Tattoos have never been more popular, and part of the appeal lies in the rich variety of body-art traditions of the past. This portrait shows a heavily tattooed 19th-century man known as "the Turk." He was an act in Barnum's, a European traveling circus. His tattoos were in the Burmese style, and he was said to have been kidnapped by the "barbarians" of Asia and forcibly tattooed.
Tattoos have never been more popular, and part of the appeal lies in the rich variety of body-art traditions of the past. This portrait shows a heavily tattooed 19th-century man known as "the Turk." He was an act in Barnum's, a European traveling circus. His tattoos were in the Burmese style, and he was said to have been kidnapped by the "barbarians" of Asia and forcibly tattooed.
Courtesy of Thames & Hudson
These engravings of fully costumed Maoris from the early 1800s were made by English sailor Barnet Burns, who himself received a full facial tattoo. When he returned to England in 1835, he styled himself as a "New Zealand chief."
These engravings of fully costumed Maoris from the early 1800s were made by English sailor Barnet Burns, who himself received a full facial tattoo. When he returned to England in 1835, he styled himself as a "New Zealand chief."
Courtesy of Thames & Hudson
A Maori chief from New Zealand, circa 1950, with the traditional facial tattoos.
A Maori chief from New Zealand, circa 1950, with the traditional facial tattoos.
Courtesy of General Photographic Agency/Getty Images
A bust made around 1840 displays Maori tattoos. It was made by Pierre Marie Dumoutier, perhaps the first scientific participant in a colonial expedition to study physical anthropology.
A bust made around 1840 displays Maori tattoos. It was made by Pierre Marie Dumoutier, perhaps the first scientific participant in a colonial expedition to study physical anthropology.
Courtesy of Thames & Hudson
This native of the Pacific island of Tikopia has rectangular chest tattoos thought to have been inspired by flags of passing sailing ships, which were considered symbols of power by indigenous peoples. It dates to 1827.
This native of the Pacific island of Tikopia has rectangular chest tattoos thought to have been inspired by flags of passing sailing ships, which were considered symbols of power by indigenous peoples. It dates to 1827.
Thames & Hudson
A Samoan man shows off his traditional pe'a, or ritual tattoos that are a marker of manhood.
A Samoan man shows off his traditional pe'a, or ritual tattoos that are a marker of manhood.
Courtesy of Thames & Hudson
This photograph, taken by Mark Adams in 1980, captures the bloody and painful process of customary tattoo among Samoan men. It involves excruciating pain, said to be the equivalent of childbirth in women.
This photograph, taken by Mark Adams in 1980, captures the bloody and painful process of customary tattoo among Samoan men. It involves excruciating pain, said to be the equivalent of childbirth in women.
Courtesy of Thames & Hudson
The pe'a covers the body from waist to the rectum and then to the knees. It is crafted using only handmade tools such as bone, tusks, turtle shell and wood.
The pe'a covers the body from waist to the rectum and then to the knees. It is crafted using only handmade tools such as bone, tusks, turtle shell and wood.
Courtesy of Sandra Mu/Getty Images
The Naga people of Assam, India, receive their tattoos when enemy flesh has been touched. This was taken in the early 1900s.
The Naga people of Assam, India, receive their tattoos when enemy flesh has been touched. This was taken in the early 1900s.
Thames & Hudson
This 17th-century tattoo stamp was used to make an imprint of a tattoo on the skin, which was then needled. It was owned by the Razzouk family of Jerusalem, originally of Coptic descent, who have been tattooing pilgrims with Christian iconography for centuries; they continue to do so today. This stamp depicts the resurrection of Christ.
This 17th-century tattoo stamp was used to make an imprint of a tattoo on the skin, which was then needled. It was owned by the Razzouk family of Jerusalem, originally of Coptic descent, who have been tattooing pilgrims with Christian iconography for centuries; they continue to do so today. This stamp depicts the resurrection of Christ.
