Lingual lymph nodes: Anatomy, clinical considerations, and oncological significance

Abstract

Lingual lymph nodes are an inconstant group of in-transit nodes, which are located on the route of lymph drainage from the tongue mucosa to the regional nodes in neck levels I and II. There is growing academic data on the metastatic spread of oral cancer, particularly regarding the spreading of oral tongue squamous cell carcinoma to lingual nodes. These nodes are not currently included in diagnostic and treatment protocols for oral tongue cancer. Combined information on surgical anatomy, clinical observations, means of detection, and prognostic value is presented. Anatomically obtained incidence of lingual nodes ranges from 8.6% to 30.2%. Incidence of lingual lymph node metastasis ranges from 1.3% to 17.1%. It is clear that lymph nodes that bear intervening tissues from the floor of the mouth should be removed to improve loco-regional control. Extended resection volume, which is required for the surgical treatment of lingual node metastasis, cannot be implied to every tongue cancer patient. As these lesions significantly influence prognosis, special efforts of their detection must be made. Reasonably, every tongue cancer patient must be investigated for the existence of lingual lymph node metastasis. Lymphographic tracing methods, which are currently implied for sentinel lymph node biopsies, may improve the detection of lingual lymph nodes.

Metastasis to the lateral lingual lymph node located behind the submandibular gland: A case of squamous cell carcinoma of the tongue

“…Researchers have had different opinions regarding LLNs. 12 Based on the anatomical evidence [8][9][10] and clinical experience, we present an idea of classifying LLNs into four groups, namely median, anterior lateral, posterior lateral, and parahyoid LLNs ( Figure 1A,B,C,D). Increasing evidence of LLN metastasis has been presented in recent years 13,14 ; incidence reported to be 1.3%-17.1%.…”

“…Increasing evidence of LLN metastasis has been presented in recent years 13,14 ; incidence reported to be 1.3%-17.1%. 12 LLN metastasis has been reported to significantly worsen locoregional control rate, indicating the necessity of thorough dissection. 14 However, the inconsistency in the definition of LLNs may be a hurdle in ensuring the accuracy of the evidence.…”

“…Researchers have had different opinions regarding LLNs 12 . Based on the anatomical evidence 8‐10 and clinical experience, we present an idea of classifying LLNs into four groups, namely median, anterior lateral, posterior lateral, and parahyoid LLNs (Figure 1A,B,C,D).…”

“…Based on the anatomical evidence 8‐10 and clinical experience, we present an idea of classifying LLNs into four groups, namely median, anterior lateral, posterior lateral, and parahyoid LLNs (Figure 1A,B,C,D). Increasing evidence of LLN metastasis has been presented in recent years 13,14 ; incidence reported to be 1.3%‐17.1% 12 . LLN metastasis has been reported to significantly worsen locoregional control rate, indicating the necessity of thorough dissection 14 .…”

A Missing Voice: The Lingual Complex and Osteopathic Manual Medicine in the Context of Five Osteopathic Models

“…It is not possible to obtain a global vision of the patient's homeostatic behavior, without also taking into account the tongue. The tongue is rich in lymphatic passages (in addition to the vascular pathways), starting from the mucous membrane of the tongue up to the neck and submental area; the tongue contains several lymphatic nodes, which are found within the lymphatic ducts [78]. The lymphatic nodes are found mainly in the anterolateral and posterolateral lingual areas within the musculature [78].…”