Decorative sentinel lymph node: a new entity?

Malignant melanoma can be a difficult lesion to differentiate clinically. However, when it spreads to regional lymph nodes, there is usually a characteristic pigmentation of the node. We describe a case of an incidental finding of a pigmented lymph node while operating on an inguinal lymph node, which raised the possibility of there being a metastatic melanoma of unknown origin. Histologically, the observed pigmentation was due to the migration of a decorative tattoo pigment instead of malignant cells.