Prepericardial nodes

At a glance

English

Prepericardial nodes

Latin (TA2)

Nodi prepericadiaci

System

Lymphatic

Region

Whole body

Side

Single, on the midline

About the prepericardial nodes

The prepericardial nodes are small anterior mediastinal nodes. They sit in the narrow space behind the body of the sternum and in front of the fibrous pericardium, in the loose fat of the anterior mediastinum. This space also holds the sternopericardial ligaments, which tie the pericardium to the back of the sternum, and in children the lower part of the thymus. The nodes are few and normally very small.

They belong to the visceral side of the thoracic lymph system and are closely linked with the parasternal chain at the edges of the sternum. They also lie just above the anterior set of superior diaphragmatic nodes, with which they are sometimes grouped.

Lymph comes to them from the front of the pericardium and from the sternum behind which they lie. Their efferent vessels pass to the parasternal nodes along the internal thoracic arteries, and through those to the bronchomediastinal trunks and the great veins of the neck.

These nodes are rarely seen unless they are enlarged. They may swell with inflammation of the pericardium, with tumours of the anterior mediastinum such as lymphoma or thymic tumours, and with spread from neighbouring structures, including the sternum. On CT an enlarged node in this space appears as a small mass between the breastbone and the heart. Surgeons opening the chest through the sternum pass directly through their territory.

Course and drainage

Begins at

Afferent vessels from the front of the pericardial sac and from the sternum.

Drains into

Efferent vessels pass to the parasternal nodes.

Drains

Filters lymph from the front of the pericardium and the sternum. Enlarged nodes form a small anterior mediastinal mass, as in lymphoma or pericardial disease.