Courtesy of Thames & Hudson
A 1920s American tattoo "flash" or page of design ideas.
A 1920s American tattoo "flash" or page of design ideas.
Courtesy of Thames & Hudson
Whang-ud, who was 92 years old when this picture was taken in 2012, has been described as the last traditional tattooist in the Philippines. In recent years, enthusiasts and tourists have hiked for hours to reach the remote village in which she practices.
Whang-ud, who was 92 years old when this picture was taken in 2012, has been described as the last traditional tattooist in the Philippines. In recent years, enthusiasts and tourists have hiked for hours to reach the remote village in which she practices.
Courtesy of Thames & Hudson
Whang-ud, 92, uses a lemon thorn attached to a wand to make these traditional tattoos.
Whang-ud, 92, uses a lemon thorn attached to a wand to make these traditional tattoos.
Courtesy of Thames & Hudson
The impulse to identify with a tribe can also be seen in criminal contexts. A former high-ranking gang member in Cape Town, South Africa, shows off his gangland tattoos. When this picture was taken, in 2007, he had retired and was working as a cleaner and handyman at St. George's Cathedral in Cape Town.
The impulse to identify with a tribe can also be seen in criminal contexts. A former high-ranking gang member in Cape Town, South Africa, shows off his gangland tattoos. When this picture was taken, in 2007, he had retired and was working as a cleaner and handyman at St. George's Cathedral in Cape Town.
Courtesy of Thames & Hudson
Inmates of the Makati City jail in Manila attend Catholic worship in 2010. Their tattoos identify them as members of particular gangs.
Inmates of the Makati City jail in Manila attend Catholic worship in 2010. Their tattoos identify them as members of particular gangs.
Courtesy of Thames & Hudson
In Japan, a rich tradition of body art, known as Irezumi, stretches back to approximately 10,000 B.C. Tattooing was banned between 1876-1948, when the art form became associated with criminality and gang culture. But once prohibitions were lifted, tattooists were free once again to work without fear of arrest. Here, a Japanese man is pictured in 1958 with full body tattoos.
In Japan, a rich tradition of body art, known as Irezumi, stretches back to approximately 10,000 B.C. Tattooing was banned between 1876-1948, when the art form became associated with criminality and gang culture. But once prohibitions were lifted, tattooists were free once again to work without fear of arrest. Here, a Japanese man is pictured in 1958 with full body tattoos.
Courtesy of Keystone Features/Getty Images
To this day, tattoos have never been more popular. They may have lost much of their traditional cultural significance but are developing a boundary-crossing modern culture of their own. Jack Mosher, a tattooist, shows off his lavish body art.
To this day, tattoos have never been more popular. They may have lost much of their traditional cultural significance but are developing a boundary-crossing modern culture of their own. Jack Mosher, a tattooist, shows off his lavish body art.
Courtesy of Thames & Hudson
Celebrity culture has played a large role in influencing and popularizing tribal tattoos. Angelina Jolie has a Buddhist Pali incantation written in Khmer script, a language spoken in Cambodia.
Celebrity culture has played a large role in influencing and popularizing tribal tattoos. Angelina Jolie has a Buddhist Pali incantation written in Khmer script, a language spoken in Cambodia.
Courtesy of Jason Merritt/Getty Images
Rihanna is pictured with a traditional Maori tattoo on her right hand. The design reportedly took 11 hours to complete, with only a chisel and mallet used to create the intricate tattoo.
Rihanna is pictured with a traditional Maori tattoo on her right hand. The design reportedly took 11 hours to complete, with only a chisel and mallet used to create the intricate tattoo.
Courtesy of Pascal Le Segretain/Getty Image
A history of body art

