Differential Diagnosis for a 14-Year-Old Female with a 1-Month History of Axillary Lump
- Single Most Likely Diagnosis
- Benign lymphadenopathy: This is the most common cause of axillary lumps in adolescents, often due to viral infections or minor trauma, which can cause lymph nodes to become enlarged and palpable.
- Other Likely Diagnoses
- Cat scratch disease: Caused by Bartonella henselae, transmitted through cat scratches or bites, leading to lymphadenopathy, which can present as an axillary lump.
- Folliculitis or abscess: Infection of the hair follicles or formation of an abscess in the axilla can cause a lump, often accompanied by signs of infection such as redness, warmth, and pus.
- Lipoma: A benign tumor composed of fat tissue, which can grow in the axilla and present as a lump.
- Do Not Miss Diagnoses
- Lymphoma: Although less common, lymphoma (Hodgkin or non-Hodgkin) can present with lymphadenopathy, including in the axilla, and is critical to diagnose early due to its potential severity and need for prompt treatment.
- Breast cancer: Though extremely rare in adolescents, any new lump in the axilla or breast area warrants consideration of breast cancer, especially if there's a family history or other risk factors.
- Tuberculosis: In areas where TB is prevalent, it can cause lymphadenopathy, including in the axilla, and is crucial to diagnose due to its public health implications and the need for specific treatment.
- Rare Diagnoses
- Soft tissue sarcoma: Rare tumors that can occur in the axilla, presenting as a lump, and require early diagnosis for effective treatment.
- Metastatic disease: Extremely rare in adolescents, but certain cancers can metastasize to the axillary lymph nodes, presenting as a lump.
- Hygroma or cystic hygroma: A rare congenital condition that can present as a lump in the axilla, typically noticed at birth or early childhood but can occasionally be diagnosed later.