Pulmonary lymphatic drainage to the mediastinum based on computed tomographic observations of the primary complex of pulmonary histoplasmosis

Abstract

Our data showed a predictable pattern of segmental and lobar lymphatic drainage to the mediastinum and suggested that skip involvement could represent the initial mediastinal node involvement via direct lymphatic drainage.

Mediastinal Nodal Involvement in Patients with Clinical Stage I Non–Small-Cell Lung Cancer: Possibility of Rational Lymph Node Dissection

“…Gorai et al 31 suggested that the incidence of skip N2 was significantly associated with pleural involvement in patients with clinical IA NSCLC and in those with nodal metastasis, and assumed an involvement of the subpleural lymphatic drainage. In addition, Takahashi et al 32,33 demonstrated a predictable pattern of lobar lymphatic drainage to the mediastinum by the assessment of CT studies of patients with primary complex histoplasmosis consisting of a single lobe pulmonary lesion and mediastinal nodal disease. They revealed that there were seven of 122 (5.7%) upper-lobe cases with skip SCLN involvement and 14 of 129 (10.8%) lowerlobe cases with skip UMLN involvement in their study.…”