~Teachingcenter的醫學筆記~

肺部淋巴結Lung Regional Lymph nodes

#1 superior mediastinal or highest mediastinal LN
#2 paratracheal LN
#3 pretracheal LN
#3a anterior mediastinal LN
#3p retrotracheal mediastinal or posterior mediastinal LN
#4 tracheobronchial LN
#5 subaortic or Batallo’s LN
#6 paraarotic (ascending aorta) LN
#7 subcarinal LN
#8 paraesophageal (below carina) LN
#9 pulmonary ligament LN
#10 hilar (main bronchus) LN
#11 interlobar LN
#12 lobar (upper lobar, middle lobar, and lower lobar) LN
#13 segmental LN
#14 subsegmental LN

American Joint Committee for Cancer Staging中，TNM分其中的N，所代表的淋巴結編號如下

可以一同參考此篇文章https://teachingcenter1.pixnet.net/blog/post/365375143

Bonchopulmonary (N1) nodes
#10 hilar (main bronchus) LN
#11 interlobar LN
#12 lobar (upper lobar, middle lobar, and lower lobar) LN
#13 segmental LN
#14 subsegmental LN
--- 影響到的淋巴結位於同側的支氣管旁、肺內、肺門
--- Metastasis in ipsilateral peribronchial and/or ipsilateral hilar lymph nodes and intrapulmonary nodes, including involvement by direct extension

Mediastinal (N2) nodes
Superior mediastinal nodes
…#1 superior mediastinal or highest mediastinal LN
…#2 paratracheal LN
…#3 pretracheal LN
…#4 tracheobronchial LN
Aortic nodes
…#5 subaortic or Batallo’s LN
…#6 paraarotic (ascending aorta) LN
Inferior mediastianl nodes
…#7 subcarinal LN
…#8 paraesophageal (below carina) LN
…#9 pulmonary ligament LN
--- 影響到同側的縱膈內或支氣管交接處下方的淋巴結
--- Metastasis in ipsilateral mediastinal and/or subcarinal lymph nodes

肺部淋巴結的手術解剖位置描述
= 2R
--- 氣管右上、無名動脈上方(right upper paratracheal and suprainnominate)，在肺尖(lung apex)區域中，位於氣管和無名動脈尾端的交角處(intersection of the caudal margin of the innominate artery with the trachea)
= 2L
--- 氣管左上、主動脈弓上方(left upper paratracheal and supra-aortic) )，在肺尖(lung apex)區域中，位於主動脈弓頂的地方
= 4R
--- 氣管右下、奇靜脈上方(the cephalic border of the azygos vein)、頭臂動脈的交角處(intersection of the caudal margin of the brachiocephalic artery)。(包含上腔靜脈旁淋巴結(paracaval nodes))
= 4L
--- 氣管左下、主動脈弓上方、動脈韌帶的內側(medial to the ligamentum arteriosum)
= 5
--- 主動脈下方和周圍(subaortic and para-aortic)、動脈韌帶的外側(lateral to the ligamentum arteriosum)、左肺動脈的外側(left pulmonary artery)，接近左肺動脈第一支的近端(proximal to the first branch of the left pulmonary artery)
= 6
--- 升主動脈或無名動脈之前方(anterior to the ascending aorta or the innominate artery)
= 7
--- 左右支氣管交接處的後下方(caudal to the carina of the trachea)
= 8
--- 氣管後側(posterior wall of the trachea and retrotracheal but not subcarinal nodes)
= 9
--- 肺韌帶中(within pulmonary ligament)
= 10R
--- 肺門處氣管右方、奇靜脈頭側(cephalic border of azygos vein)、右上肺氣管的起點處(origin of right upper lobe bronchus)
= 10L
--- 肺門處氣管左方、氣管交接處和左上肺氣管區(carina and left upper lobe bronchus)、動脈韌帶內側(medial to the ligamentum arteriosum)
= 11
--- 支氣管主幹遠端和二級氣管交接處(distal to the main-stem bronchi or secondary carina)