The right tracheobronchial and paratracheal groups of lymph nodes, interconnected by numerous lymphatic vessels, form a reservoir of ascending lymphatic current. Reaching within the mediastinum of the upper sections, this collector further extends to the neck, where it receives additional connections with the lymphatic vessels of the nodes of the right deep jugular group. Here, anastomosing with each other, the efferent lymphatic vessels of the paratracheal, prevenous, pretracheal and retrotracheal groups form the right bronchomediastinal lymphatic trunk. Often it is quite large, distinctly pronounced and located closer to the posterior surface of the right brachiocephalic vein, subsequently merging with the right jugular lymphatic trunk or entering the lymphatic vessels of the group of deep lymph nodes of the neck.
The left tracheobronchial and paratracheal groups of lymph nodes and their vessels participate in the formation of the left ascending lymphatic collector. It is less pronounced than the right and its efferent vessels, combining with the lymphatic vessels of the cervical part of the nodes of the paratracheal group flow either into the thoracic duct or into the left deep jugular lymph nodes. As on the right, the outgoing lymphatic vessels of the left paratracheal collector participate in the formation of the bronchomediastinal lymphatic trunk.
The vascular efferent groups of the anterior mediastinal lymph nodes (prevenous, pre-aortocarotid, prepericardial) reach the right supraclavicular region, where they end in the nodes of the deep jugular group.
The group of preaortocarotid lymph nodes with numerous vessels is connected with the adjacent left tracheobronchial and paratracheal nodes. The largest and most permanent, the main efferent lymphatic vessels from them are sent to the nodes of the left deep jugular group.
Detailed anatomical studies have convincingly shown that, within the mediastinum, numerous lymphatic vessels connect the lymphatic collectors of its right and left sides. Such transverse connections were established almost along the entire length between the right and left paratracheal and tracheobronchial groups of the lymph nodes, in the bifurcation region, and also between the preaortocarotid and prevenous lymph nodes . Transverse lymphatic connections are noted both within the anterior and posterior sections of the mediastinum. As far back as 1908, Most, on the basis of anatomical studies, described individual lymphatic vessels from the right or left lung, which, after passing through the root lymph nodes, reached the opposite side of the mediastinum. We managed to trace the same relationships above — in the supraclavicular areas, where the lymphatic collectors widely anastomose between themselves. Here the main place belongs to the lymph nodes of the deep jugular group – i.e. the most pronounced connecting link between the mediastinal and cervical divisions of a single lymphatic collector.
Thus, information on the structure of this department of the lymphatic system, obtained on the basis of anatomical studies and mainly by the method of injection of dyes into the vascular bed, testifies to the wide plasticity of the lymphatic apparatus of the lungs and the possibility of moving the lymph in various directions. However, these data are not quite enough to reveal the processes of regionality and the direction of its outflow from various parts of the lungs. This position is especially important for understanding the pathogenesis of lymphogenous metastasis of lung cancer and is largely determined by the physiological state of the lymphatic drainage collectors.