The lymphatic map of the lung.
Abstract
Background
The prognosis of resected N2 diseases (ipsilateral mediastinu　node　metastasis) in non-small cell carcinoma of the lung is heterogenous and hard to predict. To precisely assess the the prognosis of N2 diseases of them, we make the lymphatic map of the each pulmonary lobe and subdivise the current N2 diseases.
Method
We classified the lymphatic pathways of the lung as follows: level 1: from the lung to the intrapulmonary or hilar nodes (N1); level 2: from N1 to the ipsilateral mediastinum nodes (N2); and level 3 among N2 nodes. We assessed 585CT studies of patients with primary complex of Histoplasmosis, which included the association of single well-defined calcified lung nodules and hilar and/or mediastinum calcified lymph nodes. And we made the lymphatic map of the each pulmonary lobes.
Results
The lymphatic map disclosed the lymphatic pathways specific for each lobes. The common skip mediastinal station was specific in each lobe : the right lower paratracheal node in the right upper lobe, the subaortic node in the left upper lobe, the pulmonary ligament and paraesophageal node in the bilateral lower lobes. The skip N2 is uncommon in the right middle lobe. The preferrentially involved mediastinum stations were as follows :the most commonly involved station was the lower paratracheal node in theright upper lobe, the subcarinal node in the right middle lobe, the subcarinal node in the right lower lobe, the subaortic node in the left upper lobe, and the pulmonary ligament node in the left lower lobe.
Conclusions
We classified the current N2 into three stages :minimum, early, and advanced N2 depending on the lymphatics, of which level is mainly contributing nodal involvement.
Key Words: non-small cell carcinoma of the lung,Nstage, lymphatics
The prognosis of resected N2 diseases (ipsilateral mediastinu　node　metastasis) in non-small cell carcinoma of the lung is heterogenous and hard to predict. To precisely assess the the prognosis of N2 diseases of them, we make the lymphatic map of the each pulmonary lobe and subdivise the current N2 diseases.
Method
We classified the lymphatic pathways of the lung as follows: level 1: from the lung to the intrapulmonary or hilar nodes (N1); level 2: from N1 to the ipsilateral mediastinum nodes (N2); and level 3 among N2 nodes. We assessed 585CT studies of patients with primary complex of Histoplasmosis, which included the association of single well-defined calcified lung nodules and hilar and/or mediastinum calcified lymph nodes. And we made the lymphatic map of the each pulmonary lobes.
Results
The lymphatic map disclosed the lymphatic pathways specific for each lobes. The common skip mediastinal station was specific in each lobe : the right lower paratracheal node in the right upper lobe, the subaortic node in the left upper lobe, the pulmonary ligament and paraesophageal node in the bilateral lower lobes. The skip N2 is uncommon in the right middle lobe. The preferrentially involved mediastinum stations were as follows :the most commonly involved station was the lower paratracheal node in theright upper lobe, the subcarinal node in the right middle lobe, the subcarinal node in the right lower lobe, the subaortic node in the left upper lobe, and the pulmonary ligament node in the left lower lobe.
Conclusions
We classified the current N2 into three stages :minimum, early, and advanced N2 depending on the lymphatics, of which level is mainly contributing nodal involvement.
Key Words: non-small cell carcinoma of the lung,Nstage, lymphatics
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PDFDOI: http://dx.doi.org/10.18103/imr.v3i2.340
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