Lymph nodes of the face, neck, thorax, abdomen and pelvis - hepatic segmentation - entire body scan (CT) in oncology

Antoine Micheau - MD, Denis Hoa - MD

31/03/2009 3:52 pm

Images and anatomical references
Anatomical parts
Classifications

Procedure details of this interactive atlas of anatomy of lymph nodes anatomy of the human body

niveau-classification-ganglions-lymphatique-cou

Anatomy of the whole human body: display anatomical legends

Nodal classifcation of lymph nodes of the thorax for cancer staging (lung TNM classification)

Lymph nodes stations on a computed tomography

ganglions-noeud-lymphatique-pelvis-anatomie

References

Terminologia Anatomica: International Anatomical Terminology - FCAT Federative Committee On Anatomical Terminology, Federative Committee on Anatomical Terminology - Thieme, 1998 - ISBN 3131152516, 9783131152510
Selection and delineation of lymph node target volumes in head and neck conformal radiotherapy. Proposal for standardizing terminology and procedure based on the surgical experience. Grégoire V, Coche E, Cosnard G, Hamoir M, Reychler H. Radiother Oncol. 2000 Aug;56(2):135-50. Review.PMID: 10927132
CT-based definition of thoracic lymph node stations: an atlas from the University of Michigan. Chapet O, Kong FM, Quint LE, Chang AC, Ten Haken RK, Eisbruch A, Hayman JA.Int J Radiat Oncol Biol Phys. 2005 Sep 1;63(1):170-8.
Definition of the supraclavicular and infraclavicular nodes: implications for three-dimensional CT-based conformal radiation therapy. Madu CN, Quint DJ, Normolle DP, Marsh RB, Wang EY, Pierce LJ.Radiology. 2001 Nov;221(2):333-9.
Standardizing Neck Dissection Terminology: Official Report of the Academy's Committee for Head and Neck Surgery and Oncology
K. Thomas Robbins; Jesus E. Medina; Gregory T. Wolfe; Paul A. Levine; Roy B. Sessions; Charles W. Pruet
Arch Otolaryngol Head Neck Surg. 1991;117(6):601-605.

