[Durgical](https://durgical.com/en/) › [DurgiPedia](https://durgical.com/en/durgipedia/) › [Anatomy](https://durgical.com/en/anatomy/) › [Abdomen](https://durgical.com/en/anatomy/region/abdomen/) › Para-aortic lymph nodes

[Lymphatic system](https://durgical.com/en/anatomy/system/lymphatic-system/) · [Abdomen](https://durgical.com/en/anatomy/region/abdomen/)

# Para-aortic lymph nodes

The lumbar nodes are lymph nodes along the aorta and vena cava at the back of the [abdomen](https://durgical.com/en/anatomy/region/abdomen/); they drain the [kidneys](https://durgical.com/en/anatomy/kidney/), the testes or ovaries and the legs' lymph.

Official name: Intermediate lumbar nodes

[See in 3D →](https://durgical.app/?from=durgipedia&lang=en#region=abdomen&select=lumbar_nodes&side=r)

Opens in the Durgical app, no sign-up needed.

## What it is

Lymph nodes around the aorta and vena cava (para-aortic).

## What it does

Collect lymph from the kidneys, testes, legs and [pelvis](https://durgical.com/en/anatomy/region/pelvis/); testicular cancer spreads here first.

## Key points

- The [testis](https://durgical.com/en/anatomy/testis/) drains to para-aortic nodes near the renal vessels (about L1–L2), not to the groin, because it descended from the posterior abdominal wall with its lymphatics
- Scrotal [skin](https://durgical.com/en/anatomy/skin/), by contrast, drains to the [superficial inguinal nodes](https://durgical.com/en/anatomy/superficial-inguinal-nodes/)
- Right testis spreads first to interaortocaval nodes; left testis to the left para-aortic nodes just below the left renal vein
- The [ovary](https://durgical.com/en/anatomy/ovary/) also drains to para-aortic nodes, along the ovarian vessels

## Key facts

**Where**
Para-aortic chain around aorta and IVC: left lumbar (lateral aortic), intermediate (aortocaval) and right lumbar (caval) nodes

**Drains**
Kidneys, adrenals, testes or ovaries, [uterine tubes](https://durgical.com/en/anatomy/uterine-tube/), posterior abdominal wall; common iliac nodes (pelvis, lower limbs)

**Into**
Right and left lumbar trunks, then cisterna chyli

## Relations

**In front**
Preaortic node groups and the [left renal vein](https://durgical.com/en/anatomy/right-renal-vein/) crossing the aorta; the third part of the [duodenum](https://durgical.com/en/anatomy/duodenum/) and the [pancreas](https://durgical.com/en/anatomy/pancreas/)

**Behind**
Lumbar vertebral bodies, lumbar vessels and the origins of [psoas major](https://durgical.com/en/anatomy/psoas-major/); retroaortic and retrocaval nodes

**Lateral**
Left group on the left psoas major near the left [ureter](https://durgical.com/en/anatomy/ureter/) and [sympathetic trunk](https://durgical.com/en/anatomy/sympathetic-trunk/); right group around the [inferior vena cava](https://durgical.com/en/anatomy/inferior-vena-cava/)

**Above**
The lumbar lymph trunks rising to the [cisterna chyli](https://durgical.com/en/anatomy/cisterna-chyli/) at about L1–L2

**Below**
The [common iliac nodes](https://durgical.com/en/anatomy/common-iliac-nodes/) below the aortic bifurcation

## How to find it

Not palpable when normal. They lie around the aorta and the inferior vena cava from the renal vessels down to the aortic bifurcation; in retroperitoneal dissection they are cleared from the paracaval, interaortocaval and para-aortic zones, within templates that spare the sympathetic nerves needed for ejaculation.

## On imaging

CT or MRI stages them; bulky retroperitoneal nodes can lift the aorta off the [spine](https://durgical.com/en/anatomy/region/spine/) (the floating aorta sign, typical of lymphoma). PET-CT is used in lymphoma and other cancers.

## Common problems

- Cancers of the [stomach](https://durgical.com/en/anatomy/stomach/) and pancreas spread to them; surgeons remove them with the tumour.

## Clinical notes

- Testicular cancer: the retroperitoneal nodes are the first station; orchiectomy is done through the groin, not the [scrotum](https://durgical.com/en/anatomy/scrotum/), so as not to open new lymph routes
- Retroperitoneal lymph node dissection can cause chylous ascites and, if nerves are not spared, loss of ejaculation
- Para-aortic spread upstages cervical and endometrial cancer and widens the radiotherapy field
- Lymphoma and tuberculosis cause retroperitoneal node enlargement with fever and weight loss; both are relevant in Colombia

## Test yourself

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

## To which nodes does the testis drain, and why?

To the para-aortic nodes near the renal vessels (about L1–L2), not the groin, because the testis descended from the posterior abdominal wall with its lymphatics.

## Where does the lymph of the scrotal skin drain?

To the superficial inguinal nodes, unlike the testis.

## What is the first nodal station for right and left testicular cancer?

Right testis: the interaortocaval nodes. Left testis: the left para-aortic nodes just below the left renal vein.

## Why is orchiectomy for testicular cancer done through the groin?

So as not to open new lymph routes through the scrotum; the retroperitoneal nodes are the first station.

## What does the floating aorta sign on CT suggest?

Lymphoma: bulky retroperitoneal nodes lift the aorta off the spine.

[Add to my cards (5)](https://durgical.app/estudiar/?add=/en/anatomy/intermediate-lumbar-nodes/)

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

## Its names

**Official Latin (TA2)**
nodi lumbales intermedii; nodi preaortici; nodi lumbales sinistri TA2 5274

**Official Spanish (DeCS)**
Nódulos linfáticos lumbares DeCS D008198

**English (TA2)**
Intermediate lumbar nodes

**Also called**
nodi lumbares intermedii

Sources: Terminologia Anatomica (TA2); [DeCS](https://decs.bvsalud.org/es/ths/resource/?id=8375); [Anatomy, Abdomen and Pelvis: Lymphatic Drainage](https://www.ncbi.nlm.nih.gov/books/NBK557720/).

## **Spotted a mistake?** We are always improving for the community. Tell us what is wrong and our team will review it. Report a mistake

Representative model, for educational purposes only.

---
Source: https://durgical.com/en/anatomy/intermediate-lumbar-nodes/
License: CC BY 4.0 (https://creativecommons.org/licenses/by/4.0/). Cite as: DurgiPedia (durgical.com), https://durgical.com/en/anatomy/intermediate-lumbar-nodes/