Nodal Metastases in the Gastrocolic Ligament

Primary tumors involving the greater curvature of the antrum of the stomach in the distribution of the right gastroepiploic artery spread to the perigastric nodes (N1 station) accompanying the right gastroepiploic vessels that course along the greater curvature of the stomach. They drain into the nodes at the gastrocolic trunk (N2 station) (Fig. 6-10) or the nodes at the origin of the right gastroepiploic artery and the nodes along the gas-troduodenal artery (the subpyloric or retropyloric node). From there, they can proceed to the celiac axis or the root of the superior mesenteric artery.

Gastrocolic LigamentGastropancreatic Fold

Fig. 6—8. Adenocarcinoma at esophagogastric (EG) junction with nodal metastases.

(a) Primary tumor (T) at EG junction with metastatic perigastric node (N) in gastrohepatic ligament, an N1 station.

(b) Nodes (N) in gastropancreatic fold along left gastric vessel (white arrow), an N2 station.

(c) Nodes (N) at suprapancreatic nodes, N2 station, along splenic artery draining from posterior wall of fundus to splenic hilum via gastrosplenic ligament. Also note common hepatic artery node (black arrow), N2 station, anterior to common hepatic artery (white arrow) draining along left and right gastric anastomosis.

(d) Left inferior phrenic node (N), N3 station, located at apex of adrenal gland draining from left diaphragm at esophageal hiatus along left inferior phrenic vessels where they drain into left renal vein.

Fig. 6—8. Adenocarcinoma at esophagogastric (EG) junction with nodal metastases.

(a) Primary tumor (T) at EG junction with metastatic perigastric node (N) in gastrohepatic ligament, an N1 station.

(b) Nodes (N) in gastropancreatic fold along left gastric vessel (white arrow), an N2 station.

(c) Nodes (N) at suprapancreatic nodes, N2 station, along splenic artery draining from posterior wall of fundus to splenic hilum via gastrosplenic ligament. Also note common hepatic artery node (black arrow), N2 station, anterior to common hepatic artery (white arrow) draining along left and right gastric anastomosis.

(d) Left inferior phrenic node (N), N3 station, located at apex of adrenal gland draining from left diaphragm at esophageal hiatus along left inferior phrenic vessels where they drain into left renal vein.

Gastrocolic Ligament

Fig. 6—9. Carcinoma of the stomach.

(a) Tumor (T) involves lesser curvature of the fundus.

(b) Note enlarged nodes (N) along left gastric vessels (arrow).

Fig. 6—9. Carcinoma of the stomach.

(a) Tumor (T) involves lesser curvature of the fundus.

(b) Note enlarged nodes (N) along left gastric vessels (arrow).

Antral Adenocarcinoma

Fig. 6—10. Carcinoma of stomach.

(a) Tumor mass (T) arises in the gastric antrum.

(b) Note metastatic node (arrow), N2 station in gastrocolic ligament anterior to pancreas (P) where gastrocolic trunk drains into superior mesenteric vein.

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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