男性,58岁。咳嗽4年,2个月来痰中带血,消瘦,X线胸片示左上肺密度较高圆形阴影。如果该病人淋巴结肿大,哪组区域的浅表淋巴结最先肿大的可能性大()

男性,58岁。咳嗽4年,2个月来痰中带血,消瘦,X线胸片示左上肺密度较高圆形阴影。如果该病人淋巴结肿大,哪组区域的浅表淋巴结最先肿大的可能性大() A. 左颈深淋巴结上群 B. 右颈深淋巴结上群 C. 左锁骨上窝淋巴结 D. 右锁骨上窝淋巴结 E. 左颈深淋巴结下群 答案:D Answer: D Analysis: The patient is a 58-year-old male with a chronic cough and hemoptysis (blood in sputum) for 2 months, along with weight loss. The X-ray of the chest shows a high-density rounded shadow in the left upper lung. If there is lymph node enlargement, the most likely area affected would be the right supraclavicular lymph nodes (right Virchow's node), which are associated with metastases from abdominal or thoracic malignancies. Therefore, the correct answer is D.