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On physical examination, a right axillary mass-like engorgement was found. A shoulder MRI was performed in another imaging center showing a 6<span class="elsevierStyleHsp" style=""></span>×<span class="elsevierStyleHsp" style=""></span>2.5<span class="elsevierStyleHsp" style=""></span>cm axillary pseudomass with high-T1 weighted signal with irregular (thin and thick) linear septa (<a class="elsevierStyleCrossRef" href="#fig0005">Fig. 1</a>, arrows) surrounding axillary vessels (<a class="elsevierStyleCrossRef" href="#fig0005">Fig. 1</a>, asterisk) and several adjacent lymph nodes ranging from 0.5 to 2<span class="elsevierStyleHsp" style=""></span>cm (<a class="elsevierStyleCrossRef" href="#fig0005">Fig. 1</a>, arrowheads). Therefore, a liposarcoma was included in the differential diagnosis. A second opinion of the first MRI was required in our radiology department, and lymphadenitis due to an infectious disease was considered because of the presence of enlarged lymph nodes and “tortuous” septa. Clinical examination found a subtle herpes zoster disorder (shingles) on the thoracic right side of the patient, confirming the diagnoses and beginning treatment with acyclovir. A second MRI was taken 11 days ago, showing complete involution of the septa (lymphatic channels in this case), the volume of the pseudomass and the diameter of the lymph nodes (<a class="elsevierStyleCrossRef" href="#fig0010">Fig. 2</a>, arrowheads), confirming the hypotheses of lymphadenitis caused by herpes zoster.</p><elsevierMultimedia ident="fig0005"></elsevierMultimedia><elsevierMultimedia ident="fig0010"></elsevierMultimedia></span>" "pdfFichero" => "main.pdf" "tienePdf" => true "multimedia" => array:2 [ 0 => array:6 [ "identificador" => "fig0005" "etiqueta" => "Fig. 1" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr1.jpeg" "Alto" => 746 "Ancho" => 750 "Tamanyo" => 38083 ] ] ] 1 => array:6 [ "identificador" => "fig0010" "etiqueta" => "Fig. 2" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr2.jpeg" "Alto" => 740 "Ancho" => 750 "Tamanyo" => 26842 ] ] ] ] ] "idiomaDefecto" => "en" "url" => "/00257753/0000015600000012/v1_202106110528/S0025775320304899/v1_202106110528/en/main.assets" "Apartado" => array:4 [ "identificador" => "64289" "tipo" => "SECCION" "es" => array:2 [ "titulo" => "Imágenes médicas" "idiomaDefecto" => true ] "idiomaDefecto" => "es" ] "PDF" => "https://static.elsevier.es/multimedia/00257753/0000015600000012/v1_202106110528/S0025775320304899/v1_202106110528/en/main.pdf?idApp=UINPBA00004N&text.app=https://www.elsevier.es/" "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S0025775320304899?idApp=UINPBA00004N" ]
Journal Information
Vol. 156. Issue 12.
Pages 637 (June 2021)
Vol. 156. Issue 12.
Pages 637 (June 2021)
Image in medicine
Axillary lymphadenitis associated with a herpes-zoster mimicking a liposarcoma: MRI findings
Linfadenitis axilar asociada a herpes zóster simulando un liposarcoma: hallazgos por resonancia magnética
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15
Xavier Tomas
, Josep Maria Campistol, Joan Fontdevila, Jaume Pomes, Alex Soriano
Corresponding author
Hospital Clinic, Barcelona, Spain
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