Abstract
Background: Studies in rodents have re-kindled interest in the study of lymphatics in the central nervous system. Animal studies have demonstrated that there is a connection between the subarachnoid space and deep cervical lymph nodes (DCLNs) through dural lymphatic vessels located in the skull base and the parasagittal area. Objective: To describe the connection of the DCLNs and lymphatic tributaries with the intracranial space through the jugular foramen, and to address the anatomical features and variations of the DCLNs and associated lymphatic channels in the neck. Methods: Twelve formalin-fixed human head and neck specimens were studied. Samples from the dura of the wall of the jugular foramen were obtained from two fresh human cadavers during rapid autopsy. The samples were immunostained with podoplanin and CD45 to highlight lymphatic channels and immune cells, respectively. Results: The mean number of nodes for DCLNs was 6.91 ± 0.58 on both sides. The mean node length was 10.1 ± 5.13 mm, the mean width was 7.03 ± 1.9 mm, and the mean thickness was 4 ± 1.04 mm. Immunohistochemical staining from rapid autopsy samples demonstrated that lymphatic vessels pass from the intracranial compartment into the neck through the meninges at the jugular foramen, through tributaries that can be called intrajugular lymphatic vessels. Conclusions: The anatomical features of the DCLNs and their connections with intracranial lymphatic structures through the jugular foramen represent an important possible route for the spread of cancers to and from the central nervous system; therefore, it is essential to have an in-depth understanding of the anatomy of these lymphatic structures and their variations.
Highlights
Studies in rodents have re-kindled interest in the study of lymphatics in the central nervous system [1,2,3]
We studied the morphological features of the deep cervical lymph nodes and the lymphatic We studied the morphological features of the deep cervical lymph nodes and the lymphatic channels that interconnect between them
The lymphatic channels between the deep cervical lymph nodes (DCLNs), which correspond to collecting vessels, had a valve system, seen as a string of beads
Summary
Studies in rodents have re-kindled interest in the study of lymphatics in the central nervous system [1,2,3]. The connections between the lymphatic system of the central nervous system (CNS) and DCLNs have not been definitively described in humans. We focus on the anatomical features and variations of deep cervical lymph nodes, and their connections with the intracranial lymphatic system through the jugular foramen in humans. Animal studies have demonstrated that there is a connection between the subarachnoid space and deep cervical lymph nodes (DCLNs) through dural lymphatic vessels located in the skull base and the parasagittal area.
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