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Lymphatic anatomy: lymphatics of the uterus
Published in Charles F. Levenback, Ate G.J. van der Zee, Robert L. Coleman, Clinical Lymphatic Mapping in Gynecologic Cancers, 2022
Jennifer J. Mueller, Nadeem R. Abu-Rustum
Henriksen described three major lymphatic channels draining the cervix. The first major channel exits the cervix and connects to paracervical, external iliac, and obturator lymph nodes. The second courses along in a similar manner to connect to internal iliac lymph nodes. The third major channel travels back and forth within the uterosacral folds, connecting to presacral lymph nodes. These channels were observed intercommunicating between interiliac and presacral nodal basins. Henriksen also described three main channels draining the corpus. The upper corpus lymphatics join ovarian vessels and drain paraaortic nodal basins below the renal vessels. The middle and lower corpus (in close association with cervical lymphatic channels) coalesce and course along the uterine vessels, draining paracervical, interiliac, and obturator nodes. The fundus lymphatic channels follow the round ligament to the inguinal nodal basins.
Anatomy
Published in Peter Sagar, Andrew G. Hill, Charles H. Knowles, Stefan Post, Willem A. Bemelman, Patricia L. Roberts, Susan Galandiuk, John R.T. Monson, Michael R.B. Keighley, Norman S. Williams, Keighley & Williams’ Surgery of the Anus, Rectum and Colon, 2019
Reza Mirnezami, Alex H. Mirnezami
Although a point of controversy in the past, there is an increasing recognition that lymph from the lower third of the rectum may also drain into two additional sets of lymph nodes: the internal iliac lymph nodes bilaterally (also called the pelvic side wall nodes) and inguinal nodes (similar to drainage of the anal canal).
SBA Answers and Explanations
Published in Vivian A. Elwell, Jonathan M. Fishman, Rajat Chowdhury, SBAs for the MRCS Part A, 2018
Vivian A. Elwell, Jonathan M. Fishman, Rajat Chowdhury
The blood supply of the rectum is supplied by the superior rectal artery (first two-thirds of rectum) and the middle rectal artery (last third of rectum). The venous drainage is the superior and middle rectal veins. The nerve supply comprises the inferior anal nerves and inferior mesenteric ganglia. The lymphatic drainage comprises the inferior mesenteric, pararectal, and internal iliac lymph nodes. In males, the anterior border of the rectum comprises the rectovesical pouch, small bowel, Denonvillier’s fascia, bladder, vas, seminal vesicles, and prostate.
How reliable are imaging techniques in aging males with bladder cancer?
Published in The Aging Male, 2020
Musab Ali Kutluhan, Emrah Özsoy, Fulya Başkak, Ahmet Ürkmez, Ramazan Topaktaş, Orhan Koca
Regional lymph nodes are critical for the spread of pelvic tumors. Nodal metastases are an important prognostic factor in bladder cancer. Nodal metastases often occur in the obturator and internal iliac lymph nodes. In the absence of metastasis in these lymph node groups, it is unlikely to spread to more cranial lymph nodes [14]. In bladder cancer, lymph node involvement adversely affects the 5-year survival rates and prognosis of patients with an increased number of positive lymph nodes and an increased metastatic lymph node size and capsule penetration [15]. Since lymph node involvement is a strong prognostic marker, diagnosing lymph node-positive disease in patients with bladder cancer is of great importance to tailor the treatment algorithm in clinical practice [16]. Preoperative imaging methods are helpful for the surgeon and give information about the local spread of the tumor, lymph node status, and distant metastasis [8].
Efficacy of preemptive endoscopic submucosal dissection and surgery for synchronous colorectal neoplasms
Published in Scandinavian Journal of Gastroenterology, 2020
Yohei Yabuuchi, Kenichiro Imai, Kinichi Hotta, Sayo Ito, Yoshihiro Kishida, Shoichi Manabe, Yusuke Yamaoka, Hitoshi Hino, Hiroyasu Kagawa, Akio Shiomi, Hiroyuki Ono
During the median follow-up period of 51.7 months (IQR, 31.4–62.0), CRC recurred in three patients. In one patient with a diagnosis of pathological stage IV due to distant lymph node metastasis, common iliac lymph node and cervical lymph node metastases occurred 4 months after surgery. This patient received chemotherapy, but died of CRC 16 months after surgery. In another patient with the diagnosis of pathological stage III, liver metastases were detected 4 months after surgery and hepatic resection was performed. However, liver and lymph node metastases recurred 29 months after the first surgery. This patient received chemotherapy, but died of CRC 38 months after the first surgery. In the other patient with the diagnosis of pathological stage III, internal iliac lymph node metastasis occurred 26 months after surgery. This patient underwent chemo radiation therapy and survives without recurrence. Finally, two other patients died of CRC and one patient died of malignant melanoma. The 5-year overall survival rates of patients with all pathological stages, stage 0–II, and stage III–IV were93.7%, 100%, and 79.1%, respectively (Figure 2).
Desmoplastic small round cell tumour with ovarian involvement: a case report
Published in Journal of Obstetrics and Gynaecology, 2020
Soo-Young Lee, Yu-Jin Koo, Dae-Hyung Lee
A 31-year-old unmarried woman (gravida 0, para 0) was referred to our gynaecologic oncology department with a 1-month history of abdominal discomfort and distension. The patient had no specific medical or surgical history. A physical examination revealed a huge non-tender pelvic mass. Computed tomography showed a heterogenous solid cystic mass (11 cm in diameter) with multiple mesenteric nodules. Enlargement of the right internal iliac lymph nodes and massive ascites were noted. Whole-body positron emission tomography imaging demonstrated a diffuse and marked uptake of 18 fluorodeoxyglucose in the pelvic cavity and a positive left supraclavicular lymph node. The patient’s serum CA-125 level (229.1 U/mL) was elevated.