Lymphangiography: Diagnosis of Nodal Metastases From Testicular Malignancies

Abstract

In preparation for a discussion of our experience with lymphangiographic diagnosis in testicular malignancies, a description of the embryology and anatomy of the testicle and its lymphatic drainage is of value. <h3>Embryology.—</h3> The urogenital fold ultimately extends from C-6 to S-2. The ridge divides into a lateral mesonephric fold and a medial genital fold, the primordium of the genital gland. The testicle descends from the para-aortic region to the scrotum. Gonadal tissue may exist anywhere along this distribution. <h3>Lymphatic Drainage.—</h3> Testicular lymphatics accompany the internal spermatic artery and vein and drain into the lumbar nodes. The right trunks terminate in the right lumbar glands which lie between the level of the aortic bifurcation and the renal vein. In 10%, these trunks end in a node in the angle between the right renal vein and the inferior vena cava.¹⁹The left testicular lymphatics drain into the para-aortic nodes near the