Abstract
Unilateral axillary adenopathy may be caused by a wide range of both benign and malignant aetiologies. While the most common cause is inflammation, infection or trauma of the breast, thoracic wall or arm, a significant proportion of cases are due to occult malignancy. In female patients particularly, breast malignancy must be excluded with mammography and ultrasound. Local inflammation, infection or trauma of the thoracic wall or arm should also be sought when deciding the most appropriate recommendation for management. This case report outlines the most significant pathologies and discusses the need to rule out sinister pathology, even when a benign local cause is evident.
Highlights
A 58-year-old woman was referred for diagnostic workup for lumpiness of her left breast
Inflammation or malignancy in these regions may lead to unilateral axillary adenopathy.[1]
Systemic illness can less commonly present as unilateral axillary adenopathy. Malignancy such as lymphoma rarely presents as isolated unilateral axillary nodes,[2,3] melanoma, sarcoma and other metastatic malignancy may present in this way.[1]
Summary
Unilateral axillary adenopathy with unremarkable breast imaging – differential diagnoses. While the most common cause is inflammation, infection or trauma of the breast, thoracic wall or arm, a significant proportion of cases are due to occult malignancy. Infection or trauma of the thoracic wall or arm should be sought when deciding the most appropriate recommendation for management. This case report outlines the most significant pathologies and discusses the need to rule out sinister pathology, even when a benign local cause is evident. Bilateral mammograms (Figs 1a - d) showed a subtle asymmetrical density in the contralateral (right) breast, that was presumed to be asymmetrical breast tissue Ultrasound of both breasts demonstrated no suspicious abnormality.
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