Celiac Nodes - Structure, Location, Diagram, Function

The celiac lymph nodes are a group of preaortic lymph nodes clustered around the origin of the celiac trunk. They serve as the primary lymphatic drainage points for all organs derived from the embryologic foregut, including the stomach, liver, pancreas, spleen, and upper duodenum. These nodes act as central hubs in gastrointestinal immune surveillance and cancer metastasis tracking.

Structure

The celiac nodes are subdivided into three major groups based on their association with the terminal branches of the celiac trunk:

Subdivision	Location	Drains
Left gastric nodes	Along the left gastric artery	Lower esophagus, lesser curvature of the stomach
Common hepatic nodes	Along the common hepatic artery	Liver, gallbladder, pancreas (head), duodenum
Splenic nodes	Along the splenic artery	Spleen, body and tail of pancreas, greater curvature of the stomach

These groups send their efferent vessels to the central celiac nodes, which lie directly at the origin of the celiac trunk and drain into the intestinal lymphatic trunk.

Location

The celiac nodes are located:

Anterior to the abdominal aorta at the level of the T12 vertebra
Surrounding the origin of the celiac trunk and its branches
Posterior to the stomach and lesser sac

They are part of the retroperitoneal lymphatic system and connect upstream to the cisterna chyli via the intestinal lymphatic trunk.

Function

The celiac lymph nodes serve several critical roles:

Lymph filtration: Filter lymph from foregut organs before it is returned to the systemic circulation
Immune defense: Participate in antigen recognition and initiation of immune responses
Lymphatic convergence: Receive afferents from gastric, hepatic, splenic, and pancreatic nodes; send efferents to central lymphatic pathways

Clinical Significance

The celiac lymph nodes are of major importance in gastrointestinal oncology and surgery:

Metastatic spread: Common site of metastasis from cancers of the stomach, pancreas, liver, and esophagus
Lymphadenopathy: May be enlarged in systemic infections, lymphoma, or tuberculosis
Gastric cancer staging: Celiac node involvement is classified as distant metastasis (M1) and alters treatment strategy
Surgical resection: During lymphadenectomy (e.g., D2 dissection in gastric cancer), celiac nodes are routinely removed and examined
Imaging marker: CT, MRI, or PET-CT often evaluate celiac node size and density for staging or infection monitoring

The celiac lymph nodes are crucial in the abdominal lymphatic hierarchy, not only for their drainage role but also for their implications in cancer diagnosis, staging, and surgical planning. Their predictable location and drainage zones make them key anatomical targets in foregut pathology management.