Comparison of groin lymph node anatomy in patients with upper-extremity lymphedema and healthy subjects using contrast-enhanced computed tomography

Abstract

Purpose: Lymphedema is a chronic disease that affects patients’ quality of life. Vascularized groin lymph node transfer is a reliable treatment that requires detailed anatomic knowledge of the superficial inguinal lymph nodes (SILNs). This study compared the anatomy of SILNs between patients with upper-extremity lymphedema and individuals without lymphedema using pelvic computed tomography (CT).Methods: The CT scans of 17 patients (the patient group) with upper-extremity lymphedema and 34 individuals without lymphedema (the normal group) were studied. The reference point was marked 3 cm perpendicularly below one-third of the line from the pubic tubercle to the anterior superior iliac spine. The number, distance, and concentration of SILNs were measured relative to the reference point.Results: The SILNs in the normal group had a mean count of 6.47±1.19, a mean distance from the reference point of 21.10±9.66 mm, and a mean concentration of 84%. The patient group had a mean lymph node count of 7.68±1.63, a mean distance of 22.48±9.51 mm, and a mean concentration of 77%. The normal and patient groups had significantly different mean lymph node counts (p=0.01). The mean distance from the reference point (p=0.07) and the mean lymph node concentration (p=0.20) did not differ significantly between groups. Conclusion: Pelvic CT is a reliable method to evaluate the anatomy of SILNs in detail. A statistically significant difference was found in the number of lymph nodes between the lymphedema patient group and the normal group, but not in their distribution.