Axillary Lymph Node Calcifications due to Tattoo Pigment: A Radiologic-Pathologic Correlation

Tattoo pigment may migrate to regional lymph nodes and appear as dense deposits and/or calcifications, mimicking malignant axillary findings on breast imaging. We report a breast imaging case with apparent axillary lymph node calcifications detected on mammography and ultrasound, in which image-guided sampling and histopathology demonstrated tattoo pigment-related deposits without malignancy. Awareness of this benign mimic, combined with careful correlation with the clinical history and multimodality imaging, can prevent unnecessary escalation of care. Additionally, confirming imaging-pathology concordance supports accurate diagnosis and helps avoid overtreatment.