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 tumour location is an important information for treatment preparation
and execution. This second part describes the lymphatics of the upper limb, of the
thorax and of the upper abdomen. Providing anatomical bases for the radiological delineation
of lymph nodes areas in the axilla, in the chest and in the abdomen, it also offers
a simplified classification for labeling the mediastinal and intra-abdominal nodal
levels, grouped in each location inside three major functional areas (called I, II
and III) which are all divided into three sublevels (named a, b or c).
Keywords
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Article info
Publication history
Published online: August 28, 2007
Accepted:
July 14,
2007
Received in revised form:
July 9,
2007
Received:
March 15,
2007
Identification
Copyright
© 2007 Elsevier Ireland Ltd. Published by Elsevier Inc. All rights reserved.
