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MBBS QUESTION #10212
Question 1
A patient with gastric carcinoma develops a firm, enlarged left supraclavicular lymph node (Virchow's node/Troisier's sign). This distant metastasis reaches the neck via which lymphatic route?
  • The thoracic duct, which drains into the venous system at the left venous angle (junction of left subclavian and internal jugular veins)✔️
  • Direct hematogenous spread only, bypassing the lymphatic system
  • The right lymphatic duct
  • Retrograde flow through the inferior vena cava
Correct Answer Explanation
The thoracic duct drains lymph from the abdomen (including gastric lymphatics), lower limbs, and left side of the thorax/head/neck, emptying into the venous system at the left venous angle; malignant cells can travel retrogradely or lodge here, producing the classic left supraclavicular (Virchow's) node in abdominal malignancy.