Pereira C T, Rahal S C, de Carvalho Balieiro J C, Ribeiro A A C M
Paulista University (UNIP) Department of Surgery and Anaesthesiology, College of Veterinary Medicine, São Paulo, Brazil.
Anat Histol Embryol. 2003 Oct;32(5):282-90. doi: 10.1046/j.1439-0264.2003.00485.x.
The purpose of this research was to study the mammary lymphatic drainage under a macroscopic and mesoscopic view, comparing the vascular pattern of healthy and neoplasic mammary glands injected with drawing ink alcoholic and fluorescein solutions, in 46 mongrel female dogs. The results pointed out that the thoracic gland is drained by the axillary lymph centre, but in mammary neoplasia either superficial cervical or ventral thoracic lymph centres can be involved. Cranial and caudal abdominal glands may be drained by the axillary, inguinofemoral and popliteal lymph centres. However, the popliteal drainage is specific for the healthy caudal abdominal mammary gland. The inguinal gland can be drained by both inguinofemoral and popliteal lymph centres in both neoplasic and healthy conditions. Regarding the mammary lymphatic communications, this research demonstrated that neoplasic glands present more types of anastomosis (40.9%), than healthy glands (33.33%), and an increase in contralateral anastomosis (50%) compared with healthy ones (33%). Given the data, the mammary neoplasia can change the lymphatic drainage pattern in terms of lymph centres and vascular arborization, thus forming new drainage channels and recruiting a larger number of lymph nodes. Lastly, some comments were made about the severity of a specific neoplasic mammary gland and conditions to be considered before making a decision in terms of the most adequate operative procedure, and suggestions for further investigations.
本研究的目的是在宏观和微观视角下研究乳腺淋巴引流情况,对比46只杂种雌性犬中注射了酒精绘图墨水和荧光素溶液的健康乳腺和肿瘤性乳腺的血管模式。结果指出,胸腺由腋窝淋巴中心引流,但在乳腺肿瘤中,颈浅或胸腹侧淋巴中心可能会受累。腹部头侧和尾侧的腺体可能由腋窝、腹股沟股部和腘窝淋巴中心引流。然而,腘窝引流是健康的腹部尾侧乳腺所特有的。在肿瘤性和健康状态下,腹股沟腺均可由腹股沟股部和腘窝淋巴中心引流。关于乳腺淋巴交通,本研究表明,肿瘤性腺体的吻合类型(40.9%)比健康腺体(33.33%)更多,且与健康腺体(33%)相比,对侧吻合增加(50%)。基于这些数据,乳腺肿瘤可在淋巴中心和血管分支方面改变淋巴引流模式,从而形成新的引流通道并累及更多数量的淋巴结。最后,针对特定肿瘤性乳腺的严重程度以及在决定最适当的手术程序之前应考虑的情况提出了一些意见,并给出了进一步研究的建议。