Lymphogenic metastasis of lung cancer with damage to the lymph nodes of the mediastinum, which is one of the features of a far-reaching stage of the development of the disease, leads to peculiar changes and is accompanied by the appearance of characteristic symptoms. The basis of their appearance and development is a progressive increase and fusion into conglomerates of lymph nodes affected by metastases, as well as the tumor itself, with involvement of the adjacent mediastinal anatomical formations in the blastomatous process.

When metastases are affected by a group of bifurcation lymph nodes, compression or germination of a tumor of the initial sections of the main bronchi and keel of bifurcation of the trachea is possible . This is accompanied by the appearance of increasing, up to significantly pronounced respiratory distress. Tumor growths in the lumen of the respiratory tract cause a sensation of a foreign object, induces a frequent cough that does not bring satisfaction. Constant irritation of the mucous membrane of the respiratory tract in the departments close to the lesion site in a short time can cause pain in the trachea and behind the sternum. Partial overlap of the lumen of the trachea over its bifurcation with a growing cancerous tumor leads to episodes of suffocation, partly resembling the clinical manifestations of bronchial asthma.

Compression or sprouting of the walls of the superior vena cava, affected by metastases, encountered in 8% of patients operated on in the clinic is accompanied by characteristic hemodynamic disorders. At the same time, the flow of venous blood to the right heart, it stagnates in the overlying venous collectors. The clinical signs of such a lesion have long been known and are called “superior vena cava syndrome. In a severe degree, edema of the skin of the face, neck, upper half of the body, and the right arm appears. Collateral veins of the skin and subcutaneous tissue of the anterior surface of the chest are compensatingly expanding. They look convoluted, blood-filled, often surrounded by petechial hemorrhages. The skin of the face, neck and upper half of the body acquires a cyanotic hue. Violation of blood flow during compression of the superior vena cava with the accompanying swelling of the mucous membrane of the respiratory tract leads to shortness of breath, the appearance of a cough with the separation of a small amount of sputum mucosa. The desire of such patients to get rid of a feeling of heaviness, noise and pain in the head, to ease breathing, forces them to occupy a position with an elevated placement of the upper half of the body.

Metastasis of lung cancer through regional collectors into a group of pre-aortocarotid lymph nodes, some of which are located in the so-called “aortic window” at the branch site from the trunk of the left vagus return — lower larynx, often leads to impaired function of the latter. Then, as a result of the paresis of the left vocal cord resulting from this, patients first note a temporary, transient loss of sonority, and then its steady hoarseness. In addition, incomplete closure of the glottis violates the process of normal coughing, leading to the development of tracheitis and bronchitis.

The progressive growth of lung cancer metastases in the bifurcation and especially in the esophageal lymph nodes of the mediastinum can lead to displacement, compression of the esophagus and even tumor invasion of its wall. Similar changes were observed in 9.5% of patients operated on for cancer of the right lung. The clinical manifestations of such a lesion are not always pronounced quite clearly. Only a few patients noted the appearance of unpleasant sensations in the chest when eating.

In several patients, a tumor from metastatic lymph nodes passed to the aortic wall. For her descending department, a sign of such a lesion was pain due to compression of a conglomerate of the lymph nodes of the roots of the spinal cord nearby.