Lymph nodes on back of neck diagram. Thoracic Lymph Nodes: Anatomy, Function, and Clinical Significance

18.12.202019.07.2023 by alexxlab

What are thoracic lymph nodes and where are they located. How do thoracic lymph nodes contribute to the immune system. Why are thoracic lymph nodes important for disease diagnosis. What conditions can affect thoracic lymph nodes.

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Types and Location of Thoracic Lymph Nodes

Thoracic lymph nodes play a crucial role in the body’s immune system and are strategically positioned throughout the chest cavity. These nodes are categorized into two main types:

Parietal lymph nodes: Located in the thoracic wall
Visceral lymph nodes: Associated with internal organs

The location of thoracic lymph nodes makes them challenging to detect through physical examination. However, their position is vital for monitoring various pulmonary and extrapulmonary diseases.

Subcategories of Thoracic Lymph Nodes

For diagnostic purposes, thoracic lymph nodes are further divided into several subcategories:

Lung lymph nodes: Found along the bronchi
Paratracheal lymph nodes: Located in the neck
Tracheobronchial lymph nodes: Situated at the junction where the trachea meets the bronchi
Posterior mediastinal lymph nodes: Positioned near the thoracic aorta
Chest wall thoracic lymph nodes: Receive drainage from various upper chest structures

Function and Drainage Patterns of Thoracic Lymph Nodes

Thoracic lymph nodes serve as crucial components of the lymphatic system, playing a vital role in immune function and fluid balance. Their primary functions include:

Filtering lymph fluid
Trapping pathogens and foreign particles
Facilitating immune responses

Each group of thoracic lymph nodes has specific drainage patterns:

Paratracheal and Tracheobronchial Lymph Nodes

These nodes accept drainage from:

Heart
Lungs
Bronchi
Thoracic trachea
Other lymph nodes

Posterior Mediastinal Lymph Nodes

This group is closely linked to the tracheobronchial nodes and primarily drains into the thoracic duct.

Chest Wall Thoracic Lymph Nodes

These nodes receive drainage from:

Breasts
Arms
Pectoral muscles
Other muscles and skin in the upper chest region

Clinical Significance of Thoracic Lymph Nodes

Thoracic lymph nodes hold considerable clinical importance in various medical contexts. Changes in their size or number can indicate underlying health issues.

Diagnostic Value

Abnormalities in thoracic lymph nodes can be indicative of several conditions:

Pulmonary diseases
Extrapulmonary diseases
Metastatic cancer
Infections
Inflammatory disorders

How are thoracic lymph node abnormalities detected. Medical imaging techniques such as CT scans, MRI, and PET scans are commonly used to visualize and assess thoracic lymph nodes. These methods allow healthcare professionals to identify enlargement, structural changes, or abnormal patterns that may indicate disease.

Lymph Node Staging in Cancer

In oncology, thoracic lymph nodes play a crucial role in cancer staging, particularly for lung cancer and breast cancer. The extent of lymph node involvement helps determine the stage of cancer and guides treatment decisions.

Imaging Techniques for Thoracic Lymph Node Assessment

Several imaging modalities are employed to evaluate thoracic lymph nodes:

Computed Tomography (CT): Provides detailed cross-sectional images of the chest
Magnetic Resonance Imaging (MRI): Offers high-resolution soft tissue imaging
Positron Emission Tomography (PET): Detects metabolic activity in lymph nodes
Endobronchial Ultrasound (EBUS): Allows real-time visualization and biopsy of lymph nodes

Which imaging technique is most appropriate for thoracic lymph node evaluation. The choice depends on the specific clinical scenario, suspected pathology, and patient factors. Often, a combination of imaging modalities is used for comprehensive assessment.

Diseases Affecting Thoracic Lymph Nodes

Thoracic lymph nodes can be affected by various pathological conditions:

Malignancies

Lung cancer
Lymphoma
Metastatic breast cancer
Esophageal cancer

Infectious Diseases

Tuberculosis
Fungal infections
Viral pneumonias

Inflammatory Conditions

Sarcoidosis
Silicosis
Berylliosis

How do these conditions affect thoracic lymph nodes. Diseases can cause lymph node enlargement (lymphadenopathy), changes in internal structure, or abnormal metabolic activity. These alterations can be detected through imaging studies and may require further investigation, such as biopsy, for definitive diagnosis.

Thoracic Lymph Nodes in Immunology

Thoracic lymph nodes are integral components of the body’s immune defense system. They play several key roles in immunological processes:

Antigen Presentation

Thoracic lymph nodes serve as sites where antigen-presenting cells interact with T lymphocytes, initiating adaptive immune responses.

