A 28-year-old European female patient was referred to us because of a 4-month history of a painless, solitary mass located in the left axilla. She had no accompanying complaints, history of fatigue, night sweats, or weight loss. Her medical history was unremarkable. On routine physical examination, a solitary enlarged lymph node was detected in the left axilla in the absence of any breast pathology. No generalized lymphadenopathy or other organomegaly was noted. Peripheral blood counts and the erythrocyte sedimentation rate were within normal limits. Interestingly, the levels of lymphoproliferative markers such as serum soluble IL-2R, beta 2-microglobulin, and immunoglobulins were also normal; however, the C-reactive protein level was slightly increased. The lymph node in the left axilla measured 4 cm and was mobile, nontender, and soft in consistency. US examination of the breast and axilla was performed with an iU22 (Philips Healthcare, Bothell, WA) and ProSound 7 (Aloka, Hitachi, Zug, Switzerland) using a 12-MHz linear array transducer. High-frequency, high-resolution gray-scale US revealed a well-defined, uniformly hypoechoic, ovoid axillary mass, 38 × 17 × 28 mm in size. The longitudinal diameter was greater than the transverse diameter with a longitudinal to transverse axis ratio of more than 2. A hyperechoic fatty hilum could not be detected and was totally replaced by cortical thickening. Although soft in consistency, the lesion could only be slightly deformed by compression with the transducer. Color Doppler flow was performed with optimized color Doppler parameters set at a low wall filter (80–100 Hz) and low velocity scale (pulse repetition frequency, 1000 Hz). Color gain was adjusted dynamically to maximize depiction of blood vessels while avoiding artifactual color noise. Bizarre and multifocal peripheral flow was detected, whereas central or central perihilar flow was not revealed. A three-dimensional and multislice imaging scan with the capability of reproducing high-resolution images confirmed these B-mode findings, but could not provide additional important information. Spectral Doppler analysis along the periphery of the node showed both arterial and venous pulse wave patterns. The blood flow profile of the arteries indicated a broad range in the resistance index, pulsatility index, and peak systolic velocities varying from low to high pulsatility. Thus, no further information could be drawn on these indices. Sonoelastography US confirmed the clinical examination findings: the lesion was characterized by soft tissue with some less elastic regions of higher stiffness. An US-guided fine needle biopsy with multiple passages of the needle tip through the nodal cortex was made to sample as much of the nodal cortex as possible. Fine needle aspiration cytology (FNAC) only revealed a mixed population of small and large lymphoid cells. In particular, prominent vascularity with hyalinized capillaries was not detected. The FNAC results were subsequently reported as “negative for malignant cells,” and histopathologic examination of the lymph node was advised. Therefore, US-guided core needle biopsy using a 14-G automated gun was performed, and a diagnosis of HV-type CD was confirmed: microscopic examination revealed many variably sized hyperplastic follicles, progressive vascular proliferation, and hyalinization. A multislice CT scan of the head, thorax, and abdomen was subsequently performed and allowed for the exclusion of multicentric type CD. The lymph node in the left axilla on CT was described as a well-circumscribed, homogeneous mass lesion with moderate to intense enhancement and rapid washout. The patient underwent open biopsy by a surgical gynecologist, and the enlarged axillary lymph node was completely excised. The postoperative course was uneventful, clinical follow-ups were unremarkable, and there has been no evidence of recurrence.