Virchow's node (sentinel node, Troisier's sign) is a palpable left supraclavicular lymph node that indicates abdominal malignancy. It receives lymph via which pathway from abdominal organs?

• A Right lymphatic duct draining abdominal viscera directly into right supraclavicular nodes
• B Direct lymphatic channels from the stomach wall to the left supraclavicular nodes
• C Portal venous system bypassing lymphatics
• D Thoracic duct → left venous angle (junction of left subclavian and left internal jugular vein) → retrograde filling of left supraclavicular nodes with lymph from abdominal viscera ✓

Explanation

The thoracic duct drains lymph from the entire body below the diaphragm (including abdominal viscera via the cisterna chyli) and the left thorax/left upper limb/left head and neck. It empties at the left venous angle (junction of left subclavian and left internal jugular veins). Metastatic cells from gastrointestinal tumors (especially gastric carcinoma) travel through the thoracic duct and may arrest in the left supraclavicular nodes (Virchow's node). The right lymphatic duct drains the right upper quadrant of the body only.

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

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Written and medically reviewed by the StethoPrep medical team.