The bronchomediastinal lymph trunks are large efferent lymphatic channels draining into the venous system within the neck but originating within the mediastinum. The sources of lymphatics which run into the bronchomediastinal trunks include:
sternal - internal thoracic - nodes tracheobronchial lymph nodes superior anterior mediastinal lymph nodes lateral mediastinal nodes via the superior anterior groups On the right side, the trunk is quite short compared to the left. It lies anterior to the vertebral bodies and medial to the superior part of the azygous vein. It turns laterally, posterior to the right internal jugular vein and anterior to scalenus anterior, above the superior thoracic aperture to join with jugular and subclavian lymph trunks. The combined trunk from all three vessels is the right lymphatic duct.
On the left side, the origin of the trunk is very similar except:
it originates lateral to the larger thoracic duct it may drain directly into the thoracic duct
Topographical anatomy of the bronchomediastinal lymph vessels: their relationships and formation of the collecting trunks.
Murakami G, Sato T, Takiguchi T. Second Department of Anatomy, Faculty of Medicine, Tokyo Medical and Dental University, Japan.
This article aims to clarify the topographical relationships of the bronchomediastinal collecting lymph vessels to other structures, in particular the great vessels, the trachea, the esophagus and the mediastinal pleura. Minute dissection was performed on eight cadavers with special reference to the converging collecting lymph vessels which form the bronchomediastinal trunks. On the right side, the trunks were consistently observed on both the right brachiocephalic vein and the subserous surface of the mediastinal pleura (anterior and posterior mediastinal trunks). The pathway from the right recurrent chain nodes ran laterally behind the carotid sheath and led either into the deep cervical nodes situated on the scalenus anterior or directly into the right venous angle. On the left side, the trunks showed varying courses. The nodes from which the trunks arose were constant, and classifiable into three groups: the uppermost paratracheal nodes near the recurrent chain nodes, the anterior mediastinal nodes (the left phrenic nodes) surrounding the phrenic nerve in front of and inferior to the aortic arch (the origin of the superior mediastinal trunk), and the left tracheobronchial nodes (the origin of the inferior mediastinal trunk). The large transverse superficial communicating vessel between the right and left sides was usually found in front of the trachea above the aortic arch; it was often connected to the nodes of the brachiocephalic angle. Deep communications were also found in front of the carina and behind the trachea. These findings allow the collecting vessels from the thoracic viscera to be divided into two pathways on each side: the anterior and posterior mediastinal trunks on the right side, and the superior and inferior mediastinal trunks on the left side. In addition to the four trunks, the superficial communicating vessel between the right and left sides is also drained from the superior mediastinum. The internal mammary lymph chain, which often emptied directly into the venous angle or into the deep cervical nodes, occasionally joined with the right anterior mediastinal trunk or the left superior mediastinal trunk.
PMID: 2252631 [PubMed - indexed for MEDLINE]