Swollen Lymph Nodes in the Right Supraclavicular Fossa: Causes, Diagnosis, and What You Should Know

Swelling in the right supraclavicular fossa—commonly known as the hollow just above the right collarbone—can be a subtle but significant clinical sign. While lymph nodes in this area are typically small and not easily felt, noticeable enlargement may point to underlying health issues ranging from infections to more serious systemic conditions. Early recognition and proper evaluation are crucial for timely diagnosis and effective treatment.

Potential Causes of Right Supraclavicular Lymphadenopathy

Lymph nodes act as filters for harmful substances in the body, and swelling often indicates that the immune system is responding to a threat. The right supraclavicular lymph nodes primarily drain lymphatic fluid from regions including the lungs, mediastinum (the central chest cavity), and parts of the respiratory tract. When these nodes become enlarged, it's essential to consider several key causes.

1. Thoracic and Pulmonary Malignancies

One of the most concerning causes of right supraclavicular lymph node enlargement is cancer originating in the chest or lungs. These lymph nodes receive drainage from the trachea, pleura (lining of the lungs), and lung tissue itself, making them an early warning site for malignancies such as lung cancer, mesothelioma, or mediastinal tumors.

A particularly notable condition is Virchow's node, where an enlarged left supraclavicular node (though sometimes seen on the right) signals gastrointestinal or thoracic cancers. While more common on the left, right-sided involvement should still prompt thorough investigation. Imaging studies like chest X-rays, CT scans, or MRI are typically recommended to assess for tumors or abnormal growths in the chest cavity.

2. Infections of the Respiratory Tract

Infectious diseases affecting the airways or lungs can also lead to localized lymph node swelling. Conditions such as pneumonia, bronchitis, tuberculosis, or viral respiratory infections may trigger reactive lymphadenopathy in the right supraclavicular region.

Clinical signs like fever, cough, chest pain, or shortness of breath often accompany infection-related swelling. Blood tests—including a complete blood count (CBC), erythrocyte sedimentation rate (ESR), and C-reactive protein (CRP)—can help confirm inflammation or infection. Most cases due to infection resolve with appropriate treatment, such as antibiotics or antivirals.

3. Systemic Diseases and Viral Infections

If lymph node enlargement isn't isolated to the right supraclavicular area but occurs alongside swelling in other regions—such as the neck, armpits, or groin—it may indicate a systemic illness. Several widespread conditions can cause generalized lymphadenopathy:

Lymphoma and leukemia: Cancers of the lymphatic system often present with painless, persistent lymph node swelling.
HIV/AIDS: Early HIV infection or advanced disease stages frequently involve multiple lymph node groups.
Autoimmune disorders: Conditions like systemic lupus erythematosus (SLE) and adult-onset Still's disease can mimic infection or cancer with fever, fatigue, and swollen glands.
EB virus (Epstein-Barr) and cytomegalovirus (CMV): These herpesviruses commonly cause mononucleosis-like symptoms and multi-site lymph node enlargement.

When systemic disease is suspected, further testing—including serological assays, flow cytometry, or lymph node biopsy—may be necessary to reach a definitive diagnosis.

When to See a Doctor

You should seek medical attention if the swollen node:

Is larger than 1 cm and continues to grow
Persists for more than 2–4 weeks without improvement
Feels hard, fixed in place, or painless
Is accompanied by unexplained weight loss, night sweats, or prolonged fever

Early consultation allows for timely imaging and laboratory workups, increasing the chances of identifying treatable conditions before they progress.

Diagnostic Approach and Next Steps

A comprehensive evaluation usually begins with a detailed patient history and physical exam. Depending on initial findings, your healthcare provider may order:

Chest imaging (CT scan or PET-CT) to detect tumors or infections
Blood tests to check for infection, inflammation, or autoimmune markers
Biopsy of the affected lymph node if malignancy is suspected

Accurate diagnosis is key—while many causes are benign and temporary, ignoring persistent swelling could delay detection of serious illnesses.

Final Thoughts

Swollen lymph nodes in the right supraclavicular fossa should never be dismissed lightly. Although some cases stem from minor infections, this specific location raises red flags for potentially serious underlying conditions, especially thoracic cancers and systemic diseases. By understanding the possible causes and seeking prompt medical assessment, individuals can take proactive steps toward better health outcomes.