FIGURE 1. (A) Low-magnification view of histologic section (hematoxylin–eosin staining) extending from epidermis to underlying muscle (modified from Ackerman (157)). Locations of papillary–subpapillary plexus, dermal lymphatics, subcutaneous lymphatics, communicating lymphatics along fibrous strands, and deep epifascial lymphatics are indicated. (B) Schematic representation of regions with ambiguous lymphatic drainage around midline of body as derived from classic anatomic notions (Sappey’s concept, dark gray) and from lymphoscintigraphic, functional studies (light gray). In Sappey’s notion, ambiguous lymphatic drainage (i.e., possibility of draining toward either left- or right-sided lymph nodes) corresponds to restricted area extending only approximately 5 cm on each side of midline of body. More recent lymphoscintigraphic studies show instead that ambiguous lymphatic drainage can extend to much wider area: Head, neck, and shoulders are virtually entirely included in this area, as is relevant abdominal area around waist.
