Hemolymph Node - An Immunomorphlogical Organ: Modeling the Hemolymph Node by Allografting Renal Tissue in the Rat.

There is no authoritative characterization of the attributes of the hemolymph node (HLN) since Gibbes' first description in 1884. Early reports showed that HLN are found near the kidney in human and animals with the feature of numerous erythrocytes in sinuses. Subsequent studies mainly focused on anatomy and histology, such as the source, distribution, and quantity of erythrocytes in sinuses. Recent articles mentioned that the emergence of HLN was related to immunity, but there was no strong evidence to support this hypothesis. Therefore, it is still uncertain whether the HLN is an organ of anatomy, histology, or immunology. It has been found that the development of HLN could be elicited in the parathymic area by stimuli such as Escherichia coli, allogeneic breast cancer cells, and renal tissue that were injected/transplanted into the tail of rats in our pilot studies. In this study, the model of the HLN was established by transferring allogeneic renal tissue in the rat. Intrasinusoidal erythrocytes of the node were the component for producing a red macroscopic appearance, while macrophage-erythrocyte-lymphocyte rosettes were the major immunomorphological changes, reflecting the immune activity against the invasion of the allogeneic tissue within the node. Therefore, the HLN is an immunomorphological organ.

Superior Gait Symmetry and Postural Stability among Yoga Instructors-Inertial Measurement Unit-Based Evaluation.

This study investigates gait symmetry and single-leg stance balance of professional yoga instructors versus age-matched typically developed controls using inertial measurement unit (IMU)-based evaluation. We recruited twenty-five yoga instructors and twenty-five healthy control subjects to conduct the walking experiments and single-leg stance tests. Kinematic data were measured by attaching IMUs to the lower limbs and trunk. We assessed the asymmetry of swing phases during the normal-walk and tandem-walk tests with eyes open and closed, respectively. The subjects subsequently conducted four single-leg stance tests, including a single-leg stance on both legs with eyes open and closed. Two balance indexes regarding the angular velocities of the waist and chest were defined to assess postural stability. The gait asymmetry indexes of yoga instructors were significantly lower than those of the typically developed controls. Similarly, the yoga instructors had better body balance in all four single-leg stance tests. This study's findings suggest that yoga improves gait asymmetry and balance ability in healthy adults. In the future, further intervention studies could be conducted to confirm the effect of yoga training.

The perforator angiosome: a new concept in the design of deep inferior epigastric artery perforator flaps for breast reconstruction.

BACKGROUND: The previously described "perfusion zones" of the abdominal wall vasculature are based on filling of the deep inferior epigastric artery (DIEA) and all its branches simultaneously. With the advent of the DIEA perforator flap, only a single or several perforators are included in supply to the flap. As such, a new model for abdominal wall perfusion has become necessary. The concept of a "perforator angiosome" is thus explored. METHODS: A clinical and cadaveric study of 155 abdominal walls was undertaken. This comprised the use of 10 whole, unembalmed cadaveric abdominal walls for angiographic studies, and 145 abdominal wall computed tomographic angiograms (CTAs) in patients undergoing preoperative imaging of the abdominal wall vasculature. The evaluation of the subcutaneous branching pattern and zone of perfusion of individual DIEA perforators was explored, particularly exploring differences between medial and lateral row perforators. RESULTS: Fundamental differences exist between medial row and lateral row perforators, with medial row perforators larger (1.3 mm vs. 1 mm) and more likely to ramify in the subcutaneous fat toward the contralateral hemiabdomen (98% of cases vs. 2% of cases). A model for the perfusion of the abdominal wall based on a single perforator is presented. CONCLUSION: The "perforator angiosome" is dependent on perforator location, and can mapped individually with the use of preoperative imaging.

Blood supply to the lymphatic vessels in the leg: an incidental finding.

There are no reports or images of the blood supply to the lymphatic vessels. One lower limb of an unembalmed human cadaver was studied. Hydrogen peroxide (6%) was applied to find the lymphatic vessels by using a surgical microscope. The vessels were injected with a radio-opaque mixture and dissected. During the dissection, several sites of paralymphatics arteriole nutrient (PAN) vessels were found in close proximity to collecting lymphatic vessels in the medial aspect of the leg. The caliber of the lymphatic vessels was about 1 mm. The caliber of PAN vessels was <0.1 mm. The blood vessels were seen running along the lymphatic vessels. Some of them crossing the lymphatics and supplying the fatty tissue nearby and some running parallel on the lymph vessel walls. Histology sections show different-sized PAN vessels containing blood cells situated close to the lymphatic wall and within the lymphatic vessel wall. PAN vessels have been found and described. It will upgrade our anatomical knowledge and also be of benefit for medical and/or scientific research.

