Metastatic adenocarcinoma to axillary lymph node - unknown primary

Case contributed by Garth Kruger
Diagnosis almost certain


Routine mammogram left breast

Patient Data

Age: Adult
Gender: Female

Dense lymph node in the left axilla with no abnormality on the mammogram. Normal axillary nodes invariably contain fat in the hilum.

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.

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