What Are the Supraclavicular Lymph Nodes?

Among the deep cervical lymph nodes, the supraclavicular lymph nodes located near the subclavian artery and brachial plexus. In the late stage of esophageal and gastric cancer, cancer cells can go up through the thoracic duct, and then flow back to the left supraclavicular lymph node through the left neck shaft.

Chinese name: Supraclavicular lymph nodes

Foreign name: supraclavicular lymph nodes

Overview of the supraclavicular lymph nodes

Chest tumors, such as lung cancer, can metastasize to the right supraclavicular lymph nodes, and gastric cancer mostly metastasize to the left supraclavicular fossa lymph nodes. Therefore, the entrance of the thoracic duct into the jugular vein is called a swollen lymph node called Virchow lymph node, which is often gastric cancer , Esophageal cancer, lung cancer metastasis signs can be asymptomatic.

Classification of supraclavicular lymph nodes :

Chronic lymphadenitis of the supraclavicular lymph nodes:

Chronic lymphadenitis has a long course, mild symptoms, harder lymph nodes, mobility, tenderness is not obvious, and eventually the lymph nodes can shrink or resolve. Inguinal lymphadenopathy, especially flat lymph nodes that are long-standing and unchanged, is not significant.

Tuberculous lymphadenitis includes fever, sweating, fatigue, and increased erythrocyte sedimentation. It is more common in young adults. Often accompanied by tuberculosis, the texture of lymph nodes is uneven, some are lighter (cheese-like), some are harder (fibrosis or calcification), and adhere to each other, and adhere to the skin, so poor mobility.

Malignant lymphoma of the supraclavicular lymph node :

It can be seen in any age group, and its lymphadenopathy is usually painless and progressive. It can range from soybeans to jujubes with medium hardness. It is generally non-adhesive to the skin, and does not fuse with each other in the early and middle stages, and can move. In the later stage, the lymph nodes can grow very large, or they can fuse into large pieces, with a diameter of more than 20cm, which invades the skin and will not heal after ulceration. In addition, it can invade the mediastinum, liver, spleen, and other organs, including the lungs, digestive tract, bones, skin, breast, and nervous system. Definitive diagnosis requires biopsy. Clinically, malignant lymphoma is often misdiagnosed. Superficial lymphadenopathy is the first manifestation, and 70% to 80% are diagnosed with lymphadenitis or lymph tuberculosis at the initial diagnosis, which delays treatment.

Giant Clavicular Node Hyperplasia:

Is a rare misdiagnosis. Often manifested as unexplained lymphadenopathy, mainly invading the thorax, most of the mediastinum, but also invading the hilum and lung. Other affected areas are the neck, retroperitoneum, pelvic cavity, axilla, and soft tissue. Often misdiagnosed as thymoma, plasmacytoma, malignant lymphoma. Therefore, understanding the pathology and clinical manifestations of this disease is extremely important for early diagnosis.

Pseudolymphomas often occur outside the lymph nodes, such as orbital, gastric pseudolymphomas, and lymphatic polyps of the digestive tract. Generally considered to be a reactive hyperplasia, caused by inflammation.

Lymph node metastases from the supraclavicular lymph nodes:

Lymph nodes are often stiff, uneven in texture, and primary lesions can be found, rarely with systemic lymphadenopathy. Acute leukemia and chronic lymphocytic leukemia also often have lymphadenopathy, especially acute lymphoblastic leukemia common in children, which is clinically acute and often accompanied by fever, bleeding, liver and splenomegaly, sternal tenderness, etc. Hematology And bone marrow aspiration can confirm the diagnosis.

Diagnosis of supraclavicular lymph nodes

Based on local signs of tuberculosis contact history, especially when cold abscesses have been formed, or long-lasting sinuses or ulcers have been ruptured, a clear diagnosis can be made. If necessary, a chest radiograph can be performed to confirm the presence or absence of lung structure. For pediatric patients, the tuberculin test can help diagnose. If only cervical lymph nodes are enlarged, but no cold abscesses or ulcers are formed.

