24/03/2022 at 12:07 pm
#34586
![](https://birdultrasound.com.au/wp-content/uploads/avatars/2/5fa8b8d6d4f74-bpfull.jpg)
Keymaster
It is one of the quirks of the neck lymph node system that supraclavicular nodes (level 4 nodes in the AJCC criteria) are not draining the neck, but rather the mediastinum. So when I see a malignant looking level 4 supraclavicular node the thorax (breasts , lungs, mediastinum) need assessment to determine the source. Other levels in the neck drain from local neck sources, but level 4 is different.