Virchow-Troisier's lymph node in hepatocellular carcinoma.

Virchow-Troisier's lymph node is rarely found in patients with hepatocellular carcinoma. When present, it may or may not accompany spread of the tumor to mediastinal lymph nodes. In a 20-year-old South African black man with hepatocellular carcinoma, a Virchow-Troisier's node was evident clinically and confirmed at necropsy. Mediastinal lymph nodes were not involved by tumor, and the malignant cells probably gained access to the thoracic duct by way of lymphatic spread to the hepatic lymph nodes in the porta hepatitis and the celiac nodes, both of which were seen at necropsy to be extensively invaded by tumor.