The morphology of the human lymphatic vessels in the head and neck.

Previously little has been written about the morphology of the human lymphatic vessels since Sappey (Sappey [1874] Anatomie, Physiologie, Pathologie des Vaisseaux Lymphatiques, Paris: Adrien Delahaye) over 100 years ago. There needs to be an accurate re-evaluation of scientific observations to aid clinical management. Forty-nine combinations of tissue from the head and neck of 20 unembalmed human cadavers were studied. Six percent hydrogen peroxide was used to find the vessels. They were injected with radio-opaque mixture, dissected, photographed, and radiographed. Final results were transferred to the computer for analysis. Different sized lymphatic valves were found in the precollecting and collecting lymph vessels, the lymphatic trunks, and ducts. The intervals between the valves were of various lengths. Diverse lymphatic ampullae and diverticula were seen in precollecting and collecting lymph vessels. Initial lymph vessels arose from the dermis, the galea, and the mucosal membrane. The vasculature of the direct and indirect precollecting and collecting lymph vessels, lymphatic trunks, and ducts was recorded. The morphology of the human lymphatic vessels in the head and neck has been described and recorded using radiographs and photographs.

The arterial supply of the long head of biceps tendon: Anatomical study with implications for tendon rupture.

Zones of hypovascularity are thought to exist in several tendons of the shoulder, contributing to localized tendon weakness and subsequent rupture in clinical practice. Although these zones have been demonstrated in many frequently ruptured tendons, the existence of a similar area in the often ruptured long head of biceps (LHB) tendon is largely unknown. Twenty cadaveric upper limb specimens were dissected after injection with either a radio-opaque lead oxide/milk mixture or India ink, followed by histological sectioning of the tendons. The LHB tendon was consistently supplied via its osteotendinous and musculotendinous junctions by branches of the thoracoacromial and brachial arteries respectively. In two specimens, additional branches from the anterior circumflex humeral artery travelling in a mesotenon vascularized the midsection of tendon. These source arteries divided the LHB tendon into either two or three vascular territories, depending upon the presence of the mesotenon-derived vascular supply. A zone of hypovascularity was consistently found in the region of the LHB tendon most frequently prone to rupture. This zone covered an area 1.2-3 cm from the tendon origin, extending from midway through the glenohumeral joint to the proximal inter-tubercular groove. This hypovascular region occurred on the border of two adjacent vascular territories, where reduced caliber choke vessels provide limited arterial supply. While it is probable that the limited arterial supply contributes to the susceptibility of this area to rupture, similar to other tendons the true pathogenesis is likely to be a combination of both vascular and mechanical factors.

A three-dimensional analysis of the lymphatics of a bilateral breast specimen: a human cadaveric study.

BACKGROUND: There is an increasing clinical need for evaluation of the lymphatic anatomy of the breast. Because of tissue putrefaction, previous studies have not been able to achieve radiographic analyses of bilateral breasts in cadaver specimens. The use of improved preservation techniques with computed tomographic lymphangiography (CT; CTL) has now allowed this analysis to be undertaken. MATERIALS AND METHODS: The bilateral breasts and anterior upper torso from a female unembalmed human cadaver was studied over an 8-week period. Using microsurgical techniques, lymphatic vessels were identified with hydrogen peroxide, injected with lead oxide mixture, and radiographed to demonstrate lymphatic vessels in both breasts. Multiple frozen domestic ice bricks were used to cover the contralateral side of tissues to keep them partially frozen during this lengthy process. The specimen was radiographed, CT scanned, cross-sectioned, and radiographed again, with images digitalized for analysis. RESULTS: A three-dimensional analysis of lymph collecting vessels in the breasts, anterior upper torso and the internal mammary vascular bundles was achieved using both plain radiography and CTL. The lymphatics of the breast and anterior upper torso drain radially into the axillary lymph nodes. A predominance of superficial lymphatics are noted. Importantly, lymphatic vessel patterns of the breast are asymmetric between breasts of each side. CONCLUSION: Three-dimensional images of the lymphatic drainage of the breasts using advanced imaging technologies are described, with lymphangiography achieved in bilateral cadaveric breasts and anterior upper torso for the first time. This has significant future application for clinical practice.

