Book Reviews

Normal Lymph Node Topography: CT Atlas

E. Richter and T. Feyerabend

Berlin, Germany: Springer-Verlag, 2004, 147 pages, $89.95

Normal Lymph Node Topography: CT Atlas, a revision of the original 1991 publication, is a comprehensive presentation of the topography of normal lymphatic pathways as seen on axial CT scans. The book is soft cover, has 147 pages, and includes 66 figures in 147 separate illustrations. Schematic drawings that correspond to each scan are also included. The intended audience is radiation oncologists and diagnostic radiologists.

The first section is a general introduction to the lymphatic system. The authors describe the basic organization of the lymphatic drainage system, and schematic drawings show the main lymphatic channels of the body. The atlas is then divided into 4 chapters, covering the head and neck, thorax and breast, abdomen, and pelvic and inguinal region. Each of these chapters begins with a detailed description of the lymphatic drainage regions for that part of the body. For example, in the section on the head and neck, the lymphatics of the scalp are described, and the names of the regional lymph nodes are given. Subsequently, similar information is provided for drainage of the skin of the neck, face, nose, and ear. Drainage patterns for deeper structures such as the orbit, paranasal sinuses, oral cavity, tongue, nasopharynx, oropharynx, hypopharynx, larynx, and salivary glands are also given. The chapter ends with axial CT sections and corresponding diagrams with detailed labeling of the general and lymphatic anatomy of the previously described lymph node groups of the head and neck.

The same format is followed for the remaining 3 chapters. Throughout, reference is made to the corresponding illustrations in the plates that follow the text. These are well organized and include, on facing pages, axial CT images and 2 schematic diagrams corresponding to each CT section. One schematic diagram labels all anatomy on that image, and a second diagram at the same level shows the topography and labels the individual nodal groups described in the text.

A limitation of the atlas is the poor quality of the CT images that are presented. They were not obtained from the latest generation of CT scanner and are not of the best resolution currently possible. However, the detailed diagrams do make up for this limitation. The authors use the Latin names of the lymph nodes, following the latest edition of Nomina Anatomica, in the text. The more common English names are used in the diagrams.

This atlas provides a well-organized and detailed description of the lymphatic drainage system and main nodal groups for every major organ system in the body. The information should prove useful for diagnostic radiologists when they interpret imaging studies in order to stage tumors. Radiation oncologists should also find this atlas useful, in view of the evolution of techniques such as stereotactic radiotherapy and intensity-modulated radiotherapy, which use CT to plan and design appropriate treatment volumes for tumors at various sites in the body.