Superficial lymph node infarction

Superficial lymph node necrosis is an unusual pathologic diagnosis encountered in clinical practice. When seen it is usually indicative of involvement of the affected lymph nodes with either metastatic cancer or lymphoma. Occasionally it has been associated with hypersensitivity phenomena with arteriolar involvement. The underlying etiology in all of these instances is extensive occlusion of the rich vascular supply to the node. Rarely cases are seen where no clear-cut etiology can be found. Ten such cases have been reported in the medical literature including the case published in this report. Its occurrence, however, may be more common than previously recognized. Preoperatively it is usually not possible to distinguish this entity from the other diagnoses for which it is generally mistaken. These other diagnoses most commonly include femoral hernia and mass in the axillary tail of the breast. The patient reported here is unusual in regard to the size of the lesion encountered. In other published reports very few lymph nodes were involved. In this case extensive involvement of a large mass of nodes was noted. Once the diagnosis is made limited work-up as well as further close observation is important since it may herald the occurrence of a lymphoproliferative disorder.