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Malar (zygomatic) lymph nodes

Malar lymph nodes, also known as zygomatic lymph nodes, are small, superficial lymph nodes located along the lateral aspect of the midface, immediately over the zygomatic arch, and lateral to the infraorbital rim. They are usually 1–3 mm in size and embedded within the subcutaneous fat of the upper cheek. They lie superficial to the zygomaticus muscles and drain lymph from the cheeks, lower eyelids, lateral nose, and upper lip, eventually connecting to the preauricular and parotid lymph nodes. These nodes are not usually palpable in healthy individuals but can become evident when enlarged due to infection, inflammation, or metastatic disease.

Synonyms

  • Zygomatic lymph nodes

  • Lateral facial lymph nodes

  • Infraorbital lymph nodes

  • Superficial facial nodes

Function

  • Filter lymph from the cheeks, lateral nose, lower eyelids, and upper lip

  • Initiate immune responses by trapping pathogens and foreign particles

  • Serve as an early indicator of midfacial or ocular infection when enlarged

  • Drain lymph into preauricular and parotid lymph nodes, maintaining 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 fat, which provides clear anatomical contrast

  • Pathological nodes may appear enlarged, rounded, or demonstrate cortical thickening

T1 Post-Contrast (Gadolinium-enhanced):

  • Normal nodes may show mild, homogeneous enhancement due to vascularity

  • Enlarged or inflamed nodes demonstrate marked homogeneous or heterogeneous enhancement, highlighting the cortex and sometimes the fatty hilum

  • Post-contrast imaging is particularly helpful for detecting early metastatic involvement or inflammatory changes

T2-weighted images:

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

  • Useful for evaluating edema, inflammation, or infiltrative pathology

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

STIR (Short Tau Inversion Recovery):

  • Fat suppression highlights node edema or pathology

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

  • Useful for detecting subtle lymphadenopathy

CT Appearance:

  • Nodes appear as small, soft tissue density structures embedded in subcutaneous fat over the zygomatic arch

  • Surrounded by air in nasal cavity and paranasal sinuses, which provides natural hypodense contrast

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

  • CT is especially useful for preoperative planning, infection assessment, and detection of metastatic disease

MRI images

Malar (Zygomatic) Lymph Nodes mri axial image -img-00000-00000