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Lymphatic system · Upper limb

Central axillary nodes !

The central axillary nodes lie in the fat in the middle of the armpit; they collect lymph from the other axillary groups.

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What it is

Nodes deep in the fat at the base of the armpit, behind pectoralis minor (level II).

What it does

Collect lymph from the anterior, posterior and lateral groups and pass it to the apical nodes.

Key facts

Where
Axillary fat at the base of the axilla, behind pectoralis minor (level II)
Drains
Anterior, posterior and lateral axillary groups
Into
Apical axillary nodes

Relations

Course
Lymph enters from the pectoral, subscapular and lateral groups and leaves upward toward the apical nodes along the axillary vein
In front
Pectoralis minor and, in front of it, pectoralis major
Medial
The chest wall and serratus anterior, with the long thoracic nerve
Lateral
The axillary vein and artery, with the lateral axillary nodes along the vein
Below
The axillary fascia and the skin of the armpit

How to find it

The examiner supports the person's forearm, slides the cupped fingers high into the axilla and presses its contents against the chest wall, then draws the fingers down; enlarged central nodes roll under them.

Common problems

  • The axillary nodes most often felt when enlarged, pressed against the chest wall.
  • Large nodes here can press on the intercostobrachial nerve and cause pain in the inner arm.

How it is diagnosed

Examination of the armpit and ultrasound with a needle biopsy; in breast cancer, the sentinel node is found with a tracer during surgery.

Treatment

  • Sentinel node biopsy: only the first one to three nodes are removed and checked.
  • Axillary dissection (levels I–II) or radiotherapy when the nodes contain cancer; arm swelling (lymphoedema) is the main risk.

Clinical notes

  • Often the first palpable axillary nodes in breast cancer, lymphoma and arm or chest infections
  • Injury to the intercostobrachial nerve during their removal causes numbness or burning pain of the inner arm and axilla, part of post-mastectomy pain
  • A suppurating node here (axillary abscess) is told apart from hidradenitis suppurativa, which involves the sweat glands of the skin

Test yourself

Think of the answer, then tap the question to see it.

Which axillary groups drain into the central nodes?

The anterior (pectoral), posterior (subscapular) and lateral (humeral) groups; the central nodes then drain to the apical group.

Which nerve passes through the central axillary nodes and what follows its injury?

The intercostobrachial nerve; injury leaves numbness or pain of the inner upper arm and axilla.

Which surgical level do the central axillary nodes usually belong to?

Level II, behind pectoralis minor (some texts: level I).

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Educational information, not medical advice. For any symptom, see a health professional.

Its names

Official Latin (TA2)
nodi axillares centrales TA2 5238
Official Spanish (DeCS)
Nódulos linfáticos axilares centrales
English (TA2)
Central axillary nodes

Sources: Terminologia Anatomica (TA2); Anatomía humana (4.ª ed.), tomo 1, cap. 61: Vasos y ganglios linfáticos del miembro superior; Anatomy, Shoulder and Upper Limb, Axillary Lymph Nodes.

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Representative model, for educational purposes only.