Pelvic Lymph Nodes
Pelvic Lymph Nodes
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		    *  This chapter has been written with the contributions of Antonietta Augurio, Nicola Filippo Basilico, Antonella Filippone, and Pietro Sanpaolo
 
 9
 
 A Guide for D elineation of Lymph Nodal Clinical Target Volume in R adiation Therapy
 
 A Guide for D elineation of Lymph Nodal Clinical Target Volume in R adiation Therapy
 
 SCOUT VIEW OF pelvic region
 
 Lymph nodes
 
 Anatomical boundaries
 
 SCOUT VIEW OF pelvic region
 
 Lymph nodes
 
 Cranial
 
 Caudal
 
 Medial
 
 Lateral
 
 Anterior
 
 Posterior
 
 Bifurcation of abdominal aorta (at the inferior border of L4)
 
 Bifurcation of the common iliac vessels (at the inferior border of L5, at the level of the superior border of the ala of sacrum)
 
 Loose cellular tissue
 
 Psoas muscle
 
 Loose cellular tissue anterior to the common iliac vessels
 
 Body of L5
 
 Common iliac nodes
 
 Internal iliac nodes Bifurcation of common iliac vessels (at the inferior border of L5)
 
 Plane through superior border of the head of femurs at the level of the superior border of the coccyx
 
 Loose cellular tissue
 
 Piriformis muscle
 
 Posterior border of the external iliac lymph nodes and loose cellular tissue
 
 Loose cellular tissue
 
 External iliac nodes
 
 Bifurcation of common iliac vessels (at the inferior border of L5)
 
 Femoral artery
 
 Loose cellular tissue
 
 Iliopsoas muscle
 
 Loose cellular tissue
 
 Obturator nodes
 
 Plane through the acetabulum
 
 Superior border of the neck of femurs, at the small ischiadic foramen
 
 Loose cellular tissue
 
 Internal obturator muscle (intrapelvic portion)
 
 Presacral nodes
 
 Intervertebral space of L5–S1 (sacral promontory)
 
 Superior border of the 1st coccygeal vertebra
 
 –
 
 Inguinal nodes
 
 Superior limit of the neck of femurs
 
 Bifurcation of the femoral artery into its superficial and deep branches
 
 Adductor muscles
 
 Common iliac nodes
 
 Anatomical boundaries Cranial
 
 Caudal
 
 Medial
 
 Lateral
 
 Anterior
 
 Posterior
 
 Bifurcation of abdominal aorta (at the inferior border of L4)
 
 Bifurcation of the common iliac vessels (at the inferior border of L5, at the level of the superior border of the ala of sacrum)
 
 Loose cellular tissue
 
 Psoas muscle
 
 Loose cellular tissue anterior to the common iliac vessels
 
 Body of L5
 
 Internal iliac nodes Bifurcation of common iliac vessels (at the inferior border of L5)
 
 Plane through superior border of the head of femurs at the level of the superior border of the coccyx
 
 Loose cellular tissue
 
 Piriformis muscle
 
 Posterior border of the external iliac lymph nodes and loose cellular tissue
 
 Loose cellular tissue
 
 Anterior border of the internal iliac lymph nodes and loose cellular tissue
 
 External iliac nodes
 
 Bifurcation of common iliac vessels (at the inferior border of L5)
 
 Femoral artery
 
 Loose cellular tissue
 
 Iliopsoas muscle
 
 Loose cellular tissue
 
 Anterior border of the internal iliac lymph nodes and loose cellular tissue
 
 Loose cellular tissue
 
 Loose cellular tissue
 
 Obturator nodes
 
 Plane through the acetabulum
 
 Superior border of the neck of femurs, at the small ischiadic foramen
 
 Loose cellular tissue
 
 Internal obturator muscle (intrapelvic portion)
 
 Loose cellu		
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