Fiehn AMK, et al. - In this study of surgical specimens of 126 individuals with adenocarcinoma of the esophagogastric junction (EGJ), experts ascertained the predominance of regional lymph nodes with isolated tumor cells (ITCs) on the primary hematoxylin and eosin-stained slide and analyzed how frequently deeper sections show a true metastasis. In 59 of 3,454 lymph nodes and in 41 of 126 persons, ITCs were identified. Extra sections led to an altered status from ITCs to metastasis in 29 lymph nodes with ITCs on the primary slide. In seven of 41 individuals, modification of the pN category was noted. In conclusion, the presence of ITCs in regional lymph nodes is a prevalent observation in individuals with adenocarcinoma of the EGJ. Moreover, ITCs frequently represent part of a real metastasis. Thus, to achieve a pN category as precise as attainable, a thorough examination of regional lymph nodes with additional sections when ITCs are noted is greatly suggested.