Cervical lymph nodes
|Cervical lymph nodes|
Regional lymph tissue. (Cervical near top, in green.)⋅
Deep Lymph Nodes
2. Submandibular (Submaxillary)
Anterior Cervical Lymph Nodes (Deep)
Deep Cervical Lymph Nodes
7. Lateral jugular
8. Anterior jugular
Inferior Deep Cervical Lymph Nodes
11. Supraclavicular (scalene)
|Latin||Nodi lymphoidei cervicales|
Cervical lymph nodes are lymph nodes found in the neck. Of the 800 lymph nodes in the human body, 300 are in the neck. Cervical lymph nodes are subject to a number of different pathological conditions including tumours, infection and inflammation.
There are approximately 300 lymph nodes in the neck, and they can be classified in many different ways.
- Level I: Submental and submandibular nodes
- Level II: Upper jugular nodes - Between posterior belly of digastric muscles superiorly and hyoid bone inferiorly
- Level IIa: Anterior, medial, lateral or posterior to internal jugular vein, or if posterior, must not have an intervening fat plane
- Level IIb: Posterior to internal jugular vein with fat plane between nodes and internal jugular vein
- Level III: Middle jugular nodes - between the hyoid bone and cricoid cartilage
- Level IV: Lower jugular nodes - between the cricoid cartilage and the clavicle
- Level V: Posterior cervical or spinal accessory nodes, posterior to the sternocleidomastoid muscle
- Level VI: Visceral space lymph nodes - midline group of cervical nodes from hyoid to sternal manubrium, includes prelaryngeal, pretracheal, and paratracheal subgroups
- Level VII: Superior mediastinal nodes - between carotid arteries from top of manubrium superiorly to innominate vein inferiorly
Infectious mononucleosis (glandular fever) affects the cervical lymph nodes which become swollen.
The characterization of cancerous lymph nodes on CT scan, MRI or ultrasound is difficult, and usually requires confirmation by other nuclear imaging techniques such as PET scans. Tissue diagnosis by fine needle aspiration (which has a high rate of accuracy), may also be required. Cervical lymph node metastasis is a common feature of papillary thyroid carcinoma
Henri Rouvière produced an influential classification in 1938. However, this system was based upon anatomical landmarks found in dissection, making it imperfectly suited to the needs of clinicians, which led to new terminology for the lymph nodes that could be palpated.
More recently, classification systems have been proposed organized around what can be observed via diagnostic imaging.
- "I. Classification". Retrieved 2008-02-16.
- Eisenmenger, LB; Wiggins RH, 3rd (January 2015). "Imaging of head and neck lymph nodes.". Radiologic clinics of North America. 53 (1): 115–32. PMID 25476176. doi:10.1016/j.rcl.2014.09.011.
- Som PM, Curtin HD, Mancuso AA (1999). "An imaging-based classification for the cervical nodes designed as an adjunct to recent clinically based nodal classifications". Arch. Otolaryngol. Head Neck Surg. 125 (4): 388–96. PMID 10208676. doi:10.1001/archotol.125.4.388.[permanent dead link]
- "Neck Dissection". Archived from the original on 2008-02-20. Retrieved 2008-02-16.
- Chen, C. C.; Lin, J. C.; Chen, K. W. (2015). "Lymph node ratio as a prognostic factor in head and neck cancer patients". Radiation Oncology. 10: 181. PMC . PMID 26302761. doi:10.1186/s13014-015-0490-9.
- Park, C. H.; Song, C. M.; Ji, Y. B.; Pyo, J. Y.; Yi, K. J.; Song, Y. S.; Park, Y. W.; Tae, K (2015). "Significance of the Extracapsular Spread of Metastatic Lymph Nodes in Papillary Thyroid Carcinoma". Clinical and Experimental Otorhinolaryngology. 8 (3): 289–94. PMC . PMID 26330926. doi:10.3342/ceo.2015.8.3.289.
- Rouvière H. Lymphatic system of the head and neck. Tobias M, Translator. Ann Arbor, MI: Edwards Brothers, 1938.
- Chong V (2004). "Cervical lymphadenopathy: what radiologists need to know". Cancer Imaging. 4 (2): 116–20. PMC . PMID 18250018. doi:10.1102/1470-7330.2004.0020.