Node of ligamentum arteriosum

At a glance

English

Node of ligamentum arteriosum

Latin (TA2)

Nodus ligamenti arteriosi

System

Lymphatic

Region

Whole body

Side

Single, on the midline

About the node of ligamentum arteriosum

The node of the ligamentum arteriosum lies in the small space below the arch of the aorta and above the left pulmonary artery, known to radiologists and surgeons as the aortopulmonary window. Here the ligamentum arteriosum, the fibrous remnant of the fetal ductus arteriosus, joins the underside of the aortic arch to the start of the left pulmonary artery, and the node sits against it.

The left recurrent laryngeal nerve leaves the left vagus nerve at this level and hooks under the aortic arch just behind the ligament, so the node and the nerve are close neighbours. The left phrenic nerve passes down in front, and the mediastinal pleura over the left lung lies laterally.

The node receives lymph from the left lung, especially its upper lobe, passing up from the bronchopulmonary nodes at the left hilum. Its outflow goes to the nodes along the left side of the trachea and the left brachiocephalic vein, and on to the left bronchomediastinal trunk.

In lung cancer staging, nodes in this window are a recognised station for spread from the left upper lobe. An enlarged node here can stretch or compress the left recurrent laryngeal nerve, paralysing the left vocal fold and causing a hoarse voice, which may be the first sign of a tumour in the chest.

Course and drainage

Begins at

Afferent vessels from the left lung, mainly the upper lobe, via the bronchopulmonary nodes of the left hilum.

Drains into

Efferent vessels pass to the left paratracheal and brachiocephalic nodes and the left bronchomediastinal trunk.

Drains

Filters lymph from the left lung, especially the upper lobe. A station for spread of left upper lobe cancer; enlargement can affect the left recurrent laryngeal nerve and cause hoarseness.