Number and size of perigastric lymph nodes in human adults without gastric cancer.

For classification of perigastric lymph node metastases in gastric cancer, only topographical aspects are taken into consideration at present. As a numerical classification for lymph node metastases was proposed recently, the current problem is that of determining the number of dissectable perigastric lymph nodes and also assessing the quality of nodal dissection. The perigastric lymph nodes of 10 adults without gastric disease were therefore evaluated microscopically by a serial section technique. On average a total of 36.2 +/- 15.2 perigastric lymph nodes were found, e.g. 14.9 +/- 14.1 lymph nodes on the greater and 7.4 +/- 4.8 on the lesser curvature. These figures are similar to those in fetuses and newborn infants, but they exceed the numbers of perigastric lymph nodes reported in the literature for adults with or without gastric cancer. This difference could be attributable to our use of the serial section technique, because the so-called "micro-lymph nodes" with a diameter of less than 1.5 mm are consequently included in this study. Our results support the assumption, that pathologic processes do not result in any real increase of regional lymph nodes, but in an activation and enlargement of fetal lymph node reserve.