The left paratracheal nodes, as on the right, are a continuation of the left tracheobronchial nodes and are located higher along the left side wall of the trachea. As a rule, they are weakly expressed and are usually represented by 2 small lymph nodes, occupying a space limited by the aortic arch and trachea, above the left carotid artery, and behind the esophagus.
A group of pretracheal lymph nodes is located on the front surface of the trachea, above its bifurcation and often merges with the right paratracheal and bifurcation, forming a kind of bridge-joint between them in the form of a plate.
A retrotracheal chain of lymph nodes is located along the posterior surface of the trachea, its membranous part.
A prevenous group of lymph nodes is located along the front surface of the superior vena cava and partly the right nameless subpleurally . It is unstable and is usually represented by two to five lymph nodes ranging in size from 5 to 12 mm. Under the aortic arch, near the arterial ligament, the pre-aortocarotid group of lymph nodes begins. Extending higher along the front surface of the aortic arch, it reaches the left carotid artery. This group of lymph nodes represents the largest division of the regional lymphatic collector of the left lung in the mediastinum. It is in close relationship with the lymph nodes of the left tracheobronchial group. One of the largest lymph nodes located here, adjacent to the posterior surface of the arterial ligament, is naturally called the “Botall’s duct node”.
By the lymphatic vessels of the nodes of the so-called transverse chain located along the left unnamed vein, the lymph nodes of the pre-aortocarotid group can connect with prevenous.
In the posterior mediastinum, along the anterior and lateral surfaces of the esophagus, there are three — five lymph nodes that make up the peresophageal group.
Less constantly in the mediastinum are lymph nodes located on the side and front surface of the pericardium under the mediastinal pleura. Often they are grouped here along the phrenic nerve and the accompanying blood vessels.
It should be emphasized that the separation of the groups of lymph nodes of the mediastinum is conditional, since they all have numerous connections between each other due to well-defined lymphatic vessels. At the same time, groups of lymph nodes located in the upper sections of the mediastinum have numerous connections with the lymph nodes of the cellular spaces of the supraclavicular regions and neck, which are one of the final stages of lymph outflow from the lungs. The involvement of these lymph nodes in the process of metastasis in lung cancer in the advanced stages of the development of the disease determines the desirability of describing their structure.
In topographic and anatomical terms, the areas of lateral triangles occupy a special place on the neck. Each of them is limited by the posterior edge of the sternocleidomastoid muscle, the edge of the trapezius muscle and the clavicle. Cellulose, enclosed here in a well-defined fascial case, houses the bulk of the lymph nodes that make up the regional collector of lymph flow from the lungs. In the lower section, the fascial case surrounding the tissue with lymph nodes communicates with the anatomical formations of the chest cavity. Here, behind the first rib, there is an upper aperture of the chest cavity, occupied by the apex of the lung with a pleural sac covering it, inside of which the tissue of the supraclavicular region without a visible border passes to the mediastinal tissue, enclosing numerous lymphatic vessels. Here, in the left lateral triangle of the neck, along with numerous lymph nodes, there is the cervical part of the thoracic duct, and in the right, the often well-defined right lymphatic trunk.