title: Tattoo pigment lymphadenopathy mimicking metastasis in vulvar cancer.
abstract: BACKGROUND
  Approximately 24% of American adults have tattoos. Studies of humans and mice demonstrate that tattoo pigment migrates to lymph nodes and can cause lymphadenopathy.
  
  
  METHODS
  A 32-year-old woman presented with a 6-cm vulvar mass and extensive bilateral inguinofemoral lymphadenopathy. Bilateral small tattoos were noted in the groins. Vulvar biopsy confirmed squamous cell carcinoma, and fine needle aspiration of the lymph nodes showed no evidence of malignancy. The patient underwent a radical hemivulvectomy and bilateral inguinofemoral lymphadenectomy. Both inguinal and femoral nodes were enlarged because of extracellular tattoo pigment and reactive follicular hyperplasia without any evidence of metastasis.
  
  
  CONCLUSIONS
  This case emphasizes the need to consider tattoo pigment as a cause of lymphadenopathy in any patient with a regional tattoo.
authors: From the Departments of Obstetrics and Gynecology and Pathology and Laboratory Medicine, Olive View-UCLA Medical Center, Sylmar, California, and the Departments of Obstetrics and Gynecology and Pathology and Laboratory Medicine, David Geffen School of Medicine at UCLA, Los Angeles, California.
authors: Anna
authors: A
authors: Beavis
authors: Malaika
authors: M
authors: Amneus
authors: Chisa
authors: C
authors: Aoyama
authors: Christine H
authors: CH
authors: Holschneider
mesh_terms: D000328:Adult; D044963:Biopsy, Fine-Needle; D002294:Carcinoma, Squamous Cell / Q000139:chemically induced / Q000473:pathology*; D004396:Coloring Agents / Q000009:adverse effects*; D003937:Diagnosis, Differential; D005260:Female; D006119:Groin / Q000473:pathology; D006801:Humans; D008198:Lymph Nodes / Q000473:pathology; D008206:Lymphatic Diseases / Q000139:chemically induced* / Q000601:surgery; D013653:Tattooing; D014846:Vulvar Neoplasms / Q000139:chemically induced / Q000473:pathology*
chemical_list: D004396:Coloring Agents