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subcarinal lymph node
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Surgical nomenclature for the lymph nodes tend to differ from anatomical nomenclature. Paratracheal nodes are found alongside the trachea, hilar nodes around the mainstem bronchus within the root of the lung, subcarinal nodes in the inferior angle of the tracheal bifurcation, and peribronchial nodes along the brochi within the lung substance. Standard lymph drainage proceeds from the lung to peribronchial nodes --> hilar nodes --> subcarinal nodes --> paratracheal nodes.
While most lobes of the lung drain unilaterally to ipsilateral paratracheal nodes, the left lower lobe drains bilaterally. In patients with left lower lobe cancer surgeons will need to determine whether the cancer has spread to the right paratracheal nodes because involvement of these nodes preclude surgical treatment. To determine tumor involvement of these nodes, a mediastinoscopy or PET scan is used.
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