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Arch Surg. 1939;38(4):714-754. doi:10.1001/archsurg.1939.01200100117006.
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From the point of view of malignant tumors metastasizing through the lymphatic channels or spreading from one group of lymph nodes to another along the lymphatic channels the retroperitoneal nodes are the most important lymph nodes in the body. Perhaps they are not involved as frequently as are the cervical nodes, but, as far as the relative effect on the general condition of a patient suffering from a malignant process is concerned, the retroperitoneal nodes are far more important than any other group of nodes. Owing to their relative inaccessibility little attention has been given them, and the relation between certain clinical symptoms and physical signs and pathologic involvement of this group of nodes is often overlooked.

ANATOMY OF THE ABDOMINAL AND PELVIC NODES  From an anatomic standpoint most of the abdominal lymph nodes are retroperitoneal, in that none of them are within the peritoneal cavity. In this sense, while


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