Computed tomography of the cranio-cervical lymphatic system: anatomical and functional considerations

Abstract

As an initial route of the spread of inflammatory and neoplastic pathology, the complex lymphatic system of the cervical region assumes an important part of the examination in patients with extra-axial disease of the head and neck. In addition, the often overlooked cranio-facial lymphatics must also be routinely investigated in order to forward the understanding and sensitivity of the neuroradiologic evaluation of primary sites of disease propagation from these areas.

Iron oxide‐enhanced MR lymphography: The evaluation of cervical lymph node metastases in head and neck cancer

“…Johnson et al (5) reported that the presence of extracapsular spread reduces 2-year survival of patients by approximately 50%. Although extracapsular spread has been reported to be present in small nodes (8,14), the incidence of extracapsular spread increases with increasing node size.…”

A case of oral cancer with delayed occipital lymph node metastasis: Case report

“…Accordingly, neck dissection is performed in advanced cases, but antegrade lymphatic flow may be blocked by neck dissection itself or obstruction of adjacent lymph vessels associated with tumor progression. As a result, lymphatic regurgitation may occur, and residual tumor cells may unexpectedly disseminate by a route that ignores the original lymphatic flow 20‐22 . Yang et al hypothesized that extensive neck LN metastasis, particularly meeting the condition of N3, was a risk factor for lymphatic regurgitation to the occipital LN metastasis 23 .…”

“…As a result, lymphatic regurgitation may occur, and residual tumor cells may unexpectedly disseminate by a route that ignores the original lymphatic flow. [20][21][22] Yang et al hypothesized that extensive neck LN metastasis, particularly meeting the condition of N3, was a risk factor for lymphatic regurgitation to the occipital LN metastasis. 23 However, in the case we experienced, the pathological results of the LNs dissected in the initial surgery showed metastasis was found only in level IIa LN, but delayed metastasis to the occipital LN was found at 3 months postsurgery.…”

Metastasis of lower gingival squamous cell carcinoma to buccinator lymph node: case report and review of the literature

“…Tumor spread can result in the obstruction of adjacent lymphatic vessels, blocking antegrade lymphatic flow. This would account for retrograde lymphatic flow and unexpected dissemination of cancer cells [12–14]. (3) There is a direct and retrograde pathway from lower gingiva to BN in normal physiological state, but this seems unlikely.…”