Metastatic adenocarcinoma to axillary lymph node - unknown primary
Diagnosis almost certain
Presentation
Routine mammogram left breast
Patient Data
Age: Adult
Gender: Female
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Dense lymph node in the left axilla with no abnormality on the mammogram. Normal axillary nodes invariably contain fat in the hilum.
US guided biopsy
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The case only makes sense if the US image is seen in conjunction with the mammogram image. The biopsy image of the abnormal lymph node under US guidance.
Case Discussion
The lymph node on mammography is not enlarged but is pathologically dense. On both the mammogram and the ultrasound the node has lost its normal fatty hilum. The FNA showed metastatic adenocarcinoma cells presumably from the breast.