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Haem Exam

Axillary Lymphadenopathy

February 15th, 2021


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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