A patient with carcinoma of the lower third of the esophagus most likely has lymph node metastasis in which nodal group FIRST?

• A Left supraclavicular (Virchow's) nodes
• B Posterior mediastinal (para-aortic) nodes
• C Paratracheal nodes
• D Left gastric and celiac nodes ✓

Explanation

The lower third of the esophagus drains to left gastric lymph nodes and then celiac nodes, which is why lower esophageal cancers share lymph node drainage with gastric cancers and can spread to nodes around the celiac axis. The upper third drains to the deep cervical and paratracheal nodes; the middle third drains to posterior mediastinal nodes. Virchow's node (left supraclavicular) is a distant metastatic site reached by retrograde spread via the thoracic duct, not a primary echelon node.

Reference: BD Chaurasia's Human Anatomy, 8th ed.

High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP

Written and medically reviewed by the StethoPrep medical team.