.png){kind=small}
.png){kind=small}
BackTable / ENT / Article
Level 7 Lymph Nodes: Retropharyngeal
Reilly Fogarty • Updated May 8, 2025 • 40 hits
Level 7 lymph nodes – the superior mediastinal lymph nodes – are located in the upper mediastinum and play a crucial role in the lymphatic drainage of the head and neck. These nodes are particularly important in the detection and management of cancers of the thyroid, esophagus, and other structures in the cervical and mediastinal regions. Understanding the anatomy, drainage pathways, and clinical significance of level 7 lymph nodes is essential for accurate staging and treatment planning for head and neck cancers.
Table of Contents
(1) Anatomy of Level 7 Lymph Nodes
(2) Drainage of Level 7 Lymph Nodes
(3) Clinical Significance of Level 7 Lymph Nodes
Anatomy of Level 7 Lymph Nodes
Level 7 lymph nodes are located below the suprasternal notch and extend into the superior mediastinum. These nodes are closely associated with the trachea and esophagus and are located anterior to the great vessels in the upper mediastinum. Due to their position, they are challenging to assess clinically and often require imaging for accurate evaluation.
The retropharyngeal lymph nodes, which are not a part of the Level 7 lymph group but part of the broader lymphatic system, are anatomically distinct but are often linked to Level 7 due to their shared role in lymphatic drainage from the head and neck into the mediastinum.
Listen to the Full Podcast
Stay Up To Date
Follow:
Subscribe:
Sign Up:
Drainage of Level 7 Lymph Nodes
Level 7 lymph nodes drain lymphatic fluid from several critical areas, including:
• Thyroid Gland: These nodes serve as a drainage site for the thyroid glands, making them particularly useful in assessing advanced thyroid cancers.
• Trachea and Esophagus: The upper trachea and cervical esophagus drain lymphatic fluid into these nodes, highlighting their role in upper laryngeal and esophageal cancers.
• Larynx and Pharynx: Some lymphatic drainage from the lower larynx and pharynx, including retropharyngeal nodes, passes through to the Level 7 nodes.
• Upper Mediastinal Structures: These nodes also drain structures in the superior mediastinum, making them key in mediastinal oncology.
This lymphatic network is significant because it facilitates the spread of malignancies from the cervical region to the mediastinum and beyond.
Clinical Significance of Level 7 Lymph Nodes
Level 7 lymph nodes are critical in the staging and management of a number of cancers. Their involvement often indicates advanced disease and calls for more aggressive treatment strategies.
Associated Malignancies
• Thyroid Cancer: Papillary and medullary thyroid carcinomas often spread to Level 7 lymph nodes, particularly in advanced stages.
• Esophageal Cancer: The cervical and upper thoracic portions of the esophagus frequently metastasize to these nodes, impacting staging and prognosis.
• Lung Cancer: Due to their proximity to the mediastinum, these nodes can also be involved in primary lung malignancies.
• Laryngeal and Pharyngeal Cancer: Advanced cancers from the larynx or pharynx can spread to Level 7 via retropharyngeal nodes, necessitating careful evaluation.
Clinical Management
• Imaging: CT, MRI, and PET scans are essential for identifying Level 7 lymph node involvement due to the depth of their location.
• Surgical Intervention: In cases of thyroid or esophageal cancer, surgical resection of these nodes is often part of the treatment plan.
• Adjuvant Therapies: Radiation or chemotherapy may be employed to manage cancer spread involving these nodes.
Additional resources:
[1] Robbins KT, Clayman G, Levine PA, et al. Neck dissection classification update: Revisions proposed by the American Head and Neck Society and the American Academy of Otolaryngology-Head and Neck Surgery. Arch Otolaryngol Head Neck Surg. 2002;128(7):751-758. doi:10.1001/archotol.128.7.751.
[2] Huo L, Wu Q, Sun X, et al. Superior mediastinal lymph nodes and their significance in thyroid and esophageal cancer. Head Neck. 2021;43(5):1501-1510. doi:10.1002/hed.26627.
[3] Kim H, Lee A, Ryu H, et al. Retropharyngeal lymph nodes and their involvement in laryngeal and pharyngeal cancer. Oral Oncol. 2021;67:48-55. doi:10.1016/j.oraloncology.2021.03.003.
[4] Spector ME, Zaki HS, Kumar P. Evaluation of mediastinal and retropharyngeal lymph nodes in thyroid and esophageal cancer. Laryngoscope. 2022;132(1):123-130. doi:10.1002/lary.28549.
[5] Ferris RL, Mlynarek AM, LaVigne S, et al. Superior mediastinal lymph node dissection in thyroid and esophageal cancer. J Clin Oncol. 2020;38(19):2204-2211. doi:10.1200/JCO.20.01114.
Podcast Contributors
Dr. Mihir Patel
Dr. Mihir Patel is an otolaryngologist head and neck surgeon and assistant professor with Emory Healthcare in Atlanta, Georgia.
Dr. Ashley Agan
Dr. Ashley Agan is an otolaryngologist in Dallas, TX.
Cite This Podcast
BackTable, LLC (Producer). (2024, May 21). Ep. 172 – HPV & Oropharyngeal Cancer: Evolving Insights & Implications [Audio podcast]. Retrieved from https://www.backtable.com
Disclaimer: The Materials available on BackTable.com are for informational and educational purposes only and are not a substitute for the professional judgment of a healthcare professional in diagnosing and treating patients. The opinions expressed by participants of the BackTable Podcast belong solely to the participants, and do not necessarily reflect the views of BackTable.
Podcasts
Articles
Level 6 Lymph Nodes: Role in Cancer Diagnosis & Treatment
Level 5 Lymph Nodes: Posterior Triangle & Anterior Cervical Nodes
Level 4 Lymph Nodes: Lower Jugular
A Comprehensive Guide to Level 3 Lymph Nodes in the Neck