Heterotopic Epithelium in Axillary Lymph Nodes: Report of a Case and Review of the Literature

Benign epithelial structures are found rarely in axillary lymph nodes, but because they may simulate metastatic carcinoma, they are of clinical and pathologic significance. A case of a 45-year-old woman who underwent elective, bilateral, total subcutaneous mastectomies for chronic cystic disease is reported. Ten right axillary lymph nodes were removed incidentally. Five of these contained a variety of glands, tubules, and apocrine and squamous-lined cysts. The totally embedded breast tissue contained no malignant tumor. Based on the histologic findings in this case and a survey of the few reports in the literature, criteria for proper diagnosis of these heterotopic structures in axillary lymph nodes are suggested and the possible pathogenesis of the lesions is discussed.