An invasion of the gastric lymphatic glands occurs in every case, but it is comparatively rare for their enlargement to produce any special symptoms. Occasionally, however, the great bulk of a pyloric tumour is found to consist of cancerous glands, and in rare instances an early infection of those in the portal fissure gives rise to jaundice or ascites. Disease of the cceliac glands may produce partial obstruction of the aorta or vena cava, and occasionally gives rise to a palpable tumour.
Disease of the posterior mediastinal glands is rarely accompanied by special symptoms, but occasionally attacks of spasmodic dyspnoea, palpitation, or tachycardia ensue from compression of the vagi or sympathetic nerves (Mathieu). Metastases situated between the oesophagus and trachea, below the thyroid, are responsible for the paralysis of the left recurrent laryngeal nerve which is sometimes observed (Bristowe). Enlargement of the superficial glands has already been discussed (p. 175).