title: Anatomical variations in lymphatic drainage of the right lung: applications in lung cancer surgery.
abstract: OBJECTIVE
  To specify the topography and variations in lymphatic drainage of the right lung to the mediastinum and their therapeutic implications in non-small cell lung cancers (NSCLC).
  
  
  METHODS
  We injected a dye into the subpleural lymphatic vessels in 65 right lung segments, followed by dissection in 22 subjects.
  
  
  RESULTS
  At the upper lobe, we had injected 32 segments. We noted extrasegmental overflow in one case; extrasegmental and extralobar drainage in two cases; drainage to the lymph nodes of another lobe in one case. Fifty-six percent of the segments drained directly (skipping intrapulmonary and hilar lymph nodes) into the right paratracheal lymph nodes, and one dorsal segment drained into the thoracic duct. A ventral segment drained into the inferior tracheobronchial lymph nodes. A contralateral drainage to the recurrent chain was observed in two cases. Sixteen segments of the middle lobe were injected and mainly drained into the inferior tracheobronchial lymph nodes with six direct paths; one medial segment drained into the right anterior mediastinal chain. We noted three contralateral drainages and eight downward abdominal drainages. Out of the 17 segments of the lower lobe injected, 6 segments drained into the lymph nodes of another lobe, 5 segments showed a direct route to the lower quadrant chains. We noted one time a drainage into the paraesophageal lymph nodes.
  
  
  CONCLUSIONS
  The variations in lymphatic drainage of the right lung require to carry out systematically a radical mediastinal lymphadenectomy during the removal of non-small cell lung cancers and to associate an adjuvant treatment.
authors.affiliation: Department of Anatomy, Health Sciences Unit - Assane Seck University, Ziguinchor, Senegal. lazanat@yahoo.fr.|Clinic of Thoracic and Cardiovascular Surgery, Fann University Hospital Center, BP 16659, Dakar-Fann, Senegal. lazanat@yahoo.fr.
authors.forename: Assane
authors.initials: A
authors.lastname: Ndiaye
authors.affiliation: Anatomy Laboratory, Faculty of Medicine Timone, Aix- Marseille University, Marseille, France.
authors.forename: V
authors.initials: V
authors.lastname: Di-Marino
authors.affiliation: Clinic of Thoracic and Cardiovascular Surgery, Fann University Hospital Center, BP 16659, Dakar-Fann, Senegal.
authors.forename: P S
authors.initials: PS
authors.lastname: Ba
authors.affiliation: Anatomy and Organogenesis Laboratory, Faculty of Medicine, CADiop University, Dakar, Senegal.
authors.forename: Aï
authors.initials: A
authors.lastname: Ndiaye
authors.affiliation: Clinic of Thoracic and Cardiovascular Surgery, Fann University Hospital Center, BP 16659, Dakar-Fann, Senegal.|Anatomy and Organogenesis Laboratory, Faculty of Medicine, CADiop University, Dakar, Senegal.
authors.forename: M
authors.initials: M
authors.lastname: Gaye
authors.affiliation: Anatomy Laboratory, Faculty of Medicine Timone, Aix- Marseille University, Marseille, France.
authors.forename: S
authors.initials: S
authors.lastname: Nazarian
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D063405:Anatomic Variation; D002102:Cadaver; D002289:Carcinoma, Non-Small-Cell Lung / Q000601:surgery*; D004396:Coloring Agents; D004210:Dissection; D005260:Female; D006801:Humans; D007272:Injections, Intralymphatic; D008168:Lung / Q000033:anatomy & histology*; D008175:Lung Neoplasms / Q000601:surgery*; D008198:Lymph Nodes / Q000033:anatomy & histology*; D008207:Lymphatic Metastasis; D042601:Lymphatic Vessels / Q000033:anatomy & histology*; D008297:Male; D008482:Mediastinum
chemical_list: D004396:Coloring Agents
keywords: Anatomy; Lung cancer; Lymphatics; Mediastinum; Right lung; Surgery