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Between April 2022 and September 2025, 32 patients with sub-mesocolic aortic and iliac lymphadenopathy underwent FGLLB for disease staging purposes or to establish a diagnosis. The degree of intraoperative fluorescence was recorded and correlated with LN size and microscopic findings. A Receiver Operating Characteristic (ROC) curve analysis was performed to determine the predictive value of LN size on fluorescence uptake and to identify an optimal dimensional cut-off. Biopsies were excisional in 15 patients, incisional in 12, and 5 had both types. A total of 53 lymphatic tissue samples were analyzed. Fluorescent LNs were significantly smaller than non-fluorescent ones (\n                    <jats:italic>p<\/jats:italic>\n                    \u2009=\u20090.019). ROC curve analysis revealed an Area Under the Curve (AUC) of 0.74 (95% CI: 0.58\u20130.90). An optimal dimensional cut-off of 20\u00a0mm was identified for predicting fluorescence failure, yielding a sensitivity of 85% and a specificity of 67%. Microscopic examination confirmed that non-fluorescence in nodes\u2009&gt;\u200920\u00a0mm was strictly associated with total architectural effacement, whereas fluorescence was preserved in larger nodes only when the follicular structure remained intact. This study identifies a significant correlation between LN size and ICG uptake, suggesting a 20-mm threshold beyond which architectural disruption appears to impair fluorescence. Although these findings require validation in larger cohorts to ensure generalizability, they provide a valuable roadmap: while ICG excels for small occult nodes, surgeons should prioritize anatomical landmarks and preoperative imaging for bulky disease\u2009&gt;\u20092\u00a0cm.\n                  <\/jats:p>","DOI":"10.1007\/s13304-026-02833-1","type":"journal-article","created":{"date-parts":[[2026,9,8]],"date-time":"2026-09-08T09:53:17Z","timestamp":1788861197000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Predicting ICG fluorescence uptake in laparoscopic lymphoma biopsy: the role of a 20\u00a0mm node size cut-off"],"prefix":"10.1007","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-5048-5091","authenticated-orcid":false,"given":"Marco","family":"Casaccia","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Matteo","family":"Mascherini","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Adalberto","family":"Ibatici","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chiara","family":"Ghiggi","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marco","family":"Mora","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Franco","family":"De Cian","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2026,9,8]]},"reference":[{"issue":"5","key":"2833_CR1","doi-asserted-by":"publisher","first-page":"3071","DOI":"10.1245\/s10434-024-14904-x","volume":"31","author":"M Livin","year":"2024","unstructured":"Livin M, Maillot B, Tzedakis S, Boudjema K, Jeddou H (2024) Indocyanine green fluorescence imaging-guided laparoscopic right posterior sectionectomy with glissonean approach and modified hanging maneuver. 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The authors have no relevant financial or non-financial interests to disclose.","order":1,"name":"Ethics","label":"Conflict of interest","group":{"name":"EthicsHeading","label":"Declarations"}},{"value":"This study was performed in compliance with ethical standards and informed consent.","order":2,"name":"Ethics","label":"Informed consent","group":{"name":"EthicsHeading","label":"Declarations"}}]}}