Clinical Problem-Solving: An Anatomy Lesson

• Published in: The New England journal of medicine Vol. 331; no. 24; p. 1660
• Main Authors: Youmans, David C, Duffy, Thomas P
• Format: Journal Article
• Language: English
• Published: United States Massachusetts Medical Society 15-12-1994
• Subjects: Female; Humans; Lymphatic System - physiology; Male; Retroperitoneal Space - anatomy & histology; Scrotum - anatomy & histology; Testis - anatomy & histology
• ISSN: 0028-4793; 1533-4406
• DOI: 10.1056/NEJM199412153312414

To the Editor:
I greatly enjoyed reading “An Anatomy Lesson” by Dr. Duffy (Aug. 4 issue).
1
As a resident physician I appreciate and learn a great deal from such practical clinical vignettes.
After outlining the importance of the retroperitoneal lymphatic drainage system of the testicles, however, Dr. Duffy concludes by noting the “anatomical association between the retroperitoneum and the scrotum.” In fact, the lymphatics of the scrotum (along with those of the tunica vaginalis) drain to the superficial inguinal lymph nodes, as demonstrated by the anasarca of elephantiasis. This distinction can be important in differentiating testicular from nontesticular disease in . . .