Le ganglion de Mondor : mythe ou réalité ?

Abstract

Lymph node involvement is one of the most significant prognostic factors of patients with rectal cancer. Despite major advances in our understanding of the propagation of the rectal cancer, the lymphatic drainage of the rectum remains unclear. This study was designed to assess the number of lymph nodes located around the superior rectal artery and to assess the frequency of Mondor's lymph nodes. Twenty-five anatomic subjects were studied. All resections were performed using total mesorectal excision. Lymph nodes were sought in the tissue surrounding the superior rectal artery up to 2 cm under the ending of the superior rectal artery by manual dissection and were submitted for histological examination. The correlation between the number of lymph nodes, and the volume and weight of the tissue surrounding the superior rectal artery was evaluated by non-parametric Spearman test. The mean number of lymph nodes per specimen was 2.7 +/- 1.4. The size of the lymph nodes varied between 1 and 7 mm. The lymph nodes were mostly smaller than 3 mm (56%). The number of lymph nodes in the superior rectal mesentery was independent of its volume and its weight. Seven subjects had a Mondor's lymph node. The mean size of Mondor's lymph node was 3.4 +/- 2.1 cm. The number of NL located around the superior rectal artery is small, varying between 1 and 5. The Mondor's lymph node is an inconstant rectal NL. Its only characteristic is its location in the bifurcation or trifurcation of the superior rectal artery.