A novel approach to slow down putrefaction of unembalmed cadaveric tissue during lymphatic dissection: a preliminary study.

BACKGROUND: The putrefaction factor is one of the biggest problems when undertaking unembalmed cadaveric tissue dissections for lymphatic vessel mapping. METHODS: One female bilateral breast and anterior upper torso from an unembalmed human cadaver was studied over an 8-week period. Multiple prefrozen domestic ice bricks were used to cover in turn and keep constantly cold or partially frozen, the contralateral side of the tissue during the dissections. Using hydrogen peroxide to identify the lymphatics under the surgical microscope, the vessels were injected with a lead oxide mixture, and then radiographed to demonstrate lymphatic vessels in both breasts. The final results transferred to the computer for analysis. RESULTS: Lymph collecting vessels were found in breasts, anterior upper torso, and the internal mammary vascular bundles. The lymphatics of the breast and the anterior upper torso drain radially into the axillary lymph nodes. Unexpectedly, the lymphatic vessel drainage patterns of each breast are asymmetrical in this specimen. CONCLUSION: This study provides a new method to slow down putrefaction of unembalmed cadaveric tissue, thus enabling lymphatic dissection of a bilateral breast and torso specimen.

The heel: anatomy, blood supply, and the pathophysiology of pressure ulcers.

There remains much confusion regarding the pathophysiology of pressure ulcers. Data indicate that the prevalence of pressure ulcers is increasing. The heel is unique in structure and well adapted to the task of shock absorption. However, it is often subject to prolonged pressure, which predisposes it to tissue breakdown, with attempts at reconstruction prone to failure. Four dissections were carried out of the heel region, which included removing each heel pad en bloc for histology. Seventeen arterial injection studies, 12 venous studies, and a combined arterial and venous study of the foot were performed. The results were correlated with clinical cases and previous research. The heel was found to be richly vascularized by a subdermal plexus and periosteal plexus with vessels traveling between the 2 within fibrous septa that connect the reticular dermis and periosteum of the calcaneus. These septa effectively create isolated compartments containing relatively avascular fat. A layer of panniculus carnosus muscle was observed in the subcutaneous tissue. It is likely that the metabolically active panniculus carnosus muscle is involved early in the course of pressure ulcers. Extensive pressure damage can be concealed by intact skin. Friction and shear are additional factors important in skin breakdown.

Anatomical variations in the harvest of anterolateral thigh flap perforators: a cadaveric and clinical study.

BACKGROUND: The anterolateral thigh (ALT) flap has become increasingly popular due to its versatility and minimal donor site morbidity. Its major limitation has been uncertainty in predicting perforator anatomy, with the occasional absence of suitable perforators and high variability in their size and course. The variability of this anatomy has not been adequately explored previously. METHODS: A cadaveric study was undertaken, in which 19 thighs (from 10 fresh cadavers) underwent contrast injection and angiographic imaging. Anatomical variations of the vasculature were recorded. A clinical study of 44 patients undergoing ALT flap reconstruction was also undertaken. Perforator anatomy was described in the first 32 patients, and the subsequent 12 patients underwent computed tomography angiography with a view to predicting individual anatomy and improving operative outcome. RESULTS: Cadaver angiography was able to highlight and classify the variations in arterial anatomy, with four patterns observed and marked variability between cases. In 32 patients undergoing ALT flaps without preoperative CT angiography (CTA), five patients (16%) did not have any suitable perforators from the descending branch of the lateral circumflex femoral artery. By selecting the limb of choice with preoperative CTA, the incidence of flap unsuitability was reduced to 0%. Comparing CTA with Doppler, CTA was more accurate (sensitivity 100%) and provided more information. CONCLUSION: The perforators supplying the ALT flap show significant variability in location and course, with the potential for unsuitable perforators limiting flap success. Preoperative CTA can demonstrate the vascular anatomy and can aid perforator selection and operative success.

Historical review of breast lymphatic studies.

