ClassificationĬlassification of lymph nodes of neck or cervical lymph nodes based on American Academy of Otolaryngology and the American Joint Committee on Cancer. In order to perform surgical removal of these nodes, anatomical knowledge of these nodes is vital. The cancers developing in the head and neck region have predictable patterns of spread via the chains of lymph nodes in the neck from structures like: Surgical neck dissection for Cancers and Various other diseases The lymph nodes and other lymphoid tissues in the head and neck are often swollen and create inflammations, which are encountered by doctors regularly. Clinical Significanceĭue to the cancers developing in this region has familiar patterns of spreading via the chains of lymph nodes in the neck, which help the surgeons in order to eliminate the preferred lymph nodes these lymph nodes have high clinical value. This node is located deep towards sternocleidomastoid, and so, it can be palpated only when it is enlarged significantly. Mainly, this lymph node channels lymph from the tongue, so it is also known as lymph node of the tongue. Jugulo-omohyoid lymph node is located superior towards the intermediate tendon of omohyoid posterior towards the internal jugular vein. Mainly, it drains the lymph from the palatine tonsil and is also known as lymph node of the tonsil. One lymph node of this group is situated in the middle of the angle of the mandible inferior to the posterior belly of digastric and anterior border of the sternocleidomastoid in the triangle formed by:

They are located over the omohyoid muscle. Some on the surface of the sheath, under cover of sternocleidomastoid.ĭeep cervical lymph nodes are divided into superior and inferior deep cervical nodes.Alongside and nearby the internal jugular vein.They are located posterior towards pharynx and anterior towards prevertebral fascia in the retropharyngeal space. They surround the trachea and esophagus along the recurrent laryngeal nerves on both sides. The overall evaluation of lymphadenopathy, with a focus on findings suggestive of malignancy, as well as an approach to the patient with unexplained lymphadenopathy, will be reviewed.Inner circle is created by these lymph node groups, which are located deep towards the covering layer of deep cervical fascia: While modern hematopathologic technologies have improved the diagnostic yields of fine-needle aspiration, excisional biopsy remains the initial diagnostic procedure of choice.

Unexplained lymphadenopathy without signs or symptoms of serious disease or malignancy can be observed for one month, after which specific testing or biopsy should be performed. In addition, a complete exposure history, review of associated symptoms, and a thorough regional examination help determine whether lymphadenopathy is of benign or malignant origin. Knowledge of these risk factors is critical to determining the management of unexplained lymphadenopathy. Key risk factors for malignancy include older age, firm, fixed nodal character, duration of greater than two weeks, and supraclavicular location. The critical challenge for the primary care physician is to identify which cases are secondary to malignancies or other serious conditions. Among primary care patients presenting with lymphadenopathy, the prevalence of malignancy has been estimated to be as low as 1.1 percent. The majority of patients presenting with peripheral lymphadenopathy have easily identifiable causes that are benign or self-limited.

7 levels of lymph nodes in neck