Left supraclavicular (Virchow's) node
Local vessels and regional nodes · Troisier's sign
The most medial node of the left supraclavicular group sits where the thoracic duct terminates, so tumour emboli carried up the duct from any abdominal or pelvic organ can lodge in it. A palpable hard node there is Troisier's sign.
Traced from the start
- Gut and abdominal visceraTestis and ovary
- Left supraclavicular (Virchow's) node
Detail
- Site
- Left supraclavicular fossa at the thoracic duct termination
- Sign
- Troisier's sign when palpable
- Classic primary
- Gastric adenocarcinoma
- Also from
- Pancreas, oesophagus, colon, kidney, testis, ovary, lung, lymphoma
- Right supraclavicular node
- Points instead to a thoracic (lung, oesophagus) or right-sided source
When it goes wrong
Advanced gastric carcinoma seeding the duct terminus
Hard fixed left supraclavicular node signifying M1, incurable disease
Any new supraclavicular node in an adult
Mandates a search for an abdominal or thoracic primary before anything else
Practise this structure
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