Lymph Nodes and Collectors of Stomach, Liver and Pancreas

Lymphatic Drainage of the Stomach

The stomach has an extensive network of lymphatic vessels located in the mucosa and subserosal connective tissue. These vessels follow the major blood vessels to regional lymph nodes:

• Left Gastric Lymph Nodes: Located along the left side of the lesser curvature.
• Right Gastric Lymph Nodes: Found along the right side of the lesser curvature.
• Gastroepiploic (Gastroomental) Lymph Nodes: Located along the greater curvature:
  • Left gastroepiploic nodes drain the left side of the greater curvature.
  • Right gastroepiploic nodes drain the right side of the greater curvature.
• Additional Lymph Nodes:
  • Pancreaticolienal Nodes: Located along the splenic vein, these nodes receive lymph from the stomach’s fundus.
  • Pyloric Nodes: Located behind the pylorus, receiving lymph from the pylorus and part of the duodenum.
• Lymphatic Flow:
  • Lymph from the right gastroepiploic node can drain through the hepatic lymph nodes before entering the celiac lymph nodes.
  • Lymph from the right gastric node (lesser curvature) can drain through diaphragmatic vessels to the anterior mediastinal nodes.

Lymphatic Drainage of the Liver

1. Lymphatic Drainage of the Diaphragmatic Surface of the Liver

Upper Part

The lymphatic drainage from the upper portion of the diaphragmatic surface of the liver primarily follows the subserous lymphatic plexus. These vessels travel along the falciform ligament through the diaphragm, reaching the following lymph nodes:

• Anterior phrenic lymph nodes
• Anterior mediastinal lymph nodes
• Parasternal lymph nodes

Posterior Part

The posterior part of the diaphragmatic surface drains via the coronary ligament and the bare area of the liver. Lymph vessels travel to:

• posterior phrenic lymph nodes
• posterior mediastinal lymph nodes

2. Lymphatic Drainage of the Liver and Biliary Tract

• Lymphatic vessels form around the hepatic lobules, which converge along the branches of the portal vein, common hepatic artery, and bile ducts. These vessels drain into the following lymph nodes:
  • Hepatic lymph nodes, located near the porta hepatis, where lymph from the gallbladder and liver converge.
  • Lymph flows from these nodes along the common hepatic artery and the celiac trunk into the Celiac lymph nodes.
  • Some lymph also drains through the hepatic veins and along the inferior vena cava, passing through the diaphragm into the Posterior mediastinal lymph nodes.

Lymphatic Drainage of the Pancreas

The pancreas is surrounded by multiple lymphatic networks that collect fluid from different regions. These lymphatic collectors drain into the following lymph nodes:

• Hepatic lymph nodes: Located along the common hepatic artery, lymph from the pancreas flows toward these nodes, ascending cranially.
• Celiac lymph nodes: Lymph flows in a cranial and dorsal direction from the coeliac region, receiving contributions from other lymph nodes in the area.
• Pancreaticosplenic lymph nodes: Found along the splenic vein, these nodes collect lymph from the body and tail of the pancreas.

References:

• ČIHÁK, Radomír. Anatomy 2. 2nd ed. Prague: Grada Publishing, 2002, 470 pp. ISBN 80-247-0143-X.
• Thieme. (2021). Pocket Atlas of Human Anatomy: Volume 2 – Internal Organs (3rd ed.). Thieme Medical Publishers.