Lymph node metastases: Presence of macroscopic or microscopic tumor in regional or distant lymph nodes
Skip metastases: Direct metastases of lung cancer to mediastinal lymph nodes without hilar lymph node involvement
Staging
TNM staging system for lung cancer created by International Union Against Cancer and the American Joint Committee on Cancer
Lymph node designation (N) determined by location of lymph node metastases
N0: No lymphadenopathy
N1: Ipsilateral, peripheral, or hilar-interlobar zone involvement
N2: Ipsilateral upper or lower paratracheal, aorticopulmonary, or subcarinal zone involvement
N3: Contralateral upper or lower paratracheal, aorticopulmonary, hilar-interlobar, or any supraclavicular involvement
Extrathoracic lymph node involvement designated as distant metastases (M1 disease)
IMAGING ANATOMY
General Anatomic Considerations
CLINICAL IMPLICATIONS
Clinical Importance
Selected References
El-Sherief AH et al: International association for the study of lung cancer (IASLC) lymph node map: radiologic review with CT illustration. Radiographics. 34(6):1680-91, 2014
Kligerman S et al: A radiologic review of the new TNM classification for lung cancer. AJR Am J Roentgenol. 2010 Mar;194(3):562-73. Review. Erratum in: AJR Am J Roentgenol. 194(5):1404, 2010
Topol M et al: The problem of direct lymph drainage of the bronchopulmonary segments into the mediastinal and hilar lymph nodes. Clin Anat. 22(4):509-16, 2009
Suwatanapongched T et al: CT of thoracic lymph nodes. Part II: diseases and pitfalls. Br J Radiol. 79(948):999-1000, 2006
Okada M et al: Border between N1 and N2 stations in lung carcinoma: lessons from lymph node metastatic patterns of lower lobe tumors. J Thorac Cardiovasc Surg. 129(4):825-30, 2005
Sharma A et al: Patterns of lymphadenopathy in thoracic malignancies. Radiographics. 24(2):419-34, 2004
Aquino SL et al: Source and direction of thoracic lymphatics: Part I--upper thorax. J Comput Assist Tomogr. 27(2):292-6, 2003
Marom EM et al: Radiologic findings of bronchogenic carcinoma with pulmonary metastases at presentation. Clin Radiol. 54(10):665-8, 1999
Riquet M: [Mediastinal lymphatic spread of bronchopulmonary cancer.] Rev Mal Respir. 8(5):443-58, 1991
Related Anatomy
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Related Differential Diagnoses
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References
Tables
Tables
KEY FACTS
Terminology
General Anatomic Considerations
Lymphatic Drainage Patterns
Clinical Implications
TERMINOLOGY
Definitions
Lymph node metastases: Presence of macroscopic or microscopic tumor in regional or distant lymph nodes
Skip metastases: Direct metastases of lung cancer to mediastinal lymph nodes without hilar lymph node involvement
Staging
TNM staging system for lung cancer created by International Union Against Cancer and the American Joint Committee on Cancer
Lymph node designation (N) determined by location of lymph node metastases
N0: No lymphadenopathy
N1: Ipsilateral, peripheral, or hilar-interlobar zone involvement
N2: Ipsilateral upper or lower paratracheal, aorticopulmonary, or subcarinal zone involvement
N3: Contralateral upper or lower paratracheal, aorticopulmonary, hilar-interlobar, or any supraclavicular involvement
Extrathoracic lymph node involvement designated as distant metastases (M1 disease)
IMAGING ANATOMY
General Anatomic Considerations
CLINICAL IMPLICATIONS
Clinical Importance
Selected References
El-Sherief AH et al: International association for the study of lung cancer (IASLC) lymph node map: radiologic review with CT illustration. Radiographics. 34(6):1680-91, 2014
Kligerman S et al: A radiologic review of the new TNM classification for lung cancer. AJR Am J Roentgenol. 2010 Mar;194(3):562-73. Review. Erratum in: AJR Am J Roentgenol. 194(5):1404, 2010
Topol M et al: The problem of direct lymph drainage of the bronchopulmonary segments into the mediastinal and hilar lymph nodes. Clin Anat. 22(4):509-16, 2009
Suwatanapongched T et al: CT of thoracic lymph nodes. Part II: diseases and pitfalls. Br J Radiol. 79(948):999-1000, 2006
Okada M et al: Border between N1 and N2 stations in lung carcinoma: lessons from lymph node metastatic patterns of lower lobe tumors. J Thorac Cardiovasc Surg. 129(4):825-30, 2005
Sharma A et al: Patterns of lymphadenopathy in thoracic malignancies. Radiographics. 24(2):419-34, 2004
Aquino SL et al: Source and direction of thoracic lymphatics: Part I--upper thorax. J Comput Assist Tomogr. 27(2):292-6, 2003
Marom EM et al: Radiologic findings of bronchogenic carcinoma with pulmonary metastases at presentation. Clin Radiol. 54(10):665-8, 1999
Riquet M: [Mediastinal lymphatic spread of bronchopulmonary cancer.] Rev Mal Respir. 8(5):443-58, 1991
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