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The regional lymph node
“map” is important for clinical
staging and lymph node
sampling
All lymphatic channels
intercommunicate- lymphatic
fluid from any portion of the
oesophagus may move to
any other portion and may
spread to any region of the
thorax or draining nodes.
Tumours in the distal
oesophagus are more
likely to metastasize to
the abdomen,
Lymphatic spread of
cancer in the upper or
midesophagus can also
result in metastasis to
celiac or other
abdominal lymph
nodes.
The flow of lymph in the upper two-thirds of the
oesophagus tends to be upward, whereas that
in the distal third tends to be downward