Question
A 52-year-old male presents to your office with a painless mass in his groin. On physical examination, you palpate several hard lymph nodes in the right inguinal area. Lymph node biopsy reveals malignant cells that most likely originated from the:
| A. |
Testes
|
| B. |
Prostate
|
| C. |
Bladder
|
| D. |
Anal canal
|
Show Answer
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Correct Answer � D
Explanation
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|
Ans. D
This patient has palpable firm superficial inguinal lymph nodes. The superficial inguinal lymph nodes drain all cutaneous lymph from the umbilicus to the feet, including the external genitalia and anus (up to the beginning of the rectum, the dentate line), but excluding the posterior calf, which drains to the popliteal lymph nodes.
The superficial inguinal lymph nodes lie in a region bounded by the inguinal ligament, sartorius muscle, and adductor longus muscle, and overlie the femoral nerve, artery, and vein.
(Choice A) In general, lymph vessels follow the paths of the arteries and veins supplying a particular structure. The testes receive their blood supply from the testicular arteries, which arise directly from the abdominal aorta just inferior to the renal arteries. The lymph vessels that drain the testes follow a path from the testes to the abdominal aortic lymph nodes.
(Choice B) Lymph from the prostate drains primarily to the internal iliac nodes, but also the external iliac nodes and sacral nodes (minor pathways).
(Choice C) Lymph from the superior portion of the bladder drains to the external iliac nodes while lymph from the inferior portion of the bladder drains to the internal iliac nodes.
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