Bilateral axillary lymphadenopathy
differential diagnosis and management
Keywords:
sarcoidosis, lymphadenopathy, lymph nodes, breast diseases, tuberculosis, lymph nodeAbstract
Lymphonodopathy is an increase in volume and/or changes in the characteristics of lymph nodes, and it can be caused by benign or malignant diseases. Appropriate physical examination should define their clinical characteristics, and, if needed, complementary imaging or anatomopathological tests should be performed for diagnostic definition. In the present article, we report the case of a female patient, with sarcoidosis, who presented axillary lymph node disease, and the exams that followed until the diagnostic conclusion.
Downloads
References
Lee Y, Terry R, Lukes RJ. Lymph node biopsy for diagnosis: a statistical study. J Surg Oncol. 1980;14(1):53-60. http://doi.org/10.1002/jso.2930140108
Görkem SB, O’Connell AM. Abnormal axillary lymph nodes on negative mammograms: causes other than breast cancer. Diagn Interv Radiol. 2012;18(5):473-9. http://doi.org/10.4261/1305-3825.DIR.5491-11.2
Urban LABD, Chala LF, de Mello GGN. Mama. Rio de Janeiro: Elsevier; 2019.
Koo V, Lioe TF, Spence RA. Fine needle aspiration cytology (FNAC) in the diagnosis of granulomatous lymphadenitis. Ulster Med J. 2006;75(1):59-64.
Macedo FI, Eid JJ, Flynn J, Jacobs MJ, Mittal VK. Optimal Surgical Management for Occult Breast Carcinoma: A Meta-analysis. Ann Surg Oncol. 2016;23(6):1838-44. http://doi.org/10.1245/s10434-016-5104-8
American College of Radiology. Breast Imaging Reporting and Data System (BI-RADS®). 5ª ed. Reston: American College of Radiology; 2013.
Andrade JM, Marana HR, Sarmento Filho JM, Murta EF, Velludo MA, Bighetti S. Differential diagnosis of axillary masses. Tumori. 1996;82(6):596-9.
Ferrer RL, Aronson MD, Freedman AS. Evaluation of peripheral lymphadenopathy in adults. In: Kunins L, ed. UpToDate [Internet]. Waltham, Mass.: UpToDate; 2020 [cited on Aug 8, 2020]. Available from: https://www.uptodate.com/contents/evaluation-of-peripheral-lymphadenopathy-inadults?source=history_widget
Fijten GH, Blijham GH. Unexplained lymphadenopathy in family practice. An evaluation of the probability of malignant causes and the effectiveness of physicians’ workup. J Fam Pract. 1988;27(4):373-6. https://doi.org/10.1080/09503158808416945
Asano S. Granulomatous lymphadenitis. J Clin Exp Hematop. 2012;52(1):1-16. http://doi.org/10.3960/jslrt.52.1
Walsh R, Kornguth PJ, Soo MS, Bentley R, DeLong DM. Axillary lymph nodes: mammographic, pathologic, and clinical correlation. Am J Roentgenol. 1997;168(1):33-8. http://doi.org/10.2214/ajr.168.1.8976915
Murray ME, Given-Wilson RM. The clinical importance of axillary lymphadenopathy detected on screening mammography. Clin Radiol. 1997;52(6):458-61. http://doi.org/10.1016/s0009-9260(97)80008-6 REFERENCES
Shetty MK, Carpenter WS. Sonographic evaluation of isolated abnormal axillary lymph nodes identified on mammograms. J Ultrasound Med. 2004;23(1):63-71. http://doi.org/10.7863/jum.2004.23.1.63
American Thoracic Society, European Respiratory Society, World Association of Sarcoidosis and Other Granulomatous Disorders. Statement on sarcoidosis. Am J Respir Crit Care Med. 1999;160(2):736-55. http://doi.org/10.1164/ajrccm.160.2.ats4-99
Houssami N, Ciatto S, Turner RM, Cody HS 3rd, Macaskill P. Preoperative ultrasound-guided needle biopsy of axillary nodes in invasive breast cancer: meta-analysis of its accuracy and utility in staging the axilla. Ann Surg. 2011;254(2):243-51. http://doi.org/10.1097/SLA.0b013e31821f1564
Ganott MA, Zuley ML, Abrams GS, Lu AH, Kelly AE, Sumkin JH, et al. Ultrasound Guided Core Biopsy versus Fine Needle Aspiration for Evaluation of Axillary Lymphadenopathy in Patients with Breast Cancer. ISRN Oncol. 2014;2014:703160. http://doi.org/10.1155/2014/703160
Mohseni S, Shojaiefard A, Khorgami Z, Alinejad S, Ghorbani A, Ghafouri A. Peripheral lymphadenopathy: approach and diagnostic tools. Iran J Med Sci. 2014;39(2 Suppl.):158-70.
