Abstract
Cancer spreads locally through direct infiltration into soft tissues or at distance
by invading vascular structures, then migrating through the lymphatic or blood flow.
Although cancer cells carried in the blood can end in virtually any corner of the
body, lymphatic migration is usually stepwise, through successive nodal stops, which
can temporarily delay further progression. In radiotherapy, irradiation of lymphatic
paths relevant to the localisation of the primary has been common practice for decades.
Similarly, excision of cancer is often completed by lymphatic dissection.
Both in radiotherapy and in surgery, advanced knowledge of the lymphatic pathways
relevant to any tumor location is an important information for treatment preparation
and execution. This first part describes the major collecting trunks of the lymphatic
system and then the lymphatics of the head and neck providing anatomical bases for
the radiological delineation of lymph node areas in the cervical region, it adds to
the existing nomenclature of six nodal levels (I-VI), three new areas listed as parotid,
buccal and external jugular levels.
Keywords
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Article info
Publication history
Published online: March 31, 2007
Accepted:
February 6,
2007
Received in revised form:
January 30,
2007
Received:
January 15,
2007
Identification
Copyright
© 2007 Elsevier Ireland Ltd. Published by Elsevier Inc. All rights reserved.
