Lymphadenopathy in the mesenteric pedicle of the free jejunal flap: reactive lymphadenopathy, not metastatic

Reconstructive surgery using the free jejunal flap is sometimes performed to close surgical defects in patients undergoing pharyngolaryngectomy for laryngeal or hypopharyngeal cancer. The clinical significance of lymph nodes in the flap was retrospectively examined. Fifteen patients had undergone a laryngectomy with free jejunal flap reconstruction between March 1996 and October 1999. The appearance and size of lymph nodes of the flap were examined by 3 radiologists. Lymph nodes were observed in 10 patients. Size increases were noted within 1 year after surgery but not beyond 1 year. The pathologic diagnosis of the excised nodes was reactive lymphadenopathy. Lymph nodes may occasionally become apparent in the free jejunal flap. There was no suggestion of metastatic lymph nodes when examined retrospectively. We speculate that this reaction was the result of environmental changes attributable to surgery.