B Cell Activation

These nodes provide an environment for B cells to encounter antigens, leading to their activation and differentiation into antibody-producing plasma cells.

Cytokine Production

Activated immune cells within thoracic lymph nodes produce various cytokines, which regulate immune responses and inflammation.

Memory Cell Formation

Thoracic lymph nodes contribute to the development of immunological memory, enabling rapid responses to previously encountered pathogens.

How do thoracic lymph nodes contribute to overall immune function. By facilitating these immunological processes, thoracic lymph nodes help protect the respiratory system and surrounding tissues from infections and other harmful agents.

Surgical Considerations for Thoracic Lymph Nodes

Thoracic lymph nodes are often involved in various surgical procedures, particularly in oncology:

Lymph Node Dissection

In cancer surgeries, such as lung cancer resection or esophagectomy, thoracic lymph node dissection is often performed to accurately stage the disease and improve prognosis.

Sentinel Lymph Node Biopsy

This technique is sometimes used in breast cancer surgery to identify and examine the first lymph node(s) to which cancer is likely to spread.

Minimally Invasive Approaches

Video-assisted thoracoscopic surgery (VATS) and robotic-assisted thoracic surgery have revolutionized access to thoracic lymph nodes, allowing for less invasive procedures.

What are the potential complications of thoracic lymph node surgery. Possible risks include bleeding, infection, nerve injury, and lymphedema. The extent of lymph node removal must be balanced against the potential for these complications.

Future Directions in Thoracic Lymph Node Research

Ongoing research into thoracic lymph nodes is focused on several promising areas:

Advanced Imaging Techniques

Development of more sensitive and specific imaging modalities for early detection of lymph node metastases.

Immunotherapy Targets

Exploration of thoracic lymph nodes as potential targets for cancer immunotherapies.

Liquid Biopsy

Investigation of blood-based biomarkers that could provide information about thoracic lymph node status without invasive procedures.

Artificial Intelligence

Application of machine learning algorithms to improve the accuracy of lymph node assessment in medical imaging.

How might these advancements impact patient care. These developments could lead to earlier disease detection, more precise staging, and personalized treatment strategies, ultimately improving outcomes for patients with thoracic diseases.

Thoracic lymph nodes, while often overlooked, play a crucial role in maintaining health and combating disease. Their strategic location within the chest cavity makes them vital sentinels of the immune system, constantly monitoring for potential threats. Understanding the anatomy, function, and clinical significance of thoracic lymph nodes is essential for healthcare professionals across various specialties, from pulmonology to oncology.

As medical technology advances, our ability to assess and utilize thoracic lymph nodes in diagnosis and treatment continues to improve. From sophisticated imaging techniques to targeted therapies, these small but mighty structures remain at the forefront of medical research and clinical practice. By continuing to unlock the secrets of thoracic lymph nodes, we pave the way for more effective disease prevention, earlier detection, and improved patient outcomes in the realm of thoracic health.

Thoracic Lymph Nodes Anatomy, Diagram & Function

Thoracic Lymph Nodes Anatomy, Diagram & Function | Body Maps

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Medically reviewed by the Healthline Medical Network — By The Healthline Editorial Team on July 6, 2020

Thoracic lymph nodes are separated into two types: parietal lymph nodes located in the thoracic wall, and visceral lymph nodes, which are associated with the internal organs. Due to their location, abnormalities of the lymph nodes in the thorax, or chest, are not easily detected. However, any changes in the size or amount of these lymph nodes could be indicative of several types of extrapulmonary or pulmonary diseases. For diagnostic purposes, lymph nodes of the thorax can be further divided into sub-categories. The lung lymph nodes can be found along the bronchi. The paratracheal and tracheobronchial groups of lymph nodes are located in the neck and also in the junction where the trachea meets the bronchi, respectively. These accept drainage from the heart, lungs, bronchi, and thoracic trachea as well as other lymph nodes. The posterior mediastinal group of lymph nodes, located near the thoracic aorta, is closely linked to the tracheobronchial group and primarily drains into the thoracic duct. The chest wall thoracic lymph nodes receive drainage from the breasts, arms, pectoral muscles, and other muscles and skin located in the upper section of the chest.

