A 26-year-old Filipino female presented with a left axillary or armpit mass which was noted 3 months prior to consult and treatment.
There was no breast mass palpated. Ultrasound showed no breast mass on both sides and multiple lymph nodes on the left armpit. Needle biopsy of the armpit mass showed chronic reactive lymphadenopathy. Chest x-ray was normal and negative for signs of tuberculosis.
She underwent excision of the biggest axillary lymph node (4 cm) for biopsy.
The cut surfaces were grayish with numerous creamy areas.
Microscopy showed lymph node with numerous granuloma with both foreign body and Langhans giant cells. There were extensive areas of caseous necrosis with residual lymphoid tissue, chronic granulomatous inflammation consistent with tuberculosis.
Isolated axillary tuberculous lymphadenopathy is rare.
This case described a 26-year-old female Filipina with isolated axillary TB lymphadenopathy without evidence of previous or ongoing tuberculosis anywhere in the body.
Note1: She will undergo at least 6-months of anti-tuberculosis therapy using multiple-drug regimen.
Note2: TB can occur anywhere, though the most common site is the lung.
Note3: The absence of TB in the lungs does not rule out TB in other parts of the body.