Metastatic Thyroid Cancers : Regional Lymph Nodes

Comments:
Regional Lymph Node Involvement in Thyroid Cancers: The first group of cervical lymph nodes to be involved includes paralaryngeal, paratracheal, and prelaryngeal lymph nodes (level VI) next to the thyroid gland. Metastases can also occur to high jugular (level IIA), mid-jugular (level III), lower jugular (level IV), and the supraclavicular (level V) nodes, and less commonly to upper deep jugular and spinal accessory lymph nodes (level IIB).

Submandibular and submental lymph nodes (level I) are rarely involved. Upper mediastinal (level VII) nodes are frequently involved. In cases with extensive lateral cervical metastases, there may be spread to retropharyngeal nodes. Thyroid cancers frequently show bilateral cervical nodal metastases. For thyroid carcinomas, there is no requirement for a minimum number of lymph nodes to be sampled.

Image source: Deborah van Dijk et al. Surgical Complications and Referral Patterns in 567 Patients with Differentiated Thyroid Cancer in the Northern Region of the Netherlands: A Population-Based Study Towards Clinical Management Implementation. Annals of Surgical Oncology, April 2020, 27(9). Used under Creative Commons 4.0 Attribution International License.