Graham N J, Libshitz H I
University of Texas, M. D. Anderson Cancer Center, Diagnostic Radiology Department, Houston, USA.
Acad Radiol. 1995 Apr;2(4):282-5. doi: 10.1016/s1076-6332(05)80185-0.
Metastases of colon carcinoma from the liver to porta hepatis and celiac axis lymph nodes constitute a contraindication to hepatic metastatic resection. Our objective was to determine the frequency of anterior diaphragmatic lymph node (ADLN) enlargement, another efferent pathway of hepatic lymphatic drainage, in patients with colon carcinoma.
Abdominal computed tomography scans from 50 patients with colon carcinoma in whom hepatic metastases were either present (n = 25) or absent (n = 25) were reviewed. ADLNs greater than or equal to 5 mm were considered enlarged.
Thirteen of 25 patients with hepatic metastases had ADLNs greater than or equal to 5 mm; three of 25 patients without hepatic metastases had ADLNs greater than or equal to 5 mm. The difference was statistically significant (p = .002).
Metastases of colon carcinoma from the liver to the ADLNs probably are not rare. ADLN involvement would obviate hepatic resection. The ADLNs should be assessed preoperatively in surgical candidates with hepatic metastases of colon carcinoma.
结肠癌从肝脏转移至肝门和腹腔动脉淋巴结是肝转移瘤切除术的禁忌证。我们的目的是确定结肠癌患者肝淋巴引流的另一条输出途径——前膈淋巴结（ADLN）肿大的发生率。
回顾了50例结肠癌患者的腹部计算机断层扫描，其中有肝转移（n = 25）或无肝转移（n = 25）。直径大于或等于5mm的ADLN被视为肿大。
25例有肝转移的患者中有13例ADLN大于或等于5mm；25例无肝转移的患者中有3例ADLN大于或等于5mm。差异具有统计学意义（p = 0.002）。
结肠癌从肝脏转移至ADLN可能并不罕见。ADLN受累会使肝切除术无法进行。对于有结肠癌肝转移的手术候选者，术前应评估ADLN。