The gross anatomy of the lymphatic system is one of the least studied areas of anatomy, primarily because of the technical difficulties encountered in demonstrating this almost invisible yet vast system. Similarly, there have been very few studies of the gross lymphatic anatomy of the adult human breast. Previous studies used young pregnant female cadavers. When mercury was injected into the lactiferous ducts or breast lymphatic channels, these cadavers enabled early anatomists to see the breast lymphatics. Both Cruikshank (1786) and Cooper (1840) located the axillary lymph pathway as well as accessory pathways directly from the breast. Sappey (1874) concluded that all lymphatics arising from the breast drained into the axilla via the subareolar plexus. Current descriptions of the breast lymphatics may be traced back to the diagram made by Poirier and Cuneo (1902). However, it is apparent that this diagram is a composite of adult breast studies by Sappey, their fetal studies and even clinical feedback. This study provides an historical perspective of the methods that have been previously used to study the lymphatics of the breast and introduces an update on current investigative approaches.

The arterial anatomy of the Achilles tendon: anatomical study and clinical implications.

The Achilles tendon is the most frequently ruptured tendon in the lower limb and accounts for almost 20% of all large tendon injuries. Despite numerous published studies describing its blood supply, there has been no uniformity in describing its topography. The current study comprises a detailed anatomical study of both the intrinsic and extrinsic arterial supply of the Achilles tendon, providing the detail sought from studies calling for improved planning of surgical procedures where damage to the vascularity of the Achilles tendon is likely. A dissection, microdissection, histological, and angiographic study was undertaken on 20 cadaveric lower limbs from 16 fresh and four embalmed cadavers. The Achilles tendon is supplied by two arteries, the posterior tibial and peroneal arteries. Three vascular territories were identified, with the midsection supplied by the peroneal artery, and the proximal and distal sections supplied by the posterior tibial artery. The midsection of the Achilles tendon was markedly more hypovascular that the rest of the tendon. The Achilles tendon is at highest risk of rupture and surgical complications at its midsection. Individuals with particularly poor supply of the midsection may be at increased risk of tendon rupture, and approaches to the tendon operatively should consider the route of supply by the peroneal artery to this susceptible part of the tendon.

The arterial supply of the patellar tendon: anatomical study with clinical implications for knee surgery.

The middle-third of the patellar tendon (PT) is well-established as a potential graft for cruciate ligament reconstruction, but there is little anatomical basis for its use. Although studies on PT vascular anatomy have focused on the risk to tendon pedicles from surgical approaches and knee pathophysiology, the significance of its blood supply to grafting has not been adequately explored previously. This investigation explores both the intrinsic and extrinsic arterial anatomy of the PT, as relevant to the PT graft. Ten fresh cadaveric lower limbs underwent angiographic injection of the common femoral artery with radio-opaque lead oxide. Each tendon was carefully dissected, underwent plain radiography and subsequently schematically reconstructed. The PT demonstrated a well-developed and consistent vascularity from three main sources: antero-proximally, mainly by the inferior-lateral genicular artery; antero-distally via a choke-anastomotic arch between the anterior tibial recurrent and inferior medial genicular arteries; and posteriorly via the retro-patellar anastomotic arch in Hoffa's fat pad. Two patterns of pedicles formed this arch: inferior-lateral and descending genicular arteries (Type-I); superior-lateral, inferior-lateral, and superior-medial genicular arteries (Type-II). Both types supplied the posterior PT, with the majority of vessels descending to its middle-third. The middle-third PT has a richer intrinsic vascularity, which may enhance its ingrowth as a graft, and supports its conventional use in cruciate ligament reconstruction. The pedicles supplying the PT are endangered during procedures where Hoffa's fat pad is removed including certain techniques of PT harvest and total knee arthroplasty.

Deep lymphatic anatomy of the upper limb: An anatomical study and clinical implications.

BACKGROUND: The deep and perforating lymphatic anatomy of the upper limb still remains the least described in medical literature. MATERIALS AND METHODS: Six upper limbs with the axillary tissue were harvested from three unembalmed human cadavers amputated at the shoulder joint. A small amount of 6% hydrogen peroxide was employed to detect the lymphatic vessels around the deep palmar arch, radial and ulnar neurovascular bundles. A 30-gauge needle was inserted into the vessels and they were injected with a barium sulphate compound. Each specimen was dissected, photographed and radiographed to demonstrate deep lymphatic distribution of the upper limb. RESULTS: Continuing from the deep lymph vessels of the hand, single or multiple deep collecting lymph vessels have been found along the radial, ulnar, anterior and posterior interosseous neurovascular bundles in the forearm, brachial and deep branchial neurovascular bundles in the upper arm. During their courses, lymph nodes were found setting in the trunk of the radial, ulnar and brachial lymph vessels near or in the cubital fossa, and in the axillar. Perforating lymph vessels have been found near the wrist and in the cubital fossa, which linked the superficial and deep lymph vessels. The direction of lymphatic drainage was from the deep to superficial or superficial to deep vessels. CONCLUSION: The deep lymphatic anatomy of the upper limb has been described. The results will provide an anatomical basis for clinical management, educational reference and scientific research.

