The lymphatic drainage of the upper abdominal viscera is extensive. Lymph nodes are found along the course of all major venous structures. For convenience of reference, there are four major zones of lymph node aggregations. The superior gastric lymph nodes (A) are located about the celiac axis and receive the lymphatic channels from the lower esophageal segment and the major portion of the lesser curvature of the stomach, as well as from the pancreas. The suprapyloric lymph nodes (B) about the portal vein drain the remaining portion of the lesser curvature and the superior aspect of the pancreas. The inferior gastric subpyloric group (C), which is found anterior to the head of the pancreas, receives the lymph drainage from the greater curvature of the stomach, the head of the pancreas, and the duodenum. The last major group is the pancreaticolienal nodes (D), which are found at the hilus of the spleen and drain the tail of the pancreas, the fundus of the stomach, and the spleen. There are extensive communications among all these groups of lymph nodes. The major lymphatic depot, the cisterna chyli, is found in the retroperitoneal space. This communicates with the systemic venous system by way of the thoracic duct into the left subclavian vein. This gives the anatomic explanation for the involvement of Virchow's node in malignant diseases involving the upper abdominal viscera.