Lump in the Supraclavicular Area

CLINICAL DIAGNOSIS MANUAL

The presence of a lump in the supraclavicular area is a significant clinical finding that may indicate various pathologies, some of which can be potentially serious.

The supraclavicular region, located above the clavicle and adjacent to the posterior triangle of the neck, is a common site for enlarged lymph nodes due to local infections, systemic diseases, or metastasis from tumours.

The clinical evaluation of a lump in this area includes a detailed medical history, thorough physical examination, and specific complementary tests to determine the underlying aetiology.

Pathology	Symptoms and Clinical Signs	Diagnosis of Suspicion	Diagnosis of Confirmation
Inflammation of Lymph Nodes	Pain in the supraclavicular region, fever, systemic infection symptoms. Enlarged lymph nodes, tender on palpation, may be mobile or fixed.	Clinical history and physical examination. Full blood count: Leukocytosis.	Neck ultrasound: Reactive lymph nodes.
Lymphoma	Fatigue, weight loss, night sweats, fever. Enlarged, painless, firm, and mobile lymph nodes.	Clinical history and physical examination. Node biopsy: Initial histopathological examination.	Positron emission tomography (PET): Assessment of disease extent.
Enlarged Lymph Nodes due to Gastric or Lung Carcinoma	Weight loss, abdominal or chest pain, cough, dyspnoea. Firm, painless supraclavicular lymph nodes, may be adhered to adjacent structures (Virchow’s node).	Clinical history and physical examination. Node biopsy: Initial histopathological examination.	CT and MRI: Assessment of local and systemic extent. Endoscopy (gastroscopy or bronchoscopy): Evaluation of the primary carcinoma site.
Subclavian Artery Aneurysm	Pulsatile mass in the supraclavicular region, arm or neck pain. Palpable pulsatile mass, audible bruit over the aneurysm area, possible decreased peripheral pulses in the affected arm.	Clinical history and physical examination. Doppler ultrasound: Vascular mass in the supraclavicular region.	CT or MR angiography: Visualisation of the subclavian artery.