When lymph nodes swell, their location suggests a possible underlying cause. Supraclavicular lymph node swelling often occurs as a reaction to infection or because of metastatic cancer.
Lymph nodes are part of the immune system. They increase in size due to illnesses like infection, cancer, and autoimmune disease.
Sometimes a virus like the flu can cause lymph node swelling that recedes once the virus has resolved.
Other times, lymph node enlargement can indicate a more serious condition that needs treatment.
This article discusses possible reasons for supraclavicular lymph node swelling, diagnosis, treatment, and when to contact a doctor.
The supraclavicular lymph nodes are located just above the collarbone.
One of the supraclavicular lymph nodes is called the Virchow node (VN), named after German pathologist Rudolf Virchow.
The VN is usually the left side node closest to the center of the body. However, like the other supraclavicular lymph nodes, the position of the VN can differ from its typical location.
Lymph nodes are small glands that act as filters in the immune system.
The body’s cells and tissues eliminate waste using lymph fluid, which travels in vessels and passes through lymph nodes. Inside the lymph nodes are white blood cells called
When a person is sick, the immune system produces more lymphocytes, which causes lymph nodes to swell.
Swollen supraclavicular lymph nodes need a prompt evaluation since this type is associated with cancer. Usually, cancer has metastasized or progressed beyond the original cancer site.
Approximately 34–50% of people with supraclavicular lymphadenopathy, the medical term for swollen supraclavicular lymph nodes, also have abdominal cancer.
Swollen supraclavicular nodes on either collarbone can indicate a chest malignancy, such as
If lymph node swelling occurs only on the left side, cancer is more likely in the abdomen or pelvis. This is because
VN enlargement is called the
The Troisier sign can also occur due to other cancer types, including:
Swollen supraclavicular nodes are not always a sign of cancer. Sometimes they can indicate a reaction to an infection.
For example, a preprint 2021 case study described a 12-year-old girl who developed supraclavicular lymphadenopathy due to COVID-19 infection. It’s important to note that preprint research has not gone through the formal peer review process.
A 2019 case report suggested that lymphadenopathy may also be a temporary side effect of vaccines. The report described supraclavicular lymph node swelling in an 11-year-old boy after receiving the human papillomavirus (HPV) vaccine.
Swollen lymph nodes appear as a bump under the skin.
Lymph nodes containing cancer cells differ slightly from reactive, noncancerous nodes, as the following table shows:
|Malignant lymph nodes||Reactive lymph nodes|
|round shape||oval shape|
|sharp borders||blurred borders|
|no visible hilum or indentation||hilum is present|
|do not move when pushed||move when pushed|
Imaging like CT, PET, and ultrasound scans can help doctors determine whether cancer has spread.
Biopsy samples are analyzed in a laboratory to determine the types of cells present in a lymph node. This can identify whether cancer is present and if so, what type.
Treating swollen lymph nodes focuses on the underlying cause.
Antibiotics can treat bacterial infections, and medications like corticosteroids and immunosuppressant drugs can treat autoimmune conditions.
Doctors may use a combined treatment approach if the cause of swollen lymph nodes is cancer. This can include radiation, surgery, and systemic therapy like chemotherapy or hormone therapy to target cancer metastases in various locations.
Doctors may also treat the lymph nodes themselves with radiation or surgery to prevent trapped tumor cells from leaving the lymph nodes and recirculating.
- any supraclavicular lymph node that is larger than 0.5 centimeters (cm)
- other lymph nodes that are larger than 2 cm
- lymph nodes that are hard or firm, fixed, and not tender
- swollen lymph nodes in multiple areas
- the person experiencing swollen lymph nodes is age 40 or older
The outlook for a person with swollen supraclavicular lymph nodes depends on the underlying cause. If the lymph nodes swell due to an infection, the swelling should decrease as the infection resolves.
Swelling in supraclavicular lymph nodes is
Supraclavicular lymph nodes are located just above the collarbone on both sides of the body. Swollen supraclavicular lymph nodes may indicate an immune system reaction to infection or metastatic cancer.
Doctors can treat swollen supraclavicular lymph nodes by addressing the underlying cause.
Infections may need treatment with antibiotics or antivirals. If cancer is the cause, doctors may recommend a combined approach, including radiation, surgery, and systemic treatments like chemotherapy.