Regional nodal metastasis is one of the most common modes of tumor spread in carcinoma of the colon. The lymph nodes draining lymphatics from the colon can be classified into four groups: the epicolic nodes, the para-colic nodes, the intermediate mesocolic nodes, and the principal nodes.16,17 The epicolic nodes lie on the wall of the colon beneath the peritoneum covering the colon, generally on the antimesocolic side of the colonic wall. The paracolic nodes lie along the marginal vessels along the mesocolic side of the colon. The intermediate mesocolic nodes lie in the mesocolon accompanying the vessels in the mesocolon and draining into the principal nodes at the root of the mesocolon. In general, the pathway of lymphatic drainage follows these groups ofnodes from the epicolic to paracolic, intermediate, and principal nodes, respectively.
Table 6-5 and Figure 6-13 show the pathways of nodal spread to the intermediate mesocolic nodes and the principal nodes from various segments of the colon. These pathways follow the course of the arterial supply
and venous drainage of those colonic segments. '
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