Superior Tracheobronchial Nodes

The superior tracheobronchial lymph nodes are a subgroup of the tracheobronchial lymphatic chain, located above the bifurcation of the trachea. These nodes are involved in the drainage of the trachea, main bronchi, and nearby mediastinal structures. They serve as an intermediate station for lymph traveling from the lungs and lower trachea to the paratracheal and bronchomediastinal trunks.

Location

• Situated superior to the tracheal bifurcation (carina)
• Lie alongside the lower trachea and the origin of the main bronchi
• Located in the inferior portion of the superior mediastinum

Afferent Drainage

Lymph enters the superior tracheobronchial nodes from:

• Lower trachea
• Carina and upper main bronchi
• Inferior cervical tracheal nodes
• Also receives lymph indirectly from hilar and intrapulmonary nodes via the carinal (inferior tracheobronchial) group

Efferent Drainage

Efferent lymphatic vessels from the superior tracheobronchial nodes typically drain into:

• Paratracheal lymph nodes along the lateral trachea
• Bronchomediastinal lymph trunks
• Ultimately into the thoracic duct (left side) or right lymphatic duct (right side)

Relations

• Anterior: Ascending aorta and pulmonary trunk
• Posterior: Esophagus
• Lateral: Main bronchi and lungs
• Medial: Trachea

Function

• Filter lymph from airways proximal to the carina
• Serve as a gateway between deep pulmonary lymphatics and central thoracic drainage pathways
• Assist in immune response against respiratory pathogens and inhaled antigens

Clinical Significance

• Involved in staging: Especially relevant in mediastinal lymph node mapping for lung cancer (commonly labeled as station 4 in the IASLC system)
• Common site for lymphadenopathy: In infections (e.g., tuberculosis), lymphoma, or metastatic spread from pulmonary and esophageal cancers
• Accessible via EBUS: Can be sampled using endobronchial ultrasound-guided needle aspiration

Topographic Summary

• Location: Just above the carina, adjacent to lower trachea and main bronchi
• Afferents: From trachea, carina, and main bronchi
• Efferents: To paratracheal nodes and bronchomediastinal trunks
• Function: Filters lymph from proximal airways; key in thoracic lymphatic pathway