Lymphatic Drainage of the Stomach and Pathways of Lymph Node Metastasis

The lymphatic drainage of the stomach consists of intrinsic and extrinsic systems. The intrinsic system in cludes intramural submucosal and subserosal networks, and the extrinsic system forms lymphatic vessels outside the stomach and generally follows the course of the arteries in various ligaments around the stomach.9,10 These lymphatic vessels drain into the lymph nodes at nodal stations in the corresponding ligaments and drain into the central collecting nodes at the root of the cellac axis and the superior mesenteric artery (Table 6-4 and Fig. 6-7). Various classification systems have been developed involving complex numerical schemes to define nodal

Lymphatic Drainage Stomach

Fig. 6—5. Primary lymphoma (L) of the liver with nodal involvement of anterior diaphragmatic nodes and juxtaphrenic or inferior vena cava node.

(a) Note right and left anterior diaphragmatic nodes (N).

(b) Right juxtaphrenic nodes (N) along phrenic nerve are also involved.

Fig. 6—5. Primary lymphoma (L) of the liver with nodal involvement of anterior diaphragmatic nodes and juxtaphrenic or inferior vena cava node.

(a) Note right and left anterior diaphragmatic nodes (N).

(b) Right juxtaphrenic nodes (N) along phrenic nerve are also involved.

Fig. 6—6. Recurrent hepatocellular carcinoma after resection of primary tumor in left lobe.

Note enlarged node (N) at common hepatic artery (black arrow) and node (white arrow) at deep superior epigastric vessels. This node drains lymphatics along vessels in the falciform ligament. Nodes are proved metastatic by biopsy and progression on follow-up.

Lymphatic Drainage Stomach

stations based on the location and the distance of the nodal stations from the primary tumors, such as local group I (N1), intermediate group II (N2), and distant group III (N3).10 These nodal stations are used for correlation with prognosis and for planning treatment. In general, metastases to the nodal station closer to the primary tumor have a better prognosis than those found at the station further away from the primary.10,11

Essentials of Human Physiology

Essentials of Human Physiology

This ebook provides an introductory explanation of the workings of the human body, with an effort to draw connections between the body systems and explain their interdependencies. A framework for the book is homeostasis and how the body maintains balance within each system. This is intended as a first introduction to physiology for a college-level course.

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