Anatomic-histologic study of the floor of the mouth: the lingual lymph nodes
Anatomic-histologic study of the floor of the mouth: the lingual lymph nodes
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DOI：
10.1093/jjco/hyv029
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发表时间：
2015-06-01
影响因子：
2.4
通讯作者：
Ciciashvili, Aleksandr M.
中科院分区：
文献类型：
--
作者：
Ananian, Sargis G.;Gvetadze, Shalva R.;Ciciashvili, Aleksandr M.
舌淋巴结是位于口腔底筋膜/肌间间隙内的不规则淋巴结。据报道，口腔舌鳞状细胞癌可在舌淋巴结复发和转移，预后较差。舌淋巴结目前不包括在基本舌鳞状细胞癌手术。21具尸体（男7例，女14例），年龄57 ~ 94岁，平均年龄76.3岁。口腔底大体标本分为A（正中淋巴结）、B、B′（舌旁骨）、C、C′（副舌骨）块。连续切片切片并用苏木精-伊红染色。评估每个区舌淋巴结的频率及其显微特征。21具尸体中有5具（23.8%）检出舌淋巴结，共7具。舌淋巴结的总发生率为33.3%（7个/21具尸体）。A区未发现任何淋巴结（0%）；区块B、B‘aEuro ’分别为2个节点（9.5%）和2个节点（9.5%）；block C、C‘aEuro ’分别为1节点（4.8%）和2节点（9.5%）。平均舌淋巴结长度为4.1 mm (1.4 ~ 8.7 mm)，平均厚度为2.8 mm （0.8 ~ 7.5 mm）。5具尸体（23.8%）发现粘膜相关淋巴组织。4例（57.1%）舌淋巴结出现萎缩性改变。可见口腔底部有淋巴结组织。考虑到切除的激进性和较好的局部控制，应在舌切除术的同时切除口底脂肪组织。舌淋巴结在口腔鳞状细胞癌复发转移中的作用有待进一步的解剖和临床研究。
The lingual lymph nodes are inconstant nodes located within the fascial/intermuscular spaces of the floor of the mouth. Oral tongue squamous cell carcinoma has been reported to recur and metastasize in lingual lymph nodes with poor prognosis. Lingual lymph nodes are not currently included in basic tongue squamous cell carcinoma surgery.Twenty-one cadavers (7 males, 14 females) were studied, aged from 57 to 94 years (mean age 76.3 years). The gross specimen of the floor of the mouth was divided into blocks: A (median nodes), B, B' (parahyoid), C, C' (paraglandular). Serial histological microslides were cut and stained with hematoxylin-eosin. Frequency of lingual lymph nodes in each block and their microscopic features were assessed.The lingual lymph nodes in overall number of 7 were detected in 5 of the 21 cadavers (23.8%). The total incidence of lingual lymph node was 33.3% (7 nodes/21 cadavers). Block A failed to demonstrate any lymph nodes (0%); Blocks B, B'aEuro"2 nodes (9.5%) and 2 nodes (9.5%), respectively; Blocks C, C'aEuro"1 node (4.8%) and 2 nodes (9.5%), respectively. The mean lingual lymph node length was 4.1 mm (from 1.4 to 8.7 mm), the mean thickness was 2.8 mm (from 0.8 to 7.5 mm). Five cadavers (23.8%) revealed mucosa-associated lymphoid tissue. Atrophic changes appeared in 4 (57.1%) lingual lymph nodes.The presence of lymph node-bearing tissue in the floor of the mouth is demonstrated. In account of resection radicalism and better local control the fat tissue of the floor of the mouth should be removed in conjunction to glossectomy. Further anatomic and clinical research is required to establish the role of lingual lymph node in oral squamous cell carcinoma recurrence and metastasis.