The lymphatic anatomy of the breast and its implications for sentinel lymph node biopsy: a human cadaver study.

BACKGROUND: Current understanding of the lymphatic system of the breast is derived mainly from the work of the anatomist Sappey in the 1850s, with many observations made during the development and introduction of breast lymphatic mapping and sentinel node biopsy contributing to our knowledge. METHODS: Twenty four breasts in 14 fresh human cadavers (5 male, 9 female) were studied. Lymph vessels were identified with hydrogen peroxide and injected with a lead oxide mixture and radiographed. The specimens were cross sectioned and radiographed to provide three dimensional images. Lymph (collecting) vessels were traced from the periphery to the first-tier lymph node. RESULTS: Lymph collecting vessels were found evenly spaced at the periphery of the anterior upper torso draining radially into the axillary lymph nodes. As they reached the breast some passed over and some through the breast parenchyma, as revealed in the cross-section studies. The pathways showed no significant difference between male and female specimens. We found also perforating lymph vessels that coursed beside the branches of the internal mammary vessels, draining into the ipsilateral internal mammary lymphatics. In some studies one sentinel node in the axilla drained almost the entire breast. In most more than one sentinel node was represented. CONCLUSION: These anatomical findings are discordant with our current knowledge based on previous studies and demand closer examination by clinicians. These anatomical studies may help explain the percentage of false-negative sentinel node biopsy studies and suggest the peritumoral injection site for accurate sentinel lymph node detection.

Senile changes in human lymph nodes.

BACKGROUND: The degenerative process of lymph nodes is poorly documented. METHODS: 161 lymph nodes of seven fresh and one embalmed human cadavers in the head and neck were studied. We used 6% hydrogen peroxide, lead oxide injectant, and radiographs to demonstrate lymphatic vessels, and found both solidified and transparent lymph nodes. They were removed, fixed in 10% formalin and sent for histopathology cross section. RESULTS: Thirty-eight solidified and 123 transparent lymph nodes were found. A series of histopathological sections show the degenerative process is variable and continuous. Senile involution affects all elements of the lymph node including the cortex, the medulla, and the architecture. CONCLUSION: This study provides actual anatomical and histopathological images of lymph nodes in different degenerative stages in the head and neck region. It may help explain some clinical conditions in the elderly, especially their diminished immunological response to infection and cancer metastasis.

The angiosome territories of the spinal cord: exploring the issue of preoperative spinal angiography. Laboratory investigation.

OBJECT: The angiosome concept has been the subject of extensive research by the senior author (G.I.T.), but its specific applicability to the spinal cord was hitherto unknown. The aim of this study was to see if the spinal cord vasculature followed the angiosome concept and to review the usefulness of preoperative spinal angiography in surgery for spinal disorders. Spinal cord infarction and permanent paraplegia may result from inadvertent interruption of the artery of Adamkiewicz. Spinal angiography, which may enable avoidance of this catastrophic complication, is still not commonly used. METHODS: Two fresh cadavers were injected with a gelatin-lead oxide mixture for detailed comparative study of spinal cord vasculature. One cadaver had insignificant vascular disease, whereas the other had extensive aortic atherosclerosis, presenting a unique opportunity for study. After removal from each cadaver, radiographs of the spinal cords were obtained, then photographed, and the vascular territories of the cords were defined. RESULTS: Four angiosome territories were defined: vertebral, subclavian, posterior intercostal, and lumbar. These vascular territories were joined longitudinally by true anastomotic channels along the anterior and posterior spinal cord. Anastomosis between the anterior and posterior vasculature was poor in the thoracolumbar region. The anterior cord relied on fewer feeder arteries than the posterior, and the anterior thoracolumbar cord depended on the artery of Adamkiewicz for its supply. In chronic aortic disease with intercostal artery occlusion at multiple levels, a rich collateral circulation supporting the spinal cord was found. CONCLUSIONS: The arterial supply of the spinal cord follows the angiosome concept. The atherosclerotic specimen supports the suggestion that the blood supply is able to adapt to gradual vascular occlusion through development of a collateral circulation. Nevertheless, the spinal cord is susceptible to ischemia when faced with acute vascular occlusion. This includes inadvertent interruption of the artery of Adamkiewicz. The authors recommend the use of preoperative spinal angiography to prevent possible paraplegia in removal of thoracolumbar spinal tumors.

