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Axillary Lymphadenopathy

 
 
 
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Overview

The axillary lymph nodes drain from the neck, chest wall, breast and upper limbs. Enlargement of these lymph nodes can suggest pathology affecting these regions or a systemic process that is infective, inflammatory or malignant.
  • How to Assess

  • Using the pulps of the fingers, gently palpate each of the lymph node groups within axillary region.
  • Feel For

  • Size - normally <10mm
  • Tenderness
  • Consistency - hard (metastasis), rubbery (lymphoma), soft (reactive)
  • Mobility - mobile or tethered to underlying structures
  • Causes of Lymphadenopathy

  • Bacterial infection - localised infection, skin infection, tuberculosis / MAC, syphilis, cat-scratch disease
  • Viral infection - EBV, CMV, HIV, herpez simplex, rubella
  • Parasitic infection - toxoplasmosis
  • Malignancy - lymphoma, leukaemia, metastasis
  • Inflammatory disorders - lupus, rheumatoid arthritis
  • Sarcoidosis
  • Medications - allopurinol, atenolol, cephalosporins, penicillin, phenytoin, carbemazepine
  • Storage disorders
  • Benign idiopathic lymphadenopathy

Axillary Lymph Nodes

Pectoral nodes - anteriorly, behind the pectoralis major muscleAnterolateral chest wall, central / lateral breast
Subscapular nodes - posteriorly, in front of the subscapularis musclePosterior neck and chest wall
Lateral nodes - lateral aspect of armpitMedial hand, forearm and arm
Central nodes - within the centre of the axillaDrainage from pectoral, subscapular and lateral nodes
Infraclavicular nodes - below the distal aspect of the clavicleLateral hand, forearm and arm
Apical nodes - medially, at the lateral border of the 1st ribDrainage from all axillary lymph nodes
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