Annals of Surgical Oncology

, Volume 11, Supplement 3, pp 279S–284S | Cite as

Histologic heterogeneity and intranodal shunt flow in lymph nodes from elderly subjects: a cadaveric study

  • Gen Murakami
  • Izumi Taniguchi


Gaps of the superficial cortex of the lymph node provide intranodal shunts that are more often the cause of skip metastasis than are collateral vessels. Examination of lymph nodes from cadavers of elderly subjects often revealed cortical gaps, especially in specific three-dimensional assembled cords; these cortical gaps were readily seen in para-aortic and pelvic nodes. This architecture seemed to be more appropriate for a systemic immune response than a local defense. Evidence of poorly developed cortices, anthracosis, and hyalinization also suggested impaired nodal function. We suspect that this histologic heterogeneity, perhaps a result of aging, affects the nodal trapping of colorimetric/isotopic tracers and metastatic cancer cells. This may have implications for lymphatic mapping of the sentinel lymph node in elderly patients with early-stage cancer.

Key Words

Aging Cortex Gaps Lymph nodes Skip metastasis 


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Copyright information

© The Society of Surgical Oncology, Inc. 2004

Authors and Affiliations

  1. 1.Department of AnatomySapporo Medical University School of MedicineSapporoJapan

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