Isolated axillary tuberculous lymphadenitis in a Nigerian female: A case report with review of the literature

Tuberculosis (TB) is a chronic granulomatous infectious pulmonary and systemic disease caused mostly by members of the Mycobacterium tuberculosis complex (MTBC). It has variable clinical presentation and is a major cause of morbidity and mortality in the middle-and-low-income-countries (LMICs). Isolated axillary tuberculous lymphadenitis (ATL) is rare and is defined as the presence of axillary tuberculous lymphadenitis in the absence of previous or active pulmonary TB or evidence of extrapulmonary TB elsewhere. We present a case of isolated ATL in a 54-year-old HIV-negative Nigerian woman, whose diagnosis was made using histological evaluation that demonstrated typical Langhan’s giant cells and caseous necrosis, with the detection of mycobacterial DNA by GeneXpert TB test. Isolated ATL is a diagnostic enigma but should be considered in young and middle-aged women in TB endemic regions presenting with enlarged axillary lymph nodes in the absence of foci of infections or malignancy. Sex difference in immunological response to infection may account for this unique presentation among the female gender.