Upper Abdominal Region Lymph Nodes

Upper Abdominal Region Lymph Nodes

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*  This chapter has been written with the contributions of Antonietta Augurio, Raffaella Basilico, and Marco D’Alessandro

8

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 upper abdominal region

Station

Anatomical boundaries Cranial

Caudal

Medial

Lateral

Anterior

Posterior

1

Right paracardial nodes

Plane through upper border of cardia (~T9–T10)

Plane through lower border of cardia (~T10–T11)

Cardia

Liver (superiorly), left diaphragmatic crus (inferiorly)

Liver

2

Left paracardial nodes

Plane through upper border of cardia (~T9–T10)

Plane through lower border of cardia (~T10–T11)

Cardia

Stomach

3

Nodes along the lesser curvaturea Nodes along the left gastric artery

Plane through upper limit of the Plane through lower limit of the Left lobe of liver body and fundus of the stomach body and fundus of the stomach

Lesser gastric curvature

4

Nodes along the greater gastric curvature

Plane through upper limit of the Plane through lower limit of body and fundus of the stomach body of stomach

Greater gastric curvature

Intestine and left colic (splenic) flexure

Intestine

Spleen, anterior limit of station 10

5

Suprapyloric nodes

Plane through superior border of Plane through lower limit of the the pyloric region of the stomach hepatic hilum

Fatty tissue

Ascending colon or liver (near the bed of the gallbladder)

Intestine

6

Infrapyloric nodes

Plane through upper limit of duodenum

1–1.5 cm caudal to the pylorus

Fatty tissue

Right colic (hepatic) flexure Intestine of the ascending colon or liver (near the bed of the gallbladder)

8

Nodes along the common hepatic artery Nodes in the hepatoduodenal ligament

Horizontal plane through the origin of celiac trunk

Intervertebral space T11–T12

Celiac trunk region (superiorly), pancreas (inferiorly)

Liver

9

Nodes around the celiac artery

Horizontal plane through the origin of celiac trunk

Plane passing above the origin of – the mesenteric vessels

10

Nodes at the splenic hilum

Superior limit of the vessels of splenic hilum

Lower limit of the vessels of splenic hilum

Body of stomach Spleen (superiorly), tail of pancreas (inferiorly)

11

Nodes along the splenic artery

Superior limit of splenic artery

Lower limit of splenic artery

Abdominal aorta

13

Posterior pancreaticoduodenal nodes

Plane through superior border of Plane through lower border of the head of pancreas the head of pancreas

Abdominal aorta

14

Nodes along the superior mesenteric vesselsb

Superior limit of mesenteric vessels (~interspace T11–T12)

16

Nodes around the abdominal aorta

Plane through upper limit of the celiac trunk

17

Anterior pancreaticoduodenal nodes

18

20

7

12

110 111 112

a



b

SCOUT VIEW OF upper abdominal region

Station

Anatomical boundaries Cranial

Caudal

Medial

Lateral

Anterior

Posterior

Cardia (superiorly), abdominal aorta (inferiorly)

1

Right paracardial nodes

Plane through upper bo