Functional anatomy of the lymphatic drainage system of the upper aerodigestive tract and its role in metastasis of squamous cell carcinoma.
BACKGROUND
Although there is a significant understanding of the vascular anatomy of the upper aerodigestive tract (UADT), there is less detailed knowledge of the architecture and drainage patterns of the lymphatic system. Detailed knowledge of the lymphatic system is critical for understanding the role of sentinal node identification in the management of different cancers.


METHODS
We have combined microscopic techniques with in vivo and in vitro lymphographic studies to survey the architecture and drainage patterns of the lymphatic system of the UADT in 850 organ specimens.


RESULTS
These studies show an interaction of superficial and deep lymphatic networks that vary in density but have a constant distribution characterized by predictable patterns of lymph drainage into the regional lymph nodes.


CONCLUSIONS
Detailed knowledge of the lymphatic system of the UADT contributes to a better understanding of the patterns of metastatic spread of carcinomas of the UADT and provides a strong rationale for the practice of sentinel node identification in the management of these tumors.
Werner
Jochen A
JA
Department of Otolaryngology, Head and Neck Surgery, Philipps University Marburg, Deutschhausstr. 3, 35037 Marburg, Germany. j.a.werner@mailer.uni-marburg.de
Dünne
Anja A
AA
Myers
Jeffrey N
JN
D002294:Carcinoma, Squamous Cell / Q000000981:diagnostic imaging / Q000556:secondary* / Q000648:ultrastructure*; D004064:Digestive System / Q000000981:diagnostic imaging* / Q000503:physiopathology / Q000648:ultrastructure*; D006258:Head and Neck Neoplasms / Q000000981:diagnostic imaging / Q000473:pathology* / Q000648:ultrastructure*; D006801:Humans; D066298:In Vitro Techniques; D008207:Lymphatic Metastasis / Q000000981:diagnostic imaging* / Q000503:physiopathology / Q000648:ultrastructure*; D008208:Lymphatic System / Q000503:physiopathology / Q000648:ultrastructure*; D008220:Lymphography; D012137:Respiratory System / Q000000981:diagnostic imaging* / Q000503:physiopathology / Q000648:ultrastructure*