Assane Ndiaye1,2, V Di-Marino3, P S Ba4, Aï Ndiaye5, M Gaye4,5, S Nazarian3. 1. Department of Anatomy, Health Sciences Unit - Assane Seck University, Ziguinchor, Senegal. lazanat@yahoo.fr. 2. Clinic of Thoracic and Cardiovascular Surgery, Fann University Hospital Center, BP 16659, Dakar-Fann, Senegal. lazanat@yahoo.fr. 3. Anatomy Laboratory, Faculty of Medicine Timone, Aix- Marseille University, Marseille, France. 4. Clinic of Thoracic and Cardiovascular Surgery, Fann University Hospital Center, BP 16659, Dakar-Fann, Senegal. 5. Anatomy and Organogenesis Laboratory, Faculty of Medicine, CADiop University, Dakar, Senegal.
Abstract
OBJECTIVES: To specify the topography and variations in lymphatic drainage of the right lung to the mediastinum and their therapeutic implications in non-small cell lung cancers (NSCLC). MATERIALS AND METHOD: We injected a dye into the subpleural lymphatic vessels in 65 right lung segments, followed by dissection in 22 subjects. RESULTS: At the upper lobe, we had injected 32 segments. We noted extrasegmental overflow in one case; extrasegmental and extralobar drainage in two cases; drainage to the lymph nodes of another lobe in one case. Fifty-six percent of the segments drained directly (skipping intrapulmonary and hilar lymph nodes) into the right paratracheal lymph nodes, and one dorsal segment drained into the thoracic duct. A ventral segment drained into the inferior tracheobronchial lymph nodes. A contralateral drainage to the recurrent chain was observed in two cases. Sixteen segments of the middle lobe were injected and mainly drained into the inferior tracheobronchial lymph nodes with six direct paths; one medial segment drained into the right anterior mediastinal chain. We noted three contralateral drainages and eight downward abdominal drainages. Out of the 17 segments of the lower lobe injected, 6 segments drained into the lymph nodes of another lobe, 5 segments showed a direct route to the lower quadrant chains. We noted one time a drainage into the paraesophageal lymph nodes. CONCLUSION: The variations in lymphatic drainage of the right lung require to carry out systematically a radical mediastinal lymphadenectomy during the removal of non-small cell lung cancers and to associate an adjuvant treatment.
OBJECTIVES: To specify the topography and variations in lymphatic drainage of the right lung to the mediastinum and their therapeutic implications in non-small cell lung cancers (NSCLC). MATERIALS AND METHOD: We injected a dye into the subpleural lymphatic vessels in 65 right lung segments, followed by dissection in 22 subjects. RESULTS: At the upper lobe, we had injected 32 segments. We noted extrasegmental overflow in one case; extrasegmental and extralobar drainage in two cases; drainage to the lymph nodes of another lobe in one case. Fifty-six percent of the segments drained directly (skipping intrapulmonary and hilar lymph nodes) into the right paratracheal lymph nodes, and one dorsal segment drained into the thoracic duct. A ventral segment drained into the inferior tracheobronchial lymph nodes. A contralateral drainage to the recurrent chain was observed in two cases. Sixteen segments of the middle lobe were injected and mainly drained into the inferior tracheobronchial lymph nodes with six direct paths; one medial segment drained into the right anterior mediastinal chain. We noted three contralateral drainages and eight downward abdominal drainages. Out of the 17 segments of the lower lobe injected, 6 segments drained into the lymph nodes of another lobe, 5 segments showed a direct route to the lower quadrant chains. We noted one time a drainage into the paraesophageal lymph nodes. CONCLUSION: The variations in lymphatic drainage of the right lung require to carry out systematically a radical mediastinal lymphadenectomy during the removal of non-small cell lung cancers and to associate an adjuvant treatment.
Entities:
Keywords:
Anatomy; Lung cancer; Lymphatics; Mediastinum; Right lung; Surgery
Authors: Alex Fourdrain; Sophie Lafitte; Jules Iquille; Florence De Dominicis; Eric Havet; Johann Peltier; Patrick Bagan; Pascal Berna Journal: Surg Radiol Anat Date: 2017-08-19 Impact factor: 1.246
Authors: Rogério Rodrigo Ramos; Mariane Gabriela Terezani; Elís Claudia Ribeiro Cantarella; Jose Maria Pereira de Godoy; Fernando Batigalia; Luciana Estevam Simonato; Wagner Rafael da Silva; José Martins Pinto Neto; André Wilian Lozano; Nilton Cesar Pezati Boer Journal: Cureus Date: 2022-04-17