Pelvic Lymph Nodes

  • Mukesh G. Harisinghani


A good basic understanding of the anatomy and nomenclature of the inguino-pelvic nodal groups is essential for accurate staging of male and female urogenital pelvic neoplasms. Lymph nodes are not only crucial for staging and management but are also important factors in prognosticating the disease.


Sentinel Node Testicular Cancer Lymphatic Drainage Inguinal Node Common Iliac Artery 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.


  1. 1.
    Meyers MA, Charnsangavej C, Oliphant M. Meyers’ dynamic radiology of the abdomen: ­normal and pathologic anatomy. New York: Springer; 2010.Google Scholar
  2. 2.
    Park JM, Charnsangavej C, Yoshimitsu K, Herron DH, et al. Pathways of nodal metastasis from pelvic tumors: CT demonstration. Radiographics. 1994;14:1309–21.PubMedGoogle Scholar
  3. 3.
    Fukuya T, Honda H, Hayashi T, et al. Lymph-node metastases: efficacy for detection with ­helical CT in patients with gastric cancer. Radiology. 1995;197:705–11.PubMedGoogle Scholar
  4. 4.
    Brown G, Richards CJ, Bourne MW, et al. Morphologic predictors of lymph node status in rectal cancer with use of high-spatial-resolution MR imaging with histopathologic comparison. Radiology. 2003;227:371–7.PubMedCrossRefGoogle Scholar
  5. 5.
    Bipat S, Fransen GA, Spijkerboer AM, et al. Is there a role for magnetic resonance imaging in the evaluation of inguinal lymph node metastases in patients with vulva carcinoma? Gynecol Oncol. 2006;103:1001–6.PubMedCrossRefGoogle Scholar
  6. 6.
    Ghurani GB, Penalver MA. An update on vulvar cancer. Am J Obstet Gynecol. 2001;185:294–9.PubMedCrossRefGoogle Scholar
  7. 7.
    Klerkx WM, Bax L, Veldhuis WB, et al. Detection of lymph node metastases by gadolinium-enhanced magnetic resonance imaging: systematic review and meta-analysis. J Natl Cancer Inst. 2010;102:244–53.PubMedCrossRefGoogle Scholar
  8. 8.
    Parikh S, Beriwal S. The integration of 3D imaging with conformal radiotherapy for vulvar and vaginal cancer. In: Viswanathan AN, Kirisits C, Erickson BE, Pötter RB, editors. Gynecologic radiation therapy. Berlin/Heidelberg: Springer; 2011. p. 85–95. Available from
  9. 9.
    Selman TJ, Luesley DM, Acheson N, et al. A systematic review of the accuracy of diagnostic tests for inguinal lymph node status in vulvar cancer. Gynecol Oncol. 2005;99:206–14.PubMedCrossRefGoogle Scholar
  10. 10.
    McMahon CJ, Rofsky NM, Pedrosa I. Lymphatic metastases from pelvic tumors: anatomic classification, characterization, and staging. Radiology. 2010;254:31–46.PubMedCrossRefGoogle Scholar
  11. 11.
    Adams M, Jasani B. Cancer metastasis: biological and clinical aspects, gynaecological cancer. In: Jiang WG, Mansel RE, editors. Cancer metastasis, molecular and cellular mechanisms and clinical intervention. Dordrecht: Kluwer Academic Publishers; 2004. p. 381–420. Available from
  12. 12.
    Berek JS, Hacker NF. Practical gynecologic oncology. Philadelphia: Lippincott Williams & Wilkins; 2005.Google Scholar
  13. 13.
    Narayanan P, Lyngkaran T, Sohaib SA, et al. Pearls and pitfalls of MR lymphography in ­gynecologic malignancy. Radiographics. 2009;29:1057–69.PubMedCrossRefGoogle Scholar
  14. 14.
    Lai G, Rockall AG. Lymph node imaging in gynecologic malignancy. Semin Ultrasound CT MRI. 2010;31:363–6.CrossRefGoogle Scholar
  15. 15.
    Mironov S, Akin O, Pandit-Taskar N, Hann LE. Ovarian cancer. Radiol Clin North Am. 2007;45:149–66.PubMedCrossRefGoogle Scholar
  16. 16.
    Ricke J, Sehouli J, Hach C, et al. Prospective evaluation of contrast-enhanced MRI in the ­depiction of peritoneal spread in primary or recurrent ovarian cancer. Eur Radiol. 2003;13:943–9.PubMedCrossRefGoogle Scholar
  17. 17.
    Bristow RE, Giuntoli 2nd RL, Pannu HK, et al. Combined PET/CT for detecting recurrent ovarian cancer limited to retroperitoneal lymph nodes. Gynecol Oncol. 2005;99:294–300.PubMedCrossRefGoogle Scholar
