The external iliac lymph nodes can be found surrounding the external iliac artery and act as the draining nodes for several regions of the pelvis and lower limb.
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Gross anatomy
The external iliac lymph nodes lie anterior to the internal iliac lymph nodes and usually form three separate subgroups according to their relation to the external iliac artery:
lateral (considered the main channel of drainage)
medial
anterior
The efferent channels pass on towards the common iliac nodes. The nodes collect lymph from the:
infraumbilical abdominal wall
adductor region of the thigh
membranous urethra
fundus of the urinary bladder
uterine cervix and upper vagina 1
Radiographic features
Structural features remain as diagnostic standards for evaluation of pelvic lymph nodes. The size threshold of pelvic nodes ranges from 0.5 to 2 cm. A short axis diameter <1 cm in oval nodes or <0.8 cm in round nodes is considered the upper limit of normal 2. Using these parameters, the specificity for detecting positive pelvic nodes on CT reaches 97%, but with a low sensitivity of 34% 3.
Related pathology
The external iliac nodes are an important nodal group when considering lymphatic spread of pelvic malignancy. The lymphatic drainage patterns of urogenital malignancies are complex in the pelvis; however, spread from the pelvic organs to the medial chain of the external iliac nodal group is the most common route through which metastasis can occur 4.
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