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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).
The presence of swollen inguinal lymph nodes is an important clinical sign because lymphadenopathy (swelling) may indicate an infection, or spread as a metastasis from cancers, such as anal cancer and vulvar cancer. Inguinal lymph nodes may normally be up to 2 cm. [1] The cut-off value for normal sized inguinal nodes is up to 10 mm. [6]
The left supraclavicular nodes are the classical Virchow's node because they receive lymphatic drainage of most of the body (from the thoracic duct) and enters the venous circulation via the left subclavian vein. The metastasis may block the thoracic duct leading to regurgitation into the surrounding Virchow's nodes.
The efferent vessels of the subclavicular group unite to form the subclavian trunk, which opens either directly into the junction of the internal jugular and subclavian veins or into the jugular lymphatic trunk; on the left side it may end in the thoracic duct.
Lymphedema, also known as lymphoedema and lymphatic edema, is a condition of localized swelling caused by a compromised lymphatic system. [2] The lymphatic system functions as a critical portion of the body's immune system and returns interstitial fluid to the bloodstream.
Localized lymphadenopathy: due to localized spot of infection; e.g., an infected spot on the scalp will cause lymph nodes in the neck on that same side to swell up; Inflammatory localized lymphadenopathy at right mandibular angle. Generalized lymphadenopathy: due to a systemic infection of the body; e.g., influenza or secondary syphilis
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Left and right inguinal regions shown in lower part of diagram. In human anatomy, the groin, also known as the inguinal region or iliac region, [1] is the junctional area between the torso and the thigh. [2] The groin is at the front of the body on either side of the pubic tubercle, where the lower part of the abdominal wall meets the thigh.