The bronchomediastinal lymphatic trunks (right and left) drain lymph from the lungs, the heart, the mediastinum and the deep anterior chest wall. Each forms from efferent vessels of the tracheobronchial, parasternal and anterior mediastinal lymph nodes. The right trunk usually joins the right lymphatic duct and the left joins the thoracic duct, though either may open separately into the venous angle.
| Origin | Efferent vessels of the tracheobronchial, parasternal and anterior mediastinal lymph nodes |
|---|---|
| Course | Ascends on each side of the trachea to the root of the neck, ending in the right lymphatic duct on the right and the thoracic duct on the left, or independently in the venous angle |
| Branches |
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The trunks carry lymph from lung and oesophageal cancers and from the inner breast via the parasternal nodes, so they connect thoracic node stations with the supraclavicular nodes and the venous system. Enlarged supraclavicular nodes can therefore be the first sign of a chest cancer. Obstruction of thoracic lymph drainage by tumour or radiation may contribute to pleural effusions.
Lung cancer cells move through the tracheobronchial nodes and bronchomediastinal trunks toward the supraclavicular nodes, which affects cancer staging and treatment options.
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