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Lesser curvature lymph nodes

The lesser curvature lymph nodes are a group of lymph nodes located along the lesser curvature of the stomach, embedded in the connective tissue between the layers of the lesser omentum (hepatogastric ligament). They follow the course of the left and right gastric vessels and form part of the gastric lymphatic drainage system.

Anatomically, they are distributed in the following pattern:

  • Right gastric nodes: Along the right gastric artery, draining the pyloric and lower gastric regions.

  • Left gastric nodes: Along the left gastric artery, draining the cardia and upper lesser curvature.

These nodes drain lymph from the anterior and posterior walls of the stomach adjacent to the lesser curvature. From here, lymph flows into the celiac lymph nodes, eventually reaching the cisterna chyli and thoracic duct.

Clinically, the lesser curvature lymph nodes are of paramount importance in gastric cancer staging (Japanese Gastric Cancer Association classification: stations 1 and 3), where involvement alters surgical management and prognosis. They are routinely removed during gastrectomy with D2 lymphadenectomy. They may also be involved in benign conditions such as gastritis, peptic ulcer disease, and infections.

Synonyms

  • Gastric lymph nodes of the lesser curvature

  • Right and left gastric lymph nodes

  • Stations 1 & 3 lymph nodes (oncological classification)

Function

  • Drain lymph from the anterior and posterior gastric walls adjacent to the lesser curvature

  • Serve as sentinel nodes in gastric carcinoma

  • Participate in immune surveillance of gastric mucosa

  • Provide lymphatic communication between the stomach, esophagus, and hepatoduodenal region

MRI Appearance

T1-weighted images:

  • Nodes appear as low to intermediate signal intensity structures adjacent to gastric wall and lesser omentum

  • Surrounded by hyperintense fat, which helps delineation

T2-weighted images:

  • Nodes appear intermediate to mildly hyperintense

  • Pathological nodes may show heterogeneous hyperintensity

STIR:

  • Fat suppression makes nodes more conspicuous against the omental fat

  • Enlarged or inflamed nodes appear hyperintense

T1 Fat-Saturated Post-Contrast (Gadolinium):

  • Normal nodes enhance mildly and homogeneously

  • Malignant or inflamed nodes may show heterogeneous or rim enhancement

  • Useful for detecting micrometastatic involvement in gastric cancer

MRI Non-Contrast 3D Imaging:

  • Allows volumetric mapping of nodal chains along lesser curvature relative to gastric wall

  • Helps in oncological staging and surgical planning

CT Appearance

CT Pre-Contrast:

  • Nodes appear as small soft tissue densities along lesser curvature, often difficult to distinguish without contrast

CT Post-Contrast:

  • Nodes enhance moderately and uniformly if benign

  • Malignant nodes may appear irregular, necrotic, or conglomerated

  • Detects nodal spread to celiac nodes and hepatogastric ligament

CT Venography (CTV):

  • Provides 3D mapping of lymph nodes and their relation to gastric vessels

  • Useful in gastric cancer staging, lymphadenectomy planning, and vascular invasion assessment

CT image

Lesser curvature lymph nodes axial ct image