Intermediate lumbar nodes

At a glance

English

Intermediate lumbar nodes

Latin (TA2)

Nodi lumbales intermedii

System

Lymphatic

Region

Trunk

Side

Single, on the midline

About the intermediate lumbar nodes

The lumbar nodes form a long chain on the posterior abdominal wall, running up the front of the lumbar vertebrae beside the two great vessels. They are divided into a left group around the aorta, a right group around the inferior vena cava, and an intermediate group in the gap between the two. Surgeons often call this last group the interaortocaval nodes.

The intermediate nodes lie behind the peritoneum, in front of the bodies of the lumbar vertebrae and the right crus of the diaphragm at their upper end. They are wedged in by the aorta on their left and the vena cava on their right, with the left renal vein crossing in front of them higher up, and the third part of the duodenum passing across the lower part of the chain.

Their work has two sides. For lymph already filtered lower down, coming up from the common iliac nodes, they are the next stop. For several organs of the upper abdomen and the posterior abdominal wall they are the first: the kidneys, the suprarenal glands and the ureters send vessels straight to them, as does the deep musculature of the abdominal wall. Their efferents join the lumbar trunks, which end in the cisterna chyli.

Because these nodes receive lymph directly from the kidney and the upper ureter, they may hold the first deposits from a renal cancer, and they are cleared in a retroperitoneal lymph node dissection. They are also a common place for lymphoma to show on a scan, where enlarged nodes can push the aorta and vena cava apart.

Course and drainage

Begins at

Efferent vessels of the common iliac nodes, and direct vessels from the kidneys, suprarenal glands, ureters and posterior abdominal wall.

Drains into

Efferent vessels join the right and left lumbar trunks, which end in the cisterna chyli.

Drains

A second relay for lymph from the pelvis and lower limbs and a first relay for the kidneys, suprarenals, ureters and abdominal wall. They are a site of spread for renal cancer and of enlargement in lymphoma, and are removed in retroperitoneal dissection.