Troisier sign

Last revised by Dr Francis Deng on 08 Nov 2019

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 the Virchow node, which is the name given by Rudolf Virchow (1821-1902) 6, a German pathologist, to the left supraclavicular lymph node but not necessarily to a pathological lymphadenopathy 1.

The left supraclavicular lymph node drains via the thoracic duct, the abdomen, and thorax. It is the junction where incoming lymph is returned to the venous circulation through the left subclavian vein. Hence, any malignancy arising in these territories can be responsible for Troisier sign.

It was described by Charles-Emile Troisier (1844-1919) 5, a French pathologist, in 1889 2.

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