Brachiocephalic nodes

At a glance

English

Brachiocephalic nodes

Latin (TA2)

Nodi brachiocephalici

System

Lymphatic

Region

Whole body

Side

Single, on the midline

About the brachiocephalic nodes

The brachiocephalic nodes belong to the anterior mediastinal group. They sit in the upper part of the mediastinum, behind the manubrium of the sternum, where the left brachiocephalic vein crosses in front of the branches of the aortic arch to meet the right brachiocephalic vein and form the superior vena cava. The nodes are scattered along both veins and over the front of the arch and the roots of its large branches, in the fat that also holds the thymus or its remnant.

This is a crowded region. The phrenic and vagus nerves pass down nearby on each side, and the left recurrent laryngeal nerve hooks under the arch close behind. Enlarged nodes can therefore affect more than one structure at once.

Lymph comes to them from the thymus, from the thyroid gland through vessels that descend from the lower poles, and from the pericardium. They also receive the outflow of the parasternal nodes, which bring lymph from the front of the chest wall. Their efferent vessels empty into the right and left bronchomediastinal trunks, and through these the lymph reaches the great veins at the root of the neck.

Swelling of these nodes produces a mass in the anterior mediastinum, one of the classic sites for lymphoma, particularly Hodgkin lymphoma. Thymic tumours, thyroid cancer and lung cancer may also spread here. A large mass may compress the superior vena cava, causing swelling of the face and arms with distended neck veins, or press on the trachea and nerves, causing breathlessness, cough or hoarseness.

Course and drainage

Begins at

Afferent vessels from the thymus, the thyroid gland, the pericardium and the parasternal nodes.

Drains into

Efferent vessels empty into the right and left bronchomediastinal trunks.

Drains

Filters lymph from the thymus, thyroid, pericardium and front of the chest wall. Enlargement gives an anterior mediastinal mass, as in lymphoma, and may compress the superior vena cava.