Parasternal lymph nodes !
The parasternal lymph nodes lie beside the breastbone, along the internal thoracic vessels; they drain the chest wall and the inner part of the breast.
Official name: Parasternal nodes
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What it is
Lymph nodes along the internal thoracic vessels beside the sternum, and between the ribs.
What it does
Drain the chest wall and part of the breast.
Key facts
- Where
- Along internal thoracic vessels at anterior ends of intercostal spaces
- Drains
- Medial breast, anterior chest wall, anterior diaphragm, upper anterior abdominal wall, upper surface of liver
- Into
- Bronchomediastinal trunks (or directly into venous angles)
Relations
- In front
- Costal cartilages and the front ends of the internal intercostal muscles, mostly in the upper intercostal spaces
- Behind
- Endothoracic fascia and parietal pleura; the transversus thoracis muscle lower down
- Medial
- Sternal edge, with the internal thoracic artery and veins running alongside the nodes
How to find it
Not palpable. They lie in the upper intercostal spaces, mostly the 1st to 3rd, along the internal thoracic vessels about a finger-breadth from the sternal edge, deep to the costal cartilages and intercostal muscles. They are seen on CT, MRI and PET, and sentinel node mapping can show drainage to them.
On imaging
Normally too small to see. On CT, MRI or PET-CT an enlarged node shows in the fat beside the internal thoracic vessels, mostly in the upper spaces; sentinel node scintigraphy sometimes shows drainage to them.
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
- Included in the radiotherapy field for some breast cancers, which brings part of the heart and lung into the field on the left
- A cancer in the medial half of the breast can spread here even when the axillary nodes are clear
Related conditions
Test yourself
Think of the answer, then tap the question to see it.
Which part of the breast drains mainly to the parasternal (internal mammary) lymph nodes?
The medial half; most breast lymph still drains to the axilla.
Along which vessels do the parasternal lymph nodes lie?
Along the internal thoracic artery and veins, at the front ends of the intercostal spaces beside the sternum.
Why can a medial breast cancer reach the other side or the upper abdomen?
The parasternal nodes link across the midline and with the anterior diaphragmatic nodes.
Educational information, not medical advice. For any symptom, see a health professional.
Its names
- Official Latin (TA2)
- nodi parasternales TA2 5250
- Official Spanish (DeCS)
- Nódulos linfáticos paraesternales DeCS D008198
- English (TA2)
- Parasternal nodes
- Also called
- lymphonodi sternales
Sources: Terminologia Anatomica (TA2); DeCS; Anatomy, Thorax, Internal Mammary (Internal Thoracic) Arteries; Anatomy, Thorax, Breast.
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Representative model, for educational purposes only.
