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Image Description

Primary lymph nodes draining the urinary bladder include perivesical, internal and external iliac, and obturator nodes. Sacral lymph nodes are also classified as a primary drainage region; however, they are less frequent site of primary regional metastases in bladder malignancies. Primary nodal regions drain into the secondary nodes consisting of the common iliac lymph nodes.

This image shows micropapillary variant of urothelial carcinoma of bladder in a common iliac lymph node. Note that the micropapillary architecture is preserved in the metastases.

Regional lymph node staging is of prognostic significance in bladder cancer. Involvement of regional lymph nodes increases the risk of recurrence following treatment and negatively impacts long-term survival.

Image 24 of 30