[Durgical](https://durgical.com/en/) › [DurgiPedia](https://durgical.com/en/durgipedia/) › [Anatomy](https://durgical.com/en/anatomy/) › [Chest](https://durgical.com/en/anatomy/region/chest/) › Mediastinal lymph nodes [Lymphatic system](https://durgical.com/en/anatomy/system/lymphatic-system/) · [Chest](https://durgical.com/en/anatomy/region/chest/) # Mediastinal lymph nodes The mediastinal lymph nodes sit in the centre of the [chest](https://durgical.com/en/anatomy/region/chest/) around the airways and heart; they filter lymph from the lungs and chest organs. [See in 3D →](https://durgical.app/?from=durgipedia&lang=en#region=thorax&select=mediastinal_lymph_nodes&side=r) Opens in the Durgical app, no sign-up needed. ## What it is Lymph nodes around the trachea, bronchi, heart and esophagus. ## What it does Filter lymph from the lungs and chest organs. ## Key points - Lung cancer staging uses numbered nodal stations: spread to same-side mediastinal or subcarinal nodes is N2; opposite-side or supraclavicular nodes is N3 - Lymph from the [left lower lobe](https://durgical.com/en/anatomy/inferior-lobe-of-left-lung/) often crosses to the right paratracheal nodes, so a left lung tumour can spread to the right mediastinum - Enlarged subcarinal nodes widen the angle of the carina and can indent the esophagus and the left atrium - Lymph from the heart follows the coronary arteries: the left trunk drains to the tracheobronchial (subcarinal) nodes, the right trunk runs along the aorta to anterior mediastinal nodes near the arch ## Key facts **Where** Anterior mediastinal, paratracheal, tracheobronchial (including subcarinal), bronchopulmonary (hilar), posterior mediastinal **Drains** Lungs and bronchi (pulmonary to hilar to tracheobronchial to paratracheal), heart, [pericardium](https://durgical.com/en/anatomy/pericardium/), esophagus, thymus **Into** Bronchomediastinal trunks, then [thoracic duct](https://durgical.com/en/anatomy/thoracic-duct/), right lymphatic duct or venous angles ## Relations **In front** Prevascular nodes in front of the great vessels and [brachiocephalic veins](https://durgical.com/en/anatomy/brachiocephalic-vein/), near the [thymus](https://durgical.com/en/anatomy/thymus/) **Lateral** Paratracheal nodes on each side of the [trachea](https://durgical.com/en/anatomy/trachea/) and hilar nodes at each lung root; on the left, subaortic nodes in the aortopulmonary window beside the left [recurrent laryngeal nerve](https://durgical.com/en/anatomy/recurrent-laryngeal-nerve/) **Below** Subcarinal nodes below the tracheal bifurcation, in front of the [esophagus](https://durgical.com/en/anatomy/esophagus-abdominal-part/) and above the [left atrium](https://durgical.com/en/anatomy/left-atrium/) **Behind** Paraesophageal and para-aortic nodes in the posterior mediastinum, along the esophagus and descending aorta ## How to find it Not palpable. They are named by numbered stations on CT and PET: 1 low cervical and supraclavicular, 2 and 4 paratracheal, 3 prevascular and retrotracheal, 5 subaortic, 6 para-aortic, 7 subcarinal, 8 paraesophageal, 9 pulmonary ligament and 10 hilar. Stations 2, 4 and 7 are reached by EBUS or mediastinoscopy. ## On imaging On CT a node over about 1 cm in short [axis](https://durgical.com/en/anatomy/axis/) is usually called enlarged; PET-CT adds metabolic activity. On a frontal X-ray, enlargement widens the right paratracheal stripe or fills the aortopulmonary window. Calcified nodes suggest old tuberculosis or fungal infection; eggshell calcification suggests silicosis or sarcoidosis. ## Common problems - Enlarge with infections, sarcoidosis or cancer; checking them is key to staging lung cancer. ## How it is diagnosed CT and PET scans; biopsy through a bronchoscope (EBUS). ## Clinical notes - Sampled by endobronchial ultrasound-guided needle aspiration (EBUS) or by cervical mediastinoscopy; aortopulmonary window nodes need an anterior mediastinotomy or thoracoscopy - Enlarged aortopulmonary window nodes can compress the left recurrent laryngeal nerve and cause hoarseness - Tuberculosis enlarges hilar and paratracheal nodes, especially in children, where they can compress a bronchus and collapse a lobe - Symmetric hilar and right paratracheal enlargement is the classic pattern of sarcoidosis - Bulky nodes from lymphoma or lung cancer can obstruct the [superior vena cava](https://durgical.com/en/anatomy/superior-vena-cava/) or compress the airway ## Related conditions - [HIV infection and AIDS](https://durgical.com/en/conditions/hiv-infection-and-aids/) - [Hodgkin lymphoma](https://durgical.com/en/conditions/hodgkin-lymphoma/) - [Superior vena cava syndrome](https://durgical.com/en/conditions/superior-vena-cava-syndrome/) - [Castleman disease](https://durgical.com/en/conditions/castleman-disease/) - [Histoplasmosis](https://durgical.com/en/conditions/histoplasmosis/) - [Anthrax](https://durgical.com/en/conditions/anthrax/) - [Sarcoidosis](https://durgical.com/en/conditions/sarcoidosis/) - [Mediastinal masses (thymoma and anterior mediastinal mass)](https://durgical.com/en/conditions/mediastinal-masses/) - [Mediastinitis (acute and fibrosing)](https://durgical.com/en/conditions/mediastinitis/) ## Test yourself Think of the answer, then tap the question to see it. ## In lung cancer staging, what N category is spread to same-side mediastinal or subcarinal nodes, and to opposite-side nodes? Same-side mediastinal or subcarinal is N2; opposite-side mediastinal or supraclavicular is N3. ## Why can a left lower lobe tumour spread to the right mediastinum? Lymph from the left lower lobe often crosses to the right paratracheal nodes. ## What does enlargement of the subcarinal lymph nodes do to the carina? It widens the carinal angle and can indent the esophagus and the left atrium. ## Which mediastinal lymph node pattern is classic for sarcoidosis? Symmetric hilar and right paratracheal enlargement. ## Why can enlarged aortopulmonary window lymph nodes cause hoarseness? They lie beside the left recurrent laryngeal nerve and can compress it. [Add to my cards (5)](https://durgical.app/estudiar/?add=/en/anatomy/mediastinal-lymph-nodes/) Educational information, not medical advice. For any symptom, see a health professional. ## Its names **Official Latin (TA2)** nodi lymphoidei mediastinales; nodi tracheobronchiales TA2 5254 **Official Spanish (DeCS)** Nódulos linfáticos mediastínicos DeCS D008198 **English (TA2)** Mediastinal lymph nodes Sources: Terminologia Anatomica (TA2); [DeCS](https://decs.bvsalud.org/es/ths/resource/?id=8375); [Anatomy, Thorax, Mediastinal Lymph Nodes](https://www.ncbi.nlm.nih.gov/books/NBK532863/); Tratado de anatomía humana (9.ª ed.), tomo II, Libro IV Angiología, sección 1, cap. I Corazón (arts. VI–IX) y cap. II Pericardio. ## **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/mediastinal-lymph-nodes/ License: CC BY 4.0 (https://creativecommons.org/licenses/by/4.0/). Cite as: DurgiPedia (durgical.com), https://durgical.com/en/anatomy/mediastinal-lymph-nodes/