Paratracheal thoracic nodes

At a glance

English

Paratracheal thoracic nodes

Latin (TA2)

Nodi paratracheales thoracis

System

Lymphatic

Region

Whole body

Side

Single, on the midline

About the paratracheal thoracic nodes

The paratracheal nodes of the thorax lie in the superior mediastinum on each side of the trachea, from the thoracic inlet down to the level of the main bronchi. On the right they sit between the trachea and the superior vena cava and brachiocephalic vessels, with the arch of the azygos vein at their lower end. On the left they lie between the trachea and the aortic arch and left common carotid artery, close to the left recurrent laryngeal nerve, which climbs in the groove between the trachea and oesophagus. Above, the chain continues into the paratracheal nodes of the neck.

They receive lymph from the trachea and oesophagus, and above all from the lungs, by way of the bronchopulmonary nodes at the hila and the superior and inferior tracheobronchial nodes. Their outflow joins the bronchomediastinal trunk on each side, which ends near the junction of the internal jugular and subclavian veins or joins the thoracic duct or right lymphatic duct.

In lung cancer staging these nodes form the upper and lower paratracheal stations. Spread to nodes on the same side as the tumour, or across to the other side, changes the stage and the choice between surgery and other treatment. The nodes are sampled by mediastinoscopy, through a small cut above the sternum, or by needle through the airway wall under ultrasound guidance.

Enlargement of the left-sided nodes can involve the left recurrent laryngeal nerve and cause hoarseness.

Course and drainage

Begins at

Afferent vessels from the lungs via the tracheobronchial nodes, and from the trachea and oesophagus.

Drains into

Efferent vessels form or join the bronchomediastinal trunk on each side, ending at the venous angle, the thoracic duct or the right lymphatic duct.

Drains

Filters lymph from both lungs, the trachea and oesophagus. Key stations in lung cancer staging; left-sided enlargement can cause hoarseness through the recurrent laryngeal nerve.