10L-11L : Left hilar and interlobar nodes - 10L-11L
10R-11R : Right hilar and interlobar nodes - 10R-11R
1L - Left highest mediastinal nodes - 1L
1R - Right highest mediastinal nodes - 1R
2L - Left upper paratracheal nodes - 2L
2R - Right upper paratracheal nodes - 2R
3A - Prevascular nodes - 3A
3B - Retrotracheal nodes - 3B
4L - Left lower paratracheal nodes - 4L
4R - Right lower paratracheal nodes - 4R
5 - Subaortic (aortic–pulmonary window) - 5
6 - Paraaortic nodes - 6
7 - Subcarinal nodes - 7
8 - Paraeosphageal nodes - 8
9 - Lymph nodes of pulmonar ligaments - 9
Abdomen - Abdomen - Pelvis - Pelvis
Abdominal aorta - Aorta abdominalis
Alimenentary system - Systema digestorium
Anatomical structures - Anatomical structures
Anterior cervical nodes - Nodi cervicales anteriores; Nodi colli anteriores : Superficial nodes; Anterior jugular nodes - Nodi superficiales; Nodi jugulares anteriores
Anus - Anus
Aortic arch - Arcus aortae
Aortic bifurcation - Bifurcatio aortae
Apical nodes - Nodi apicales
Appendicular nodes - Nodi appendiculares
Appendix - Appendix vermiformis
Arch of azygos vein - Arcus venae azygos
Arteries - Arteriae - Heart - Cor
Arytenoid cartilage - Cartilago arytenoidea
Ascending aorta - Pars ascendens aortae; Aorta ascendens
Ascending colon - Colon ascendens
Axillary artery - Arteria axillaris
Axillary lymph nodes - Nodi lymphoidei axillares
Azygos vein - Vena azygos
Bones; Skeletal system - Ossa; Systema skeletale
Brachiocephalic nodes - Nodi brachiocephalici
Brachiocephalic trunk - Truncus brachiocephalicus
Bronchopulmonary nodes - Nodi bronchopulmonales
Caecum - Caecum
Central nodes - Nodi centrales
Central superior mesenteric nodes - Nodi superiores centrales
Cervical vertebrae [C I-C VII] - Vertebrae cervicales [C I-C VII]
Clavicle - Clavicula
Coccyx coccygeal vertebrae [I-IV] - Os coccygis; Coccyx vertebrae coccygeae [I-IV]
Coeliac nodes - Nodi coeliaci
Coeliac trunk - Truncus coeliacus
Common hepatic artery - Arteria hepatica communis
Common iliac artery - Arteria iliaca communis
Common iliac nodes - Nodi iliaci communes
Common iliac vein - Vena iliaca communis
Cranium - Cranium
Cricoid cartilage - Cartilago cricoidea
Cystic node - Nodus cysticus
Deep inguinal nodes - Nodi inguinales profundi
Deep parotid nodes - Nodi parotidei profundi : Infraauricular nodes - Nodi infraauriculares
Deep parotid nodes - Nodi parotidei profundi : Intraglandular nodes - Nodi intraglandulares
Deep parotid nodes - Nodi parotidei profundi : Preauricular nodes - Nodi preauriculares
Descending aorta - Pars descendens aortae; Aorta descendens
Descending colon - Colon descendens
Duodenum - Duodenum
Epiglottis - Epiglottis
External carotid artery - Arteria carotis externa
External iliac artery - Arteria iliaca externa
External iliac nodes - Nodi iliaci externi
External iliac vein - Vena iliaca externa
External jugular vein - Vena jugularis externa
Facial nodes - Nodi faciales : Buccinator node - Nodus buccinatorius
Facial nodes - Nodi faciales : Malar node - Nodus malaris
Facial nodes - Nodi faciales : Mandibular node - Nodus mandibularis
Facial nodes - Nodi faciales : Nasolabial node - Nodus nasolabialis
False ribs [VIII-XII] - Costae spuriae [VIII-XII]
Femoral artery - Arteria femoralis
Femoral vein - Vena femoralis
Femur; Thigh bone - Femur; Os femoris
Gallbladder - Vesica biliaris
Gluteal nodes - Nodi gluteales : Inferior nodes - Nodi inferiores
Gluteal nodes - Nodi gluteales : Superior nodes - Nodi superiores
Great saphenous vein - Vena saphena magna
Head - Caput - Neck - Collum; Cervix
Heart - Cor
Hepatic nodes - Nodi hepatici
Hepatic portal vein - Vena portae hepatis
Hepatic segmentation lobes, parts, divisions and segments - Segmentatio hepatis lobi, partes, divisiones et segmenta
Hip bone; Coxal bone; Pelvic bone - Os coxae
Hyoid bone - Os hyoideum
Ileocolic nodes - Nodi ileocolici
Ileum - Ileum
Inferior diaphragmatic nodes - Nodi phrenici inferiores
Inferior epigastric nodes - Nodi epigastrici inferiores
Inferior mesenteric artery - Arteria mesenterica inferior
Inferior mesenteric nodes - Nodi mesenterici inferiores
Inferior mesenteric vein - Vena mesenterica inferior
