Thoracic duct tributaries from intrathoracic organs

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Presentation transcript:

Thoracic duct tributaries from intrathoracic organs Marc Riquet, MD, PhD, Françoise Le Pimpec Barthes, MD, Redha Souilamas, MD, Geneviève Hidden, MD The Annals of Thoracic Surgery Volume 73, Issue 3, Pages 892-898 (March 2002) DOI: 10.1016/S0003-4975(01)03361-6

Fig 1 Lymphatic vessels from the lungs. Connections with the thoracic duct: right paratracheal nodes (rpt) (4 R); left superior bronchial (lsb) (4 L); left recurrent chain (lrc); aortic arch nodes (ao) (aortic subclavian and carotid nodes chains) (5); left anterior mediastinal (lam) (6); right inferior pulmonary (rpl) ligament nodes (9); left inferior pulmonary (lpl) ligament nodes (9); nodes of tracheal bifurcation (bif) (intertracheobronchial nodes) (7). Numbers in parentheses refer to the 1997 regional lymph nodes classification [7]. (ESO = esophagus.) The Annals of Thoracic Surgery 2002 73, 892-898DOI: (10.1016/S0003-4975(01)03361-6)

Fig 2 Thoracic duct tributary (arrow) from the left superior bronchial nodes (lsb) (4 L). (eso = esophagus; b = posterior aspect of the right main bronchus; td = thoracic duct; tra = posterior aspect of the trachea [membranous part].) The Annals of Thoracic Surgery 2002 73, 892-898DOI: (10.1016/S0003-4975(01)03361-6)

Fig 3 Tributary connecting with the arch of the thoracic duct (tda) by the left recurrent chain (arrow). (lj = left internal jugular vein; lsa = left subclavian artery.) The Annals of Thoracic Surgery 2002 73, 892-898DOI: (10.1016/S0003-4975(01)03361-6)

Fig 4 Tributaries from the aortic arch nodes (5) traveling posteriorly to connect with the thoracic duct. The Annals of Thoracic Surgery 2002 73, 892-898DOI: (10.1016/S0003-4975(01)03361-6)

Fig 5 Right lymphatic trunk from the heart ascending between the aorta and the pulmonary trunk (arrow) before joining the upper part of the left anterior mediastinal node chain (lam) and then emptying into the arch of the thoracic duct (arrow). (ao = aortic arch nodes.) The Annals of Thoracic Surgery 2002 73, 892-898DOI: (10.1016/S0003-4975(01)03361-6)

Fig 6 Left lymphatic trunk from the heart draining into the right paratracheal nodes (rpt). From there the lymph may follow the azygos vein (arrow) or reach the left suprabronchial nodes (lsb) and also the aortic arch nodes (ao). From these lymph node groups, tributaries may further connect with the thoracic duct. The Annals of Thoracic Surgery 2002 73, 892-898DOI: (10.1016/S0003-4975(01)03361-6)

Fig 7 Lymphatic vessels from the esophagus (ESO) may connect with the thoracic duct directly (anodal route) or after crossing the epiesophageal lymph nodes. (RMB = right main bronchus.) The Annals of Thoracic Surgery 2002 73, 892-898DOI: (10.1016/S0003-4975(01)03361-6)

Fig 8 Tributaries from the diaphragm connecting with the origin of the thoracic duct; anodal route (n = 4). (CE = celiac nodes; IVC = inferior vena cava; RA = renal artery nodes; RV = renal vein; TD = thoracic duct.) The Annals of Thoracic Surgery 2002 73, 892-898DOI: (10.1016/S0003-4975(01)03361-6)