Thoracic lymph node stations

Dr Tim Luijkx et al.

Thoracic lymph nodes are divided into 14 stations as proposed by the International Association for the Study of Lung Cancer (IASLC) 1, principally in the context of oncologic staging.

  • highest mediastinal nodes: low cervical, supraclavicular, and sternal notch nodes
  • 2R: upper paratracheal right
  • 2L: upper paratracheal left

The upper paratracheal lymph nodes lie inferior and superior to the transverse planes demarcated by where the left brachiocephalic vein crosses the trachea and upper margin of the aortic arch respectively.

  • 3A: prevascular (anterior to the great vessels)
  • 3P: retrotracheal (posterior to the trachea)
  • 4R: lower paratracheal right
  • 4L: lower paratracheal left

The lower paratracheal lymph nodes lie inferior to the upper border of the aortic arch and superior to the upper border of the ipsilateral upper lobe bronchus.

    • subaortic: in the aortopulmonary window
    • para-aortic (ascending aorta or phrenic): lateral to the ascending aorta and aortic arch
    • subcarinal: below the tracheal carina
    • para-oesophageal: below carina, adjacent to the oesophagus 

    • pulmonary ligament
    • hilar
    • interlobar
    • lobar
    • segmental
    • subsegmental

    For the purpose of prognostic analyses these stations have also been grouped into several zones 1:

    • supraclavicular zone: station 1
    • upper zone: station 2-4
    • AP zone: station 5-6
    • subcarinal zone: station 7
    • lower zone: station 8-9
    • hilar/intralobar zone: station 10-11
    • peripheral zone: station 12-14
    Anatomy: Thoracic
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    Article information

    rID: 35392
    System: Chest
    Section: Anatomy
    Synonyms or Alternate Spellings:
    • Thoracic lymph nodes
    • Thoracic lymph node
    • Thoracic lymph node classification
    • Thoracic lymph nodes classification
    • Thoracic lymph node levels
    • Mediastinal lymph node stations

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