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Published on: February 9, 2020
Mediastinal lymph node distribution, size and number: definitions based on an anatomical study
Aurelino Fernandes Schmidt1, Olavo Ribeiro Rodrigues, Roberto Storte Matheus
1Surgery Department, Universidade de Mogi das Cruzes, University of Mogi das Cruzes-School of Medicine, Mogi das Cruzes, SP, Brazil. aurelino@institutodotorax.com.br
Insights
This study mapped mediastinal lymph nodes, revealing consistent size and distribution across demographics. The findings establish a reference map for these crucial anatomical structures.
Area of Science:
- Anatomy
- Medical Imaging
- Surgical Pathology
Background:
- Accurate anatomical knowledge of mediastinal lymph nodes is crucial for staging and treatment of thoracic malignancies.
- Existing lymph node maps lack detailed size and distribution data, hindering precise clinical application.
Purpose of the Study:
- To establish a comprehensive reference map of mediastinal lymph nodes.
- To analyze the size, number, and distribution of lymph nodes across different anatomical stations.
- To provide data for improved diagnostic and therapeutic strategies in thoracic oncology.
Main Methods:
- Bilateral mediastinal dissection was performed on 50 cadavers (38 male, 12 female, 39 Caucasian).
- Lymph nodes were resected, isolated, and analyzed using radiographic imaging.
- Measurements included area and transverse diameters; station presence and node counts were recorded.
Main Results:
- A total of 1742 lymph nodes were dissected from 485 chains.
- Stations 1, 2R, 4R, 5, and 7 were consistently present (>90%); stations 4R and 7 were always present.
- Stations 2R, 4R, and 7 exhibited the highest number and largest size of mediastinal lymph nodes.
Conclusions:
- A feasible reference map for mediastinal lymph node size and distribution was created.
- No significant variations in lymph node distribution, number, or size were observed based on age, gender, race, weight, or height.
Objective:
To create a reference map of mediastinal lymph nodes through the analysis of their size, number and distribution in various lymph node stations.
Method:
A total of 50 cadavers, 38 males and 12 females, were studied. Of those 50, 39 were Caucasian. The mean age was 59.9 +/= 14.1 years, the mean height was 173.1 +/= 7.6 cm, and the mean weight was 71.0 +/= 12.0 kg. A bilateral mediastinal dissection was performed in order to resect and isolate all lymph nodes. The area, as well as the major and minor transverse diameters, of each lymph node was determined by radiographic imaging analysis.
Results:
In a sample of 485 chains, 1742 lymph nodes were dissected (2.58 +/= 1.89 lymph nodes/station), revealing a mean number of 21.2 +/= 8.5 lymph nodes on the right and 13.6 +/= 6.3 on the left. The lymph node stations 1, 2R, 4R, 5, and 7 were present in more than 90% of the sample. Only the 4R and 7 lymph node stations were always present. The lymph node stations 2L, 3p, and 8 were present in 32, 36, and 54% of the sample, respectively. Mediastinal lymph nodes were present in greater numbers in the 2R, 4R and 7 lymph node stations. In addition, these stations presented the largest mediastinal lymph nodes.
Conclusion:
Composing a reference map for lymph node sizes was feasible. No alterations were observed in the distribution, number, or size of lymph nodes in the age brackets studied, regardless of gender, race, weight, or height.
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