After a biopsy of a cervical leukoplakia shows invasive squamous cell carcinoma, to which lymph nodes will lymph most likely drain first?

• A. Femoral
• B. Superficial inguinal
• C. Internal iliac
• D. Lumbar

Answer: (C)

Invasive squamous cell carcinoma of the cervix primarily drains lymphatic fluid to the local lymph nodes associated with the pelvic region. The first lymph nodes to receive drainage from cervical tissues are typically the internal iliac nodes. These nodes are located laterally to the cervix and are a key component of the pelvic lymphatic system.

The internal iliac lymph nodes receive lymphatic drainage from the cervix and then can further drain into the common iliac nodes and subsequently to the lumbar and paraaortic nodes. However, the initial drainage from a cervical lesion, especially one that is invasive, involves the internal iliac lymph nodes.

Understanding this pathway is crucial for assessing cancer spread and planning treatment. Other lymph nodes mentioned, like the femoral, superficial inguinal, and lumbar nodes, do not serve as the first site of lymphatic drainage for cervical cancer, which emphasizes the significance of the internal iliac nodes in this context.