Retroperitoneal Lymph Nodes

Retroperitoneal lymph nodes are in the abdomen, but at the back, behind the intestines..


Retroperitoneal lymph nodes are lymph nodes located in the retroperitoneum. The retroperitoneum is an area at the back of the abdomen behind the intestines.

Lymph nodes are small structures located all over the body around blood vessels and are a part of the lymph system of the body. There are many different reasons for lymph nodes to swell or gain the attention of doctors.

Lymphomas are a group of cancers of the lymph system.

Lymphomas usually start in the lymph nodes, and retroperitoneal lymph nodes are affected in many lymphomas.

Lymph Nodes

Retroperitoneal lymph nodes are in the retroperitoneum; there are more precise definitions, such as “the part of the abdominal cavity that lies between the posterior parietal peritoneum and anterior to the transversalis fascia,” but thinking of it as an area at the back of the abdomen is just fine here. The retroperitoneum is the site of just one of many groups of lymph nodes located around the body, as shown here:

  • Retroperitoneal lymph nodes - found in the retroperitoneum
  • Inguinal lymph nodes - found in the groin region
  • Axillary lymph nodes - found in the armpits

Lymph nodes can be named for a region, a specific organ or any combination of these – it’s a bit like Russian dolls. For example, let’s take a particular lymph node in the thorax that is near the aorta. That lymph node might be called a thoracic lymph node, a mediastinal lymph node or a periaortic lymph node – all of which would be correct, but periaortic would be the most specific.

The peritoneum is a membrane that lines the cavity of the abdomen and also covers abdominal organs. Imagine it as a 'double bubble of plastic wrap' that gets all twisted up in itself during development. Some organs are intra -- or within – the peritoneum, while others are behind it, or retroperitoneal.

Retroperitoneal Organs

Some organs are actually even partially within and partially outside the peritoneum. A memory device students use to learn which organs are retroperitoneal is SAD PUCKER:

S: suprarenal or adrenal gland
A: aorta/inferior vena cava
D: duodenum (second and third part)

P: pancreas (except tail)
U: ureters
C: colon (ascending and descending)
K: kidneys
E: esophagus
R: rectum

The organs followed by parentheses are only partially retroperitoneal. Sometimes a disease process that affects one of these organs will also affect the associated lymph nodes. The ureters carry urine from the kidney to the bladder, and masses in this area can block a ureter, causing urinary symptoms.

Retroperitoneal Lymph Nodes in Lymphoma

There are two main categories of lymphoma:
1) Hodgkin’s lymphoma, or HL-- and here is the link out to Hodgkin’s.
2) Non-Hodgkin’s lymphoma, or NHL which accounts for nearly 90 percent of all lymphomas, is comprised of far more types than Hodgkin's lymphoma.

Both HL and NHL may result in retroperitoneal lymph node involvement.

While HL is more likely to spread in a defined pattern, from one lymph node group to the next, NHL may arise and come to involve different groups of lymph nodes, including retroperitoneal lymph nodes, at the time of presentation. Other cancers can also metastasize to these lymph nodes. Retroperitoneal lymphadenopathy often does not produce any symptoms, but extensive disease can lead to abdominal discomfort or blocked urine flow.

Updated January 2016, TI.


Lymph Nodes. Lawrence M. Weiss. Cambridge University Press, Apr 28, 2008 Retroperitoneal organs (mnemonic). Accessed January 2016.

Non-Hodgkin Lymphomas. James Armitage et al. Lippincott Williams & Wilkins, Aug 8, 2013.

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