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Axillary Lymph Node Calcification: A Review of Local and Systemic Disease Processes

Johnson, Jason M. MD; Franceschi, Ana M. MD; Reed, Marianne S. MD; Primm, Jane C. MD; Herschorn, Sally D. MD

Contemporary Diagnostic Radiology: 30 June 2014 - Volume 37 - Issue 13 - p 1–5
doi: 10.1097/01.CDR.0000451016.34682.05
Article

Routine breast imaging studies frequently detect abnormal axillary lymph node findings including increase in node density, interval increase in size, loss of the normal fatty hilum, and calcification.1 The presence of calcified axillary lymph nodes is significant because it can be the only finding indicative of serious regional or systemic disease. Although primary breast cancer has been associated with axillary lymph node calcifications, familiarity with additional local and systemic processes presenting in this manner can aid in planning further diagnostic evaluation of patients. In many cases, it will not be possible to distinguish benign and malignant axillary lymph nodes on mammography alone; therefore, fine-needle aspiration, preferably with ultrasound guidance, or biopsy of the lymph nodes will be needed for further evaluation. However, after an appropriate review for likely benign etiologies, it may be possible to limit the number of unnecessary invasive procedures.

Dr. Johnson is Clinical Instructor in Radiology and Biomedical Imaging, Department of Radiology, University of California San Francisco, 505 Parnassus Avenue, San Francisco, CA 94143; E-mail: jason.johnson@ucsf.edu; Dr. Franceschi is Resident, Department of Radiology, SUNY at Stony Brook, Stony Brook, New York; Dr. Reed is Resident, Department of Diagnostic Radiology, Yale University School of Medicine, New Haven, Connecticut; Dr. Primm is Radiologist, Elliot Health System, Manchester, New Hampshire; and Dr. Herschorn is Associate Professor of Radiology, University of Vermont, Burlington, Vermont.

After participating in this activity, the diagnostic radiologist should be better able to evaluate the potential implications of calcified axillary lymph nodes as identified on routine breast imaging studies.

The authors and all staff in a position to control the content of this CME activity and their spouses/life partners (if any) have disclosed that they have no relationships with, or financial interests in, any commercial organizations pertaining to this educational activity.

Lippincott Continuing Medical Education Institute, Inc., is accredited by the Accreditation Council for Continuing Medical Education to provide continuing medical education for physicians. Lippincott Continuing Medical Education Institute, Inc., designates this enduring material for a maximum of 2 AMA PRA Category 1 Credits™. Physicians should only claim credit commensurate with the extent of their participation in the activity. To earn CME credit, you must read the CME article and complete the quiz and evaluation on the enclosed answer form, answering at least seven of the 10 quiz questions correctly. This continuing medical education activity expires on September 19, 2014

© 2014 by Lippincott Williams & Wilkins, Inc.
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