title: Lymphatic drainage of the skull base: comparative anatomic and advanced imaging studies in the rabbit and human with implications for spread of nasopharyngeal carcinoma.
abstract: This preliminary study investigated the lymphatic drainage and distribution of lymphatic structures in the skull base. Characteristics of the rabbit skull base were analyzed and compared correspondingly with those of the human skull. The lymphatic circulation in the rabbit cranial base was detected by digital subtraction angiography (DSA), and lymph drainage in the human skull base was illustrated by interstitial magnetic resonance lymphography (MRL). Lymphatic structures and their distribution in MRL were identified by comparing with contrast-enhanced MRI and clinical data on basilar metastasis of nasopharyngeal carcinoma (NPC) in the human skull base. Anatomic similarity was found between the rabbit and human basilar regions. Well-visualized lymphatic pathways were found in the rabbit cranial base, and human lymphatic structures showed high signal intensity in enhanced T1-weighted MRL images. Lymphatic tissues in the human basilar region were found mainly distributed in the areas of the jugular foramen, foramen lacerum, and petrosal section of the internal carotid artery (ICA). Their distribution in the human basilar region was similar to the distribution in the rabbit basilar region and consistent with our clinical findings of the predilection sites of NPC metastasis in the skull base. Our studies show that bilateral symmetrical lymphatic structures were distributed along the ICA, internal jugular vein, and dura of cranial base in the central part of the middle and posterior skull base.
authors.affiliation: Center of Skull Base Surgery, China INN and Department of Otolaryngology-Head and Neck Surgery, Xuanwu Hospital, Capital Medical University, Beijing, Peoples Republic of China. shengxuewuyan@hotmail.com
authors.forename: Z
authors.initials: Z
authors.lastname: Qiuhang
authors.forename: W
authors.initials: W
authors.lastname: Zhenlin
authors.forename: Q
authors.initials: Q
authors.lastname: Yan
authors.forename: H
authors.initials: H
authors.lastname: Jun
authors.forename: S
authors.initials: S
authors.lastname: Yongfeng
authors.forename: H
authors.initials: H
authors.lastname: Bo
mesh_terms: D000818:Animals; D002277:Carcinoma; D004322:Drainage; D005260:Female; D006801:Humans; D008207:Lymphatic Metastasis; D008220:Lymphography; D008279:Magnetic Resonance Imaging; D008297:Male; D000077274:Nasopharyngeal Carcinoma; D009303:Nasopharyngeal Neoplasms / Q000473:pathology; D011817:Rabbits; D019291:Skull Base / Q000033:anatomy & histology* / Q000000981:diagnostic imaging; D019292:Skull Base Neoplasms / Q000556:secondary*