Mediastinal lymph nodes

Function

The mediastinal nodes — paratracheal, subcarinal, hilar — guard the lungs' and heart's lymphatic watershed. They enlarge in sarcoidosis (where they may be the only finding), lymphoma, tuberculosis and in response to any lung pathology.

Their station map (the IASLC map, successor to the Mountain–Dresler stations) is the language of lung cancer staging; a PET-lit node redirects the entire treatment plan.

Blood supply

Bronchial arteries.

Nerve supply

Autonomic fibres with the great vessels.

Clinical relevance

Sarcoidosis

Non-caseating granulomas light up bilateral hilar nodes — the young patient's erythema nodosum and arthralgia triad (Löfgren).

Lung cancer nodal staging

N1, N2, N3 station involvement is the difference between resection, chemoradiation and palliation.

Related conditions

• Sarcoidosis