A 50-year-old man presents with a painless left-sided cervical lymphadenopathy. Examination reveals a mass in the nasopharynx. Biopsy shows undifferentiated carcinoma. Which lymph node group is most commonly involved first in nasopharyngeal carcinoma?

• A Submandibular lymph nodes
• B Retropharyngeal lymph nodes ✓
• C Jugulodigastric lymph node
• D Supraclavicular lymph nodes

Explanation

The retropharyngeal lymph nodes are the first echelon of lymphatic drainage for the nasopharynx and are most commonly involved in nasopharyngeal carcinoma. The jugulodigastric lymph node (Level II) is commonly involved but is not the first echelon. Submandibular nodes drain the oral cavity and oropharynx, not the nasopharynx. Supraclavicular nodes are involved in advanced disease, not early disease.

Reference: Cummings Otolaryngology, 7th ed.

High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP

Written and medically reviewed by the StethoPrep medical team.