Virchow's Node - Clinical Significance

Clinical Significance

Malignancies of the internal organs can reach an advanced stage before giving symptoms. Stomach cancer, for example, can remain asymptomatic while metastatizing. One of the first visible spots where these tumors metastasize is the left supraclavicular lymph node. The left supraclavicular node is the classical Virchow's node because it is on the left side of the neck where the lymphatic drainage of most of the body (from the thoracic duct) enters the venous circulation via the left subclavian vein.The metastasis blocks the thoracic duct leading to regurgitation into the surrounding nodes i.e. virchow's node. Another concept is that one of the supraclavicular nodes corresponds to the end node along the thoracic duct and hence the enlargement.

Differential diagnosis of an enlarged Virchow's node includes lymphoma, various intra-abdominal malignancies, breast cancer, and infection (e.g. of the arm). Similarly, an enlarged right supraclavicular lymph node tends to drain thoracic malignancies such as lung and esophageal cancer, as well as Hodgkin's lymphoma.