Lymphatic drainage of lung cancer follows an intersegmental pathway within the visceral pleura

Objectives Lung cancer tumors are known to be highly lymphophilic. There two different pattern of lymphatic drainage the lung: one peribronchial pathway, and another within visceral pleura which appears more intersegmental than pathway. We aimed assess prevalence an pathway in lung determine potential influential factors. Methods In this prospective study, we included all patients for whom a major pulmonary resection (lobar) was indicated performed suspected or proven cancer. An immediate ex-vivo evaluation surgical specimen after conducted by trans-pleural injection blue dye tumor. The pathways followed vessels under were assessed define occurrence defined presence vessel crossing neighboring segment, distinct from tumorous segment. Results Fifty-three met inclusion criteria over three-year period. Lymphatic 35 53 (66 %). When tumor intersegmental, it drained single other segment 21/35 cases 14/35 cases. Logistic regression with multivariate analysis showed peripheral location risk factor (OR = 0.87 [079?0.95], p 0.003). Conclusion These results confirm that largely follow especially when is peripheral, close pleura.