Delphian lymph node

Last revised by Henry Atkinson on 8 Jul 2024

The Delphian (prelaryngeal/precricoid) lymph node (often shortened to Delphian node) is one of the cervical lymph node groups that comprise level VI cervical lymph nodes and is not routinely excised in radical neck dissections, increasing the importance of alerting surgeons to the presence of metastases in this location.

The Delphian lymph node is located between the cricothyroid muscles, above the thyroid isthmus, lying directly anterior to the cricothyroid membrane 2,3. It receives lymph from the thyroid gland (mainly the upper poles) and the larynx 3.

The Delphian node was named in 1948 by Dr Randall B. Raymond, then a Harvard medical student, who theorized the importance of metastases in this nodal group in predicting a poor outcome and made an analogy with the Oracle of Delphi, whose prophecy, in this case, would be of death secondary to laryngeal cancer 5.

Involvement of this node can be as a result of diffuse nodal involvement in head and neck squamous cell carcinoma or in isolation from direct lymphatic spread of laryngeal cancer through the anterior commissure. Thyroid carcinomas may also involve this node, in which case it usually signifies disease spread to the central and lateral cervical lymph nodes 3,4

Cases and figures

  • Case 1: necrotic node from SCC
  • Case 2: in Hashimoto thyroiditis
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