supraclavicular lymph nodes

What are supraclavicular lymph nodes?

Sufferers from some diseases have swelling of their supraclavicular glands (also called suprachiasmatic nuclei). These glands produce fluid that helps regulate body temperature. They are located just above your heart and sit under the armpit. They do not affect blood flow or other vital functions. However, they can cause problems if they become infected.

Symptoms of swollen supraclavicular glands include:

Fatigue

Headache

Nausea and vomiting (sometimes)

Sweating and chills (rarely)

Sudden weight gain or loss (often with no obvious reason) sometimes accompanied by diarrhea or constipation. Sometimes these changes occur suddenly and without warning. Other times they may take months or even years to develop.

How common are swollen supraclavicular glands?

It is estimated that up to 10% of the population has them. Most people have them only occasionally, but some people experience it all the time. There is no known cure for having swollen supraclavicular glands. Treatment involves lifestyle changes such as exercise and dieting, along with medications like anti-viral drugs and steroids. There is no known cause of swollen supraclavicular glands.

How to Check for Swollen Supraclavicular Glands

To check your supraclavicular lymph nodes, you should stand in front of a mirror and press gently on both armpits. If you see or feel any growths, lumps or anything else other than normal armpit tissue, you should seek medical advice immediately. If you do not feel anything out of the ordinary, this does not rule out swollen supraclavicular glands.

Not everyone experiences obvious symptoms. It is recommended that you have a doctor check for swollen supraclavicular glands at least once a year or as soon as you experience any of the symptoms mentioned above.

Why do supraclavicular glands swell?

Most of the time, causes are unknown. The most common types of swollen supraclavicular glands are:

1. Infections or inflammations:

Infections of the supraclavicular glands usually occur after a chest infection such as pneumonia. It is not always easy to find the source of the infection. Other possible causes of infection or inflammation of the supraclavicular glands include:

Fungal infection, which can develop if you are immune-suppressed, you have diabetes, you have had a recent surgery or you have been on medication that suppresses your immune system.

Bacterial infection, caused by Staphylococcus aureus (staph), Streptococcus pyogenes (strep) or Mycobacterium tuberculosis (TB).

Injury to the supraclavicular glands caused by a direct hit to the chest or clavicles, blunt force trauma or burns.

Parasites such as Strongyloides stercorium, pinworms (Enterobius vermicularis) or hookworms (Necator americane).

HIV/AIDS

Cancer or tumors

2. Non-infectious causes

There are a variety of other non-infectious causes of swollen supraclavicular glands, including:

Allergies. The most common cause of allergies are airborne allergens like pet dander, dust mites, mold or pollen. Food allergies are also a common cause.

Allergies usually cause itchy eyes, a runny nose and sneezing. In some cases, swelling of the supraclavicular glands may occur.

Autoimmune disorders. These are when your body produces antibodies (proteins used by the immune system to defend against foreign objects like bacteria and viruses) that attack your healthy body tissue by mistake. Rheumatoid arthritis, systemic lupus erythematosus and other immune system disorders can cause swollen supraclavicular glands.

Exposure to toxins. Chemicals like Dursban, which is no longer used to kill insects, have been linked to swollen supraclavicular glands. Other toxins that may cause swollen supraclavicular glands include cigarette smoke and sulfur dioxide.

Hormonal changes due to pregnancy or menopause.

Radiation exposure.

Other causes of swollen supraclavicular glands include:

Allergic fungal sinusitis (a fungal infection of the sinuses)

Blunt injury to the chest

Cat scratch disease

Inflammation of the salivary glands (Mandelain tumor or Viral or allergic infection)

Overtraining or overuse of arm muscles (Tennis elbow, Golfer’s elbow, etc.

Sarcoidosis

Tuberculosis

Risk factors

There are some factors that can put you at higher risk of developing swollen supraclavicular glands, including:

Age. One of the most common age-related causes is an infection with cat scratch disease, which can be prevented by avoiding contact with cats.

Gender. Men are more likely to suffer from swollen supraclavicular glands caused by trauma, while women are more likely to suffer from non-infectious causes like rheumatoid arthritis or hormonal changes due to pregnancy or menopause.

Medical history. If you have a family history of rheumatoid arthritis, you are at higher risk of developing swollen supraclavicular glands caused by an autoimmune disorder. People that have previously undergone chemotherapy or radiation therapy are at greater risk of developing swollen supraclavicular glands caused by tumor growth.

Complications

Infected supraclavicular glands can develop complications if not treated properly, although this is relatively rare. Complications may include:

Abscess formation

Cellulitis (infection of the skin and supporting soft tissue)

Infection of the salivary glands (Mandelain tumor or Viral or allergic infection)

Lymphangitis (infection and swelling of the lymphatic vessels)

Lymphadenitis (infection and swelling of the lymph nodes)

Meningitis (infection and swelling of the membranes that surround the brain and spinal cord)

Osteomyelitis (infection of the bone marrow)

Fistula formation (An abnormal passage from an abscess or diseased part of the body to the skin or to a normal organ)

Excess lymphatic drainage may also cause pain, swelling and tissue damage due to “lymph edema”.

Treatment

Your doctor will start by asking questions about your medical history and performing a physical examination. Your doctor may also order X-rays or other tests to rule out conditions that appear similar to swollen supraclavicular glands.

If your swollen supraclavicular glands are caused by an infection, your doctor will start treatment with antibiotics. In some cases surgery is needed to drain pus from the area. If your swollen supraclavicular glands are due to another disease like rheumatoid arthritis, your treatment will be aimed at reversing that condition.

Sources & references used in this article:

Virchow’s node revisited. Analysis with clinicopathologic correlation of 152 fine-needle aspiration biopsies of supraclavicular lymph nodes. by JR Cervin, JF Silverman, BW Loggie… – Archives of pathology & …, 1995 – europepmc.org

Enlargement of the supraclavicular lymph nodes as the initial sign of prostatic carcinoma by JJ Butler, CD Howe, DE Johnson – Cancer, 1971 – Wiley Online Library

Metastases in supraclavicular lymph nodes in lung cancer: assessment with palpation, US, and CT by H van Overhagen, K Brakel, MW Heijenbrok… – Radiology, 2004 – pubs.rsna.org

The diagnostic value of fine needle aspiration cytology (FNAC) in the assessment of palpable supraclavicular lymph nodes: a study of 218 cases by RK Gupta, S Naran, S Lallu, R Fauck – Cytopathology, 2003 – Wiley Online Library

Supraclavicular lymph node: incidence of unsuspected metastatic prostate cancer by K Hematpour, CJ Bennett, D Rogers… – European Archives of Oto …, 2006 – Springer

Vascularized supraclavicular lymph node transfer for lower extremity lymphedema treatment by GA Althubaiti, MA Crosby… – Plastic and reconstructive …, 2013 – journals.lww.com