  18. 18.
    Paño B, Sebastià C, Buñesch L, et al. Pathways of lymphatic spread in male urogenital pelvic malignancies. Radiographics. 2011;31:135–60.PubMedCrossRefGoogle Scholar
  19. 19.
    Park JM, Charnsangavej C, Yoshimitsu K, et al. Pathways of nodal metastasis from pelvic tumors: CT demonstration. Radiographics. 1994;14:1309–21.PubMedGoogle Scholar
  20. 20.
    Morisawa N, Koyama T, Togashi K. Metastatic lymph nodes in urogenital cancers: contribution of imaging findings. Abdom Imaging. 2006;31:620–9.PubMedCrossRefGoogle Scholar
  21. 21.
    Weckermann D, Holl G, Dorn R, et al. Reliability of preoperative diagnostics and location of lymph node metastases in presumed unilateral prostate cancer. BJU Int. 2007;99:1036–40.PubMedCrossRefGoogle Scholar
  22. 22.
    Picchio M, Treiber U, Beer AJ, et al. Value of 11C-choline PET and contrast-enhanced CT for staging of bladder cancer: correlation with histopathologic findings. J Nucl Med. 2006;47:938–44.PubMedGoogle Scholar
  23. 23.
    Albers P, Bender H, Yilmaz H, et al. Positron emission tomography in the clinical staging of patients with stage I and II testicular germ cell tumors. Urology. 1999;53:808–11.PubMedCrossRefGoogle Scholar
  24. 24.
    Singh AK, Saokar A, Hahn PF, Harisinghani MG. Imaging of penile neoplasms. Radiographics. 2005;25:1629–38.PubMedCrossRefGoogle Scholar
  25. 25.
    Misra S, Chaturvedi A, Misra NC. Penile carcinoma: a challenge for the developing world. Lancet Oncol. 2004;5:240–7.PubMedCrossRefGoogle Scholar
  26. 26.
    Ravizzini GC, Wagner M, Borges-Neto S. Positron emission tomography detection of ­metastatic penile squamous cell carcinoma. J Urol. 2001;165:1633–4.PubMedCrossRefGoogle Scholar
  27. 27.
    Young RH. Testicular tumors – some new and a few perennial problems. Arch Pathol Lab Med. 2008;132:548–64.PubMedGoogle Scholar
  28. 28.
    Woodward PJ, Sohaey R, O’Donoghue MJ, Green DE. From the archives of the AFIP: tumors and tumorlike lesions of the testis: radiologic-pathologic correlation. Radiographics. 2002;22:189–216.PubMedGoogle Scholar
  29. 29.
    Ray B, Hajdu SI, Whitmore Jr WF. Proceedings: distribution of retroperitoneal lymph node metastases in testicular germinal tumors. Cancer. 1974;33:340–8.PubMedCrossRefGoogle Scholar
  30. 30.
    Hilton S, Herr HW, Teitcher JB, et al. CT detection of retroperitoneal lymph node metastases in patients with clinical stage I testicular nonseminomatous germ cell cancer: assessment of size and distribution criteria. AJR Am J Roentgenol. 1997;169:521–5.PubMedGoogle Scholar
  31. 31.
    Lont AP, Horenblas S, Tanis PJ, et al. Management of clinically node negative penile carcinoma: improved survival after the introduction of dynamic sentinel node biopsy. J Urol. 2003;170:783–6.PubMedCrossRefGoogle Scholar
  32. 32.
    Sharma S, Ksheersagar P, Sharma P. Diagnosis and treatment of bladder cancer. Am Fam Physician. 2009;80:717–23.PubMedGoogle Scholar
  33. 33.
    Husband JE. CT/MRI of nodal metastases in pelvic cancer. Cancer Imaging. 2002;2:123–9.Google Scholar
  34. 34.
    Abol-Enein H, El-Baz M, Abd El-Hameed MA, et al. Lymph node involvement in patients with bladder cancer treated with radical cystectomy: a patho-anatomical study – a single center experience. J Urol. 2004;172:1818–21.PubMedCrossRefGoogle Scholar
  35. 35.
    Barentsz JO, Jager GJ, van Vierzen PB, et al. Staging urinary bladder cancer after transurethral biopsy: value of fast dynamic contrast-enhanced MR imaging. Radiology. 1996;201:185–93.PubMedGoogle Scholar

Copyright information

© Springer Science+Business Media New York 2013

Authors and Affiliations

  • Mukesh G. Harisinghani
    • 1
  1. 1.Department of Radiology Harvard Medical SchoolMassachusetts General HospitalBostonUSA

Personalised recommendations