Inferior tracheobronchial nodes - Nodi tracheobronchiales inferiores
Inferior vena cava - Vena cava inferior
Infraclavicular fossa - Fossa infraclavicularis
Intercostal nodes - Nodi intercostales
Interiliac nodes - Nodi interiliaci
Intermediate lumbar nodes - Nodi lumbales intermedii
Internal carotid artery - Arteria carotis interna
Internal iliac artery - Arteria iliaca interna
Internal iliac nodes - Nodi iliaci interni
Internal iliac vein - Vena iliaca interna
Internal jugular vein - Vena jugularis interna
Interpectoral nodes - Nodi interpectorales
Intrapulmonary nodes - Nodi intrapulmonales
Jejunum - Jejunum
Juxtaintestinal mesenteric nodes - Nodi juxtaintestinales
Juxtaoesophageal nodes - Nodi juxtaoesophageales
Larynx - Larynx
Lateral aortic nodes - Nodi aortici laterales
Lateral caval nodes - Nodi cavales laterales
Lateral cervical nodes - Nodi cervicales laterales; Nodi colli laterales : Inferior deep nodes - Nodi profundi inferiores : Anterior nodes - Nodi anteriores
Lateral cervical nodes - Nodi cervicales laterales; Nodi colli laterales : Inferior deep nodes - Nodi profundi inferiores : Juguloomohyoid node - Nodus juguloomohyoideus
Lateral cervical nodes - Nodi cervicales laterales; Nodi colli laterales : Inferior deep nodes - Nodi profundi inferiores : Lateral node - Nodus lateralis
Lateral cervical nodes - Nodi cervicales laterales; Nodi colli laterales : Superficial nodes - Nodi superficiales
Lateral cervical nodes - Nodi cervicales laterales; Nodi colli laterales : Superior deep nodes - Nodi profundi superiores : Anterior node - Nodus anterior
Lateral cervical nodes - Nodi cervicales laterales; Nodi colli laterales : Superior deep nodes - Nodi profundi superiores : Jugulodigastri c nod - Nodus jugulodigastricus
Lateral cervical nodes - Nodi cervicales laterales; Nodi colli laterales : Superior deep nodes - Nodi profundi superiores : Lateral node - Nodus lateralis
Lateral pericardial nodes - Nodi pericardiaci laterales
Lateral vesical nodes - Nodi vesicales laterales
Left atrium - Atrium sinistrum
Left brachiocephalic vein - Vena brachiocephalica
Left common carotid artery - Arteria carotis communis
Left inferior pulmonary vein - Vena pulmonalis sinistra inferior
Left internal jugular vein - Vena jugularis interna
Left lung - Pulmo dexter
Left main bronchus - Bronchus principalis sinister
Left pulmonary artery - Arteria pulmonalis sinistra
Left renal artery - Arteria renalis
Left renal vein - Vena renale
Left subclavian artery - Arteria subclavia
Left subclavian vein - Vena subclavia
Left superior pulmonary vein - Vena pulmonalis sinistra superior
Left suprarenal gland; Adrenal gland - Glandula suprarenalis
Left ventricle - Ventriculus sinister
Level III - III
Level IIa - IIa
Level IIb - IIb
Level IV - IV
Level Ia - Ia
Level Ib - Ib
Level V - V
Level VI - VI
Lingual nodes - Nodi linguales
Liver - Hepar
Lumbar vertebrae [L I-L V] - Vertebrae lumbales [L I-L V]
Lymph node - Nodus lymphoideus; Nodus lymphaticus; Lymphonodus
Lymph node stations - Nodus lymphoideus
Mandible - Mandibula
Mastoid nodes - Nodi mastoidei
Nasal cavity - Cavitas nasi
Node of anterior border of omental foramen - Nodus foraminalis
Node of arch of azygos vein; Lymph node of arch of azygos vein - Nodus lymphaticus arcus venae azygos
Node of ligamentum arteriosum; Lymph node of ligamentum arteriosum - Nodus lymphaticus ligamenti arteriosi
Nodes around cardia; Lymph nodes around cardia - Anulus lymphaticus cardiae
Nose - Nasus
Obturator nodes - Nodi obturatorii
Occipital nodes - Nodi occipitales
Oesophagus - Oesophagus
Oral cavity - Cavitas oris
Ostium primum - Ren; Nephros
Pancreas - Pancreas
Pancreatic nodes - Nodi pancreatici
Pancreaticoduodenal nodes - Nodi pancreaticoduodenales
Paracolic nodes - Nodi paracolici (Mesocolic nodes - Nodi mesocolici)
Paramammary nodes - Nodi paramammarii
Pararectal nodes - Nodi pararectales; Nodi anorectales
Parasternal nodes - Nodi parasternales
Paratracheal nodes - Nodi paratracheales
Paratracheal nodes - Nodi paratracheales (Anterior cervical nodes - Nodi cervicales anteriores; Nodi colli anteriores : Deep nodes - Nodi profundi)
