The para-aortic (lumbar or lateral aortic) lymph nodes form chains on either side of the abdominal aorta and around the inferior vena cava on the back wall of the abdomen. They collect lymph from paired structures such as the kidneys, adrenals and gonads, and from the iliac nodes below, and their efferents form the lumbar lymphatic trunks.
| Location | Posterior abdominal wall along both sides of the abdominal aorta and around the inferior vena cava, from the aortic bifurcation up to the diaphragm |
|---|---|
| Receives lymph from |
|
| Lymphatic drainage |
|
Filter lymph from the lower limbs and pelvis (via the iliac nodes) and from the paired retroperitoneal organs and gonads.
Because the testes and ovaries develop high in the abdomen and descend, their lymph drains directly to the para-aortic nodes rather than to the groin, so testicular cancer typically spreads here first. Retroperitoneal lymph node dissection (RPLND) removes these nodes and can injure sympathetic fibres, causing ejaculatory dysfunction. They are also commonly involved in lymphoma and in cervical and endometrial cancers.
Spread of germ cell tumours to para-aortic nodes near the renal hilum, the main site of nodal spread for testicular cancer.
Bulky para-aortic node enlargement from lymphoma, sometimes compressing the ureters or IVC.
Lymph leak into the abdomen after para-aortic node dissection disrupts lumbar lymphatics.
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