The deep lymphatic anatomy of the hand.

BACKGROUND: The deep lymphatic anatomy of the hand still remains the least described in medical literature. METHODS: Eight hands were harvested from four nonembalmed human cadavers amputated above the wrist. A small amount of 6% hydrogen peroxide was employed to detect the lymphatic vessels around the superficial and deep palmar vascular arches, in webs from the index to little fingers, the thenar and hypothenar areas. A 30-gauge needle was inserted into the vessels and injected with a barium sulphate compound. Each specimen was dissected, photographed and radiographed to demonstrate deep lymphatic distribution of the hand. RESULTS: Five groups of deep collecting lymph vessels were found in the hand: superficial palmar arch lymph vessel (SPALV); deep palmar arch lymph vessel (DPALV); thenar lymph vessel (TLV); hypothenar lymph vessel (HTLV); deep finger web lymph vessel (DFWLV). Each group of vessels drained in different directions first, then all turned and ran towards the wrist in different layers. CONCLUSION: The deep lymphatic drainage of the hand has been presented. The results will provide an anatomical basis for clinical management, educational reference and scientific research.

Perforating and deep lymphatic vessels in the knee region: an anatomical study and clinical implications.

BACKGROUND: To determine the relationship between the perforating and deep lymphatic vessels in the knee region for clinical implications. METHODS: Four lower limbs from two unembalmed human cadavers were used. Under a surgical microscope, 6% hydrogen peroxide was employed to detect lymph vessels accompanying the small saphenous vein, anterior tibial, posterior tibial and fibular blood vessels all commencing from distal ends of specimens. Each lymphatic vessel was inserted by a 30-gauge needle and injected with a barium sulphate mixture. Each specimen was dissected, radiographed and photographed to determine the perforating and deep lymphatic vessels in the region. RESULTS: A perforating lymph vessel was observed in the popliteal fossa of each specimen. It arose from the superficial popliteal lymph node and terminated in the deep popliteal lymph node. The anterior tibial, posterior tibial and peroneal lymph vessels were discovered in the region travelling with the corresponding vascular bundles. After penetrating the vascular aperture of the interosseous membrane between the tibia and fibula, the anterior tibial lymph vessel entered directly into the deep popliteal lymph node or converged to either the posterior tibial or fibular lymph vessel, before entering the node. The posterior tibial and peroneal lymph vessels entered the deep popliteal lymph node. The efferent lymph vessel of the deep popliteal lymph node travelled with the femoral vascular bundle. CONCLUSION: The perforating and deep lymphatic vessels in the knee region has been presented and discussed. The information advances our anatomical knowledge and the results will benefit clinical management.

Radiologic Manifestations of Senile Lymph Nodes in the Popliteal Fossa.

PURPOSE: To determine the radiologic manifestations of senile lymph nodes in the popliteal fossa for radiologic and clinical application. METHODS: A total of six lower extremities from four unembalmed human cadavers were studied. Under a surgical microscope, 6% hydrogen peroxide was used to detect the lymphatic vessels commencing from the foot and leg. A 30-gauge needle was inserted into the vessels and injected with a radio-opaque lead oxide mixture. The specimens were radiographed and photographed to demonstrate the lymph nodes in the popliteal fossa. The final results were transferred to the computer for image analysis. RESULTS: An average of two lymph nodes (range 1 to 3) were found in the popliteal fossa of the lower extremity. They were divided into superficial and deep popliteal groups. The superficial group was located in the superficial layer of the popliteal fossa around the small saphenous vein (SSV). The deep group was close to the popliteal surface of the femur and always located next to the popliteal vein. All lymph nodes were transparent in appearance and contained coiled lymphatic tubules. The size and density of the tubules varied. CONCLUSION: The radiologic manifestations of senile lymph nodes in the popliteal fossa have been presented and discussed to upgrade our radiologic and anatomical knowledge. This will be of benefit for radiologic and clinical applications.