Symptomatic isolated axillary lymph node sarcoidosis: an unusual presentation

An 82-year-old woman admitted following a 4-week history of feeling unwell, abdominal pain and constipation. Initial investigations revealed severe hypercalcaemia with suppressed parathyroid hormone and elevated 1,25-dihydroxycholecalciferol. ACE was also raised. CT scans of the head, chest, abdomen and pelvis were normal. Fluorodeoxyglucose-positron emission tomography scan showed metabolically active right axillary lymphadenopathy which when biopsied under ultrasound guidance confirmed sarcoidosis. The patient was started on high-dose prednisolone with resolution of symptoms within 2 weeks. Isolated lymph node sarcoidosis is uncommon, and the reported usual sites are lymph nodes in the head and neck. Rarely has it been reported in the axillary lymph nodes.

Automated summary

An 82-year-old woman was admitted to the hospital due to feeling unwell, abdominal pain, and constipation for 4 weeks. Further investigations revealed severe hypercalcemia and ultimately diagnosed with sarcoidosis in the axillary lymph nodes. After treatment, her symptoms resolved, and this rare presentation of sarcoidosis in the axillary lymph nodes is uncommon.