Summary
Lymphatic spread of carcinoma of the lung to the mediastinum is an essential factor determining prognosis. An anatomic study of the mediastinal lymph nodes was made on 360 cadavers of adult subjects based on injection of the pulmonary segment. Eleven anatomic sites were involved. In 20 to 40% of cases the lymph reached these sites without any relay in the intrapulmonary lymph nodes. Within these sites the lymph flow continued towards the systemic circulation by traversing a variable number of lymph nodes, or sometimes none. The lymph flow reached the venous circulation in the neck, but in more than one case in ten the lymph had already entered the thoracic duct in the mediastinum, and in an intermediate number of cases the sites in the opposite mediastinum.
Résumé
L'extension lymphatique des cancers du poumon au médiastin est le facteur essentiel du pronostic. L'étude anatomique des lymphonoeuds du médiastin a été menée sur 360 cadavres de sujets adultes à partir de l'injection du segment pulmonaire. Onze sites anatomiques sont concernés. La lymphe rejoint ces sites sans faire relais dans les lymphonoeuds intra-pulmonaires dans 20 à 40% des cas. Au sein de ces sites le courant lymphatique se poursuit vers la grande circulation en traversant un nombre variable de lymphonoeuds ou parfois aucun. Le courant lymphatique rejoint la circulation veineuse au niveau cervical mais plus d'une fois sur dix la lymphe a déjà rejoint le conduit thoracique au médiastin et dans un nombre intermédiaire de cas les sites du médiastin contro-latéral.
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Riquet, M. Anatomic basis of lymphatic spread from carcinoma of the lung to the mediastinum: Surgical and prognostic implications. Surg Radiol Anat 15, 271–277 (1993). https://doi.org/10.1007/BF01627878
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DOI: https://doi.org/10.1007/BF01627878