History of Medicine


An Open Access Journal

Virchow’s node: historical and didactic features of the description of the eponym

DOI: 10.17720/2409-5834.v5.1.2018.09i

Nikolay N. Krylov,
Aftandil V. Alekberzade,
Elena A. Piatenko
FSAEI HE I.M. Sechenov First MSMU MOH Russia (Sechenov University)
8 Trubetskaya St., building 2, Moscow 119991, Russia

The eponym is a part of the nomenclature of medicine. In 1848, R. Virchow described the enlarged left supraclavicular lymph node (Virchow’s node), which he uncovered by physical examination. He believed that such lymphadenopathy occurs in cases of stomach cancer (less often – with lung cancer), when the metastatic process spreads up the thoracic duct to the left supraclavicular fossa. He described the pathogenesis of this trait and proved its malignant nature. Russian authors, apparently, borrowed this eponym from German textbooks on medicine. In 1886, Troisier added to Virchow’s insights and presented a detailed substantiation for the increase in the size of the left supraclavicular lymph node. Troisier described its typical location above the middle third of the clavicle behind the clavicular portion of the sternocleidomastoid muscle. He considered this enlargement as a direct sign of the existence of a neoplasm in the abdominal cavity or in the pelvic cavity, breast cancer, tuberculosis, and syphilis. In his opinion, identifying a diseased lymph node by physical examination does not indicate the exact location of the primary focus of the tumor, but will direct the diagnostic search in the right direction. Palpable lymph nodes in the supraclavicular fossa (Troisier-Virchow), as a rule, indicate a malignant nature. If the lymph node enlargement is due to tumor emboli in cases of stomach cancer, it should be referred to as Virchow’s metastasis. Troisier’s symptom can be detected due to the metastasizing of cancer of other abdominal organs and the small pelvis, lung, breast, esophagus and tuberculosis lesions.

Keywords: Virchow’s node, Troisier’s sign, the history of oncology, teaching in medical higher education institutions


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