Parotid gland - Glandula parotidea
Pectoral nodes; Anterior nodes - Nodi pectorales; Nodi anteriores
Pharynx - Pharynx
Postaortic nodes - Nodi retroaortici; Nodi postaortici
Postcaval nodes - Nodi retrocavales; Nodi postcavales
Postvesical nodes - Nodi retrovesicales; Nodi postvesicales
Preaortic nodes - Nodi preaortici
Precaecal nodes - Nodi precaecales
Precaval nodes - Nodi precavales
Prelaryngeal nodes - Nodi prelaryngei (Anterior cervical nodes - Nodi cervicales anteriores; Nodi colli anteriores : Deep nodes - Nodi profundi)
Prepericardial nodes - Nodi prepericardiaci
Pretracheal nodes - Nodi pretracheales (Anterior cervical nodes - Nodi cervicales anteriores; Nodi colli anteriores : Deep nodes - Nodi profundi)
Prevertebral nodes - Nodi prevertebrales
Prevesical nodes - Nodi prevesicales
Prostate - Prostata
Pulmonary trunk - Truncus pulmonalis
Pyloric nodes - Nodi pylorici
Pylorus - Pylorus
Rectum - Rectum
Regions - Regiones
Respiratory system - Systema respiratorium
Retrocaecal nodes - Nodi retrocaecales
Retropharyngeal nodes - Nodi retropharyngeales (Anterior cervical nodes - Nodi cervicales anteriores; Nodi colli anteriores : Deep nodes - Nodi profundi)
Retropharyngeal nodes - Retropharyngeal nodes
Right atrium - Atrium dextrum
Right brachiocephalic vein - Vena brachiocephalica
Right inferior pulmonary vein - Vena pulmonalis dextra inferior
Right lung - Pulmo sinister
Right main bronchus - Bronchus principalis dexter
Right pulmonary artery - Arteria pulmonalis dextra
Right renal artery - Arteria renalis
Right renal vein - Vena renale
Right subclavian artery - Arteria subclavia
Right subclavian vein - Vena subclavia
Right superior pulmonary vein - Vena pulmonalis dextra superior
Right suprarenal gland; Adrenal gland - Glandula suprarenalis
Right ventricle - Ventriculus dexter
Right/left gastric nodes - Nodi gastrici dextri/sinistri
Rightleft gastroomental nodes - Nodi gastroomentales dextrisinistri
Rightmiddleleft colic nodes - Nodi colici dextrimediisinistriD (Mesocolic nodes - Nodi mesocolici)
Rightmiddleleft colic nodes - Nodi colici dextrimediisinistriG (Mesocolic nodes - Nodi mesocolici)
Rightmiddleleft colic nodes - Nodi colici dextrimediisinistriM (Mesocolic nodes - Nodi mesocolici)
Rigth common carotid artery - Arteria carotis communis
Root of penis - Radix penis
Sacral nodes - Nodi sacrales
Sacrum - Os sacrum
Scapula - Scapula
Seminal vesicle - Vesicula seminalis
Septum inferius - Urinary system - Male genital system - Systema genitale masculinum
Sigmoid colon - Colon sigmoideum
Sigmoid nodes - Nodi sigmoidei
Spleen - Splen; Lien
Splenic artery - Arteria splenica; Arteria lienalis
Splenic nodes - Nodi splenici; Nodi lienales
Splenic vein - Vena splenica; Vena lienalis
Sternum - Sternum
Stomach - Gaster
Submandibular gland - Glandula submandibularis
Submandibular nodes - Nodi submandibulares
Submental nodes - Nodi submentales
Subscapular nodes; Posterior nodes - Nodi subscapulares; Nodi posteriores
Superficial inguinal nodes - Nodi inguinales superficiales
Superficial parotid nodes - Nodi parotidei superficiales
Superior diaphragmatic nodes - Nodi phrenici superiores
Superior mesenteric artery - Arteria mesenterica superior
Superior mesenteric nodes - Nodi mesenterici superiores
Superior mesenteric vein - Vena mesenterica superior
Superior rectal nodes - Nodi rectales superiores
Superior tracheobronchial nodes - Nodi tracheobronchiales superiores
Superior vena cava - Vena cava superior
Supraclavicular fossa - Fossa supraclavicularis
Supraclavicular nodes - Nodi supraclaviculares
Teeth - Dentes
Thoracic vertebrae (TI-TXIII) - Vertebrae thoracicae (TI-TXIII)
Thorax - Thorax
Thyroid cartilage - Cartilago thyroidea
Thyroid gland - Glandula thyroidea
Thyroid nodes - Nodi thyroidei (Anterior cervical nodes - Nodi cervicales anteriores; Nodi colli anteriores : Deep nodes - Nodi profundi)
Tongue - Lingua
Trachea - Trachea
Tracheal bifurcation - Bifurcatio tracheae
Transverse colon - Colon transversum
True ribs [I-VII] - Costae verae [I-VII]
Ureter - Ureter
Urethra - Urethra
Urinary bladder - Vesica urinaria
Veins - Venae
Vertebral artery - Arteria vertebralis

