FLOW OF LYMPH FROM THE RECTUM TO THE LUMBAR VERTEBRAE AND SACRUM

Purpose:The purpose of this study was to study the flow of lymph from the rectum to the lumbar vertebrae and sacrum,a pathway suggested by clinical studies. Materials and Methods:Indian ink containing 3% gelatin was injected under a stereoscopic microscope into the submucosal tissues of the rectum of 22 fetuses(12 to 20 weeks’ gestation,18 males and 4 females,previously warmed to 37°C).The injection site was the left wal near the rectum,which is defined as“Rb”in the General Rules for Clinical and Pathological Studies on Cancer of the Colon,Rectum and Anus in Japan.To distinguish lymphatic channels from arteries and veins,a red Liquitex dye solution(dissolved in alcohol containing corn starch)was injected into the umbilical vein.The bodies were fixed in 50% alcohol and 10% formalin.The lymph pathways were studied under a stereoscopic microscope. Results and Discussion:In al 22 cases,a lymph pathway was observed from the lower part of the rectum to the lumbar and sacral plexus through the paraproctium.This lymph pathway is not described in the General Rules for Clinical and Pathological Studies on Cancer of the Colon,Rectum and Anus in Japan but might be re-formed in adults under certain circumstances,such as cancer in the rectal area. (Tokyo Jikeikai Medical Journal 2002;117:1-8)