Reactivation tuberculosis presenting with unilateral axillary lymphadenopathy

Unilateral axillary lymphadenopathy has various benign and malignant etiologies. Although benign causes are more common, it is important to exclude malignant causes, including metastasis from primary breast carcinoma. Benign etiologies include reactive adenopathy, granulomatous disease, and collagen vascular disease. We present a case of unilateral right axillary lymphadenopathy in a patient with rheumatoid arthritis. The pathologic diagnosis of granulomatous lymphadenitis and interval discovery of patient's history of latent tuberculosis led to a second biopsy for special mycobacterial staining and cultures with a final diagnosis of reactivation tuberculosis. The extrapulmonary manifestation of reactivation tuberculosis with tuberculous lymphadenitis is uncommon and particularly rare in the axillary lymph nodes.