Mediastinal Lymph Nodes

Deep in the chest, the mediastinum is an anatomical "box" that contains the heart, important lymph nodes, and much more.


Mediastinal lymph nodes are lymph nodes located in the mediastinum. What is the mediastinum, you ask? Inside the chest, if you imagine your lungs as two huge balloons hogging up all the space, there is a pocket in between them. The mediastinum refers to this pocket or box that is jam-packed with the chest organs like the heart, blood vessels, nerves, lymph nodes and other structures.​

Lymph nodes become enlarged for many different reasons.

Mediastinal lymph nodes, in particular, can become enlarged on their own, or along with diseases of the lungs.

The Mediastinum

Mediastinum is a term that refers both to the “box” and to all of its contents. It can be thought of as a cube: bordered on two sides by the lungs; two sides by the breastbone and backbone; at the top by the outlet to the neck; and at the bottom by the chest floor, or diaphragm muscle, that helps the lungs expand and contract with breathing.

Enlarged Mediastinal Lymph Nodes

Lymph nodes are small structures located all over the body. Lymph nodes in the mediastinum, or mediastinal lymph nodes, are important medically for many different reasons -- one of them being that they can potentially indicate the presence of cancer.

Not all swollen lymph nodes in the chest are lymphoma, or even cancer. Infection and nonmalignant diseases like sarcoidosis may be to blame. When lymph nodes in the chest are enlarged due to cancer, lymphoma and lung cancer are two common possibilities.

Cancer from other sites can also metastasize to these lymph nodes.

Mediastinal Lymph Nodes - in Lymphoma

Lymphoma, a cancer of the lymphocyte white blood cells, has two basic categories – Hodgkin lymphoma and non-Hodgkin lymphoma.

Hodgkin lymphoma, or HL, often starts with the mediastinal lymph nodes.

Non-Hodgkin lymphoma, or NHL, can arise in the mediastinal lymph nodes, too; however, NHL often has a different pattern of lymph node involvement and spread. While HL typically progresses in an orderly fashion from one group of lymph nodes to the next, the same may not be true for many common NHLs, though some can have a more Hodgkin's-like behavior.

While chest imaging can identify suspicious looking lymph nodes, the initial diagnosis of lymphoma, regardless of type, is made by biopsy.​


American Cancer Society. What is Hodgkin disease?  Accessed January 2016.

Agostinelli C, Pileri S. Pathobiology of Hodgkin Lymphoma. Mediterr J Hematol Infect Dis. 2014;6(1):e2014040.

Mehrian P, Ebrahimzadeh SA. Differentiation between sarcoidosis and Hodgkin’s lymphoma based on mediastinal lymph node involvement pattern: Evaluation using spiral CT scan. Pol J Radiol. 2013;78(3):15-20.

Updated January 2016, TI.

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