[Topographic study of parasternal lymph nodes. Finding a window for radiotherapy]

Area of Science:

• Anatomy
• Thoracic Surgery
• Medical Imaging

Background:

• The internal thoracic arteries are crucial for thoracic wall vascularization.
• Accurate anatomical knowledge of these vessels and associated lymphatic chains is vital for surgical planning and radiation therapy.
• Previous studies have not precisely delineated the lymphatic drainage pathways relative to arterial anatomy.

Purpose of the Study:

• To precisely map the anatomical pathway of the internal thoracic arteries.
• To investigate the relationship between internal thoracic arteries and parasternal lymphatic chains.
• To define a precise irradiation field for parasternal lymph nodes based on anatomical findings.

Main Methods:

• Performed arteriographies of the internal thoracic arteries in multiple subjects.
• Superimposed tracings from 55 thoracic walls to identify arterial pathways.
• Dissected 22 parasternal lymphatic chains to assess their relationship with arteries.

Main Results:

• Identified a preferential and precise pathway for the internal thoracic arteries.
• Observed that the lymphatic chains are closely associated with the arteries.
• The pathway is located at a specific distance from the manubrio-corporeal angle and median axis.

Conclusions:

• The internal thoracic artery follows a predictable anatomical course.
• Parasternal lymphatic chains are intimately related to the internal thoracic arteries.
• A precise anatomical basis for defining parasternal lymph node irradiation fields has been established.