Axillary lymph node accumulation on FDG-PET/CT after influenza vaccination

Shirone, Norihisa; Shinkai, Takayuki; Yamane, Toshimi; Uto, Fumiaki; Yoshimura, Hitoshi; Hiroyuki, Tamai; Imai, Takeshi; Inoue, Makoto; Kitano, Satoru; Kichikawa, Kimihiko; Hasegawa, Masatoshi

doi:10.1007/s12149-011-0568-x

Cited by 122 publications

(104 citation statements)

References 18 publications

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“…The highest uptake typically occurred within the first 2 weeks after vaccination [1,3], but persisted beyond 1 month in some cases [2]. Additionally, lymph node size was normal [1][2][3][4], in contrast to our case. These reports advocate caution when considering changes to the treatment plan prior to confirmation of the suspected false-positive uptake.…”

contrasting

confidence: 66%

“…Several previous reports demonstrated the occurrence of false-positive ipsilateral FDGavid axillary lymph nodes following vaccination [1][2][3][4]. The highest uptake typically occurred within the first 2 weeks after vaccination [1,3], but persisted beyond 1 month in some cases [2]. Additionally, lymph node size was normal [1][2][3][4], in contrast to our case.…”

contrasting

confidence: 64%

“…Compared to the initial scan (left), new enlarged and FDG-avid left axillary lymph nodes (a) were seen on the examination 2-3 days following the influenza vaccination (middle), which resolved 12 days later (right). Several previous reports demonstrated the occurrence of false-positive ipsilateral FDGavid axillary lymph nodes following vaccination [1][2][3][4]. The highest uptake typically occurred within the first 2 weeks after vaccination [1,3], but persisted beyond 1 month in some cases [2].…”

mentioning

confidence: 93%

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Systemic Immune Response to Vaccination on FDG-PET/CT

Mingos

Howard

Giacalone

et al. 2015

Nucl Med Mol Imaging

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A patient with newly diagnosed right lung cancer had transient 18 F-fluorodeoxyglucose (FDG)-avid left axillary lymph nodes and intense splenic FDG uptake on positron emission tomography (PET)/computed tomography (CT). History revealed that the patient received a leftsided influenza vaccine 2-3 days before the examination. Although inflammatory FDG uptake in ipsilateral axillary nodes is reported, to our knowledge, this is the first report of visualization of the systemic immune response in the spleen related to the influenza vaccination on FDG-PET/ CT. The history, splenic uptake and time course on serial FDG-PET/CT helped to avoid a false-positive interpretation for progressing lung cancer and alteration of the radiation therapy plan.

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contrasting

confidence: 66%

contrasting

confidence: 64%

mentioning

confidence: 93%

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Systemic Immune Response to Vaccination on FDG-PET/CT

Mingos

Howard

Giacalone

et al. 2015

Nucl Med Mol Imaging

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“…and s.c.) for IIV were chosen based on patterns of antigen drainage with i.p. immunization draining to the lung-draining, mediastinal lymph nodes (MedLN) (22, 23) and s.c. immunization at the base of the neck, draining to the axillary lymph nodes, similar to intradeltoid injection in humans (24, 25). We observed increased numbers of CD3 + T cells in the lungs and MedLN and increased percentages of CD44 + CD62L lo effector/memory CD4 + and CD8 + T cells in the lungs of i.n.…”

Section: Resultsmentioning

confidence: 99%

Vaccine-generated lung tissue–resident memory T cells provide heterosubtypic protection to influenza infection

Zens¹,

Chen²,

Farber³

2016

JCI Insight

336

368

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Tissue-resident memory T cells (TRM) are a recently defined, noncirculating subset with the potential for rapid in situ protective responses, although their generation and role in vaccine-mediated immune responses is unclear. Here, we assessed TRM generation and lung-localized protection following administration of currently licensed influenza vaccines, including injectable inactivated influenza virus (IIV, Fluzone) and i.n. administered live-attenuated influenza virus (LAIV, FluMist) vaccines. We found that, while IIV preferentially induced strain-specific neutralizing antibodies, LAIV generated lung-localized, virus-specific T cell responses. Moreover, LAIV but not IIV generated lung CD4+ TRM and virus-specific CD8+ TRM, similar in phenotype to those generated by influenza virus infection. Importantly, these vaccine-generated TRM mediated cross-strain protection, independent of circulating T cells and neutralizing antibodies, which persisted long-term after vaccination. Interestingly, intranasal administration of IIV or injection of LAIV failed to elicit T cell responses or provide protection against viral infection, demonstrating dual requirements for respiratory targeting and a live-attenuated strain to establish TRM. The ability of LAIV to generate lung TRM capable of providing long-term protection against nonvaccine viral strains, as demonstrated here, has important implications for protecting the population against emergent influenza pandemics by direct fortification of lung-specific immunity.

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“…To our knowledge, such research is not being pursued elsewhere in the context of dengue, even though the value of tracking inflammation through 18 F-FDG-PET for acute viral diseases has been discussed for flu virus in both ferret and human models of infection (44,45). However, one recent case study reported an incidental 18 F-FDG-PET imaging in an adult male with DF with detectable serum viremia during an annual cancer screening (46).…”

Section: Discussionmentioning

confidence: 99%