Troisier sign is the clinical finding of a hard and enlarged left supraclavicular node (Virchow node), and is considered a sign of metastatic abdominal malignancy.
It is sometimes referred to as Virchow node, which is the name given by Dr Rudolf Virchow (1821-1902), a German pathologist, to the left supraclavicular lymph node but not necessarily a pathologic lymphadenopathy 1.
The left supraclavicular lymph node drains via the thoracic duct, the abdomen, and thorax. It is the junction where incoming lymph is introduced back in the venous circulation through the left subclavian vein. Hence, any malignancy arising in these territories can be responsible for Troisier sign.
History and etymology
It was described by Dr Charles Emile Troisier, a French pathologist, in 1889 2.
- 1. Virchow R, « Zur Diagnose der Krebse in Unterleibe », dans Med. Reform., vol. 45, 1848, p. 248.
- 2. Troisier CE, « L'adénopathie sus-claviculaire dans les cancers de l'abdomen », Arch. Gen. de Med., vol. 1, 1889, p. 129–138 and 297–309.
- 3. Loh KY, Yushak AW. Images in clinical medicine. Virchow's node (Troisier's sign). N. Engl. J. Med. 2007;357 (3): 282. doi:10.1056/NEJMicm063871 - Pubmed citation
- 4. Casiello A. [Troisier's ganglion: pilot sign in the diagnosis of latent stomach cancer]. Dia Med. 1958;30 (1): 10 passim. - Pubmed citation