Ravinsky E, Morales C. Diagnosis of lymphoma by imageguided needle biopsies: fine needle aspiration biopsy, core biopsy or both? Acta Cytol. 2005;49(1):51-7. http://doi.org/10.1159/000326095
Freedman AS, Friedberg JW, Aster JC, Lister A. Clinical presentation and initial evaluation of non-Hodgkin lymphoma. In: Rosmarin AG, ed. UpToDate [Internet]. Waltham, Mass.: UpToDate; 2020 [cited on Sept 3, 2020]. Available at: https://www.uptodate.com/contents/clinical-presentation-andinitial-evaluation-of-non-hodgkin-lymphoma?search=lymphoma&source=search_result&selectedTitle=1~150&usage_type=default&display_rank=1#H26
Wessendorf TE, Bonella F, Costabel U. Diagnosis of Sarcoidosis. Clin Rev Allergy Immunol. 2015;49(1):54-62. http://doi.org/10.1007/s12016-015-8475-x
Soto-Gomez N, Peters JI, Nambiar AM. Diagnosis and Management of Sarcoidosis. Am Fam Physician. 2016;93(10): 840-50.
Akhtari M, Quesada JR, Schwartz MR, Chiang SB, Teh BS. Sarcoidosis presenting as metastatic lymphadenopathy in breast cancer. Clin Breast Cancer. 2014;14(5):e107-e110. http://doi.org/10.1016/j.clbc.2014.05.001
Fontanilla JM, Barnes A, von Reyn CF. Current diagnosis and management of peripheral tuberculous lymphadenitis. Clin Infect Dis. 2011;53(6):555-62. http://doi.org/10.1093/cid/cir454
Brasil. Ministério da Saúde. Secretaria de Vigilância em Saúde. Departamento de Vigilância das Doenças Transmissíveis. Manual de Recomendações para o Controle da Tuberculose no Brasil. Brasília: Ministério da Saúde; 2019.
Trajman A, Steffen RE, Menzies D. Interferon-Gamma Release Assays versus Tuberculin Skin Testing for the Diagnosis of Latent Tuberculosis Infection: An Overview of the Evidence. Pulm Med. 2013;2013:601737. http://doi.org/10.1155/2013/601737
Shriner KA, Mathisen GE, Goetz MB. Comparison of mycobacterial lymphadenitis among persons infected with human immunodeficiency virus and seronegative controls. Clin Infect Dis. 1992;15(4):601-5. http://doi.org/10.1093/clind/15.4.601
Jawahar MS, Rajaram K, Sivasubramanian S, Paramasivan CN, Chandrasekar K, Kamaludeen MN, et al. Treatment of lymph node tuberculosis--a randomized clinical trial of two 6-month regimens. Trop Med Int Health. 2005;10(11):1090-8. http://doi.org/10.1111/j.1365-3156.2005.01493.x
NCCN Clinical Practice Guidelines in Oncology (NCCN Guidelines). Version 6 [Internet]. NCCN; 2020 [cited on Sept 28, 2020]. Available from: https://www.nccn.org/professionals/physician_gls/pdf/breast.pdf
Fayanju OM, Stoll CR, Fowler S, Colditz GA, Jeffe DB, Margenthaler JA. Geographic and temporal trends in the management of occult primary breast cancer: a systematic review and meta-analysis. Ann Surg Oncol. 2013;20(10):3308- 16. http://doi.org/10.1245/s10434-013-3157-5
Kim SJ, Park YM. Clinical Importance and Sonographic Features of Nonpalpable Axillary Lymphadenopathy Identified on Breast Sonography in Patients Without Malignancy. J Ultrasound Med. 2015;34(12):2193-202. http://doi.org/10.7863/ultra.15.01056
Instituto Nacional de Câncer. Estimativa 2020. Incidência do Câncer no Brasil. Rio de Janeiro: INCA; 2019.
Downloads
Published
How to Cite
Issue
Section
License
Copyright (c) 2020 Paula Clarke, Carolina Nazareth Valadares, Débora Balabram, Douglas de Miranda Pires
This work is licensed under a Creative Commons Attribution 4.0 International License.