Prevertebral nodes

At a glance

English

Prevertebral nodes

Latin (TA2)

Nodi prevertebrales

System

Lymphatic

Region

Whole body

Side

Single, on the midline

About the prevertebral nodes

The prevertebral nodes of the thorax lie in the posterior mediastinum, in the narrow space between the back of the oesophagus and the front of the vertebral bodies. Here they rest on the anterior longitudinal ligament, close to the thoracic duct, the azygos vein and the descending thoracic aorta, which all run vertically through the same compartment. They are small and few, and they are not easily separated from the other posterior mediastinal nodes.

Their name describes their position rather than a separate territory. Together with the juxta-oesophageal nodes beside the oesophagus and the intercostal nodes at the backs of the rib spaces, they form part of the chain of nodes that lines the back of the chest.

Lymph comes to them from the back wall of the oesophagus, from the vertebral bodies and the tissues in front of them, and from neighbouring posterior mediastinal nodes. Some lymph from the intercostal nodes may also pass through them. Their outflow goes mainly into the thoracic duct, which lies right beside them, and partly to the tracheobronchial nodes higher up.

These nodes are reached by cancer of the oesophagus that spreads backwards from the organ, and their involvement can make a tumour harder to remove. Infection of the vertebrae, such as tuberculosis of the spine, may also involve them. On scans, enlarged nodes in this position lie between the oesophagus and the spine and need to be told apart from a paravertebral abscess or a widened thoracic duct.

Course and drainage

Begins at

Afferent vessels from the posterior wall of the oesophagus, the front of the thoracic vertebral column and the surrounding posterior mediastinal tissues.

Drains into

Efferent vessels drain mainly into the thoracic duct, with some to the tracheobronchial nodes.

Drains

Filters lymph from the back of the oesophagus and the front of the thoracic spine. Involved in backward spread of oesophageal cancer and in spinal infection.