with solid malignant tumors and enlarged regional lymph nodes (eRLN) using lymphoscintigraphy and/or near-infrared fluorescence imaging. Two distinct patterns of nodal tracer distribution were observed: Pattern 1 (41% of cases) identified only the eRLN, while Pattern 2 (59%) identified additional non-palpable, normal-sized SLNs either within the same lymphocentrum (25%) or different lymphocentra (75%). Notably, 54% of these adjunctive non-palpable SLNs contained metastatic disease. In three cases, eRLNs showed incomplete or absent tracer uptake, with tracers rerouting to normal-sized nodes that became neo-SLNs. The findings demonstrate that neoplastic or inflammatory processes can significantly alter lymphatic drainage patterns. The authors conclude that comprehensive SLN mapping should be performed in dogs with eRLN rather than limiting surgical intervention to enlarged nodes alone, as this approach may prevent missing microscopic metastatic disease in additional sentinel lymph nodes.

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