Virchow's node (Troisier's sign) is an enlarged left supraclavicular lymph node indicating intra-abdominal malignancy. Which lymphatic pathway explains how abdominal tumor cells reach this node?

• A Via the right lymphatic duct which carries lymph from the entire abdomen
• B Retrograde flow through the internal mammary lymph chain
• C Via the thoracic duct which drains the intestinal lymph trunks and terminates at the left venous angle near the left subclavian vein ✓
• D Hematogenous spread to left supraclavicular region with secondary lymph node involvement

Explanation

The thoracic duct collects lymph from the lower limbs, pelvis, abdomen, and left upper body. It ascends from the cisterna chyli, enters the thorax, and terminates at the left venous angle (junction of left internal jugular and left subclavian veins). The left supraclavicular (Virchow's) node lies in the terminal tributaries of the thoracic duct; tumor emboli from gastric, pancreatic, or other abdominal cancers can travel retrogradely or embolically to this node. The right lymphatic duct drains only the right upper quadrant and empties at the right venous angle.

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

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Written and medically reviewed by the StethoPrep medical team.