Revisiting Virchow`s Node: Exploring the Diagnostic Spectrum of the Supraclavicular Lymph Node Through Fine-Needle Aspiration Cytology in a Tertiary Care Hospital.

OBJECTIVE

Virchows node, described in 1848, represents a metastasis to the left supraclavicular lymph node, commonly arising from gastric cancer. However, in regions with lower gastric cancer incidence, the relevance of Virchows node and the spectrum of diagnosis associated with supraclavicular lymphadenopathy (SCLAP) needs reevaluation. This study aimed to analyze the spectrum of fine-needle aspiration cytology (FNAC) at a tertiary care institute.

MATERIAL AND METHODS

We retrospectively reviewed all supraclavicular lymph node aspirations performed between March 2019 and August 2022. Data were collected from the Department of Pathology`s electronic records and descriptive analyses were performed.

RESULTS

Out of 270 FNAC procedures for SCLAP, 50 were non-diagnostic. Of the 220 patients, cytological diagnosis was categorized as metastatic malignancy in 120 (54.5%) patients, granulomatous lymphadenitis in 57 (25.9%), reactive lymphadenitis in 11 (5.0%), acute suppurative lymphadenitis in 21 (9.5%), and lymphoproliferative disorder in 10 (4.54%) patients. Among the 120 metastatic cases, the most common type was adenocarcinoma (58.3%). The most common primary site was the lung (22.5%), oral cavity (19.2%), breast (12.5%), and gallbladder (10%). Primary gut carcinomas constitute only 9% of supraclavicular lymph node metastases.

CONCLUSION

The findings suggest a need to reconsider the clinical significance of Virchow`s node, especially in regions with different cancer epidemiology. FNAC remains a critical diagnostic tool in evaluating SCLAP.