Immunocytochemical detection of tumour cells in the thoracic duct of patients with an adenocarcinoma of the oesophagus

Background. Compared to other hollow viscus organs, the oesophagus has a un ique anatomy in which lymphatic channels are abundantly present in the muco sa and submucosa. It has been hypothesized that tumour cells can directly d isseminate from these superficial layers into the thoracic duct without pas sing juxta-tumoral lymph nodes. We investigated whether tumour cells of an oesophageal carcinoma could be detected in the thoracic duct during operati ve manipulation. Methods: In patients with an adenocarcinoma of the oesopha gus and/or gastro-oesophageal junction, undergoing a transthoracic resectio n with two-field lymphadenectomy, lymph was collected and cells were immuno stained. Results: Tumour cells could be detected in the thoracic duct lymph of only 1 out of 19 patients during operative manipulation. Conclusion: Pe roperative data from this study do not support the hypothesis that oesophag eal carcinoma readily metastasizes directly into the thoracic duct. Copyrig ht (C) 2001 S. Karger AG, Basel.