Neck node levels (Robbin)

Level	Name	Cranial	Caudal	Anterior	Posterior	Lateral	Medial
Ia	Submental nodes	Geniohyoid m.	Platysma m.	Platysma m. Symphysis menti;	Body of hyoid bone	Medial edge of anterior belly of digastric m.	Midline
Ib	Submandibular nodes	Mylohyoid m., cranial edge of submandibular gland or caudal edge of medial pterygoid m.	Platysma m.	Symphysis menti	Body of hyoid bone; posterior edge of submandibular gland	Basilar edge of mandible; platysma m.	Lateral edge of anterior belly of digastric m.
II	Upper jugular nodes	Bottom edge of the body of C1	Bottom edge of the body of hyoid bone	Posterior edge of submandibular gland; posterior edge of posterior belly of digastric m.	Posterior border of sternocleidomastoid m.	Medial edge of sternocleidomastoid m.	Internal edge of internal carotid artery, paraspinal (levator scapulae) m.
III	Middle jugular nodes	Bottom edge of the body of hyoid bone	Bottom edge of cricoid cartilage	Posterolateral edge of sternohyoid m.	Posterior edge of sternocleidomastoid m.	Medial edge of sternocleidomastoid m.	nternal edge of carotid artery, paraspinal (scalenius) m.
IV	Lower jugular nodes	Bottom edge of cricoid cartilage	Cranial border of clavicle	Posterolateral edge of sternohyoid m.	Posterior edge of sternocleidomastoid m.	Medial edge of sternocleidomastoid m.	Internal edge of internal carotid artery, paraspinal (scalenius) m.
V	Posterior cervical nodes	Skull base	Cranial border of clavicle	Posterior edge of sternocleidomastoid m.	Anterior border of trapezius m.; scalenius m.	Platysma m.; skin	Paraspinal (levator scapulae, splenius capitis) m.
VI	Anterior cervical nodes	Bottom edge of the body of hyoid bone	Sternal manubrium	Skin; platysma m.	Posterolateral edge of sternohyoid m.	Medial edge of common carotid artery, skin and anterior±medial edge of sternocleidomastoid m.	Midline
	Retropharyngeal nodes	Base of skull	Cranial edge of the body of hyoid bone	Levator veli palatini m.	Prevertebral m. (longus colli, longus capitis)	Medial edge of internal carotid artery	Midline

