The aim of this study was to determine connections between thoracic duct and lymphatic pathways of the diaphram, in order to better understand the propagation in the mediastinum of infectious of neoplastic processes, the tumorous recurrence, physiopathology of the chylothorax in surgey of lung cancer. Subpleural lymphatics of 30 adults cadavers and 12 fetuses were injected with a modified Gerota's medium to permit lymph vessels and nodes to be visualized and then dissected. Each stage of the dissection was described and photographed. Diaphragmatic lymphatic afferents to the thoracic duct, originated from the posterior portion of the diaphram, were injected in 75% of cases (with 25% of direct connections). Mediastinal lymphatic lymph vessels (para-esophageal lymph patways) arose from posterior portion of diaphram, ascending along the esophagus and ending in the intertracheobronchial lymph nodes. Diaphragmatic and mediastinal lymphatic afferents to the thoiacic duct are playing a major role in intraleural cells resorption.
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