A patient with bronchogenic carcinoma has a tumour in the hilum of the right lung. Metastasis to which lymph node group is expected FIRST at the hilum?

• A Bronchopulmonary (hilar) nodes ✓
• B Supraclavicular nodes
• C Tracheobronchial nodes
• D Paratracheal nodes

Explanation

Intrapulmonary lymph nodes located at the hilar region (bronchopulmonary or hilar nodes) are the first to receive lymph from the lung parenchyma and bronchi. From there, lymph passes sequentially to tracheobronchial, paratracheal, and then supraclavicular nodes. Option B represents a late, distant spread. Options C and D are second-echelon nodes in the mediastinal chain, not the first.

Reference: Gray's Anatomy, 42nd ed.

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