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Buccinator lymph nodes

Buccinator lymph nodes are small, superficial lymph nodes located along the course of the buccinator muscle, embedded in the subcutaneous fat of the cheek, lateral to the oral cavity. They are part of the facial lymphatic chain and lie superficial to the buccinator muscle and deep to the facial skin, usually 1–3 mm in size. These nodes receive lymph from the cheeks, lateral oral mucosa, and sometimes the upper and lower lips, and drain primarily into the preauricular and parotid lymph nodes. Buccinator lymph nodes are generally non-palpable in healthy individuals but can become prominent during infection, inflammation, or metastatic spread.

Synonyms

  • Facial buccinator nodes

  • Cheek lymph nodes

  • Subcutaneous facial nodes

Function

  • Filter lymph from the cheeks, lateral oral mucosa, and portions of the lips

  • Participate in immune surveillance by trapping pathogens and foreign particles

  • Serve as an early indicator of midfacial infection or neoplastic involvement

  • Drain lymph into preauricular and parotid lymph nodes, maintaining normal facial lymphatic flow

MRI Appearance

T1-weighted images:

  • Normal nodes appear as small, oval, hypointense to intermediate signal structures within subcutaneous fat

  • Surrounded by hyperintense subcutaneous fat, providing natural contrast

  • Enlarged or pathological nodes may appear rounded, hypointense, with cortical thickening

T1 Post-Contrast (Gadolinium-enhanced):

  • Normal nodes show mild, homogeneous enhancement

  • Enlarged or pathological nodes demonstrate marked homogeneous or heterogeneous enhancement, highlighting cortical thickening and potentially the fatty hilum

  • Especially useful for detecting early metastatic involvement or inflammatory changes

T2-weighted images:

  • Nodes show intermediate to slightly hyperintense signal, with surrounding fat bright

  • Useful for identifying edema, inflammation, or infiltrative pathology

  • Fatty hilum (if present) may appear slightly hyperintense relative to cortex

STIR (Short Tau Inversion Recovery):

  • Fat suppression highlights edema or pathology

  • Normal nodes remain low to intermediate signal, whereas inflamed or metastatic nodes appear hyperintense

  • Ideal for detecting subtle lymphadenopathy

CT Appearance:

  • Nodes appear as small, soft tissue density structures within the subcutaneous fat over the buccinator muscle

  • Surrounded by air in the oral cavity, which provides natural hypodense contrast

  • Enlarged or pathological nodes appear as well-defined or irregular soft tissue masses

  • CT is particularly useful for preoperative planning, infection evaluation, and detection of metastatic disease