📄 SCRS
Axillary Lymphadenitis
Axillary Lymphadenitis ultrasound case study
USG
Axillary Lymphadenitis ultrasound case study
Case Study Record
| SN | Case Name | Report Line |
|---|---|---|
| 1 | Right Axillary lymphadenitis | View Report Line |
| 2 | Left Axillary lymphadenitis | View Report Line |
| 3 | - | View Report Line |
CASE–1
Multiple Right Axillary Lymphadenitis
Multiple Right Axillary Lymphadenitis
Clinical History
A 28-year-old lactating female presented with pain, tenderness, and localized swelling in the right axillary region for the past 3 days. She also reported discomfort in the adjacent right breast with low-grade fever. There was no history of nipple retraction, bloody nipple discharge, previous breast surgery, or known breast malignancy.
Ultrasound Findings
Ultrasound examination of the right axilla demonstrates multiple enlarged lymph nodes of variable size, predominantly oval in morphology, with relatively preserved echogenic fatty hila. The lymph nodes demonstrate mild to moderate cortical thickening with maintained hilar architecture. On Color Doppler imaging, increased hilar vascularity is noted. No definite cystic necrosis, liquefaction, calcification, or matting of the lymph nodes is identified. The surrounding axillary soft tissues show mild inflammatory changes.
The visualized right breast parenchyma may demonstrate mild inflammatory changes in the appropriate clinical setting. No definite focal suspicious solid mass or drainable fluid collection is identified within the visualized breast or axillary region.
|
| Ultrasound of the right axilla. Sonographic image demonstrates multiple enlarged oval lymph nodes with relatively preserved echogenic fatty hila and mild cortical thickening, favoring reactive/inflammatory axillary lymphadenopathy. |
Report Line
Multiple enlarged right axillary lymph nodes with preserved echogenic fatty hila and mild cortical thickening, demonstrating predominantly hilar vascularity on Color Doppler, favoring reactive/inflammatory lymphadenitis. No definite nodal necrosis, calcification, or collection identified.
Impression
Multiple right axillary lymphadenopathy with sonographic features favoring reactive/inflammatory lymphadenitis.
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Recommendation
Clinical correlation is advised, particularly for an underlying inflammatory or infectious process involving the right breast or adjacent soft tissues. Appropriate medical management and clinical follow-up should be considered according to the patient's symptoms. If the lymph nodes persist, progressively enlarge, develop abnormal morphology, or fail to regress after resolution of the underlying inflammatory process, repeat ultrasound examination may be performed. Further breast and axillary evaluation should be considered for persistent or atypical lymphadenopathy.
Key Learning Points
- Reactive axillary lymphadenitis is commonly associated with inflammatory or infectious conditions of the breast and adjacent tissues.
- Ultrasound typically demonstrates oval lymph nodes with preserved echogenic fatty hila and mild cortical thickening.
- Color Doppler may demonstrate predominantly hilar vascularity in reactive lymph nodes.
- Features such as loss of the fatty hilum, marked eccentric cortical thickening, irregular contour, abnormal peripheral vascularity, necrosis, or calcification should raise concern for an alternative etiology and warrant further evaluation.
- Multiple enlarged lymph nodes can occur as a reactive response to breast inflammation or infection.
- Ultrasound is useful for assessing the morphology, cortical thickness, internal architecture, and vascular pattern of axillary lymph nodes.
- Persistent, progressive, or morphologically suspicious axillary lymphadenopathy requires appropriate clinical and breast-imaging follow-up.
CASE–2
Single Left Axillary Lymphadenitis
Single Left Axillary Lymphadenitis
Clinical History
A 30-year-old female presented with localized pain, tenderness, and swelling in the left axillary region for the past 4 days. She also reported mild discomfort in the adjacent left breast with low-grade fever. There was no history of nipple retraction, bloody nipple discharge, previous breast surgery, or known breast malignancy.
Ultrasound Findings
Ultrasound examination of the left axilla demonstrates a single mildly enlarged oval lymph node with a relatively preserved echogenic fatty hilum. Mild cortical thickening is noted with maintained nodal architecture. Color Doppler examination demonstrates predominantly hilar vascularity. No definite cystic necrosis, liquefaction, calcification, matting, or surrounding collection is identified.
The visualized left breast parenchyma does not demonstrate a definite focal suspicious solid mass or drainable fluid collection. The sonographic appearance of the axillary lymph node favors a reactive/inflammatory lymphadenitis in the appropriate clinical setting.
|
| Ultrasound of the left axilla. Sonographic image demonstrates a single enlarged oval lymph node with preserved echogenic fatty hilum and mild cortical thickening, favoring reactive/inflammatory lymphadenitis. |
Report Line
Single mildly enlarged oval left axillary lymph node with preserved echogenic fatty hilum and mild cortical thickening, demonstrating predominantly hilar vascularity on Color Doppler, favoring reactive/inflammatory lymphadenitis. No definite nodal necrosis, calcification, matting, or collection identified.
Impression
Single left axillary lymph node with sonographic features favoring reactive/inflammatory lymphadenitis.
Go To Table
Recommendation
Clinical correlation is advised for an underlying inflammatory or infectious process involving the left breast or adjacent soft tissues. Appropriate medical management and clinical follow-up should be considered according to the patient's symptoms. If the lymph node persists, enlarges, develops abnormal morphology, or fails to regress after resolution of the underlying inflammatory process, repeat ultrasound examination may be performed. Further breast and axillary evaluation should be considered for persistent or atypical lymphadenopathy.
Key Learning Points
- Reactive axillary lymphadenitis may occur secondary to inflammatory or infectious conditions of the breast and adjacent tissues.
- A reactive lymph node is commonly oval in shape with a preserved echogenic fatty hilum.
- Mild cortical thickening may be seen in reactive lymphadenopathy.
- Color Doppler may demonstrate predominantly hilar vascularity.
- Suspicious features include loss of the fatty hilum, marked or eccentric cortical thickening, irregular contour, abnormal peripheral vascularity, necrosis, or calcification.
- Ultrasound is useful for evaluating lymph-node morphology, cortical thickness, internal architecture, and vascular pattern.
- Persistent or progressively enlarging axillary lymphadenopathy requires appropriate clinical and breast-imaging follow-up.
