Orthopedic Tip of
the Month
VIRCHOW NODES
Virchow Nodes is named after Rudolf Virchow (1821 – 1902), the German pathologist who first described the association. The presence of an enlarged Virchow Node is also referred to as TROISIERS SIGN, named after Charles Emile Troisier, who also described this.
In medicine (oncology), VIRCHOWS NODE (or SIGNAL NODE) is an enlarged, hard, left supraclavicular lymph node which can contain metastasis of visceral (abdominal) malignancy.
Malignancies of the internal organs can reach an advanced stage before giving symptoms. Stomach cancer, for example, can remain symptomless while metastasizing. One of the first visible spots where these tumors metastasize is the left Supraclavicular lymph node. The left Supraclavicular node is the classical VIRCHOW NODE because it is on the left side of the body (from the thoracic duct) enters the venous circulation via the left subclavian vein.
Because an enlarged Virchow’s Node is often a harbinger of malignant disease, it is sometimes called the Sentinel node. This needs to be contrasted with the technique of sentinel lymph node biopsy. If should also not be confused with the “sentinel gland” of the greater omentum.
Differential diagnosis of an enlarged Virchow’s Node includes lymphoma, various intra-abdominal malignancies, breast cancer, lung cancer and infection of the arm.
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