Cervical Lymph Nodes - Classification

Classification

There are approximately 300 lymph nodes in the neck, and they can be classified in many different ways.

Henri Rouvière produced an influential classification in 1938. However, this system was based upon anatomical landmarks found in dissection, making it imperfectly suited to the needs of clinicians, which led to new terminology for the lymph nodes that could be palpated.

More recently, classification systems have been proposed organized around what can be observed via diagnostic imaging.

Commonly used systems have been devised by the American Academy of Otolaryngology and the American Joint Committee on Cancer.

One system divides the nodes as follows:

• Level I: Submental and submandibular nodes
  • Level Ia: Submental triangle
  • Level Ib: Submandibular triangle
• Level II: Upper jugular nodes
• Level III: Middle jugular nodes
• Level IV: Lower jugular nodes
• Level V: Posterior triangle group
• Level VI: Anterior triangle group
• Level VII: Upper mediastinal nodes.