The axillary arch of Langer is a frequent axillary muscular anomaly that might complicate sentinel lymph node biopsy by altering the position of the sentinel lymph node.1,2 Based on a case series of eight patients over three years, sentinel lymph nodes were found lateral to the axillary arch of Langer in the sub-pectoral region and were associated with stretching of the efferent lymphatic vessels around the axillary arch of Langer (figs 1 and 2). It is important to anticipate this anatomical variation during sentinel lymph node biopsy and to document its presence, particularly if axillary lymph node dissection is subsequently required in a distorted and anatomically abnormal field.
Figure 1.
The sentinel lymph node in relation to the axillary arch of Langer in the right axilla.
Figure 2.
The normal and aberrant axillary lymphatic pathways in the presence of the axillary arch of Langer.
References
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