LYMPHATICS - LYMPHATICS A practical description of the...

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LYMPHATICS A practical description of the lymphatic drainage of the thyroid gland for the thyroid surgeon has been proposed by Taylor. 12 The results of his studies, which are clinically very relevant to the lymphatic spread of thyroid carcinoma, are summarized in the following. Central Compartment of the Neck 1. The most constant site to which dye goes when injected into the thyroid is the trachea, the wall of which contains a rich network of lymphatics. This fact probably accounts for the frequency with which the trachea is involved by thyroid carcinoma, especially when it is anaplastic. This involvement is sometimes the limiting factor in surgical excision. 2. A chain of lymph nodes lies in the groove between the trachea and the esophagus. 3. Lymph can always be shown to drain toward the mediastinum and to the nodes intimately associated with the thymus. 4. One or more nodes lying above the isthmus, and therefore in front of the larynx, are sometimes involved. These nodes have been called the Delphian nodes (named for the oracle of Delphi) because it has been said that if palpable, they are diagnostic of carcinoma. However, this clinical sign is often misleading.
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