The mediastinal lymph nodes are the nodes in the central compartment of the chest between the lungs. They include anterior (prevascular) nodes in front of the great vessels, nodes around the trachea and its bifurcation, and posterior nodes beside the oesophagus and descending aorta. Lung cancer staging uses a numbered station map for them.
| Location | Throughout the mediastinum: anterior (prevascular and brachiocephalic) nodes, paratracheal and subcarinal nodes around the trachea and bronchi, and posterior nodes along the oesophagus and descending aorta |
|---|---|
| Receives lymph from |
|
| Lymphatic drainage |
|
Filter lymph from the heart, lungs, oesophagus and other mediastinal structures.
Mediastinal node status determines whether lung cancer is operable and is assessed by PET-CT, endobronchial ultrasound (EBUS) biopsy and mediastinoscopy. Bilateral hilar and mediastinal node enlargement is typical of sarcoidosis, and bulky anterior mediastinal nodes suggest lymphoma. Massive enlargement can compress the superior vena cava or airways.
Spread of lung cancer to mediastinal stations, which upstages the disease and often changes treatment from surgery to chemoradiotherapy.
Granulomatous disease commonly causing symmetrical hilar and mediastinal node enlargement.
Compression of the SVC by bulky malignant nodes, causing swelling of the face and arms and distended neck veins.
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