THE LYMPHATIC DRAINAGE OF THE PARIETAL PERICARDIUM IN MAN

Abstract

Parietal pericardial lymphatics were visualized by indirect and direct India ink injections in35 human cadavers. Studies included examination of cleared specimens under the dissectingmicroscope and standard light microscopy.The lymphatic vessels of the ventral pericardial surface most often pass along the phrenicnerves cranially to terminate in the anterior right and left and transverse mediastinal nodes, orcaudally to the diaphragm or prepericardial lymph nodes. The lymphatics draining the lateralparts of pericardium pass to the anterior mediastinal, tracheobronchial, lateropericardial,prepericardial and posterior mediastinal (juxtaesophageal) lymph nodes. The posterior part ofthe pericardium drains to the juxtaesophageal and tracheobronchial nodes. Lymphatics from thediaphragmatic part of the pericardium pass to the right lateropericardial and prepericardial,juxtaesophageal and tracheobronchial nodes. The pericardial cupula is anteriorly drained to theanterior mediastinal nodes, and posteriorly to the tracheobronchial nodes. In cleared specimenstwo networks of lymphatic vessels are seen to surround the pericardial space. On the ventralsurface, the lymphatics of the parietal pericardium connect to lymphatics in the pericardial fatand areolar tissue. On the lateral and posterior surfaces, the lymphatics of the parietalpericardium anastomose with lymphatics of the reflected mediastinal pleura. These anatomicalobservations offer new insights into the mechanisms of turnover of pericardial fluid and into themechanisms of occurrence of chylopericardium.