What is the cause of a 2-month history of axillary fullness with computed tomography (CT) showing a benign lymph node?

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Differential Diagnosis for Armpit Fullness Feeling with Benign Lymph Node on CT

  • Single Most Likely Diagnosis
    • Benign lymphadenopathy: This is the most likely diagnosis given the CT scan result showing a benign lymph node. The symptoms of armpit fullness could be due to the enlargement of the lymph node, which may be caused by a variety of benign conditions such as infection, inflammation, or a reactive process.
  • Other Likely Diagnoses
    • Lipoma or other soft tissue benign tumor: A lipoma or other soft tissue tumor in the armpit could cause a feeling of fullness. Although the CT scan mentions a benign lymph node, it's possible that another benign lesion is present.
    • Brachial cleft cyst or other congenital anomaly: A congenital anomaly such as a brachial cleft cyst could cause a mass or fullness in the armpit, which might be mistaken for a lymph node on imaging.
    • Fatty tissue or lipodystrophy: Abnormalities in fatty tissue distribution could lead to a feeling of fullness in the armpit area.
  • Do Not Miss Diagnoses
    • Lymphoma: Although the CT scan indicates a benign lymph node, lymphoma is a critical diagnosis that must not be missed. Further evaluation, including biopsy, might be necessary to rule out lymphoma, especially if the lymph node does not resolve or if other systemic symptoms are present.
    • Metastatic cancer: The possibility of metastatic cancer to the lymph nodes, even if the initial CT suggests a benign process, is a diagnosis that cannot be overlooked. A thorough investigation into the patient's history and additional diagnostic tests may be warranted.
    • Infection (e.g., cat-scratch disease, tuberculosis): Certain infections can cause lymphadenopathy that might initially appear benign but requires specific treatment.
  • Rare Diagnoses
    • Neurofibromatosis or other neurocutaneous syndromes: These conditions can cause soft tissue tumors or neurofibromas in the armpit, leading to a feeling of fullness.
    • Sarcoidosis: This systemic disease can cause lymphadenopathy and might present with armpit fullness among other symptoms.
    • Kimura disease: A rare, chronic inflammatory disorder that can cause lymphadenopathy and eosinophilia, potentially presenting with armpit fullness.

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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