title: Carcinomas of the ventral and dorsal pancreas exhibit different patterns of lymphatic spread.
abstract: In patients with carcinoma of the head of the pancreas with positive lymph nodes, the extent of an adequate lymph node dissection beyond peripancreatic area has remained controversial. Based on the two anlagens, the ventral or dorsal pancreas, we assessed the lymphatic spread pattern in 58 primary adenocarcinoma of head of the pancreas. Detection of lymph node metastasis was based on microscopic detection of carcinoma in consecutive serial sections of resected specimens including lymph nodes. When the tumor was confined to the ventral pancreas domain (n=20), the lymph node metastases were limited to areas along the superior mesenteric artery (SMA) besides peripancreatic lymph nodes. When the tumor was in the dorsal pancreas domain (n=6), the lymph node metastases were limited to areas along the common hepatic artery (CHA) and the hepatoduodenal ligament besides peripancreatic lymph nodes. When the tumor was extended into both domains (n=32), the lymph node metastases were distributed widely in areas along the SMA, CHA and the hepatoduodenal ligament besides peripancreatic lymph nodes. Based on these findings, the lymphatic spread of carcinomas of the head of the pancreas can be divided into two patterns by tumor location based on the two anlagens of the pancreas.
authors.affiliation: Department of Gastroenterologic Surgery, Graduate School of Medical Science, Kanazawa University, Kanazawa, Japan.
authors.forename: Hirohisa
authors.initials: H
authors.lastname: Kitagawa
authors.forename: Tetsuo
authors.initials: T
authors.lastname: Ohta
authors.forename: Isamu
authors.initials: I
authors.lastname: Makino
authors.forename: Takashi
authors.initials: T
authors.lastname: Tani
authors.forename: Hidehiro
authors.initials: H
authors.lastname: Tajima
authors.forename: Hisatoshi
authors.initials: H
authors.lastname: Nakagawara
authors.forename: Ichiro
authors.initials: I
authors.lastname: Ohnishi
authors.forename: Hiroyuki
authors.initials: H
authors.lastname: Takamura
authors.forename: Masato
authors.initials: M
authors.lastname: Kayahara
authors.forename: Hiroyuki
authors.initials: H
authors.lastname: Watanabe
authors.forename: Toshifumi
authors.initials: T
authors.lastname: Gabata
authors.forename: Osamu
authors.initials: O
authors.lastname: Matsui
authors.forename: Yoh
authors.initials: Y
authors.lastname: Zen
mesh_terms: D002277:Carcinoma / Q000378:metabolism / Q000473:pathology*; D015972:Gene Expression Regulation, Neoplastic; D006801:Humans; D007150:Immunohistochemistry; D008197:Lymph Node Excision; D008198:Lymph Nodes / Q000473:pathology; D008207:Lymphatic Metastasis; D008954:Models, Biological; D009362:Neoplasm Metastasis; D010179:Pancreas / Q000378:metabolism / Q000473:pathology*; D010190:Pancreatic Neoplasms / Q000378:metabolism / Q000473:pathology*; D014057:Tomography, X-Ray Computed