Last medically reviewed on July 6, 2020

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Medically reviewed by the Healthline Medical Network — By The Healthline Editorial Team on July 6, 2020

Cervical lymph nodes: anatomy, groups and drainage

Author:
Roberto Grujičić MD
•
Reviewer:
Dimitrios Mytilinaios MD, PhD

Last reviewed: December 05, 2022

Reading time: 3 minutes

Superficial anterior cervical lymph nodes

Nodi lymphoidei cervicales anteriores superficiales

1/7

Synonyms:
Nodi lymphatici cervicales anteriores superficiales, Lymphonodi cervicales anteriores superficiales

The cervical lymph nodes, commonly known as the lymph nodes of the neck, are a large group of lymph nodes that can be classified into several groups. These groups of nodes include:

The superficial anterior cervical lymph nodes that are situated adjacent to the anterior jugular vein. These nodes drain lymph from the infrahyoid region, isthmus of the thyroid gland, inferior larynx to the deep lateral cervical lymph nodes.

The deep anterior cervical lymph nodes that are situated mostly in the midline and can be divided into four groups of nodes including the prelaryngeal, thyroid, paratracheal and pretracheal nodes. They drain lymph from the larynx, trachea, and thyroid to the deep lateral cervical lymph nodes.

The superficial lateral cervical lymph nodes that are situated adjacent to the external jugular vein. They drain lymph from the parotid nodes to the supraclavicular nodes.

The deep lateral cervical lymph nodes that are situated adjacent to the internal jugular vein. They can be subdivided into superior and inferior groups. These nodes receive the majority of lymph from the head and neck region and drain to the jugular trunk.

The accessory lymph nodes that are the most lateral group of cervical nodes, located adjacent to the accessory nerve. These nodes drain lymph from the lateral neck, pharynx and shoulder regions and empty into the supraclavicular nodes.

The supraclavicular lymph nodes that are situated at the root of the neck. These nodes receive lymph from the deep lateral cervical lymphatic vessels and empty into the jugular trunk on each side.

The retropharyngeal lymph nodes that are situated posterior to the pharynx. These nodes receive afferents from the nasal cavities, paranasal sinuses, soft palate, palatine arch, outer and middle ear and drain into the superior and inferior deep lateral cervical lymph nodes of the neck.

In summary, all lymphatic vessels from the head and neck drain directly or indirectly into the deep cervical lymph nodes. Lymph from these deep nodes passes to the jugular lymphatic trunk, which joins the thoracic duct on the left side and the internal jugular vein or brachiocephalic vein on the right side.

Terminology	English: Cervical lymph nodes English synonym: Lymph nodes of the neck Latin: Nodi lymphoidei cervicales Latin synonyms: Nodi lymphatici cervicales, Lymphonodi cervicales
Main groups	Superficial anterior cervical lymph nodes Deep anterior cervical lymph nodes Superficial lateral cervical lymph nodes Deep lateral cervical lymph nodes Accessory lymph nodes Supraclavicular lymph nodes Retropharyngeal lymph nodes
Function	Lymph nodes of the neck filter and transport lymph from surrounding lymph nodes and viscera back into the bloodstream

Test your knowledge on the lymphatics of the head and neck with this quiz.

Learn all about the lymph nodes of the head and neck with the following study unit:

Lymphatics of the head and neck

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All content published on Kenhub is reviewed by medical and anatomy experts. The information we provide is grounded on academic literature and peer-reviewed research. Kenhub does not provide medical advice. You can learn more about our content creation and review standards by reading our content quality guidelines.

Lambert SM. Shoulder girdle and arm. In: Gray’s Anatomy: The Anatomical Basis of Clinical Practice. 41st ed. Elsevier; 2016. p. 834.

Richter E, Feyerabend T. Normal lymph node topography: CT atlas. Springer; 2004.

Iwanaga J, Lofton C, He P, Dumont AS, Tubbs RS. Lymphatic System of the Head and Neck. J. Craniofac. Surg. 2021;32(5):1901–5.

Kyriacou H, Khan YS. Anatomy, Shoulder and Upper Limb, Axillary Lymph Nodes. StatPearls. 2021;

Cervical lymph nodes: want to learn more about it?

