Virchow node is a left supraclavicular lymph node lying near where the thoracic duct empties into the junction of the left internal jugular and subclavian veins. Because the thoracic duct carries lymph from the abdomen and pelvis, enlargement of this node can be the first sign of a hidden abdominal cancer.
| Location | Left supraclavicular fossa, near the junction of the left internal jugular and subclavian veins, at the termination of the thoracic duct |
|---|---|
| Receives lymph from |
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| Lymphatic drainage |
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Filters lymph close to the termination of the thoracic duct, making it a sentinel for disease spreading from below the diaphragm.
A hard, enlarged left supraclavicular node (Troisier sign) is classically associated with stomach cancer but may also arise from pancreatic, oesophageal, colorectal, ovarian, testicular and other cancers, as well as lymphoma. It should prompt imaging and biopsy. It is felt deep in the left supraclavicular fossa, often best with the patient performing a Valsalva manoeuvre.
A palpable, hard Virchow node indicating metastatic cancer, most classically from the stomach.
Enlargement of the left supraclavicular node by Hodgkin or non-Hodgkin lymphoma.
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