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Axillary swellings


The great majority of axillary swellings are enlarged lymph nodes. Axillary nodes can be enlarged due to secondary deposits from carcinoma of the breast. Most axillary swellings are easily diagnosed from clinical examination alone.

Causes

Superficial

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    Acute abscess

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    Sebaceous cyst

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    Lipoma

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    Viral or bacterial infections

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    Hidradenitis suppurativa

Deep

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    Lymphadenopathy (e.g. lymphoma, leukaemia, lupus)

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    Benign or malignant breast lump (arising in the axillary tail)

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    Lipoma

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    Chronic abscess (e.g. TB)

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    Axillary artery aneurysm

History

Superficial

Acute abscess

This presents as a tender erythematous swelling in the skin. There may be a purulent discharge. Common in diabetics.

Sebaceous cyst

A sebaceous cyst will present as a firm swelling in the skin, often with a punctum. It may be tender if it becomes inflamed along with discharge.

Lipoma

These present as a soft, lobulated swelling in the subcutaneous tissues and are often not tender.

Hidradenitis suppurativa

The patient presents with multiple tender swellings in the superficial tissue of the axilla, with the infection occurring in the apocrine sweat glands. A purulent discharge usually occurs. There may be a history of diabetes.

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