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Differential diagnosis of an enlarged Virchow's node includes lymphoma, various intra-abdominal malignancies, breast cancer, and infection (e.g. of the arm). Similarly, an enlarged right supraclavicular lymph node tends to drain thoracic malignancies such as lung and esophageal cancer, as well as Hodgkin's lymphoma.
The first sign of a malignancy, especially an intra-abdominal one, may be an enlarged Virchow's node, a lymph node in the left supraclavicular area, in the vicinity where the thoracic duct empties into the left brachiocephalic vein, right between where the left subclavian vein and left internal jugular join (i.e., the left Pirogoff angle).
Lung cancer is a large and exceptionally heterogeneous family of malignancies. [3] Over 50 different histological variants are explicitly recognized within the 2004 revision of the World Health Organization (WHO) typing system ("WHO-2004"), currently the most widely used lung cancer classification scheme. [1]
Lymphadenopathy or adenopathy is a disease of the lymph nodes, in which they are abnormal in size or consistency.Lymphadenopathy of an inflammatory type (the most common type) is lymphadenitis, [1] producing swollen or enlarged lymph nodes.
[3] [13] [14] Diagnosis, if enlarged lymph nodes are present, is usually by lymph node biopsy. [1] [2] Blood, urine, and bone marrow testing may also be useful in the diagnosis. [2] Medical imaging may then be done to determine if and where the cancer has spread. [1] [2] Lymphoma most often spreads to the lungs, liver, and brain. [1] [2]
Most patients with limited-stage small cell lung cancer will receive a CT scan of the chest and abdomen to search for abnormality within the lungs and lymph nodes, as well as abnormal areas in more distal organs such as adrenal glands and liver that might arise from the metastasis of lung cancer. [15]
Compared to most other lung cancer variants, cells comprising GCCL tend to be much larger (up to 150 micrometers diameter, or even larger), [9] Both cells and nuclei show extreme variation in size distribution and shape. Carcinomatous giant cells carcinoma nuclei have been reported to average 5 times the size of lymphocyte nuclei.
Trousseau described several cases in which recurrent thrombosis was the presenting feature of visceral cancer, and his confidence in the utility of this connection led him to say, "So great, in my opinion, is the semiotic value of phlegmasia in the cancerous cachexia, that I regard this phlegmasia as a sign of the cancerous diathesis as certain ...