Brachogenic Carcinoma (Lymphs)

Into which structures may bronchogenic cancers extend due to anatomical relations of the bronchi and lungs?

Into the mediastinum, root of the neck, thoracic wall, or diaphragm.

In a tumor of the left bronchus, which areas are most likely to be directly invaded?

The left superior mediastinum and root of the neck.

What happens when a tumor directly infiltrates the pleurae?

It produces pleural effusion into the pleural cavity.

What might the pleural fluid contain in malignant infiltration?

Bloody pleural exudate with exfoliated malignant cells.

Which lymph nodes recieve all lymph from the lungs first

Bronchopulomonary lymph nodes

Where do bronchopulmonary lymph nodes drain

Into the tracheobronchial lymph nodes.

Where the traceobronchial lymph nodes located

In the angles between the trachea and bronchi

Describe the main lymphatic drainage pathway from the right lung.

Right lung → tracheobronchial nodes → right paratracheal nodes → right bronchomediastinal trunk → right lymphatic trunk.

Describe the main lymphatic drainage pathway from the left superior lobe (and part of the inferior lobe).

Left lung - left superior tracheobronchial nodes - left bronchomediastinal trunk - thoracic duct. 

How might lymphatic spread differ if the tumor was in the inferior lobe of the left lung.

Lymph of the Inferior lobe may partially cross over to drain via the right tracheobronchial nodes, leading to contralateral node involvement.

Where are the scalene lymph nodes located

Just superior to the clavicle

What is the relationship of the right scalene lymph nodes to the lymphatic trunks

Nodes are at the junction where 3 trunks join to form the right lymphatic trunk.

What is the relationship of the left scalene lymph nodes to the lymphatic trunks

Nodes are at the point where the bronchomediastinal trunk enters the thoracic duct.

Why are scalene lymph nodes clinically significant in lung cancer

Their enlargement can signal advanced disease with spread along lymphatic pathways.

Why are foreign bodies more likely to enter the right main bronchus?

It’s wider, shorter and more vertically oriented than the left

When foreign objects are enhaled which lobes of the right lung are most often affected

Middle and infeiror lobes.