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A Virchow’s node is an enlarged lymph node located in the left side of the body in the region above the clavicle. It is sometimes referred to as a sentinel node because it is a sign that an underlying cancer could be present. Diverse processes such as stomach cancer, intestinal cancer, breast cancer, lung cancer, or lymphoma could cause enlargement of the Virchow’s node. Diagnosis of this enlargement is typically made on the basis of a physical examination. Sometimes the node is sampled with a needle in order to understand what type of disease process might be occurring in the body.
In order to understand the clinical importance of having a Virchow’s node, it helps to understand the function of the body’s lymphatic system. Essentially, this system is important for filtering the blood, identifying abnormal cells or substances circulating throughout the body, and initiating an immune response to rid the body of these dangerous entities. The lymphatic system is one mechanism by which cancers can spread from their location of origin to other parts of the body. For this reason, enlarged lymph nodes can herald the spread of a cancer in the body.
Lymphatic fluid from specific parts of the body empty into the Virchow’s node, including organs located in the upper part of the abdomen. Additionally, lymphatic fluid from the breast and lungs can also drain into this lymph node. As a result, the identification of a Virchow’s node can suggest that there is an underlying cancer of the stomach, small intestine, large intestine, breast, lungs, or pancreas. Enlargement of this node could also signal that a lymphoma is present, which is a cancer that originates in the lymphatic tissue itself.
Diagnosis of a Virchow’s node is typically made on the basis of a physical exam performed by a health care professional. Palpation of the tissue in the neck is often done as part of a comprehensive physical exam in order to identify enlargement of any lymph nodes in this area of the body. Identification of the node can be facilitated if the patient stands up straight and bears down as the doctor or other health care professional palpates the region above the clavicle.
There is no specific treatment of a Virchow’s node. Instead, it serves as a signal that a cancer might be growing in the patient’s body. After identification of this structure, a doctor might suggest that a patient undergo imaging studies such as computed tomography (CT) scanning to identify underlying malignancies. Sometimes the Virchow’s node is biopsied, or sampled, in order to characterize the microscopic features of the tissue located in the node. This evaluation could identify what type of primary cancer might be present.