Summary
The lymphatic vessels from around the esophagus which drain into the thoracic duct were identified macroscopically and histologically in 106 cadavers. Direct lymphatic drainage to the duct was macroscopically demonstrated by 84 vessels in 46 cases (43.4%). In 23 cases (19.8%), large collecting vessels arose from the thoracic esophagus and opened directly imto the duct. In most of these cases (15/23) these lymphatic connections were found at the levels of the 1st–3rd or 6th–8th thoracic vertebrae. Histologic study revealed that two vessels originated from the fine lymphatic plexus in the esophageal adventita, which showed monocytic infiltration. In 11 of the 23 cases, an intercalated node was found along the thoracic duct. The results suggest that lymph drains rapidly into the systemic circulation via the thoracic duct. In view of the clinical applications in esophageal carcinoma, previous accounts of the extramural esophageal lymphatics concerned in direct drainage are discussed.
Résumé
Chez 106 cadavres de japonais adultes, nous avons mis en évidence, aussi bien macroscopiquement que microscopiquement, des vaisseaux lymphatiques péri-oesophagiens qui se drainaient dans le conduit thoracique. Macroscopiquement, le drainage lymphatique de l'oesophage dans le conduit thoracique existait chez 46 des 106 cadavres (43,4 %). 23 gros collecteurs ont été vus qui naissaient de l'oesophage thoracique et s'abouchaient directement dans le conduit thoracique chez 21 des 106 cadavres (19,8 %). Le plus souvent (15 des 23 gros collecteurs), ces lymphatiques reliaient l'oesophage au conduit thoracique au niveau des 1er-3ème ou des 6ème-8ème vertèbres thoraciques. D'après l'examen histologique de ces 23 gros collecteurs, 2 prenaient naissance à partir d'un fin plexus lymphatique de l'adventice de l'oesophage infiltré de cellules mononucléaires. Dans 11 cas sur 23, un lymphonoeud intermédiaire a été trouvé sur le conduit thoracique grâce à des “clearing methods”. Ces résultats suggèrent que la lymphe de l'oesophage se draine rapidement dans la circulation systémique par l'intermédiaire du conduit thoracique. Importantes en clinique dans le cancer de l'oesophage, les descriptions antérieures de lymphatiques extrapariétaux de l'oesophage ont été discutées à propos de ce drainage lymphatique direct de l'oesophage.
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References
Ahn HK, Hoshi H, Horie K, Nagata H (1990) Site of lymph follicle formation in the draining popliteal lymph nodes of mice locally injected with antigenic and mitogenic substances. Histol Histopath 5: 493–504
Bartels P (1909) Das Lymphgefäßsystem. Gustav Fischer, Jena, pp 172–185
Caplan I (1990) Anatomical review of the lymph nodes of the human mediastinum. Surg Radiol Anat 12: 9–18
Carr I, Levy M, Orr K, Bruni J (1985) Lymph node metastasis and cell movement: ultrastructural studies on the rat 13762 mammary carcinoma and Walker carcinoma. Clin Expl Metastasis 3: 125–139
Davis HK (1915) A statistical study of the thoracic duct in man. Am J Anat 17: 211–244
Deki H, Sato T (1988) An anatomical study of the peripancreatic lymphatics. Surg Radiol Anat 10: 121–135
Groszek I, Matysiak WJ (1985) Morphologie der phrenico-esopageal Membran. Gegenbaur Morphol Jahrb 131: 1–18
Haagensen CD, Feind CR, Herter FP, Slanetz CA, Weinberg JA (1972) The lymphatics in cancer. Saunders, Philadelphia, pp 245–268, 293–296
Hermanek P, Sobin LH (1987) TNM classification of malignant tumours, 4th edn. Springer, Berlin
Horie K, Hoshi H (1989) Induction of lymph follicle formation with several mitogens and adjuvants in the mouse popliteal lymph node. Histol Histopath 4: 17–25
Ito M, Mishima Y, Sato T (1991) An anatomical study of the lymphatic drainage of the gallbladder. Surg Radiol Anat 13: 89–104
Japanese Society for Esophageal Disease (1992) Guide lines for the clinical and pathological studies on carcinoma of the esophagus (in Japanese), 8th edn. Kanehara, Tokyo
Jossifow GM (1930) Das Lymphgefäßsystem des Menschen. Gustav Fischer, Jena, pp 135–145
Kihara T (1953) Anatomie der Japaner, III. Lymphgefäßsystem der Japaner, 1. Lief ductus thoracicus der Japaner. Kenkyusha, Kyoto
Matubara T (1992) Pattern of lymphatic spreading in cancer of the thoracic esophagus (Abstract in English). J Jpn Surg Soc 93: 377–387
Miyazaki H (1933) Die feinere Verteilung der Lymphgefäße in dem Oesophagus des Menschen. Folia Anat Jpn 11: 229–240
Mori T (1968) The lymphatics of the trachea and the esophagus (in Japanese). J Jpn Bronchoesophagol Soc 19: 85–98
Murakami G, Sato T, Takiguchi T (1990) Topographical anatomy of the bronchomediastinal lymph vessels. Arch Histol Cytol 53: 219–235
Riquet M, Hidden G, Debesse B (1989) Direct lymphatic drainage of lung segments to the mediastinal nodes. J Thorac Cardiovasc Surg 97: 623–632
Riquet M, Dupont P, Hidden G, Debesse B (1991) Mediastinal lymphatic pathways of the azygos and aortic arches: injection based on segments of the adult lung. Surg Radiol Anat 13: 149–154
Riquet M, Saab M, Le Pimpec Barthes F, Hidden G (1993) Lymphatic drainage of the esophagus in the adult. Surg Radiol Anat 15: 209–211
Rouvière H (1932) Anatomie des lymphatiques de l'homme. Masson, Paris, pp 168–181
Sakata K (1903) Über die Lymphgefäße des Oesophagus und über seine regionären Lymphdrüsen mit Berücksichtigung der Verbreitung des Carcinoms. Mitteil Grenzgeb Med Chir 11: 634–655
Sato T, Sakamoto H (1992) Color atlas of surgical anatomy for esophageal cancer. Illustrations and photographs of surgical esophageal anatomy specially prepared for lymph node dissection. Springer, Berlin, pp 25–90
Sato T, Takiguchi T, Takahashi K, Menjo M (1983) The lymphatics of the esophagus (in Japanese). Shujutu 37: 211–217
Yamazaki S, Yoshino K, Takiguchi T, Kawano T, Hunakoshi T, Hatano Y, Suzuki H, Nakamoto K, Matubara M, Okuyama T, Sato T (1984) The thoracic duct plays a critical role in the skipped metastasis of esophageal cancer (in Japanese). Jpn J Lymphol 7: 77–80
Yoshinaka H, Shimazu H, Natsugoe S, Haraguchi Y, Shimada M, Baba M, Fukumoto T (1992) Histological features of the lymph node metastases in patients with thoracic esophageal cancer. J Jpn Surg Soc 93: 1289–1296
Watanabe H, Kato H, Tachimori Y, Yamaguchi H, Itabashi M (1989) Characteristics of the spread pattern for esophageal carcinoma (Abstract in English). Jpn J Thorac Surg 42: 682–689
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Murakami, G., Sato, I., Shimada, K. et al. Direct lymphatic drainage from the esophagus into the thoracic duct. Surg Radiol Anat 16, 399–407 (1994). https://doi.org/10.1007/BF01627660
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DOI: https://doi.org/10.1007/BF01627660