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    Related Topics

    From Lymphatic System

    Spleen
    Filters blood and initiates immune response.
    Lateral Axillary Nodes
    Located along the humerus in the axilla.
    Right Lymphatic Duct
    Drains right upper quadrant of the body.
    NALT
    Nasal-associated lymphoid tissue.
    BALT
    Bronchus-associated lymphoid tissue.
    Waldeyer’s Ring
    Ring of lymphoid tissue surrounding the naso- and oropharynx.
    Subclavian Trunk
    Drains lymph from the upper limbs.
    Subscapular Axillary Nodes
    Located along the posterior chest wall.
    Lymphatic Capillaries
    Initial lymphatic vessels that collect interstitial fluid.
    Palatine Tonsils
    Located on each side of the oropharynx.
    Central Axillary Nodes
    Located centrally in the armpit.
    Inguinal Lymph Nodes
    Drain the lower limbs and external genitalia.
    Intestinal Trunk
    Drains lymph from the intestines.
    Axillary Lymph Nodes
    Drain the upper limbs and chest wall.
    MALT
    Mucosa-associated lymphoid tissue.
    GALT
    Gut-associated lymphoid tissue.
    Pharyngeal Tonsil
    Located in the nasopharynx (adenoids).
    Apical Axillary Nodes
    Located at the apex of the axilla.
    Jugular Trunk
    Drains lymph from the head and neck.
    Lymph Nodes
    Small structures that filter lymph and store immune cells.
    Retroaortic Nodes
    Located behind the aorta.
    Iliac Lymph Nodes
    Include external, internal, and common iliac nodes.
    Tracheobronchial Nodes
    Drain lungs and bronchi.
    Posterior Mediastinal Nodes
    Drain posterior thoracic structures.
    Peyer’s Patches
    Lymphoid nodules in the small intestine.

    Supraclavicular Lymph Nodes

    Reviewed by our medical team

    Located above the clavicle; key in thoracic drainage.

    1. Overview

    The supraclavicular lymph nodes are a group of deep cervical lymph nodes located just above the clavicle (collarbone). These nodes are important filtering stations for lymph drained from the head, neck, upper limbs, and portions of the thoracic and abdominal cavities. Although small and often impalpable in healthy individuals, they are of high clinical importance due to their association with systemic infections and malignancies—particularly when they become enlarged, as in the case of Virchow’s node.

    2. Location

    Supraclavicular lymph nodes are found in the supraclavicular fossa, which lies superior to the clavicle and lateral to the sternocleidomastoid muscle. Based on their position, they are categorized into:

    • Right supraclavicular nodes: Drain lymph primarily from the mediastinum, lungs, and esophagus.

    • Left supraclavicular node (Virchow’s node): Receives lymph from the thoracic duct and reflects drainage from the entire abdominal cavity, especially the gastrointestinal tract.

    The left supraclavicular node is particularly significant as a potential site for early detection of abdominal malignancies.

    3. Structure

    Supraclavicular lymph nodes are small, encapsulated, bean-shaped structures made up of organized lymphoid tissue. Key structural features include:

    • Cortex: Contains follicles rich in B lymphocytes for humoral immune responses.

    • Paracortex: T-cell rich zone for antigen presentation and cellular immunity.

    • Medulla: Contains macrophages, plasma cells, and lymphatic sinuses for lymph filtration.

    • Afferent lymphatic vessels: Bring lymph from regional and distant sites (especially on the left).

    • Efferent lymphatic vessels: Drain into the subclavian lymphatic trunks or thoracic duct.

    4. Function

    The supraclavicular lymph nodes serve several critical functions in the lymphatic and immune systems:

    • Filtration of lymph: Remove pathogens, cancer cells, debris, and foreign particles from lymph before it enters the venous system.

    • Immune response initiation: Site of lymphocyte activation and antigen processing, especially in systemic infections or metastatic disease.

    • Relay of deep lymphatic flow: These nodes act as conduits between cervical lymphatics and the thoracic duct or right lymphatic duct.

    5. Physiological Role(s)

    Despite being few in number, supraclavicular nodes perform vital physiological tasks, including:

    • Monitoring for thoracic and abdominal pathology: Especially the left supraclavicular node, which reflects lymph drainage from the entire gastrointestinal tract.

    • Maintenance of systemic immune integrity: By filtering lymph from critical regions before it returns to venous blood.

    • Prevention of metastatic spread: Attempt to contain and process malignant cells before they spread systemically.

    • Early immune detection: Serve as early detection points for deep-seated infections or neoplasms.

    6. Clinical Significance

    Virchow’s Node

    The left supraclavicular lymph node is often referred to as Virchow’s node. Enlargement of this node—termed a Trosier’s sign—is highly suggestive of abdominal malignancy, especially:

    • Gastric cancer

    • Pancreatic cancer

    • Ovarian cancer

    • Testicular cancer

    This is due to the fact that the thoracic duct, which drains abdominal viscera, empties near this node.

    Right-Sided Lymphadenopathy

    Enlarged right supraclavicular nodes may reflect pathology in the:

    • Lungs (lung carcinoma)

    • Mediastinum (lymphoma or metastatic disease)

    • Esophagus (esophageal carcinoma)

    Lymphadenopathy Causes

    General supraclavicular lymphadenopathy may be due to:

    • Infections: Tuberculosis, mononucleosis, or systemic fungal infections

    • Malignancies: Metastatic disease or lymphomas

    • Autoimmune diseases: Such as sarcoidosis or systemic lupus erythematosus

    Diagnostic Approach

    Enlarged supraclavicular lymph nodes should always prompt further investigation, especially when painless and persistent. Evaluation may include:

    • Physical examination: Palpation for size, mobility, tenderness, and consistency

    • Ultrasound or CT scan: For nodal architecture and localization

    • Fine needle aspiration (FNA): First-line for cytological analysis

    • Excisional biopsy: In cases of inconclusive FNA or suspected lymphoma

    Prognostic Indicator

    Presence of supraclavicular lymphadenopathy in cancer patients is often a sign of advanced disease and may indicate unresectability or poor prognosis. It is a key factor in staging for gastrointestinal, thoracic, and gynecologic malignancies.

    Did you know? The body's immune cells, such as T-cells and B-cells, travel through the lymphatic system to fight infections and diseases.