There are three major collecting lymphatic trunks in the oropharynx: (i) the middle collecting, (ii) the palatine tonsil, and (iii) the posterior lingual. These drain into the parapharyngeal or retropharyngeal nodes. The jugulodigastric and jugulo-omohyoid are the most common draining nodes, although upper and lower deep cervical nodes also are first-station nodes. Because of the location of palatine tonsillar lymphoid tissue between the anterior and posterior pillars, and the location of lingual tonsils in the base of the tongue, lymphomas commonly arise at these sites. Occasionally, all of Waldeyer's ring can be involved with lymphomatous infiltration, obstructing the oropharynx and nasopharynx. These tumors can become large, growing rapidly and remaining submucosal. Both lymphomas and carcinomas often spread into the jugulodigastric and omodigastric nodes. Rapid spread into other cervical nodes and bilateral involvement is common, reflecting the bilateral drainage of the base of the tongue.