Story highlights

Doctors suspected that a woman had lymphoma and removed a lymph node

But under a microscope, the "tumor" was found to be black tattoo pigment

CNN  — 

Doctors in Australia suspected that a woman had a type of cancer called lymphoma, but they were stunned when they put her enlarged lymph node under a microscope – and instead found black tattoo pigment from 15 years ago to which her immune system was just now reacting.

They recounted the strange case in a report released Monday in the journal Annals of Internal Medicine.

The 30-year-old woman had come in with small lumps under her arms, which had been there for two weeks. A body scan showed even more enlarged lymph nodes in her chest, including near the roots of her lungs.

“Ninety-nine times out of 100, (this) will be lymphoma,” said Dr. Christian Bryant, a hematologist at the Royal Prince Alfred Hospital in Sydney. Bryant is one of the woman’s doctors.

The lymph node that was removed from the woman's armpit.
The lymph node that was removed from the woman's armpit.
Othman, et al. Royal Prince Alfred Hospital/Annals of Internal Medicine

Many cancers – including lymphomas, which come from immune cells – can cause lymph nodes to swell. Lymph nodes may also enlarge due to infection and inflammation.

In the case of the Australian woman, whose name was not released, her lymph nodes were inflamed because of a reaction to the old tattoo ink, not due to cancer cells. Doctors removed a lymph node from her armpit and found a cluster of immune cells that were loaded with black pigment. The woman had a 15-year-old tattoo covering her back, and there was a smaller, more recent one on her shoulder.

“The skin has its own immune cells that are always surveilling the skin,” said Dr. Bill Stebbins, director of cosmetic dermatology at Vanderbilt University Medical Center, who was not involved in the report.

Once these immune cells found the tattoo pigment, a foreign substance, they ingested it and traveled from the skin to the lymph nodes over a period of years.

“The pigment is too large for these cells to eat and digest,” Stebbins said. “That’s why they’re still there many years later.”

A woman shows off several facial piercings and a tattoo.
A woman shows off several facial piercings and a tattoo.
Getty Images

Related article Your kids want a tattoo or piercing? Here's what pediatricians recommend

But why the woman had a reaction 15 years after her tattoo is a mystery. Something set off the immune cells, but her doctors couldn’t pin down what that trigger might be, Bryant said. The patient noted that her tattoos would occasionally itch, but only for a few days each month. The type of inflammatory response found in her lymph nodes, called a granuloma, was not found in her skin.

Bryant and his colleagues had never seen anything quite like it. Other reports have described swollen, pigmented lymph nodes that were mistaken for melanoma, but this is the first time they had heard of a case with lymph nodes deep enough to fit the picture of lymphoma.

“I think there’s absolutely no way to know how common it is,” Bryant said. “Most people who have tattoos have absolutely no problems.”

“We do a lot of tattoo removal with lasers in our practice, and sometimes we see people developing allergic reactions to the ink,” said Dr. Bruce Katz, a fellow with the American Academy of Dermatology and director of the Juva Skin and Laser Center in Manhattan. Katz was not involved with the new report.

But these reactions are usually to red pigments, not black.

01 tattoo infected sepsis death vibrio study
Parkland Health & Hospital System

Related article Man dies after swimming with new tattoo

In the US, nearly four in 10 millennials have tattoos, according to a Pew Research Center report. Among Generation X, slightly fewer have tattoos: about 32%. For baby boomers, that number drops to 15%.

For those looking to get inked, Katz said, it’s crucial to do your research: Make sure the artist is reputable, get references from clients, and ensure that they are using disposable needles and unopened ink to prevent infections.

Stebbins said it’s important for people to be aware of these rare complications, because people might not realize that a tattoo can cause inflammation years later. “It’s important for physicians to be aware of a tattoo history,” he said.

Tattoos are often hidden from view, meaning a doctor may not notice them right away. Almost three-quarters of Americans with tattoos usually hide them under clothing, according to the Pew report.

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    There are other potential complications of tattoos, including infections and other inflammatory reactions. One Texas man even died after swimming with a new tattoo, which became infected with a bacterium found in coastal waters.

    But the Australian woman’s case is far less serious. The last time Bryant saw her, the swollen lymph nodes had subsided.

    “It’s not going to cause this lady any major problems,” Bryant said, “which means we’re allowed to be interested without feeling sad.”

    The hematologist added, “My job’s often not like that.”