纵隔淋巴结IASLC课件.ppt

1、The International Association for the Study of Lung Cancer (IASLC) lymph node mapThe IASLC lymph node map defines 14 different lymph node stations,which may be grouped into 7 zones.7 zones Supraclavicular Zone Upper Zone Aortopulmonary Zone Subcarinal Zone Lower Zone Hilar and Interlobar Zone Periph

2、eral ZoneSupraclavicular ZoneStation 1R: Right Low Cervical, Supraclavicular,and Sternal Notch Lymph Nodes.The upper border of station 1R is the lower margin of the cricoid cartilage. The lower border of station 1R is the clavicles bilaterally and, in the midline,the upper border of the manubrium. T

3、he midline of the trachea serves as the boundarybetween stations 1R and 1L.Station 1L: Left Low Cervical, Supraclavicular,and Sternal Notch Lymph Nodes.The upper border of station 1L is the lower margin of the cricoid cartilage. The lower border of station 1L is the clavicles bilaterally and, in the

4、 midline, the upper border of the manubrium. The midline of the trachea serves as the border between stations 1R and 1L.Upper ZoneStation 2R: Right Upper Paratracheal Lymph Nodes.The upper border of station 2R is the apex of the right lung and pleural space, and in the midline, the upper border of t

5、he manubrium.The lower border of station 2R is the intersectionof the caudal margin of the innominate vein with the trachea. The left lateral wall of the trachea (not the midline) serves as the boundary between stations 2R and 2L.Station 2L: Left Upper Paratracheal Lymph Nodes.The upper border of st

6、ation 2L is the apex of the left lung and pleural space, and in the midline, the upper border of the manubrium.The lower border of station 2L is the superior superior border of the aortic arch. The left lateral border of the trachea (not the midline) serves as the boundary between stations 2R and 2L

7、.Station 3A: Prevascular Nodes.The upper border of station 3A is the apex of the chest.The lower border of station 3A is the level of the carina. The anterior border of station 3A is the posterior aspect of the sternum. The posterior border of station 3A is the anterior border of the superior vena c

8、ava (SVC) on the right and the left carotid artery on the left.Station 3P: Retrotracheal Lymph Nodes.Retrotracheal lymph nodes are those located in the retrotracheal region or the area posterior to the trachea. The upper border of station 3P is the apex of the chest. The lower border of station 3P i

9、s the carina.Station 4R: Right Lower Paratracheal Lymph Nodes.The upper border of station 4R is the intersection of the caudal margin of the innominate vein with the trachea. The lower border of station 4R is the lower border of the azygos vein. The left lateral wall of the trachea (not the midline)

10、 serves as the boundary between stations 4R and 4L.Station 4L: Left Lower Paratracheal Lymph Nodes.The upper border of station 4L is the upper margin of the aortic arch. The lower border of station 4L is the upper rim of the left main pulmonary artery. The left lateral border of the trachea (not the

11、 midline) serves as the boundary between stations 4R and 4L.Aortopulmonary ZoneStation 5: Subaortic Lymph Nodes.Subaortic (aortopulmonary window) lymph nodes are those that are lateral to the ligamentum arteriosum. The upper border of station 5 is the lower border of theaortic arch. The lower border

12、 of station 5 is the upper rim of the left main pulmonary artery.Station 6: Paraaortic Lymph Nodes.Paraaortic lymph nodes are those that are anterior and lateral to the ascending aorta and aortic arch. The upper border of station 6 is a line tangential to the upperborder of the aortic arch. The lowe

13、r border of station 6 is the lower border of the aortic arch.Subcarinal ZoneStation 7: Subcarinal Lymph Nodes.The upper border of station 7 is the carina of the trachea.The lower border of station 7 is the upper border of the lower lobe bronchus on the left and the lower border of the bronchus inter

14、medius on the right.Lower ZoneStation 8: Paraesophageal Lymph Nodes.Paraesophageal lymph nodes are those that lie adjacent to the wall of the esophagus and to the right or left of the midline, excluding the subcarinal nodes. The upper border of station 8 is the upper border of the lower lobe bronchu

15、s on the left and the lower border of the bronchus intermedius on the right. The lower border of station 8 is the diaphragm.Station 9: Pulmonary Ligament Lymph Nodes.Pulmonary ligament lymph nodes are those that lie within the pulmonary ligament.The upper border of station 9 is the inferior pulmonar

16、y vein. The lower border of station 9 is the diaphragm.Hilar and Interlobar ZoneStation 10: Hilar Lymph Nodes.Hilar lymph nodes are those that are immediately adjacent to the main-stem bronchus and hilar vessels, includingthe proximal portions of the pulmonary veins and main pulmonary artery, with s

17、tation 10R on the right and station 10L on the left. The upper border of station 10R is the lower rim of the azygos vein, and the upper border ofstation 10L is the upper rim of the pulmonary artery on the left. The lower borders of stations 10R and 10L are the interlobar regions bilaterally.Station

18、11: Interlobar Lymph Nodes.Interlobar lymph nodes are those that are between the origin of the lobar bronchi, with station 11R on the right and station 11L on the left. Station 11R is subdivided into stations 11Rs, which refers to lymph nodes between the right upper lobe bronchus and the bronchus in

19、termedius, and 11Ri,which refers to lymph nodes between the right middle and lower lobe bronchi.Peripheral ZoneStation 12: Lobar Lymph Nodes.Lobar lymph nodes are those that are adjacent to the lobar bronchi. Station 12R is on the right, and station 12L is on the left.Station 13: Segmental Lymph Nod

20、es.Segmental lymph nodes are those that are adjacent to the segmental bronchi. Station 13R is on the right, and station 13L is on the left.Station 14: Subsegmental Lymph Nodes.Subsegmental lymph nodes are those that are adjacent to the subsegmental bronchi. Station 14R is on the right, and station 14L is on the left.THE END