Multiple lymph nodes visible bilaterally is a commonly reported finding on imaging such as ultrasound or CT. Normal lymph nodes are not always fully visible by ultrasound or CT, and when lymph nodes appear enlarged, they will reflect lymph node display, indicating that the lymph nodes may be enlarged. The causes of enlarged lymph nodes can be broadly classified into reactive hyperplastic lymph node enlargement caused by inflammation, and lymph node enlargement caused by metastasis of malignant tumors. 1. Reactive hyperplasia of axillary lymph nodes: inflammation of chest skin can cause lymph node enlargement, breastfeeding inflammation of mammary glands can cause lymph node enlargement, and injury of upper limb trunk can also cause reactive hyperplasia of lymph node enlargement. 2. Malignant tumors cause axillary lymph node enlargement: breast cancer can appear axillary lymph node metastasis, causing painless lymph node enlargement. Systemic diseases such as leukemia and lymphoma will also involve axillary lymph nodes, resulting in hyperplasia and enlargement of lymph nodes like ping-pong balls, which are full and elastic in shape. If imaging suggests that bilateral axillary lymph nodes are visible, sometimes further close follow-up or even puncture pathology is needed to further define the nature of the lymph node display.