Learning objectives
Review axillary anatomy as it appears onchest CT
Illustratea range of axillary pathology that can be encountered on chest CT
Describe imaging findings and clues that will help the radiologist establish a diagnosis or a limited differential diagnosis for an axillary abnormality.
Background
The axilla is a pyramidal compartment bounded by the chest wall and muscles that make the anterior,
posterior,
medial,
and lateral walls (Fig. 1).
The axillary space contains the lymphatics,
adipose tissue,
accessory breast tissue,
and the axillary sheath that consists of the axillary artery and vein and the brachial plexus.
Axillary massesand lymphadenopathy arecommon indications for cross-setional imaging.
Axillary abnormalities can also be incidental findings on chest CT performed for other reason.
Lesions in the axilla can result from infection,
inflammation,
systemic diseases,
neoplasm,...
Findings and procedure details
Trauma
Hematoma and Vascular Injuries
Hematomas can develop from blunt or penetrating trauma or complicate surgery or other invasive procedures.
Vascular injuries range from intimal tears to transections or occlusions.
Displaced fracture fragments into the axilla or axillary hematoma should prompt careful examination of the axillary blood vessels.
Key imaging findings:
Collection with poorly-defined margins (hematoma)
Usually high attenuation when acute but become more heterogeneous over time
Filling defect,
occlusion,
or pseudoaneurysm (vascular injury)
Displaced fracture fragments from ribs,
scapula,
humerus,
or clavicle
Seroma and...
Conclusion
An accurate differential diagnosis of axillary pathologies can beestablished with knowledge of the axillary anatomy,
anatomic location of the lesion,
imaging characteristics,
and clinical history.
Furthermore,
routine use of full field-of-view on chest CT provides the radiologist with the opportunity to detect and characterize palpable and incidental axillary abnormalities.
Personal information
Corresponding author
Jeffrey P.
Kanne,
M.D.
Professor and Chief of Thoracic Imaging
Vice Chair of Quality and Safety
Department of Radiology
University of Wisconsin School of Medicine and Public Health
Madison,
WI USA
E-mail:
[email protected]
jkrads.net
Twitter:@JeffreyKanneMD
Co-authors
Ruchi Sharma,
M.D.,
Ph.D.
Radiology Resident
Department of Radiology
University of Wisconsin School of Medicine and Public Health
Madison,
WI USA
Joanna E.
Kusmirek,
M.D.
Assistant Professor,
Thoracic and Cardiovascular Imaging
Department of Radiology
University of Wisconsin School of Medicine and Public Health
Madison,
WI USA
M.Daniela...
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