Abstract
Key Clinical Message
Tattooed pigments often migrate to the regional lymph nodes, leading to staining and swelling of these nodes. This migration can create confusion for surgeons when evaluating regional lymph nodes for staging of malignant disease like breast cancer.
Abstract
A 50‐year‐old woman with left breast carcinoma underwent left mastectomy and sentinel lymph node (SLN) biopsy. A cherry blossom tattoo was observed on the left pectoral region, which she had acquired 6 years prior. Two lymph nodes were excised as SLNs and one of the two SLNs exhibited partial pink staining. Serial sections were performed on the block, revealing pinkish particles within the colored area on pathological examination. However, no metastasis was detected.
Keywords: lymph node pigmentation, tattoo
Axillary lymph node pigmentation in tattooed patients.
A 50‐year‐old woman with left breast carcinoma underwent left mastectomy and sentinel lymph node (SLN) biopsy. A cherry blossom tattoo was observed on the left pectoral region, which she had acquired 6 years prior (Figure 1A). Two lymph nodes, both showing uptake of indigo carmine and 99 m‐technetium‐labeled phytate, were excised as SLNs. In the formalin‐fixed paraffin‐embedded tissue block, one of the two SLNs exhibited partial pink staining (Figure 1B). Serial sections were performed on the block, revealing pinkish particles within the colored area (Figure 1C, hematoxylin and eosin stain) on pathological examination. However, no metastasis was detected. The patient remained recurrence‐free during the 12‐month follow‐up period.
FIGURE 1.
(A) Photograph showing a cherry blossom tattoo on the left pectoral region of the patient. (B) One of the two sentinel lymph nodes exhibited partial pink staining. (C) Pathological examination revealed pinkish particles in the colored portion (hematoxylin and eosin stain; original magnification, 100×).
Tattoo pigments tend to migrate toward the regional lymph nodes, leading to staining and swelling of these nodes. 1 This migration can create confusion for surgeons when evaluating regional lymph nodes for staging of malignant disease like breast cancer and malignant melanoma. This confusion may result in unnecessary examinations, leading to complications and making correct staging difficult. 1 Tattooing is a widely practiced cosmetic procedure, and the interest in tattoos has steadily increased. 2 However, it is concerning that half of the individuals with tattoos are unaware of the potential migration of tattoo pigments to regional lymph nodes. 3 Clinicians should strongly advise tattoo recipients to make an informed decision by deepening their knowledge of the medical risks and complications associated with tattoos. This knowledge can help individuals make a more informed choice about whether to proceed with getting a tattoo.
AUTHOR CONTRIBUTIONS
Toshiyuki Yamaguchi: Conceptualization; data curation; writing – original draft; writing – review and editing.
FUNDING INFORMATION
Nothing to declare.
CONFLICT OF INTEREST STATEMENT
The author has nothing to disclose.
ETHICS STATEMENT
All procedures performed were in accordance with the ethical standards. The examination was made in accordance with the approved principles.
CONSENT
Written informed consent was obtained from the patient to publish this report in accordance with the journal's patient consent policy.
ACKNOWLEDGMENTS
The Author would like to thank the patient for giving consent.
Yamaguchi T. Axillary lymph node pigmentation in tattooed patients. Clin Case Rep. 2023;11:e8293. doi: 10.1002/ccr3.8293
DATA AVAILABILITY STATEMENT
All data relevant to the study are included in the article.
REFERENCES
- 1. Soran A, Kanbour‐Shakir A, Bos O, et al. A tattoo pigmented node and breast cancer. Bratisl Lek Listy. 2014;115(3):311‐312. [DOI] [PubMed] [Google Scholar]
- 2. Kluger N. Insights into worldwide interest in tattoos using Google trend. Dermatology. 2019;235(3):240‐242. [DOI] [PubMed] [Google Scholar]
- 3. Rahimi IA, Eberhard I, Kasten E. Tattoos: what do people really know about the medical risks of body ink? J Clin Aesthet Dermatol. 2018;11(3):30‐35. [PMC free article] [PubMed] [Google Scholar]
Associated Data
This section collects any data citations, data availability statements, or supplementary materials included in this article.
Data Availability Statement
All data relevant to the study are included in the article.