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Lymph nodes : normal anatomy

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Literature

Terminologia Anatomica: International Anatomical Terminology – FCAT Federative Committee On Anatomical Terminology, Federative Committee on Anatomical Terminology – Thieme, 1998 – ISBN 3131152516, 9783131152510
Selection and delineation of lymph node target volumes in head and neck conformal radiotherapy. Proposal for standardizing terminology and procedure based on the surgical experience. Grégoire V, Coche E, Cosnard G, Hamoir M, Reychler H. Radiother Oncol. 2000 Aug;56(2):135-50. Review.PMID: 10927132
CT-based definition of thoracic lymph node stations: an atlas from the University of Michigan.Chapet O, Kong FM, Quint LE, Chang AC, Ten Haken RK, Eisbruch A, Hayman JA.Int J Radiat Oncol Biol Phys. 2005 Sep 1;63(1):170-8.
Definition of the supraclavicular and infraclavicular nodes: implications for three-dimensional CT-based conformal radiation therapy. Madu CN, Quint DJ, Normolle DP, Marsh RB, Wang EY, Pierce LJ. Radiology. 2001 Nov;221(2):333-9.
Standardizing Neck Dissection Terminology: Official Report of the Academy’s Committee for Head and Neck Surgery and Oncology
K. Thomas Robbins; Jesus E. Medina; Gregory T. Wolfe; Paul A. Levine; Roy B. Sessions; Charles W. Pruet
Arch Otolaryngol Head Neck Surg. 1991;117(6):601-605.

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What to do if the lymph nodes in the neck are inflamed

The enlargement of the lymph nodes in the neck, as a rule, occurs as a result of contact with bacteria and viruses. If the enlargement is caused by an infection, it is called lymphadenitis. Rarely, cancer can be the cause.

The lymphatic system plays a vital role in keeping our body alive and is a major component of our immunity. Lymph nodes can be felt in the neck, chin, armpits and groin. In some cases, no action is required for treatment and a warm compress is enough. Treatment depends on the cause.

Symptoms

The lymphatic system includes a network of organs and lymph nodes located throughout the body. Most of them are in the head and neck area. Swollen lymph nodes indicate that something is wrong in the body. The first signs are sensitivity, soreness and an increase in lymph nodes to the size of a bean and even more.

Depending on the cause of the appearance, the symptoms of the disease may be as follows:

Runny nose, sore throat, fever and other signs of an upper respiratory tract infection.
Swollen lymph nodes throughout the body may indicate HIV, mononucleosis, or immune disorders such as lupus or rheumatoid arthritis.
Swollen limbs may indicate a blockage in the lymphatic system caused by tumors in the lymph nodes that are deep under the skin and cannot be felt.

When treatment of lymph nodes in the neck requires a visit to a doctor

Lymph nodes return to normal over time if the cause of the increase was an infection that could be treated. But there are a number of factors in which you should consult a doctor:

Swelling without apparent cause
Duration 2-4 weeks
Knots are difficult to feel and do not move when pressed
Associated with persistent fevers, night sweats and weight loss
Accompanied by sore throat and difficulty swallowing.

Why lymph nodes in the neck become inflamed – causes

A lymph node is a small, round or bean-shaped cluster of cells covered with a capsule of connective tissue. The cells are a combination of lymphocytes that produce protein particles that fight viruses and macrophages that break down harmful substances. Lymphocytes and macrophages filter the lymphatic fluid that flows throughout the body and protects us.

Lymph nodes are located in groups, each of which serves a specific area of the body. An increase in a specific area may suggest a cause. The most common is an infection, especially a viral one, such as a cold. But there are other types0019 lymphadenitis of the cervical lymph nodes , such as parasitic or bacterial, which can cause enlargement of the lymph nodes.

Common infections:

Measles
Ear infections
Infection of the tooth – abscess
Mononucleosis
Skin infections
HIV

Atypical infections:

Tuberculosis
Sexually transmitted (syphilis and others)
Toxoplasmosis
Cat scratch bacterial infection

Autoimmune diseases:

Lupus
Rheumatoid arthritis

Cancer:

Lymphoma
Leukemia
Other cancers that have spread to lymph nodes

Complications

If the cause is an infection and not properly treated, complications may occur.

Abscess formation. Localization of the accumulation of pus caused by infection. Pus contains fluid, white blood cells, dead tissue, bacteria, and other harmful elements. If an abscess occurs, drainage or antibiotic treatment may be required. Significant damage can be done if vital organs are affected.

Bloodstream infection. Bacterial, can start anywhere in your body and progress to sepsis caused by significant blood poisoning. Sepsis can lead to multiple organ failure and death. Treatment includes hospitalization and intravenous antibiotics.

Diagnosis

To diagnose an illness, your doctor may need to:

Medical history
Medical examination
Blood test
Chest x-ray and computed tomography
Lymph node biopsy (as a last resort).

Treatment of lymph nodes in the neck

If the cause is a virus, the lymph nodes in the neck will recover on their own after the infection itself is treated. But if this does not happen or there is another reason, the following treatment may be required:

Infection.