Ink on the move: tattoo pigment resembling axillary lymph node calcifications

Calcified axillary lymph nodes in a case of de novo metastatic breast cancer

At the time of a mammogram, calcifications may be seen in axillary lymph nodes. Metastatic breast cancer is the most common malignant cause of calcifications in the axillary lymph nodes. Benign causes may include but are not limited to granulomatous disease, fat necrosis, gold deposits in rheumatoid arthritis patients, pigmentation from tattoos, and sarcoidosis. We present a case of a 37-year-old female with axillary lymph node calcifications due to metastatic breast cancer. Calcification morphology seen in the primary breast tumor and the axillary lymph nodes are nearly identical on mammogram, which is seldom seen. The similar morphology almost guarantees metastatic breast cancer, underscoring the importance of identifying the etiology of any calcifications present in axillary lymph nodes on mammography.

Lymph node microcalcifications after neoadjuvant chemotherapy: A therapeutic response marker

Lymph node microcalcifications are rare events, and when they are accompanied by neoplasia, they usually seem to be associated with a metastatic condition. We present a case of a patient with breast cancer and lymph node microcalcifications undergoing neoadjuvant chemotherapy (NCT). A change in the calcification pattern towards becoming coarse was observed. Calcification represented a marker of axillary disease, and it was resected after NCT. This is the first report of a patient with lymph node microcalcification undergoing NCT. We observed a change in the calcification format, which facilitated lymph node sentinel identification. Pathological evaluation indicated metastatic disease.