This is a 49 year old Asian female with history of Rheumatoid arthritis, left axillary lymphadenopathy, and positive serology for anti-dsDNA, anti-RNP, anti-chromatin, and anti-SM antibodies. Excised lymph node showed prominent foci of geographic necrosis with plasma cells and no neutrophils. These clinical and pathologic features are most consistent with lupus lymphadenitis. The differential diagnosis would include Kikuchi lymphadenitis in which patients would most often lack positive serologies.