A large number of lymph node inclusions excluding endometriosis have been described in a variety of anatomical sites; they are usually epithelial and only rarely non-epithelial. Their presence can give rise to an erroneous diagnosis of metastasis. Recently the staging laparotomy has become a frequent procedure in the management of neoplasms of the female genital tract, and involves abdominal lymphadenectomy, inspection of the peritoneal surface, multiple biopsies and the resection of suspicious lesions. During the surgery, and among the lesions excised, the occasional presence of lymph node inclusions can lead to a diagnostic error. In order to avoid this problem, it is necessary to be adequately informed about these inclusions, including their anatomic sites, their histologic characteristics and the knowledge that they can present in lymph nodes related to an inflammatory process or a tumour. This revision is to alert pathologist towards a group of lesions which can imitate metastatic carcinoma, and specially towards those inclusions which present together with malignant neoplasias of the female genital tract. Recently we received two cases of pelvic lymph nodes, initially diagnosed as metastatic carcinoma, and eventually found to correspond to mesothelial cell hyperplasia in one case, and to lymph node inclusions in the other.