They drain the posterior chest wall and pleura. Paravertebral nodes lie lateral to the vertebral bodies, posterior to the aorta on the left ( Fig. Together with the paraesophageal nodes, they drain the medial lower lobes, esophagus, pericardium, and posterior diaphragm. Below the hila, they are difficult to distinguish from paraesophageal nodes. ![]() On CT, they are usually seen adjacent to the esophagus on the right and the descending aorta on the left. Inferior pulmonary ligament nodes are located below the pulmonary hila, medial to the inferior pulmonary ligament. An enlarged left paravertebral lymph node (small arrows) is also visible posterior to the aorta. They appear inhomogeneous and are necrotic. Large lymph nodes on the right (large arrow) can be considered paraesophageal or inferior pulmonary ligament nodes. Subcarinal nodes are not included in this group. Paraesophageal nodes lie posterior to the trachea or are associated with the esophagus, or both ( Fig. 4.4C and D ), subcarinal, and paratracheal nodes. They communicate with bronchopulmonary (hilar Fig. Peribronchial nodes surround the main bronchi on each side ( Fig. They communicate in turn with the right paratracheal chain. 4.4B–D ), and drain the inferior hila and both lower lobes. Subcarinal nodes are located in the subcarinal space, between the main bronchi ( Fig. The left upper lobe is drained by this node group. Because of this, they are commonly abnormal regardless of the location of lung disease.Īortopulmonary nodes are considered by Rouvière to be in the anterior mediastinal group, but they serve the same function as right paratracheal nodes ( Figs. These nodes form the final pathway for lymphatic drainage from most of both lungs (except the left upper lobe). Pretracheal or paratracheal nodes occupy the pretracheal (or anterior paratracheal) space ( Figs. Lung diseases (e.g., lung cancer, sarcoidosis, tuberculosis, and fungal infections) that secondarily involve lymph nodes typically involve middle mediastinal lymph nodes. (D) Below (C) large subcarinal (SC) and bronchopulmonary (BP) nodes are again visible. Hilar lymph nodes are termed bronchopulmonary (BP). (C) At a lower level, aortopulmonary (AP), peribronchial (PB), and subcarinal (SC) nodes are again visible. Subcarinal (SC) lymph nodes are located posterior to the carina. ![]() Lymph nodes adjacent to the main bronchi are termed peribronchial (PB). (B) At the level of the tracheal carina, aortopulmonary (AP) lymph nodes lie lateral to the left pulmonary artery. (A) At the aortic arch level, enlarged pretracheal (PT) and prevascular (PV) nodes are visible.
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