Background: Decorative tattooing is associated with acute complications, such as pain, infection, and hypersensitivity. Delayed reactions also occur, including regional lymphadenopathy that may masquerade as malignant disease (1–3).

Objective: To describe a case of tattoo pigment–induced lymphadenopathy that mimicked the clinical and radiologic features of lymphoma.

Case Report: A 30-year-old woman presented to our clinic reporting a 2-week history of bilateral axillary lumps noted on self-examination. She had no fever, night sweats, weight loss, or pulmonary symptoms. She had a history of cluster headaches and had had breast augmentation surgery at age 19 years. Her only medication was an oral ...