What is the diagnosis of a 2.7 x 1.9 x 2.6 cm mildly heterogeneous isoechoic to mildly hyperechoic area with mild internal vascularity in the right axilla, possibly representing a lymph node with prominent fatty hilum (Computed Tomography (CT) scan scheduled for further evaluation)?

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Last updated: March 19, 2025View editorial policy

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Differential Diagnosis for Right Axilla Mass

  • Single most likely diagnosis
    • Lymphadenopathy (reactive or infectious): The presence of a mildly heterogeneous isoechoic to mildly hyperechoic area with mild internal vascularity and a prominent fatty hilum is suggestive of a lymph node. The patient's symptoms and the location of the mass in the right axilla support this diagnosis.
  • Other Likely diagnoses
    • Lipoma: The description of the mass as isoechoic to mildly hyperechoic with mild internal vascularity could also be consistent with a lipoma, which is a common benign tumor.
    • Cyst or abscess: The heterogeneous appearance of the mass could represent a cyst or abscess, although the presence of a prominent fatty hilum makes this less likely.
    • Neurofibroma or other benign nerve sheath tumor: The location in the axilla and the ultrasound characteristics could also suggest a neurofibroma or other benign nerve sheath tumor.
  • Do Not Miss (ddxs that may not be likely, but would be deadly if missed.)
    • Metastatic lymph node: Although less likely, a metastatic lymph node from a breast, lung, or other cancer could present with similar ultrasound characteristics, making it essential to consider and rule out with further evaluation, such as the scheduled CT scan.
    • Sarcoma (e.g., liposarcoma): A soft tissue sarcoma could also present as a mass in the axilla, and although rare, it is crucial to consider due to its potential for aggressive behavior and poor prognosis if not promptly diagnosed and treated.
  • Rare diagnoses
    • Hemangioma or other vascular malformation: Although less common, a hemangioma or other vascular malformation could present with similar ultrasound characteristics, including mild internal vascularity.
    • Soft tissue tumor (e.g., schwannoma, granular cell tumor): Other rare soft tissue tumors could also present as a mass in the axilla, and while unlikely, should be considered in the differential diagnosis.

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This information is intended for healthcare professionals. Any medical decision-making should rely on clinical judgment and independently verified information. The content provided herein does not replace professional discretion and should be considered supplementary to established clinical guidelines. Healthcare providers should verify all information against primary literature and current practice standards before application in patient care. Dr.Oracle assumes no liability for clinical decisions based on this content.

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