Riquet M, Hidden G, Debesse B
Ann Chir. 1989;43(8):646-57.
Dye injection of lung segments reveals the existence of lymphatic drainage of the lungs generally into cervical venous confluents and more rarely into the arch of the thoracic duct in the neck and also occasionally into the thoracic duct in the mediastinum. Direct drainage of the lymph into the thoracic duct was observed in 10 cases out of a series of 589 injections of lung segments in adult cadavers. In one half of cases, the thoracic duct was injected from the left suprabronchial lymph node chain, the origin of the left recurrent chain, and in one quarter of cases from the lateral anteroposterior right major azygos and left azygo-aortic lymph node chains, not recognised by the classical authors. More rarely, direct lymphatic collaterals drained certain segments of the lower lobes into the thoracic duct via the triangular ligament. Analysis of cases of chylothorax occurring after lung resection and observed in the authors' department or in the literature reveals that most of them can be attributed to a chyle leak from one of these pulmonary lymph collaterals. These pathways are probably also involved in the development of medical or idiopathic chylothorax.
肺段染料注射显示，肺的淋巴引流通常进入颈静脉汇合处，较少进入颈部胸导管弓，偶尔也进入纵隔内的胸导管。在对成年尸体进行的589次肺段注射中，有10例观察到淋巴直接引流至胸导管。在一半的病例中，胸导管由左支气管上淋巴结链（左喉返神经链的起始处）注入；在四分之一的病例中，由经典作者未认可的右主奇静脉和左奇静脉-主动脉淋巴结链的外侧前后链注入。更罕见的是，直接的淋巴管侧支通过三角韧带将下叶的某些节段引流至胸导管。对作者所在科室或文献中观察到的肺切除术后发生乳糜胸的病例分析表明，其中大多数可归因于这些肺淋巴侧支之一的乳糜漏。这些途径可能也参与了医源性或特发性乳糜胸的发生。
