What is the diagnosis for a patient with a benign-appearing axillary lymph node, normal bone mineralization, and no evidence of fracture, dislocation, or soft tissue mass?

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Differential Diagnosis

  • Single most likely diagnosis
    • Benign lymph node: The presence of a benign-appearing axillary lymph node with a thin uniform cortex and prominent fatty hilum, as described in the findings, strongly suggests a benign condition. The node's size (2.9 x 2.5 x 0.9 cm) is not significantly enlarged, which further supports a benign diagnosis.
  • Other Likely diagnoses
    • Reactive lymphadenopathy: This condition could be a response to a minor infection or inflammation in the body, which might not be directly related to the axilla. The lymph node's appearance is consistent with a reactive rather than a malignant process.
    • Lipoma or other benign soft tissue tumor: Although the report mentions no discrete soft tissue mass, a small lipoma or other benign tumor could potentially be overlooked or not fully visualized, especially if it's deep or not significantly different in density from surrounding tissues.
  • Do Not Miss (ddxs that may not be likely, but would be deadly if missed.)
    • Lymphoma: Although the lymph node appears benign, lymphoma is a critical diagnosis that must be considered, even if the likelihood is low. The presence of a single enlarged lymph node could be an early sign, and missing this diagnosis could have significant consequences.
    • Metastatic disease: Similarly, a solitary metastatic lymph node from a primary cancer elsewhere in the body is a possibility that cannot be overlooked. The absence of other findings does not rule out this possibility entirely.
  • Rare diagnoses
    • Castleman disease: This is a rare disorder that involves an overgrowth of cells in the lymphatic system. It could present with lymphadenopathy, although the described node's appearance does not specifically suggest this diagnosis.
    • Kimura disease: A rare, chronic inflammatory disorder that can cause lymphadenopathy and eosinophilia. It is more common in Asian males and could be considered in the appropriate clinical context, although it is quite rare.

Professional Medical Disclaimer

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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