Clinical manifestations of supraclavicular lymph nodes

There are multiple swollen lymph nodes of various sizes on one or both sides of the neck, which are generally located at the anterior and posterior edges of the sternocleidomastoid muscle. In the early stage, the enlarged lymph nodes are hard, painless and can be pushed. The lesions continued to develop, and peri-lymphitis occurred, causing the lymph nodes to adhere to the skin and surrounding tissues. Each lymph node can also adhere to each other and fuse into a mass, forming a nodular mass that is not easy to push. In the later stages, caseinous necrosis and liquefaction of the lymph nodes occur, forming cold abscesses. After the abscess has ulcerated, pomace-like or thin soup-like pus flows. Finally, a long-lasting sinus tract or chronic ulcer is formed. The skin at the edge of the ulcer is dark red and sneaks, and the granulation tissue is pale and edema. The above-mentioned lesions in different stages can appear in each lymph node of the same patient at the same time. Patients with increased disease resistance and proper treatment can stop the development of TB in the lymph nodes and become calcified.

Classification of supraclavicular lymph nodes

Chronic lymphadenitis

Most of them have obvious infections, and often have localized lymphadenopathy, pain and tenderness. Generally, the diameter does not exceed 2 to 3 cm, and it will shrink after anti-inflammatory treatment. Inguinal lymphadenopathy, especially flat lymph nodes that are long-standing and unchanged, is not significant. However, there is no obvious cause of swelling of the lymph nodes in the neck and supraclavicular region, which indicates systemic lymphoproliferative diseases, which should be paid attention to and further confirmed.

Malignant lymphoma

It can also be seen in any age group, and its lymphadenopathy is usually painless and progressive, ranging from soybeans to jujubes with medium hardness. It is generally non-adhesive to the skin, and does not fuse with each other in the early and middle stages, and can move. In the later stage, the lymph nodes can grow very large, or they can fuse into large pieces, with a diameter of more than 20cm, which invades the skin and will not heal after ulceration. In addition, it can invade the mediastinum, liver, spleen, and other organs, including the lungs, digestive tract, bones, skin, breast, and nervous system. Definitive diagnosis requires biopsy. Clinically, malignant lymphoma is often misdiagnosed. Superficial lymphadenopathy is the first manifestation, and 70% to 80% are diagnosed with lymphadenitis or lymph tuberculosis at the initial diagnosis, which delays treatment.

Giant lymph node hyperplasia

Lymph node metastases

Lymph nodes are often stiff, uneven in texture, and primary lesions can be found, rarely with systemic lymphadenopathy.

Acute leukemia and chronic lymphocytic leukemia also often have lymphadenopathy, especially acute lymphoblastic leukemia common in children, which is clinically acute and often accompanied by fever, bleeding, liver and splenomegaly, and sternal tenderness. And bone marrow aspiration can confirm the diagnosis.

Sarcoidosis

Rarely in our country, often invading bilateral hilars, is radial, accompanied by long-term low fever. Lymph nodes can swell throughout the body, especially before and after the ear, under the jaw, and near the trachea. It is difficult to distinguish clinically from malignant lymphoma.

Mononucleosis

More common with young men and women, caused by EB virus, but patients are generally in good condition, may have fever and generalized lymphadenopathy, may also have mild spleen enlargement, heteromorphic lymphocytes in peripheral blood, heterophilic agglutination A positive test can confirm the diagnosis.

Serum disease

A disease that occurs after the use of serum products (tetanus antitoxin, rabies vaccine, etc.) on patients. A few patients have lymphadenopathy as the first clinical symptom, but most of them are the lymph node enlargement at the injection site and the pulley. It can be diagnosed based on injection history and fever, rash, and eosinophilia.

Lymph node enlargement is very common. I enumerate the above 10 causes of diseases, and hope to give you enlightenment, and promptly seek treatment, diagnosis and identification, so that timely and effective treatment can be obtained.