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Boils in armpits

Answered by: N. Ananthakrishnan
Head of Department of Surgery
JIPMER
Pondicherry

Q. This question is regarding my mother. She is 48 years old, she has had boils in both armpits(axilla) with pus discharge in the left axilla for the past 6 months. The condition has been diagnosed as Axillary Lymphadenitis . She has had no fever, no anorexia, no weight loss, no diabetes, no TB. The doctor has suggested a Lymph nodes biopsy on both arms, with full anaesthesia. Is this absolutely necessary? Can fine-needle biopsy be done instead? or open biopsy with local anaesthesia at least? Are any of the symptoms above associated with malignancy? Ive heard someone say underarm boils dissapeared after consuming Lymphomax Can this be had to see if the lumps reduce, before doing a biopsy?Kindly advise us what a safe way to proceed with this situation would be.

A.  The answers to your questions are as follows:1. Fine needle aspiration can be tried before a biopsy. In most cases oftuberculosis this is sufficient to give the diagnosis and a biopsy may notbe necessary.2. In case Fine needle aspiration report is not conclusive a biopsy may haveto be done. Depending on the individual patients condition this can be doneunder local anesthesia (that is by giving a numbing injection at the site ofbiopsy without a general anesthetic)3. It is best to establish the diagnosis in patients with enlargement of thelymphnodes before taking any form of drug treatment.4. Only a biopsy or a fine needle aspiration can exclude malignancy. Henceit is necessary to come to a diagnosis without undue delay.5. It is best that the patient is taken to a surgeon who would adviseaccordingly

A.  The answers to your questions are as follows:1. Fine needle aspiration can be tried before a biopsy. In most cases oftuberculosis this is sufficient to give the diagnosis and a biopsy may notbe necessary.2. In case Fine needle aspiration report is not conclusive a biopsy may haveto be done. Depending on the individual patients condition this can be doneunder local anesthesia (that is by giving a numbing injection at the site ofbiopsy without a general anesthetic)3. It is best to establish the diagnosis in patients with enlargement of thelymphnodes before taking any form of drug treatment.4. Only a biopsy or a fine needle aspiration can exclude malignancy. Henceit is necessary to come to a diagnosis without undue delay.5. It is best that the patient is taken to a surgeon who would adviseaccordingly

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