Bilateral axillary node calcifications: a case report and revisiting causes

A 48-year woman was found to have bilateral axillary nodal microcalcifications on screening mammogram; a new finding compared to the prior mammogram done about 8 years ago. Combining the new finding with the amorphous and fine morphology of the microcalcifications, deemed it suspicious. In the absence of a definite benign cause, that could be attributed to this finding, biopsy was performed. Histology from the bilateral axillary node was reported to be benign with calcifications identified within granulomas. There are only a few cases with bilateral axillary nodal microcalcifications reported in the literature till date. Most of these are from ovarian cancer or related to chrysotherapy for rheumatoid arthritis. Our case is distinct from them as this rare finding was not due to any of the known etiologies and the morphology is quite different from the known granulomatous causes. As we report this rare case, we also revisit the causes of axillary nodal microcalcifications. Familiarity with this subject can help the reporting radiologists to avert an invasive procedure like biopsy in some cases, if the cause of benignity can be confidently identified.