[Intertracheobronchial lymph nodes: lymph inflow and outflow in lung segments from 200 adult subjects]

Abstract

Topographic anatomy of the intertracheobronchial lymp nodes has been thoroughly studies and is now well known. Cinetic aspects of the lymphatic flux passing through these lymph nodes is not completely understood. Supleural lymphatics of lung segments were injected in 200 adults. Almost 300 segments were then injected among the different lobes. The intertracheobronchial lymph node group was interested by the afferencies of 3 segments out of 5. It was injected only once out of 5 from the upper lobes but in 90 to 100% of segmental injections of the lower lobes. Nine times out of ten, the middle lobe was drained by this group, the lingula less than on time out of fife. In almost one third of the cases, the injection was localized to this group and without further progression. This phenomenon was more frequent in the injections of the left lung. The other times the injection continued toward the latero tracheal ascendent chains : right paratracheal chain and esophageal-tracheal, left recurrent chain (left latero or paratracheal). In one third of the cases, only one of these chain was interested and in one time out of two, the right paratracheal chain was concerned. The other times, the injection continued in 2 chains, occasionally three. If these findings are analyzed in regard to the side injected, a contralateral lymphatic drainage is observed either from the left or from the right side. Finally, in less than 10% of the cases, there was a drainage of this group towards the thoracic duct in the mediastinum. Scarcely, it was observed a descendant drainage pathway to the abdomen.