A patient with carcinoma of the stomach involving the lesser curvature develops a left supraclavicular lymph node enlargement (Virchow's node). Through which lymphatic structure does tumour spread from the stomach to the left supraclavicular node?

• A Right lymphatic duct
• B Cisterna chyli
• C Thoracic duct ✓
• D Right bronchomediastinal trunk

Explanation

Abdominal lymph from the stomach drains via the intestinal lymphatic trunks into the cisterna chyli and then through the thoracic duct to the left venous angle. The thoracic duct terminates at the junction of the left internal jugular and left subclavian veins, where Virchow's node receives lymph via the left jugular trunk. The right lymphatic duct (A) drains the right upper quadrant, not abdominal organs. The cisterna chyli (B) is an intermediate dilatation, not the final conduit to the supraclavicular node. The right bronchomediastinal trunk (D) drains the right thorax.

Reference: Gray's Anatomy, 42nd ed.

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Written and medically reviewed by the StethoPrep medical team.