Hidden G
Laboratoire d'Anatomie, U.E.R. Biomédicale des Saints Pères, Paris.
J Mal Vasc. 1990;15(2):149-51.
Superficial collecting lymphatics of the limbs are present in much greater number than deep collecting vessels. There is practically no connexion between both networks. Although lymphatics are abundant distally, they tend to fuse toward the root of the limb. At certain "critical" points along their course, local aggression of the vessels may cause lymphedema. In the lower extremity, at the knee and thigh levels, the "critical" area takes the form of a narrow strip of adipose tissue along the path of the great saphenous vein. In the groin, danger is localized at the inferior superficial inguinal nodes, where the superficial collecting lymph vessels merge. In the upper limb, superficial lymphatics converge towards the base of the axilla, where they form three or four trunks that perforate the clavipectoral fascia, each penetrating through its own orifice. Draining lymphatics may approach the axillary space independently. Unfortunately, the inferior axillary nodes wherein they converge also drain the breast, as can be demonstrated by injecting different coloring materials concurrently in both areas. Excision of nodes draining the mammary gland unavoidably jeopardize superficial lymphatic drainage of the upper extremity.