Virchow’s Node

Virchow’s node (or signal node) is a lymph node in the left supraclavicular fossa (the area above the left clavicle). It takes its supply from lymph vessels in the abdominal cavity. Virchow’s node is also sometimes coined “the seat of the devil” given its ominous association with malignant disease. The finding of an enlarged, hard node (also referred to as Troisier’s sign) has long been regarded as strongly indicative of the presence of cancer in the abdomen, specifically gastric cancer, that has spread through the lymph vessels.

Image from NEJM (link)

The above patient presented with weight loss.  He was found to have gastric cancer.

Left supraclavicular adenopathy can be an indicator of gastric cancer, as in this case. Virchow’s node, or Troisier’s node, refers to carcinomatous involvement of the supraclavicular nodes at the junction of the thoracic duct and the left subclavian vein. Usually, nodal enlargement is caused by metastatic gastric carcinoma, although supraclavicular nodal involvement can also be seen in other gastrointestinal, thoracic, and pelvic cancers. (from NEJM)

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