The cystic node (also known as the cystic lymph node, cystic lymph node of Lund, Lund's node, or Mascagni's lymph node and often erroneously referred to as Calot's node) is the

sentinel lymph node The sentinel lymph node is the hypothetical first lymph node or group of nodes draining a cancer. In case of established cancerous dissemination it is postulated that the sentinel lymph nodes are the target organs primarily reached by metastasiz ...

of the gall bladder. It is located within the cystohepatic triangle (Calot's triangle).

Structure

The cystic lymph node is situated at the neck of the gallbladder. It is invariably situated lateral to the biliary tree. The node receives lymphatic drainage from the gallbladder, cystic duct, hepatic duct, and the superior portion of the common bile duct. It in turn drains lymph into the

hepatic lymph nodes The hepatic lymph nodes consist of the following groups: * (a) hepatic, on the stem of the hepatic artery, and extending upward along the common bile duct, between the two layers of the lesser omentum, as far as the porta hepatis; the cystic gla ...

Clinical significance

It increases in size in

cholecystitis Cholecystitis is inflammation of the gallbladder. Symptoms include right upper abdominal pain, pain in the right shoulder, nausea, vomiting, and occasionally fever. Often gallbladder attacks (biliary colic) precede acute cholecystitis. The pain l ...

and cholangitis; it becomes enlarged in most cases of acute cholecystitis which serendipitously also makes it easier to identify in case of subsequent surgery. It is an anatomic landmark and may be removed along with the gallbladder in

cholecystectomy Cholecystectomy is the surgical removal of the gallbladder. Cholecystectomy is a common treatment of symptomatic gallstones and other gallbladder conditions. In 2011, cholecystectomy was the eighth most common operating room procedure performed i ...

. The node can be used as a landmark to prevend

iatrogenic injury A medical error is a preventable adverse effect of care ("iatrogenesis"), whether or not it is evident or harmful to the patient. This might include an inaccurate or incomplete diagnosis or treatment of a disease, injury, syndrome, behavior, ...

during surgery in the cystohepatic triangle so as to avoid the bile ducts and other structures of the porta hepatis.

Research

According to one retrospective study, the node could be identified in about 78% of patients undergoing laproscopic cholecystectomy; of those in whom the node could be identified, the node was related to the

cystic artery The cystic artery (also known as bachelor artery) supplies oxygenated blood to the gallbladder and cystic duct. Most common arrangement In the classic arrangement, occurring with a frequency of approximately 70%, a singular cystic artery originat ...

in ~97% of cases.

Etymology

The node is named after

Fred Bates Lund Fred may refer to: People * Fred (name), including a list of people and characters with the name Mononym * Fred (cartoonist) (1931–2013), pen name of Fred Othon Aristidès, French * Fred (footballer, born 1949) (1949–2022), Frederico Rodr ...

(1865-1950), an American surgeon. It was also named after the Italian anatomist and physician, Paolo Mascagni (1752-1815), who first identified the node around 1787.

References

{{Reflist Lymphatics of the torso Anatomic Landmarks