A 58-year-old man presents with early satiety, anorexia, and weight loss. Endoscopy reveals a linitis plastica appearance — rigid, non-distensible stomach. Biopsy confirms signet-ring cell gastric adenocarcinoma. Which lymph node group is the sentinel indicator of unresectability in gastric cancer?
- A Perigastric nodes along the lesser curvature
- B Left supraclavicular node (Virchow's node) ✓
- C Para-aortic nodes
- D Mesenteric nodes
Correct answer: B. Left supraclavicular node (Virchow's node)
Explanation
Virchow's node (left supraclavicular) enlargement in gastric cancer (also called Troisier's sign) indicates distant lymphatic spread via the thoracic duct, rendering the tumour incurable by surgery (M1 disease). Other indicators of unresectability include periumbilical nodule (Sister Mary Joseph's nodule), Blumer's shelf on rectal examination, and Krukenberg tumour in the ovaries. Perigastric nodes are regional and resectable.
Reference: Bailey & Love's Short Practice of Surgery, 27th ed.
High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP
Written and medically reviewed by the StethoPrep medical team.