Identifying Supraclavicular Lymph Node in a Pinch

Open biopsy or fine-needle aspiration of a supraclavicular lymph node-especially the node on the left side of the neck where the thoracic duct exits-is a relatively easy way to diagnose malignancies. However, the supraclavicular node may be difficult to palpate, particularly in an obese patient. I have found that palpating the area just lateral to the supraclavicular joint, then compressing this area between your thumb and forefinger (after the patient has expired deeply), often facilitates identification of the lymph node.

-- Bernard Kabakow, MD
         New York City

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