Suami Hiroo, O'Neill Jennifer K, Pan Wei-Ren, Taylor G Ian
Parkville, Victoria, Australia From the Jack Brockhoff Reconstructive Plastic Surgery Research Unit, Royal Melbourne Hospital, Department of Anatomy and Cell Biology, University of Melbourne.
Plast Reconstr Surg. 2008 Apr;121(4):1231-1239. doi: 10.1097/01.prs.0000302511.21140.36.
Lymphoscintigraphy has become a routine examination for identifying the sentinel lymph node in various cancer patients. Despite increasing clinical information, the basic anatomy of the superficial lymphatic system of the upper torso has not been fully elucidated.
Five female breasts, three anterior chest walls, and three forequarter specimens from fresh nine cadavers (two male and seven female) were used for this study. Our original radiographic method for delineating the lymphatics was applied. The course of the lymph vessels was traced from the x-ray films and color coded in accordance with their sentinel lymph node to define the lymph territories of the upper torso. In addition, cross-sectional studies were performed on the female breasts to demonstrate the three-dimensional pathway and connections of the lymphatic vessels.
The lymphatic territories of the upper torso were divided by the midaxillary line. The anterior side drained into the external mammary or axillary vein lymph nodes and the posterior side drained into the scapular nodes. There was no significant difference between sexes. In most cases, one sentinel lymph node in the axilla notably covered a large lymph territory in both the upper arm and the upper torso.
The authors have demonstrated by radiography and dissection the superficial lymphatics of the upper torso in male and female cadavers. The lymph vessels originating in the lower region of the upper torso have close spatial association with the breast tissue and seemed to play a key role in the breast lymph drainage.
淋巴闪烁造影已成为各类癌症患者前哨淋巴结识别的常规检查。尽管临床信息不断增加，但上半身浅表淋巴系统的基本解剖结构尚未完全阐明。
本研究使用了来自9具新鲜尸体（2男7女）的5个女性乳房、3个前胸壁和3个前半侧标本。应用我们最初描绘淋巴管的放射学方法。从X线片上追踪淋巴管的走行，并根据其前哨淋巴结进行颜色编码，以确定上半身的淋巴区域。此外，对女性乳房进行了横断面研究，以展示淋巴管的三维路径和连接。
上半身的淋巴区域以腋中线为界划分。前侧引流至乳腺外侧或腋窝静脉淋巴结，后侧引流至肩胛下淋巴结。两性之间无显著差异。在大多数情况下，腋窝中的一个前哨淋巴结显著覆盖上臂和上半身的大片淋巴区域。
作者通过放射学和解剖学方法展示了男性和女性尸体上半身的浅表淋巴管。起源于上半身下部区域的淋巴管与乳腺组织有密切的空间关联，似乎在乳腺淋巴引流中起关键作用。
