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The pyramidal lobe: Connecting a case study with lymphatic system topics in gross anatomical education

The pyramidal lobe is a variably present structure extending superiorly from the midline of the thyroid gland. A remnant of the thyroglossal duct, the pyramidal lobe may harbor precricoid (also known as Delphian) lymph nodes, which receive lymphatic drainage predominantly from the larynx, pyriform sinus, and thyroid gland. The grossly visible presence of precricoid lymph nodes can serve as an indication of metastasis of head and neck cancers. A sixty‐one year old male donor present in a human anatomy course displayed a shockingly pronounced pyramidal lobe, measuring nine centimeters in length. This individual also displayed several small swellings in the center of the pyramidal lobe where the precricoid lymph nodes frequently rest. This donor's cause of death was metastatic salivary gland carcinoma, and therefore involvement of the precricoid lymph nodes is an intriguing possibility. This case highlights the importance of the lymphatic system in gross anatomical education. Unfortunately, the lymphatic system may not be examined extensively in gross anatomy laboratory settings in part due to reduction in course hours and this system's relative inconspicuousness and fragility in dissection. However, this case study brings to light the clinical importance of seemingly insignificant segments of the lymphatic system as well as the necessity of comprehensive gross anatomical education on this topic.