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Copyright ©The Author(s) 2020. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Clin Oncol. Jun 24, 2020; 11(6): 337-347
Published online Jun 24, 2020. doi: 10.5306/wjco.v11.i6.337
Lingual lymph nodes: Anatomy, clinical considerations, and oncological significance
Shalva R Gvetadze, Konstantin D Ilkaev
Shalva R Gvetadze, Konstantin D Ilkaev, Central Research Institute of Dentistry and Maxillofacial Surgery, Moscow 119991, Russia
Konstantin D Ilkaev, Blokhin National Medical Research Center of Oncology, Moscow 115478, Russia
Author contributions: Gvetadze SR wrote the paper; Ilkaev KD performed the collection of the data and reviewed the manuscript.
Conflict-of-interest statement: The authors declare no conflict of interests for this article.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Corresponding author: Shalva R Gvetadze, MD, PhD, Doctor, Surgeon, Surgical Oncologist, Teacher, Central Research Institute of Dentistry and Maxillofacial Surgery, Timura Frunze 16, Moscow 119991, Russia. shalvagvetadze@yandex.ru
Received: December 31, 2019
Peer-review started: December 31, 2019
First decision: March 24, 2020
Revised: April 4, 2020
Accepted: May 5, 2020
Article in press: May 5, 2020
Published online: June 24, 2020
Abstract

Lingual lymph nodes are an inconstant group of in-transit nodes, which are located on the route of lymph drainage from the tongue mucosa to the regional nodes in neck levels I and II. There is growing academic data on the metastatic spread of oral cancer, particularly regarding the spreading of oral tongue squamous cell carcinoma to lingual nodes. These nodes are not currently included in diagnostic and treatment protocols for oral tongue cancer. Combined information on surgical anatomy, clinical observations, means of detection, and prognostic value is presented. Anatomically obtained incidence of lingual nodes ranges from 8.6% to 30.2%. Incidence of lingual lymph node metastasis ranges from 1.3% to 17.1%. It is clear that lymph nodes that bear intervening tissues from the floor of the mouth should be removed to improve loco-regional control. Extended resection volume, which is required for the surgical treatment of lingual node metastasis, cannot be implied to every tongue cancer patient. As these lesions significantly influence prognosis, special efforts of their detection must be made. Reasonably, every tongue cancer patient must be investigated for the existence of lingual lymph node metastasis. Lymphographic tracing methods, which are currently implied for sentinel lymph node biopsies, may improve the detection of lingual lymph nodes.

Keywords: Lingual lymph node, Sublingual lymph node, Tongue cancer, Regional metastasis, Lymph drainage, Head neck region, En-bloc resection

Core tip: Lingual lymph nodes comprise an inconstant group of in-transit nodes, which are located on the route of lymph drainage from the tongue mucosa to the regional nodes in neck levels I and II. This group of lymph nodes may represent a site of tongue cancer metastasis or locoregional recurrence. These nodes are not currently included in diagnostic and treatment protocols for oral tongue cancer. The reported rate of anatomical existence, as well as metastatic lingual node involvement incidence, may not be considered low. As these lesions were shown to significantly influence survival prognosis, special efforts for their detection must be carried out.