Illustration of cervical lymph nodes : based on nodal classification of head and neck by Robin

Classification of the nodes of the neck : illustration by A. MIcheau based on a CT-3D volume rendering of head and neck - Copyright Imaios

Thoracic Lymph Node Map Definitions (Mountain and Dressler)

Nodal station	Name	Anatomic landmarks
1R- 1L	Highest mediastinal nodes	Nodes lying above a horizontal line at the upper rim of the bracheocephalic (left innominate) vein where it ascends to the left, crossing in front of the trachea at its midline
2R-2L	Upper paratracheal nodes	Nodes lying above a horizontal line drawn tangential to the upper margin of the aortic arch and below the inferior boundary of No. 1 nodes
3A-3B	Prevascular and retrotracheal nodes	Prevascular and retrotracheal nodes may be designated 3A and 3P; midline nodes are considered to be ipsilateral
4R-4L	Lower paratracheal nodes	The lower paratracheal nodes on the right lie to the right of the midline of the trachea between a horizontal line drawn tangential to the upper margin of the aortic arch and a line extending across the right main bronchus at the upper margin of the upper lobe bronchus, and contained within the mediastinal pleural envelope; the lower paratracheal nodes on the left lie to the left of the midline of the trachea between a horizontal line drawn tangential to the upper margin of the aortic arch and a line extending across the left main bronchus at the level of the upper margin of the left upper lobe bronchus, medial to the ligamentum arteriosum and contained within the mediastinal pleural envelope Researchers may wish to designate the lower paratracheal nodes as No. 4s (superior) and No. 4i (inferior) subsets for study purposes; the No. 4s nodes may be definedby a horizontal line extending across the trachea and drawn tangential to thecephalic border of the azygos vein; the No. 4i nodes may be defined by the lower boundary of No. 4s and the lower boundary of No. 4, as described above
5	Subaortic (aorto-pulmonary window)	Subaortic nodes are lateral to the ligamentum arteriosum or the aorta or left pulmonary artery and proximal to the first branch of the left pulmonary artery and lie within the mediastinal pleural envelope
6	Para-aortic nodes (ascending aorta or phrenic)	Nodes lying anterior and lateral to the ascending aorta and the aortic arch or the innominate artery, beneath a line tangential to the upper margin of the aortic arch
7	Subcarinal nodes	Nodes lying caudal to the carina of the trachea, but not associated with the lower lobe bronchi or arteries within the lung
8	Paraesophageal nodes (below carina)	Nodes lying adjacent to the wall of the esophagus and to the right or left of the midline, excluding subcarinal nodes
9	Pulmonary ligament nodes	Nodes lying within the pulmonary ligament, including those in the posterior wall and lower part of the inferior pulmonary vein
10R-10L	Hilar nodes	The proximal lobar nodes, distal to the mediastinal pleural reflection and the nodes adjacent to the bronchus intermedius on the right; radiographically, the hilar shadow may be created by enlargement of both hilar and interlobar nodes
11R-11L	Interlobar nodes	Nodes lying between the lobar bronchi
12R-12L	Lobar nodes	Nodes adjacent to the distal lobar bronchi
13R-13L	Segmental nodes	Nodes adjacent to the segmental bronchi
14R-14L	Subsegmental nodes	Nodes around the subsegmental bronchi

Definition of thoracic lymph node stations : medical anatomical diagram

Illustraion of the thoracic lymph nodes based on Mountain and Dresler classification system - Illustration by A. Micheau - Copyright Imaios

Thoracic Lymph Node Map Definitions (IASLC)

Liver segmentation

Classification	Segments*	Other names**	Lobes (Godsmith et Woodburne)	Parts (Couinaud)	Divisions*	Hepatic parts*
I	Posterior segment; Caudate lobe;	Spigel lobe	Caudate lobe			Posterior liver; Posterior part of liver;
II	Left posterior lateral segment	Latéral supérior	Left lobe	Left lateral	Left lateral division	Left liver; Left part of liver
III	Left anterior lateral segment	Latéral inférior, left paramédian		Left paramedian	Left lateral division
IV	Left medial segment	Quadrate lobe IVa : left superomedial IVb : left inferomedial		Left paramedian	Left medial division
V	Anterior medial segment	Anteroinferior	Right lobe	Right paramedian	Right medial division	Right liver; Right part of liver
VIII	Posterior medial segment	Anterosuperior		Right paramedian	Right medial division
VI	Anterior lateral segment	Posteroinferior		Right lateral	Right lateral division
VII	Posterior lateral segment;	Posterosuperior		Right lateral	Right lateral division