Quick Facts
Location: Anterior to the brachiocephalic veins and aortic arch.
Drainage: Thymus, pleura, pericardium, thyroid gland.
Direction of Flow: Right lymphatic duct (right) or thoracic duct (left).
Description: (Location & Drainage)
The anterior mediastinal lymph nodes are situated around the great vessels in the mediastinum. They may be described as three chains, including the right anterior, left anterior, and intermediate anterior mediastinal nodal chains.
The right anterior mediastinal nodal chain is situated anterior to the right brachiocephalic vein and superior vena cava. This group contains about two to five nodes, with the uppermost node sitting in the angle where the brachiocephalic veins unite. This node is therefore known as the brachiocephalic angle node. The second node in this chain is located between the right brachiocephalic vein and the superior vena cava and is referred to as the cardiac node. The brachiocephalic angle node receives lymph from the thyroid gland and larynx via the prelaryngeal and pretracheal nodes, respectively. The remaining nodes in this group collect lymph from the heart, pericardium, and thymus, and receives lymph from the lateral pericardial lymph nodes. The efferent vessels form a trunk that drains into the terminal part of the right lymphatic duct.
The left anterior mediastinal nodal chain is situated anterior to the aortic arch and left common carotid artery. The lower node of this group is called the node of ligamentum arteriosum, or Botallo’s node, since it sits beside the ligamentum arteriosum (formally known as the ligament of Botallo). Since the left recurrent laryngeal nerve sits close to this ligament, it may be fused with the node in that position. The left anterior mediastinal nodal chain receives lymph from the left lung, pericardium, pleura, and thymus. The efferent vessels form a trunk that drains into the terminal part of the thoracic duct.
The intermediate nodal chain is located just inferior to the left brachiocephalic vein. It receives lymph from the thymus, thyroid gland, and trachea. It also connects the left and right anterior mediastinal nodal chains together.
List of Clinical Correlates
—Paralysis of left recurrent laryngeal nerve
