title: Immunocytochemical detection of tumour cells in the thoracic duct of patients with an adenocarcinoma of the oesophagus.
abstract: BACKGROUND
  Compared to other hollow viscus organs, the oesophagus has a unique anatomy in which lymphatic channels are abundantly present in the mucosa and submucosa. It has been hypothesized that tumour cells can directly disseminate from these superficial layers into the thoracic duct without passing juxta-tumoral lymph nodes. We investigated whether tumour cells of an oesophageal carcinoma could be detected in the thoracic duct during operative manipulation.
  
  
  METHODS
  In patients with an adenocarcinoma of the oesophagus and/or gastro-oesophageal junction, undergoing a transthoracic resection with two-field lymphadenectomy, lymph was collected and cells were immunostained.
  
  
  RESULTS
  Tumour cells could be detected in the thoracic duct lymph of only 1 out of 19 patients during operative manipulation.
  
  
  CONCLUSIONS
  Peroperative data from this study do not support the hypothesis that oesophageal carcinoma readily metastasizes directly into the thoracic duct.
authors.affiliation: Department of Surgery, Academic Medical Center, University of Amsterdam, The Netherlands. LCLemaire@amc.uva.nl
authors.forename: L C
authors.initials: LC
authors.lastname: Lemaire
authors.forename: F J
authors.initials: FJ
authors.lastname: ten Kate
authors.forename: J W
authors.initials: JW
authors.lastname: van Sandick
authors.forename: H
authors.initials: H
authors.lastname: Obertop
authors.forename: J J
authors.initials: JJ
authors.lastname: van Lanschot
mesh_terms: D000230:Adenocarcinoma / Q000473:pathology* / Q000601:surgery; D000368:Aged; D004938:Esophageal Neoplasms / Q000473:pathology* / Q000601:surgery; D005260:Female; D006801:Humans; D007150:Immunohistochemistry; D008196:Lymph / Q000166:cytology*; D008207:Lymphatic Metastasis; D008297:Male; D008875:Middle Aged; D013897:Thoracic Duct / Q000473:pathology*