Expansion
Four main zones draining ultimately to the coeliac nodes
Expansion
Four zones, each following its artery:
- Superior gastric nodes - upper lesser curve, with the left gastric artery
- Suprapyloric nodes - lower lesser curve, with the right gastric artery
- Pancreaticosplenic nodes - upper greater curve, with the short gastrics and left gastro-omental
- Subpyloric nodes - lower greater curve, with the right gastro-omental
All converge on the coeliac nodes, then the cisterna chyli and thoracic duct.
Two eponymous signs of advanced gastric cancer follow this pathway:
- Virchow’s node - left supraclavicular node at the termination of the thoracic duct, giving Troisier’s sign
- Sister Mary Joseph nodule - a periumbilical deposit spreading along the ligamentum teres
Transcoelomic spread to the ovaries gives a Krukenberg tumour, and to the rectovesical pouch a palpable Blumer’s shelf.